What Is a Plantar Plate Tear? Forefoot Pain You Shouldn’t Ignore

If you’ve ever felt a nagging pain in the ball of your foot, under a toe, or noticed your toe drifting out of place, you might be dealing with a plantar plate tear—a small problem that can cause significant discomfort.

We see this problem regularly in active adults who spend long hours on their feet. Let’s break down what a plantar plate tear is, how to spot it, and what can be done about it.

👣 What Is the Plantar Plate?

The plantar plate is a thick ligament in the ball of your foot, beneath the metatarsophalangeal (MTP) joints (where your toes meet the rest of your foot). It plays a key role in stabilizing the toes.

Over time—or due to trauma—this plate can stretch or tear, leading to pain, instability, and often visible toe changes.

🚨 Symptoms of a Plantar Plate Tear

Symptoms can develop gradually or suddenly and include:

• Pain under the ball of the foot (beneath the affected toe)

• Swelling or bruising in the forefoot area

• A feeling of toe instability or a “popping” sensation

• Separation or deviation of the toes (one toe begins to drift toward the next toe)

• Difficulty wearing certain shoes due to pressure on the ball of the foot

  
  

🩻 How Is It Diagnosed?

Clinical examination with advanced imaging if required to confirm a diagnosis.

• A “drawer test” (moving the toe upward) is used to assess the range of motion and stability of the toe.

• Ultrasound or MRI is sometimes used to visualize the tear and assess its severity

💡 What Causes a Plantar Plate Tear?

There are a few usual suspects:

• Chronic overuse (runners, dancers, or those on their feet all day)

• Improper footwear (high heels or unsupportive shoes)

• Biomechanical issues like bunions, flat feet, clawed toes or long second toes

• Trauma or sudden toe hyperextension

🩺 Treatment Options: What Can You Do About It?

1. Conservative (Non-Surgical) Treatments

Most effective in early or mild cases:

• Taping or splinting the toe into a better position

• Activity modification to avoid exercises that aggravate the pain.

• Custom orthotics to offload pressure

• Supportive footwear with good arch support and cushioning.

• Anti-inflammatory medications or corticosteroid injections

• Exercise prescription to strengthen surrounding muscles

2. Surgical Repair

If pain persists despite treatment or the toe starts to drift significantly, surgery may be recommended to relieve pain and improve function.

• Direct plantar plate repair is the gold standard, stability and toe alignment

• Minimally invasive or arthroscopic options are now available, with faster recovery

• Realignment procedures may be needed in severe cases

  
  

🏃 Can You Return to Normal Activity?

Yes—with the right treatment plan, most patients return to walking, exercising, and even running pain-free. Early intervention is key. The longer a plantar plate tear is left untreated, the more complex the treatment and recovery.

✅ Takeaway: Don’t Ignore Forefoot Pain

If you’ve got pain under the ball of your foot, especially near the second toe, don’t chalk it up to “just being on your feet too much.” A plantar plate tear is a real medical condition that’s treatable—especially when caught early.

At Ayres Health, we diagnose and treat forefoot pain. Whether you’re an athlete, a dancer, or just want to walk without wincing, we’re here to help.

📞 Book an appointment with Andrew today to get back on your feet.