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Partial Plantar Plate Tear Injury Update: From Sidelined to Finish Lines!

First off, to anyone who has left comments on previous blog posts or emailed me privately, I owe you a huge apology for responding late. That was a shitty thing to do. Yes, I said shitty. Because it was. And sure, I’ve been very burned out and busy this year, but that’s no excuse. So I promise to keep up from now on, starting with this injury update!

For those visiting because you’ve been diagnosed with a plantar plate tear, I’m so sorry you’re dealing with this tough injury! You’re in my prayers and I hope my experience is both helpful and hopeful. Here’s some previous posts I’ve written about my PPT. And if you haven’t already, DO NOT get a cortisone shot, okay? That treatment for plantar plate tears is outdated and can lead to your ligament being ruptured, so if your current doctor recommends this … get another doctor.

I’m so serious.

It’s astonishing how many people I’ve heard from who have had further complications after getting a cortisone shot. This makes me use language much stronger than shitty. Sure, it might be okay for other injuries, but a PPT? Nope. Just say no to drugs.

Moving on. (With no more shitties, I promise.)

Now, in my PPT: The Full Scoop post back in April, 2017, I covered everything from the beginning up me seeing a orthodist. In this post, I’ll cover what’s happened since then, some of which I chatted about in this June, 2017 video. So let’s get to it!

One thing I’ve mentioned before is how I knew, to the core of my soul, that I would not need surgery. Thankfully, this prediction turned out to be true. I have been able to completely heal using conservative treatment such as:

  • Wearing a boot for six weeks.
  • Taping my second toe down in a technique similar to this one.
  • Wearing carbon graphite inserts with a rocker-bottom shoe. (I used Hoka Arahi.)
  • Taking turmeric cumin, horsetail, rhus tox (for only a week,) and beet root supplements. [NOTE: these were not recommended by any of my doctors and I am not a physician or medical expert, so consult with your own doctor before taking.]
  • Getting custom orthotics with metatarsal pads and structured heel to correct my valgus, (incorrect heel strike.)

It took a while to get to this point, however. A total of eleven months from injury to my first run. If you’ve been recently diagnosed with a PPT, this news will be upsetting. It was upsetting for me as well when I first learned that it’s taken up to a year for others to heal. But there are no typical results. Some people were able to return to running after only a few months. Some were operated on and have never been able to run again. Some have had great success with the surgery and went back to running marathons with no problem. Everyone is different but one thing remains the same:

A plantar plate tear is one frustrating bugger of a rare injury.

By March 2017, my frustration had grown to epic proportions and I was battling a pretty nasty case of depression. My running friends tried to be sympathetic but I got the sense that they had grown tired of this topic and I was becoming a reminder of their own injury fears. So I did my best to smile and continue doing Joyful Miles duties: writing, vlogging, and taping running podcasts even though I wasn’t sure I’d ever be able to run again. I did my best to be okay.

Sometimes I was successful. Sometimes I wasn’t.

Which reminds me. I really need to write a post on “Things to Never Say to an Injured Runner,” because, good God, I’ve heard some doozies. For example, don’t ever say, “Well, at least now you have more time to [insert activity.]

Seriously?

Moving on.

Then after a few more frustrating weeks, I started to wonder if my constant foot pain was from my PPT injury or from my foot being immobile for so long due to taping and wearing stiff inserts. I wondered if pain was something I’d always have to deal with or if I still needed more recovery time.

So I contacted my second doctor and requested another MRI. He later called with good news: I no longer had signs of a tear, my bone edema had healed, and I had no fractures, etc. But then he said something that nearly knocked me on my rear.

“I’m not convinced you ever had a PPT to begin with.”

Huh? What the heck was that supposed to mean, and WHAT HAVE YOU BEEN TREATING ME FOR???? Has he totally forgotten that my first MRI did, in fact, mention in no uncertain terms that there was a partial tear?? I was too astonished to say any of this, however. And I could tell by his tone that he didn’t care anyway. He just informed me that he was leaving his practice and referred me to Dr. Stuart Miller of MedStar Health.

Dr. Miller was the doctor I had initially tried to make an appointment with him back in September, 2016, but the receptionist I had spoken with said he only saw patients who were ready for surgery. This turned out to not be true … which was very irksome, but okay, whatever, let’s move on. I was just thrilled to finally be able to see him and having an appointment with him gave me a feeling of true hope.

This hope was confirmed in our first appointment. Dr. Miller said that my second doctor did put me on the right track for recovery by recommending taping, Hokas, etc. He also told me I was very smart to turn down the cortisone shot my first doctor had recommended, seeing as how that treatment is outdated and can lead to the ligament being ruptured. He then recommended me giving my custom orthotics another chance. I had received them back in April but hated them. HATED THEM!! They felt unnatural and uncomfortable and made my foot and knees ache after wearing them for only twenty minutes so I couldn’t even imagine running in them.

(I now can’t imagine running without them, but I’m jumping ahead of myself, here.)

Another thing Dr. Miller pointed out was how my calves had become VERY stiff and tight, (especially my left one,) due to months of limited use and me walking with a limp. Imagine if you will walking without rolling your foot and staying flat-footed. By doing so, you walked stiff-legged, and after doing so for nine months, it really wrecked havoc on my entire body.

He recommended that I stretch my calves and legs at least eight times a day. Dr. Miller also wanted me to start using my foot more and work my way back to normal slowly. I still didn’t have clearance to run, but it was a huge step forward! And then six weeks later at our next appointment, I finally heard what I’ve been praying for: YOU CAN RUN!!!

Oh my gosh.

Talk about amazing!

In the parking lot, I called Bob, called my parents, and then sent a message to Jackey and Rob with the good news. It seemed to shock them a little, as though they, too, didn’t know if this news would never come.

Now, I couldn’t just hit the roads like all was normal, however. It took a lot of work before that happened! My left foot had become so stiff and inflexible that I could barely lift my toes off the ground while standing. So the first I had to do was to stop wearing my carbon graphite insert and to start treating my foot as though it were normal. I also had to learn how to walk without a limp. My husband gave me a great trick that helped: Walk with your buttocks tightened. Sounds simple, but that really worked! He also would tell me when I was limping and on my daily walks, there were some times when he’d open the door and holler, “STOP LIMPING!”

I also had to get my body back in alignment since everything had been feeling out of whack! I did a lot of yoga and PiYo, (lower body is my favorite since it has great stretches for runners.) I also had to condition my body again. Doing spin classes on my stationary bike was great for this!

Another action I took that was extremely helpful were the feet strengthening exercises shown on this video from The Run Experience. It took a long time before I could walk on my toes, though, so I skipped them at first!

After a few weeks, I was finally walking normally again and on July 5, 2017, I went for my very first run in eleven months. ELEVEN MONTHS!! Oh my gosh, I was so out of shape and couldn’t do more than 30 second run intervals, but that didn’t matter. I was RUNNING!!! I was so happy that I (foolishly) couldn’t help but do a #JoyfulJumpshot while being careful to land on my healthy foot. (Still – I don’t recommend this.)

For the next few months, running intervals have been an amazing way to ease me back into my normal running style. I was beginning to feel hopeful that running the Dopey Challenge in January 2018 was very possible!

Then October, 2017 happened.

I woke one morning feeling the exact same pain on my left foot’s second metatarsal area that I had on my injured left foot. It’s quite common for those who have had a PPT to get another in their opposite foot, so this was obviously quite devastating. THANK GOODNESS I had already made a follow-up appointment with Dr. Miller two weeks from then. Until then, I put my Dopey training on hold by doing no running and absolutely babying my left foot.

Thankfully, it was not a tear. He said it was from continued tightness in my calves which was a surprise. I thought I had been doing enough to gain more flexibility but apparently not. So afterward, I tripled my stretching and did a lot more yoga to help. This sidetracked my Dopey training quite a bit, so I also did lots of biking in order to get my conditioning back up.

By January, the farthest run I had done was ten miles but I survived all four runs and earned that gorgeous medal! And a couple of weeks ago, I finished the Frederick Half Marathon in 02:03, making me feel for the first time in a long time as back in running form.

So now what?

I am conscious, every single day, that just because I have managed to recover from one PPT doesn’t mean it can’t happen to me again. I’m not saying this to be negative, just realistic. So it’s important for me, (and you, too,) to take every step possible to remain injury-free, such as:

  • Walking for at least five minutes before each run as a warm-up.
  • Doing five minutes worth of dynamic stretches, such as knee lifts, butt kicks, and toy soldier kicks before runs as well.
  • Tracking my shoe mileage.
  • Stretching thoroughly after each workout.
  • Doing lots of yoga and PiYo to increase flexibility.
  • Rolling, using The Stick, and my CAS daily. (Some folks have the pricey BFF: The Miracle Body Buffer. I bought a $20.00 car polisher from Wal-Mart and named it my CAS: Cheap Ass Friend … and it works great!)

I’ve also noticed that my Hoka shoes won’t last as long. The average mileage for running shoes is 300 to 500, but even without orthotics, Hokas tend to break down faster due to their heavy cushioning. With stiff orthotics like mine, they must be retired much sooner, at around 200 to 300 miles. This costs more, but hey. I don’t care as long as I can run!

Another thing I had to do was shake off the coulda, woulda, shoulda. Maybe I could have returned to running much sooner but I mistook my pain as injury and not stiffness. Maybe I would have healed much sooner had I insisted on making an appointment with Dr. Miller rather than see my first nightmare doctor. Maybe I should have been more careful in the first place in order to avoid injury.

But coulda, woulda, shoulda is a waste of time.

And I did many things right, like saying no to the cortisone shot. And those extra healing months might have set me up for a lifetime of running whereas hitting the road too soon could have brought me back to square one.

It is what it is, folks. I’m grateful to God for my recovery and I’m moving on.

So there you have it, my injury update! If you have any questions, feel free to leave them in the comments below and I promise to do a better job keeping up. And finally, if you are dealing with a plantar plate tear yourself … that really sucks. I’m praying for your speedy recovery so you can get back on the road, doing what you love!

Take care and thanks for reading!

About the author: Laura is a writer, runner, reader, runDisney addict, blogger, vlogger, mom of two college boys, excellent chili maker, and obsessive list keeper. She still thinks Spice World was an awesome movie and feels no shame about that.

{ 9 comments… add one }
  • Ashley May 15, 2018, 11:13 am

    Thank you for sharing your story! It is hard to be an injured runner!! I have been sidelined from running for the last four months due to a really nasty sprained ankle. Last week was the first time I could run intervals without pain. Yay!!! I am a little paranoid about reinjury, so I will definitely check out the feet/ankle strengthening link you posted.

    Anyway, just wanted to say thank you Joyful Miles! I love the podcast, videos, and blogs! So informative, entertaining, and inspiring! 😊

    • Laura Bowers May 16, 2018, 7:35 pm

      Sorry about your injury but I’m so happy that you’re back out there running! It’s such a great feeling. Those strengthening exercises (and so much more on Run Experience) will help … I need to do more!

      Thanks also for your lovely comment about JM! We’re all so glad our content has been helpful. 🙂

  • Tori K June 18, 2018, 4:18 pm

    Hi Laura…I am dealing with the same injury. Unfortunately I had a cortisone shot and now am worried about rupturing but am going to soldier on. I too feel like surgery is not the best choice (my brother is an orthotist) and will be getting new orthotics and am going to do whatever I can to help this heal. I’m 6 months in. Tanks for the blog!

    • Laura Bowers August 9, 2018, 7:41 am

      Hi Tori, my apologies for the hideously late response! How are you doing now? I’m hoping and praying that you’ve had some relieve in the past couple of months with no signs of rupture. Be sure to give me an update and sorry you’re dealing with this frustrating injury!

  • Ron Murphy July 5, 2018, 8:52 pm

    Laura, thank-you for starting these posts and for continuing to update us on your journey back to running. I have been dealing with this injury (at least I’m now convinced it is PPT) since November 2017. I stumbled upon your post about 6 weeks ago and it was the first I have heard of this injury which seemed to perfectly describe my symptoms. I began reading everything I could find on it and then tried the taping technique. Voila! The first pain free walking in about 6 months. I’ve seen doctors, sports medicine practitioners, physiotherapists, chiropractors, massage therapists, podiatrists, osteopaths and no one ever mentioned this. I’ve had X-rays, ultrasounds, MRIs and nothing provided a definitive diagnosis. Unfortunately one of the first things I was treated with was a steroid injection and BAM! my pain went from low grade to high grade. I tried a PRP injection. No go. Laser therapy. Nope. Ultrasound treatments and everything else that was being suggested and nothing helped except 25 cents worth of tape. Wow! I’m glad you got your condition under control and are back to running. It gives me a lot of hope. I’ve just started my 6 week walking boot journey and see where things are from there. Custom orthotics will probably follow. But that’s okay as long as I get to run again. Thanks again for sharing and giving me hope.

    • Laura Bowers August 9, 2018, 7:38 am

      First off, my apologies for the late response. I’ve been doing a horrible job keeping up!

      Second, OH MY GOODNESS, you have truly been through the ringer with this frustrating injury! Wow, I was getting tired just reading everything you’ve had done. I’m really sorry about your injury and pray you’ll continue to heal and get back out there on the road soon. You are probably out of the boot by now, so I will say it’s very important to stretch your calves and stay flexible. My remaining occasional foot pain is from tight calves and not rolling/stretching enough.

      Thanks for sharing your story and be sure to give me an update!

  • Tori K August 9, 2018, 10:21 pm

    Hi Laura! Thanks for responding to my post. I have been taping still and being cautious with the running and so far so good. I also started running in hokas which are stiffer and got new orthotics. I am building up mileage for a half. I’m leery of much speed training so I am being careful. I think I had a partial tear for a long time, and I may have ruptured when I had the acute injury happen. So…I am hoping to stay pain free and have been crosstraining too. I’m optimistic now. Goal is never have surgery.

  • Maggie September 11, 2018, 4:01 pm

    I just had my 1 year injury anniversary (did NOT celebrate that!). Mine was a fully ruptured PP in my big toe, the result of my flip flop coming apart at the exact instant that I was running up a stair and bam, toe collided with stair. Despite the fact that I could barely squeeze my swollen foot into my shoe, I went for an 8 mile hike the next day by walking on the side of my foot. Dumb! First ortho diagnosed a torn joint capsule & put me in a boot for 2 months, then PT. After a few weeks of PT, my therapist said there is something else going on because I could not make my toe move in the least little bit. I finally had an MRI which diagnosed the full tear and I went back in the boot for a total of 5 months, then went to Hokas. My foot would swell like a balloon every day until just recently. I am just now able to move my toe a little bit and can go on short hikes, and I’m working with a trainer who is getting me back in shape. I couldn’t even spin due to pain. It is such a frustrating injury, and like you, I gained weight and suffered from depression. Training is helping, and I hope to get back to running intervals soon. Thanks for sharing your story!

    • Laura Bowers September 23, 2018, 11:04 am

      Oh my gosh, so sorry to hear about your injury!!!! Yes, it’s so frustrating, especially when it takes a long time to diagnosis exactly what is going on. At least now you are on the path to recovery with a plan. Praying you’re back on the road soon and feeling normal again!!! You’ll get there. 🙂

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