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My Partial Plantar Plate Tear Injury: The Full Scoop

My Partial Plantar Plate Tear Injury: The Full Scoop

I haven’t been able to run in eight months.

Eight. Long. Frustrating. Months.

Another thing I haven’t done during this time is a good job blogging about my partial plantar plate tear injury. I’ve given Coping with Injury tips, talked about Walking a Race in a Boot, and given a few updates and did some videos on YouTube, but I’ve yet to truly dig deep in the topic. Maybe because it’s been easier to mentally cope by writing about other topics. Plus there’s my fear of being a running blogger/vlogger who can’t run.

That, my friends, would suck. 

My Partial Plantar Plate Tear: The Full Scoop

But after doing many google searches, I’ve only found a few blog posts about this bugger of a rare injury. I’m doing a disservice to others who are trying to find information about plantar plate tears, (PPT,) by not writing about my experience.

So here goes. In this post, I’m going to give the full scoop and then follow up with tips on how you can prevent injuries and more updates.

What is a Partial Plantar Plate Tear?

The plantar plate is a strong ligament on the bottom of the foot that attaches your toes from your metatarsal joint to the long bones at the base your toes, keeping your toes in place instead of splaying. Aka, a very important ligament if you don’t want hammer toes.

Image from Infinity Foot and Ankle Institute

PP tears are more common in middle-aged women, (10:1,) especially those who over-pronate or roll their foot inward. (Hello, that’s me.) There are three different stages: Stage One being a sprain, Stage Two, (again, that’s me,) a partial tear that can be treated with conservative measures, and Stage Three, where the ligament has torn completely from the joint and surgery is the only option.

The symptoms can include:

  • Pain in the ball of your foot.
  • The feeling of walking on the bones of your foot or like there’s a pebble in your shoe.
  • Your toe starts to shift upward and cross toward your big toe.
  • Swelling and redness on the foot above the second toe.

How did it happen?

I’ve been sidelined with a partial PPT in my second metatarsal joint since running the Disneyland Half in September. The cause is unknown since I didn’t have any distinct moment of trauma but my unwise decision to switch to a less stabilizing shoe, (Asics Kayano to Asic GT-2000,) too close to the half could have been a major factor.

NEVER switch shoe styles before a race!

Once back home, the balls of both my feet were sore, but it felt more from walking long hours in the parks rather than from an injury. Still, I took a week off from running before getting on the treadmill for an easy five miles. There was minimal pain at first, but it subsided after a couple of miles. Same thing a week later when I tried another easy run on the treadmill. An ache at first that soon dissipated. This time, however, there was substantial more pain in my left foot afterward, telling me something was wrong.

With the Wine and Dine Half Marathon on my horizon, I knew I needed to see a doctor. Like, fast. I tried making an appointment with a podiatrist I’ve seen before, but his schedule was booked for an entire month. So I tried several others, both podiatrists and orthopedic surgeons, and booked with the first who could see me that week.

I sat nervous in the waiting room on September 20th with that question all of us runners dread swirling in my head. Will I run again?

The doctor seemed sympathetic to my situation. My X-rays showed no broken bones or fractures, although some hairline stress fractures won’t show up on an X-ray. So he diagnosed either a stress fracture or sprain and recommended I return after six weeks of no running if the pain is still there.

“Will I run again?”

“Most likely.”

But the Chicago Marathon was now definitely out, which was upsetting since I was to run it with my friend and Princess Half pal, Kelly. Instead, my husband took us to our beach house that weekend where I drank too much beer, ate an entire pizza by myself, and wrote a very depressing blog post.

TIP: never blog when your depressed, stuffed, and slightly buzzed.

Seeing as how there was no improvement with my injury after six weeks, I went back to the doctor on October 13th for another round of X-rays.

This time, he said it was possible I had a Freiburg Infraction due to my second metatarsal joint appearing flattened. A Freiburg what???

Freiberg disease, also known as a Freiberg infraction, is a form of avascular necrosis in the metatarsal. It generally develops in the second metatarsal, but can occur in any metatarsal. (Thank you, Wikipedia.)

An MRI would be the only way for a true diagnosis, however. My husband and I are self-employed with a very high insurance deductible, so we’d have to pay for this out of pocket. After relating this to him, he said I could skip it for now, seeing as how conservative treatments for both a stress fracture and Freiburg Infraction are the same: rest. So I decided to wait for now.

HUGE mistake. Always, ALWAYS do whatever it takes to get an accurate diagnosis! (Especially after I later discovered it would only cost me $199 after our insurance company absorbed most of the cost.)

The doctor then recommended wearing a stiff-soled insert and metatarsal pad. He also said a cortisone shot could ease the pain, but I refused. THANK GOD. While this can be helpful with other foot conditions, it can cause a ligament rupture for those with a PPT, sending you straight to the operating table. So my biggest tip today is to NEVER get a cortisone injection unless your diagnosis is firm. Just don’t!

I then asked about wearing a walking boot. Would it help? He said it couldn’t hurt and had me fitted for one that I wore for six weeks. As for walking the Wine and Dine Half Marathon, I had clearance if I took it easy.

“But will I run again?”

“It’s possible.”

After my doctor appointment, I immediately jumped online and researched Freiburg Infractions in hopes it wouldn’t sideline my running career for good.

The prognosis? Not great.

Most runners with this injury never fully returned to their original form and many required surgery.

I did not take this well.

I was certain this was my injury, seeing as how the symptoms are very similar to a PPT. And in retrospect, maybe that’s why I foolishly decided to walk the Wine and Dine Half Marathon. Because if my runDisney career was soon going to come to an end, I was going to go out big.

One thing I did purchase that has been helpful is a carbon graphite fiber insole from My Foot Shop as well as some gel metatarsal pads, both of which I still use.

Fast forward a couple weeks. After still no improvement, I decided to get the MRI, something I should have done right from the get-go. There was an appointment available the day before Thanksgiving at 6:00am so I grabbed it. At 3:00pm that same day, I got a call from my doctor’s assistant.

The diagnosis?

Indications of an injury that resulted in a tear of the attachment of the second plantar plate at the base of my second toe, as well as signs of bone marrow edema.

Aka, a partial plantar plate tear and inflammation and absolutely no Freiburg Infraction. I immediately made another appointment with my doctor for that Friday and then spent the rest of my day googling PPTs and gathering as much information as possible from those who had or have the same injury.

The results were all over the place.

Some runners healed in months. Some years.

Some had surgery. Some of the results were good. Some of them led to even more pain.

In general, a PPT is one bugger of a slow-healing injury.

Still, the prognosis is much better than a Freiburg Infraction so I was grateful, despite having to pull out of the WDW Marathon Weekend. And for the moment, I managed to pull myself out of the Deep Dark as I explained in this blog post.

Let’s fast forward.

During my previous appointment, my doctor said custom orthotics would be a good next step and said he’d give me a referral before leaving. We both forgot about it, however, so I left a message with his office in hopes of it being forwarded to a certified orthotist. No reply. A week later, I left another message. His assistant returned it a few days later, saying that she was confused about my initial request. She then said I could pick up the referral, but after speaking with my doctor, she relayed his belief that if I wasn’t feeling better by now, surgery was my only option.

Seriously? Just like that? Even though I had no signs of toe shifting and very little pain?

Yeah. No. This went up me sideways.

I was starting to believe this doctor was only truly interested in case that required surgery, so I sought out a second opinion. On January 20th, I saw my second doctor who thoroughly examined my foot and reviewed my MRI. Due to my ligament was still being intact with no inflammation, he did not think surgery was necessary at all.

“But will I run again?”

“Oh yeah, most likely.”

Thank God.

He also recommended things my first doctor never did, such as taping my second toe down to relieve the pressure on the torn ligament as well as wearing a rocker-sole shoe such as the Hoka One One. As for custom orthodics, he recommended waiting to see how the taping went, but he could give me a prescription then if I wanted one.

I should have said yes, please, give me the prescription. Honestly, I don’t know why I didn’t. I’m still pissed at myself for this one.

And I was pissed at my first doctor for never suggesting taping or rocker-soled shoes, seeing as how it’s usually always the first step in conservative treatments for a PPT. And I was pissed at myself for not discovering this for myself and being assertive during my past doctor appointments.

Pissed, pissed, pissed.

But I was also extremely thankful for getting clearance to walk each race during the Princess Half Marathon. And for the first time since October, I started to believe that yes, I WILL RUN AGAIN, even thought it might take several more months.

Then I saw my doctor again on March 16th for another round of X-rays.

Long story short, considering there has been no improvement since our last visit, he said there’s nothing more he can do.

Sigh.

He did recommend I try custom orthodics now and said he’d forward a prescription to an office in Towson, Maryland, about a 45 minute drive for me. (According to his assistant later on, the office would contact me to make an appointment.) Before leaving, however, the doctor looked at my X-ray again and expressed concern about my second toe possibly drifting, (aka, I’m screwed,) but then again … it could just be naturally crooked. The only way to know for sure would be to take X-rays of my right foot.

Now. Had I been smart, I would have said, “Okay, let’s take the X-rays now,” rather than have this fear haunting me for the next few weeks.

Or better yet. I could have said, “Hey, I have my first X-rays on my phone. Would it help to compare it to that one?”

And how about, “There’s a great orthotist right here in town who can do my custom inserts. Can I just go there rather than drive 45 minutes?”

But no. I wasn’t thinking straight. His nothing more we can do comment put me in a frenzy, causing me to forget about other options I’ve read about online. What about shock wave therapy? Or PRP (platelet-rich plasma) therapy? Or an ultrasound? Dry pin therapy?

Tip: ALWAYS go to your doctor’s armed with a list and a plan in case your mind goes blank.

Instead, I sat in the waiting room afterwards, beating myself up mentally for being so unprepared and unassertive. I also made a quick collage on my phone comparing the two X-rays that the receptionist emailed him later.

I never heard back, not that I really expected to.

And I never heard from the orthodist office that he recommended. They never called to make an appointment so after one week, I called his office and left a message. No reply. Three days later, I called and spoke with the receptionist instead, who forwarded me to my doctor’s assistant to leave another voice mail.

Meanwhile, I called the certified orthotist in town who said he could see me that very day if I was able to get my prescription.

Thankfully, my doctor’s assistant called me back an hour later and was more than willing to have it waiting for me at the front desk, no fight necessary. (When I asked her about PRP and other therapies, she said in her years with this doctor, he has only prescribed such treatments one time and would most likely not recommend them.)

Now. David, my orthotist?

I loved him.

He was very knowledgeable about my injury and proved that getting custom orthodics should have been one of my first steps, after diagnosing me as both an over-pronator and there’s also something funky going on with my heels … I didn’t think to write down the word he used.

And dang it! I didn’t take a picture of my foot mold!

David said I will most likely need custom orthotics for running for the rest of my life as well as continuing to use the carbon graphite fiber insole. And there’s a chance that I’ll always have pain when I run.

Plus a chance I’ll need surgery after all.

There’s just no guarantees with this persnickety injury. If I do? There’s only one surgeon who will do it, a doctor in the same office as David. (And one I tried to make an appointment with but he only sees patients who are ready for surgery, he’s that good.) David recommended me trying to make an appointment again after wearing the custom orthodics for a few weeks, just to get a third opinion.

Where I’m at now

In the core of my sole … I don’t think I need surgery. My gut says I will heal and run again, maybe by the summer. There’s hardly any pain in my foot now, even when I press down trying to find a ‘hot spot,’ and my second toe does not appear to be shifting, splaying, or lifting of the ground.

One thing is certain, however.

I need to learn how to walk again.

I’ve been limping and favoring my metatarsal joint for so long that I now walk with my foot pointed out and weight rolled to my third and fourth metatarsal joints. I’m trying to correct this and hope my custom orthodics will help, once they are in. (It’s been two weeks so I’m calling today, hello, Ms. Assertive.) If not, my next step might be seeing a physical therapist and using a zero-gravity treadmill to ease into running slowly.

But that’s a conversation for a different day, seeing as how I’m not there yet.

I will be, though.

I don’t know when but it will happen. I will Recover. Run. Rejoice. And in time to be trained and ready to run the 2018 WDW Dopey Challenge next January.

Until then, I will do a better job documenting my recovery with bi-monthly updates for those of you who are diagnoses with the same injury. Before wrapping up this one, however, I want to mention some other things I’ve been doing in an effort to heal:

  • I’m still taping down my second toe as well as taping it to my third toe just as a preventative to keep it from drifting.
  • I’ve been taking a Turmeric supplement daily since it can help with soft tissue damage.
  • I’m also taking Rhos Tox and Horsetail, both of which can be helpful for ligament damage.
  • I tried using this BSFT Inferno Wrap after reading in this very long forum thread how it’s been helpful for some, but I have mixed feelings about it and couldn’t be sure if it was helping or hurting, so I’ve discontinued using it.

Thanks for reading my VERY long update. Take care, be safe, and happy running!

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.

{ 47 comments… add one }
  • Melanie April 13, 2017, 12:01 pm

    Laura, I am sorry to read about your injury. Hopefully the orthotics will help. I wear them for other reasons and they are great. So if you have to wear them for the rest of your running career just do it. Make sure you break them in. Wear them 2 hours the first day, 3 hours the next day, 4 the next etc.. sometimes they forget to tell you and you can feel it in your knees. Also my guess is your feet will ache. Both feet, your entire foot. This is common b/c it is shifting your entire foot and how it strikes the ground when walking/running. Also I am surprised no one has recommended PT. Not to cure the tear but to help strengthen/stretch the muscles in your leg/foot. Which will help with your limp. I am a PT so I am bias but I am surprised. Please push for this for yourself. You mentioned that your deductible is high so just explain to the PT office you can only come a few times to get a good home program. Good luck and stay positive!

    • Laura Bowers April 25, 2017, 7:58 am

      Thanks, Melanie!! I just posted today about my new orthodics … that I totally hate. 😉 The orthodist did give me a program to break them in, but I’m going back tomorrow to get the one trimmed and then I’ll try again with them. ShaeLee also gave me a heads up on the new Hoka Ora recovery sliders that I can wear the orthodics in, so I’m really excited about them! Ordering soon.

      My orthodist did recommend ‘stride and strike’ PT and another person who went through a PPT also said using a zero-gravity treadmill helped a lot. I’m waiting to see how it goes with the orthodics and maybe get a second MRI before starting.

      Hope you had a great time at SW Dark Side!! 🙂

  • ShaeLee April 13, 2017, 12:38 pm

    Love your determination to find a solution and to keep in top of your care. I have a question; have you ever considered that treadmill use may be harming your recovery? I say this because though it has its uses (bad-weather training, etc), the pull of the belt isn’t normal to running. I get what I compare to “turf toe” when I do a lot of running on the treadmill and Shalane Flanagan actually pulled out of Boston due to a back unjustly that she sustained while training on the treadmill. Do you have a school track around you? I’m not a fan of trail running because I have to watch for the rocks and roots but that might also help.

    • Laura Bowers April 25, 2017, 8:02 am

      Hmm, that’s something I definitely need to look into, since I normally do a lot of running on the treadmill. I’ve been sticking with the stationary bike or biking outside during the past seven months, but I’ll remember this for when I can start again. And yeah, I think my days of trail running are out. 🙁 And I’m ordering those Hoka sliders today! Thanks again for the heads up! 🙂

  • Lesley April 13, 2017, 2:44 pm

    I was wearing the first GT-2000 style when I got ITBS, and when I went to the running store, they found the tread wasn’t where it should’ve been. I keep thinking “what if” I had known about the changes in ASICS and got fitted properly. I just assumed since I was wearing the 2100 series, the new GT-2000s would work fine. I won’t even wear ASICS now because they keep changing their models.

    • Laura Bowers April 25, 2017, 8:05 am

      Yeah, I’m a Hoka girl from now on, not that I have much choice in the matter. 😉 And I won’t go by the opinion of a running store when it comes to shoes. I’ll do my research first! Had I done so, then maybe I wouldn’t be in this pickle. #couldawouldashoulda But yes, that’s great advice for everybody! Thanks! 🙂

  • WendyTaking the Long Way Home April 13, 2017, 8:53 pm

    I’m so so sorry to hear this. People always tell runners they’re going to ruin their knees, but it’s the feet that are the problem! It’s hard to be patient and wait for things to get better too. Some things I’ve learned: podiatrist are really variable in how they treat foot issues, I’m not a fan of custom orthotics (i use Spenco soft orthotics), and warming up my feet in the morning on a heat pad really helps.

    I’ve had a lot of issues with my feet. Right now I’m testing out some PF flip flops that I’ll be reviewing next week on the blog. I’m liking them a lot…

    • Laura Bowers April 25, 2017, 8:38 am

      Thanks so much, Wendy! My custom orthotics did come in …. and I hate them. 🙁 I’m getting them trimmed tomorrow to see if that helps and will give them another shot, but wow. The Spenco’s are sounding pretty good right now! And I’ll try your tip of warming up my feet … they’re always cold anyway and it sounds really nice. 😉

  • Karen April 18, 2017, 1:53 pm

    I am so sorry to hear about all of your frustrations and the back and forth circles you’ve had to go in! Glad to hear the foot is feeling better and on the mend!

    • Laura Bowers April 25, 2017, 8:40 am

      Thanks, Karen! I know God always has a reason for things that happen so I’m hoping this is all just a long, long lesson learned that others can benefit from. 😉

  • Kristen K. April 24, 2017, 10:02 pm

    I’m following along with your story Laura, stay strong, and take care of yourself! I know how hard having to slow down is, but can totally do what you need to in order to heal.

    • Laura Bowers April 25, 2017, 9:07 am

      Thanks so much, Kristen, I appreciate it! 🙂

  • Ashley Wilson July 28, 2017, 12:32 pm

    Hi there. I randomly came across your blog and I just wanted to recommend reaching out to Dr. Richard Blake – http://www.drblakeshealingsole.com/ for advice on your injury. His blog is FULL of info and he will happily answer questions via email, give advice and even look at your MRI if you mail it to him. It’s always nice to get another opinion especially from such a wonderful, caring and knowledgeable doctor.

    • Laura Bowers August 2, 2017, 4:21 pm

      Thanks so much for the lovely message! I’ll keep Dr. Blake in mind. 🙂

  • Karen September 6, 2017, 4:05 am

    Found your blog article whilst googling about PPT’s. Will be following your recovery with interest. I was diagnosed with a PPT about 6 months ago and am desperate to get back to running. In fact to walk without limping would be nice! I have been a distance runner for a number of years and have always felt indestructible – never struggling with injuries until this. I changed my shoes from Brooks Ariels – very supportive shoes to Brooks Vapor as it was suggested that perhaps I did not need as much support. Now I am wondering if this lead to the injury or perhaps I am just falling apart now that I have turned 50😧. I was given orthotics by the podiatrist, shown how to tape my toes and told to ease back into running but as soon as I up the distance, my foot becomes painful and I am back to limping. Just today, the podiatrist suggested I try Hokas – so think I will give them a go. Hope you are making a steady recovery – would love to see an update o your progress.

    • Laura Bowers October 17, 2017, 11:18 am

      Hi, Karen, sorry for my late response, but I’m hoping the Hokas are working out better for you! I wear the Hoka Arahi’s and they’re great. I’ve also heard that taking calcium, turmeric, and beet root are also helpful, so I’m taking them now. I still have pain in my left foot, but my doctor believes it’s from my calves being so stiff. I’m also now having pain in my right foot and have an appointment scheduled for next Tuesday. I miss the days when I had healthy feet!

  • Eileen November 29, 2017, 3:50 am

    Thank you Laura. I am in NY and was diagnosed with a PPT in April. Spent 12 weeks in a boot. Believe it or not, it happened because I used the “press to release feature” of my new Bosch oven warming drawer. Am going through much the same as you. Have to relearn how to walk. Tend to walk with my toes of injured foot curled downward to protect it, favoring by leaning foot to put pressure on 4th and 5th toes. Have seen 3 podiatrists and an orthopedic surgeon in NYC, HSS. I use a metatarsal pad daily which offloads pressure at the injury. Have not been taping toe, but am considering resuming that after your article, because the toe is not migrating upward and I want to keep it that way. My podiatrist says he doesn’t think the carbon graphite insole will be tolerable for me. But I feel I need the rigidity to be able to walk without having to stiffen my foot for protection. Is insole uncomfortable or hard on your hip or knees? I was a speed walker and yoga person. Painful losses. I too am hopeful and determined. We need to get more information out about this injury. Your post helps and I will follow your progress and keep you and others updated on mine. I am thinking of starting a support group in my area. There are more and more of us because MRI is now diagnosing accurately. Thanks again for speaking out on this important but little known injury.

    • Laura Bowers May 10, 2018, 8:59 pm

      Oh my gosh. I can’t believe I’ve allowed this comment and others to slip under my radar!! It’s been a while, but how are you feeling? And good news? I hope that by now, you’re well on your way to recovery and once again, my apologies for the late response.

      Oh, and no, I didn’t think the carbon graphite was uncomfortable and I barely noticed it. It did alter my gate, though, since I had stopped “rolling” my foot as I walked and after I had been given the go-ahead to run again, I could barely lift my toes off the ground. I had to do a lot of foot strengthening exercises to get it back to normal! There’s one on The Run Experience that really helped:

      https://youtu.be/6nz6kDUgirc

      Take care!

  • Sam Harrison January 23, 2018, 7:21 pm

    Laura,
    My case sounds a lot like yours. I’m an avid athlete and very frustrated with the planter plate injury that I’ve had since May. I had an x-ray and an MRI which showed the tear. I’ve tried everything from cortisone shots, physical therapy, anti-inflammatory medication, off the shelf orthotics to the boot and metatarsel pads. Nothing has relieved the pain totally. The only shoe that helps is Hoka running shoe. My current orthopedist at HSS has told me repeatedly that the pain should subside over time and that surgery is not warranted. When you look at my two feet they both look the same. I don’t have a visible problem, however my third toe really hurts. The only thing I haven’t tried is a custom orthotic which is treatment of choice by the orthopedist at HSS. Previously I went to another orthopedist and two podiatrists. Laura, how did you make out with your custom orthotics? Any one have any other suggestions?

    • Laura Bowers May 13, 2018, 10:42 am

      Hey Sam, my deepest apologies for my late response! I’m hoping that by now, you’ve found some relief. Please let me know how you’re doing!

      I am still wearing my custom orthodics every time I run and I can’t imagine running without them now! I’m also loving my Hoka Arahi shoes. One thing I noticed, though, is that using custom orthodics makes them break down a lot faster compared to the 400+ miles I used to get out of my Brooks. I talked to my orthodist and she said it’s because my inserts are harder (especially at the heel to correct my poor heel strike,) so I will have to replace my running shoes more often. (Hokas tend to not last as long regardless.) But whatever, as long as I can still run, I’m fine with that!

      So I’m curious: where are you feeling pain on your third toe, at the metatarsal joint? Or along the toe? I had a setback in October where I was feeling the same exact pain in my second metarasal on my right foot as I did on my injured left foot. I feared it was another PPT, but my doctor said the pain was because of tight muscles in my calves. I had grown very inflexible in my calves and hamstrings from limping and not working out for so long plus I have some nasty muscle knots that I’ve yet to work out. Calf stiffness can cause pain in your feet, knees, hips, etc., so he recommended stretching at least eight times daily, yoga, and more rolling.

      I started doing PiYo Lower Body since it has great leg moves for runners. The first time made me very nervous whenever a move had me flexing the ball of my feet, but the more I did them, the better I felt.

      Anyway, my apologies again for the late response and please give me an update on how you’re feeling now!

      Take care,
      Laura

  • Sophie Smith February 1, 2018, 5:50 pm

    Hi Laura,
    I’m so happy I stumbled across your blog whilst research appropriate footwear for ppt. I’ve had it for about a year now, I’m a runner like you (ex runner for now!!) I spent April – October 2017 barely being able to walk with or with shoes. All doctors said it was inflamed metatarsals and to rest. Yawn. I got my custom insoles fitted Sept 1st and by October I could finally walk pain free whilst wearing them. They are now a part of me and my feet and I can’t cope without them. I can finally start walking bare foot again around the house which is so lovely! I’ve just started yoga as well which ex ppt’ers swear by. My yoga teacher had it 10 years ago. I do it at least 3 times a week and I should start seeing results in 1 month. Fingers crossed.
    I hoope yours is doing well now and you’re back running! Hopefully I can be too by the end of the year 🙂
    PS. I’ve had shock wave therapy – it really does work!!!

    • Laura Bowers May 13, 2018, 10:45 am

      Hi Sophie, sorry for the late response, but I’m so glad the orthodics are giving you relief and yes – being able to walk barefoot again is such a blessing!!! I’ve been back to running for a while now and I hope that by this time, you are as well. Please be sure to let me know!

      And oh my gosh, yoga is so important!!! I’ve become so inflexible after being seditary for so long and not flexing my left foot, so I started doing more PiYo Lower Body workouts that have been very helpful.

      Take care!

  • Dana March 18, 2018, 9:44 am

    I am now 8 months out from PPT been wearing custom orthotics and thought things were going well, but now all of a sudden feel like I am
    feeling my foot again even at night. Starting to get depressed again as summer is approaching and can’t imagine another summer wearing socks and sneakers all of the time. Also becoming an issue for work as I have been wearing sneakers for 8 months and really would like to wear other shoes. Do you have any other shoes you can recommend for summer or comfy for work but not totally the sneaker commuter look?! Do you still have pain? Looks like you are doing much better if you just did the Disney marathon. Just trying to search for something to get over the hump and move on from this nagging injury.

    • Laura Bowers May 13, 2018, 10:57 am

      Hi Dana, my sincerest apologies for the late response!!! I hope that by now, you’re feeling better.

      It took about a year for me to be able to wear normal shoes again but I had to build up slowly by doing feet strengthening exerices, (The Run Experience has some great ones, https://youtu.be/6nz6kDUgirc) because my left foot had grown so weak. I could barely lift my toes off the ground while standing! I started off with flats and cushioned inserts and moved up slowly.

      For the summer, because I work at home, I was able to get away with wearing Oofos flip flops, Hoka sliders, and Sketchers sneakers. I did see these various rocker bottom shoes online that might be good:

      https://nicershoes.com/best-rocker-bottom-shoes-reviewed/

      These are actually quite cute!!! https://tinyurl.com/ydcsns3o

      Praying for your speedy recovery and be sure to let me know how you’re doing!
      Take care,
      Laura

  • Gloria March 20, 2018, 12:31 pm

    Hi Laura,
    Today I found your notes about PPT and feel very much identified with you.
    I rolled over the stairs in flipflops one day I was running late to my karate practice and my left big toe took the worst part. Its been 6w since then and only now after 2Xray and 3 Doctors,the MRI got the diagnosis. After trying several NSAIDs, and pain killers. Im now resting at home, using marigold tablets, lidocain patchs, infrared and hot and cold therapy to help the swollen feeling in my foot as well as trying to do the first “steps” Of walking with the help of crutches and hoping in 3w on my next Dr check up Im ready to walk by myself again or at least upgrade to a cane haha. I feel your frustration and think i totally need a bracelet like yours haha. Im not giving up on this!

    • Laura Bowers May 13, 2018, 11:03 am

      Oh man, Gloria, so sorry about your injury and for my late response! I’m praying that you are feeling more relief by now and on your way to recovery. Never heard of taking marigold tablets … I tried beet root, horsehair, horsetail, rhus tox and turmeric cumin. (I’m only taking beet root and turmeric now but not as often as I should.)

      Be sure to let me know how you’re going now and yes, NO GIVING UP!! 🙂

  • Stacey March 23, 2018, 8:19 pm

    Thx for sharing your story. I found out last week that I also have a partial PPT. I went into a boot yesterday for the next 6 weeks. My dr suggested the platelet treatment or some other surgery but it would require me to be non weight bearing for a while – and I can’t do that and still work. My foot actually stopped hurting after I made my appointment and I almost cancelled it. I was floored when the MRI showed a tear – I mean it was feeling at least 75% better than when I made the original appointment. I so want to be able to run again…but I want my foot to heal. The boot has no guarantees to work. I’m just hoping it will. How did you tape your toe??

    • Laura Bowers May 13, 2018, 11:13 am

      So sorry about your injury, Stacey, that sucks! My sincerest apologies for my late response and I hope you’re feeling better by now.

      Did the MRI show a partial or full tear? And has your toe shifted at all? If it’s a partial, than it is possible to recover without surgery. I’m assuming you’re out of your boot now – taping your toe and wearing a rocker-bottom shoe such as Hokas will help. This video shows how I taped mine: https://youtu.be/meUFV2UQyf8

      I’m going to write a follow-up post today outlining some things I did after my PPT finally healed that might be helpful. Be sure to let me know how you’re doing now and I’ll do a better job responding!

      Take care,
      Laura

      • Stacey May 14, 2018, 7:04 am

        It was only a partial tear and I’m now out of the boot for past 2 weeks and doing PT. Dr isn’t having me do a follow up MRI. I don’t think the toe has shifted. I have to be in a stiff sole shoe with toe strapped down whenever I am up. I am not able to run yet per dr orders and no active or passive toe dorsiflexion. Not allowed elliptical. I am trying to maintain fitness but it’s tough without running- I am climbing stairs flat footed; it has been 8 or 9 weeks since I have ran. I go back to dr next week and hopefully she’ll let me start a little running

        • Laura Bowers May 14, 2018, 9:39 am

          So glad to hear it was only a partial and your toes haven’t shifted! It might be a good idea to take a picture of your foot (if you haven’t already,) just so you’ll have a comparison for later. And I know it’s frustrating not being able to run now but this extra recovery time will ensure you’ll have a long running future!

          There did come a point where I was allowed to bike which helped me tremendously. Best of luck and thanks for checking back in! Be sure to let me know when you get the go ahead to run. 😃

          • Stacey May 16, 2018, 8:19 am

            I’m allowed biking…but I get bored biking. I did the nustep a few times but have to concentrate heavily on intervals or it’s a snooze alert for me and pointless for any cardio if I’m not forcing myself to go hard for x amount of time and then easy. Walking and climbing flights of stairs has at least got my heart rate up. Fingers crossed for next week that maybe I could ease in to some intervals. Going to talk to the dr about the type of running shoe. She is also a runner so understands my desire to get back at it.

          • Laura Bowers May 16, 2018, 7:43 pm

            It’s always great when a doctor is a runner as well! They always understand the need to get back on the road more. Praying you can start intervals soon!!

  • Amir M March 31, 2018, 4:30 pm

    Hey Laura,

    I just read your blog and it has given me so much hope. I have been improperly diagnosed the past 1.5 years regarding the pain in the ball of my feet. I have seen countless Foot Doctors and after doing some of my own research, I feel that I have PPT. I hurt my foot from doing excessive walking while traveling overseas(not having good shoes and not knowing that I was flat footed) and when I came back after having a lot of pain in my foot, I went to a doctor who gave me a cortisone shot. This ended up making all the pain SO MUCH WORSE and I have been in excruciating pain ever since for the past year. Prior to the shot, I only had pain when wearing bad shoes, but post-shot I am in constant pain.

    I read that you found that the cortisone shot could actually rupture the ligament, which I feel is precisely what ended up happening to me. Doctors have suggested a toe shortening surgery or another cortisone shot but in the “proper area”, but I am not sure what to do. I have custom orthotics and a metatarsal pad which seems to help with some pain, along with an anti-inflammatory cream.

    I just got into grad school and need to move to New York and am hoping to solve this issue before I leave. Are there any suggestions you have?

    • Laura Bowers May 13, 2018, 11:19 am

      Oh my gosh, Amir, I’m so upset with myself for allowing your message to slip under my radar!!!! My sincerest apologies … things have been crazy on my end but that’s a crappy excuse considering how hard this injury is to deal with.

      And I’m pissed your doctor gave you a cortisone shot without getting an MRI taken first for an accurate diagnosis. Has your toe shifted or starting crossing over its neighbor? Have you gotten a second opinion yet? Have you tried taping your toe down? Taping my toe and wearing a carbon graphite insert along with my Hoka Arahi shoes really helped me to finally heal.

      Can you please give me an update on how you’re feeling now in case I can offer any more help?

  • Caryn April 12, 2018, 8:31 pm

    Hi Laura and others. I am glad to have read your blog because I was beginning to feel like this “Plantar plate tear” was a BS diagnosis. My pain probably started last fall while training for a 1/2 marathon. I remember saying to my husband “I think I broke my second toe” but since it wasn’t an important toe and I could keep running I pushed through it. The pain seemed to subside for the most part. Long runs of more than 10 miles would leave me with my foot hurting. Anyway I was training for another shamrock 1/2 marathon just recently and after an almost 12 mile training run I found myself in a lot of pain. I took a couple days off and tried but just could t keep up with my group. Again took more days off but still couldn’t get back to the training. I decided to see a foot and ankle ortho doc that I knew. He told me I had metatarsalgia and handed me these 3/4 length inserts and said wear these, they should help. Well BS, they made my foot hurt so much worse because they seemed to cause me to push forward in my shoe putting more pressure on the ball of my feet. He also told me I couldn’t make it worse by running and though I should do more cross training than running to train I could do my 1/2. A week later after ditching the inserts he gave me I decided I wanted to go to a PT. I was thankful I did, she taped my foot (differently than you show) and I was able to get through my 1/2. Though my foot went numb around mile 6, then searing pain around mile 7 and a walk/Run from there to the finish (which sucked bc I had come out of the gate so strong). The pain after was better than I suspectes it would be but it was there still and I wanted another opinion. I went to a podiatrist that came highly recommended and she concurred with the metateasalgia diagnosis and showed me how to tape my toe the way you show (they call it strapping) and said I could try a short run (no more than 3 miles) that weekend tonsee hownit feels. It didn’t feel bad, however I was doing a warm up 3/4 mile Run with the track team that I coach the following Monday and holy cow when I got home that night I was in tears. I iced my foot and called the doc the next morning. She recommended I go in a boot until after getting an MRI. I was only in the boot a couple days before the MRI last weekend and I met with her yesterday to go over my “options”. The MRI showed a “docs discontinuity at the insertion” which she explained to me was a complete tear HOWEVER she also said that there are times that the imagin is not 100% correct and her gut tells her it’s likely connected by a thread. My choices are to stay in the boot another 3 weeks and see or surgery to repair it. I am an avid runner and I absolutely love it. Not being able to run for the last 9 weeks the way I have for years has been very upsetting. I am feeling like surgery is my only option as my goal is to run again. I have another apt with another podiatrist tomorrow for another opinion but I have put the surgical lab in motion. Did they tell you what grade tear yours was? Am I crazy to let them operate on my foot? I have so many mixed feelings but not running again is not an acceptable outcome. I hope I do the right thing.

    • Laura Bowers May 13, 2018, 11:23 am

      I’m so sorry to hear about your injury!! And my deepest apologies for my delayed response … I truly am feeling like a total terd right about now for taking so long.

      Just say you responded to another reader’s question, so I’ll write a longer message there.

  • Caryn April 13, 2018, 5:50 am

    That should say “focal discontinuity” when describing the tear.

  • cheryl May 2, 2018, 5:58 pm

    I was just diagnosed with a ruptured plantar plate—lots of pain over the last couple months. I mostly walk and play pickleball, and when I pickle, I play 3-4 hours. By the end of the 3rd or 4th hour, I am miserable. Monday night, 2 days ago, I had the worse pain in my 2nd toe—felt like something popped at the same time as my 2nd toe shoving into my foot (it felt like that…not sure if that really happened). I had to stop playing, and after an xray at regular doctor, I got a referral to a podiatrist, and this a.m., she said ruptured. After reading about this, I fit the bill: middle-aged woman, pronated feet, 2nd toe longer than big toe. I did get a cortisone shot—doctor said since it was ruptured, and horribly swollen (and my 2nd toe is leaning towards my big toe), it couldn’t hurt. My pain has subsided tremendously at this point (4 hours later). I am now shopping for court shoes. Doctor recommended Hoka’s but it looks like they only make running shoes? I am going to go try some on. Oh, doctor also recommended taping of the 2nd toe, and metatarsal pad. I am not doing orthotics at this time, but maybe…want to see if I can go without. Thank you fo your info—this all sucks so much!

    • Laura Bowers May 13, 2018, 11:29 am

      Hey Cheryl, I’m so sorry about your injury … it really does SUCK!!! I hope you’re feeling better at this point and feeling some relief while resting. I second the taping recommendation as that, along with a carbon graphite insert, my Hokas, and lots of rest, was what finally got my injury to heal!

      Please leave me an update about how you’re feeling now and I’m praying for your speedy recovery!

  • Cecilia May 6, 2018, 7:30 am

    It’s been 6 months since my misdiagnosis of metatarsalgia. Treatment was rest, NSAIDS, CBD oil, acupuncture, a boot for 6 weeks. Nothing helped. The 2nd and 3rd toes looked like sausages and top of foot was very swollen. It ached all the time. The acupuncture relieved some of the swelling. I was correctly diagnosed with a ppt just last month. I finally went to an Orthopedic foot specialist at MGH. He recommended hard soled shoes like Danskos and Hokas. He said I could try one last conservative treatment before surgery; a guided cortisone shot into the 2nd met joint. Of course I tried this to avoid surgery. He said no weight bearing for 3 weeks. I’m 2 weeks into this, getting around with a scooter. Swelling is down quite a bit. Don’t really know if I can walk pain free since I can’t walk on it. As a result of this injury I feel my body is so misaligned. Now I have back and shoulder pain and just generally achy. The whole experience has been depressing. I was a speed walker who walked everywhere prior to this injury. I have been riding a bike and even tried a rowing machine.
    I’d love to hear back from Caryn and Laura to see if they had their surgeries and how they are doing since. THANK YOU!

    • Caryn May 6, 2018, 9:01 pm

      Hi there Cecilia,
      My second opinion was exactly what I needed. The doctor was very clear when he said that my plantar plate tear would not heal itself. He was an older doctor and no longer preforms surgery so my decision on which doctor to stick with was easy. I really liked the podiatrist that ordered the MRI and got to the bottom of this injury.

      I had the surgery on 4/25 and am still non weight baring. The result of the surgery was that I had a complete tear of the plantar plate ligament (which we saw on the MRI) and I also tore my tendon (the MRI didn’t pick that up). I have quite an incision on the bottom of my foot but the stitches may come out tomorrow. Some pain off and on depending on how much time I spend off the couch but ice helps a lot.

      You mention that you are having a guided cortisone shot. Something you might want to watch out for is, both of the doctors that understood the extend of my injury asked me if I had had a cortisone shot. I am allergic and in this case that allergy was the best thing I could have. A cortisone shot would have compromised the integrity of the ligament and tendon causing me to need to wait at least 6 months after the shot before surgery could have been done.

      Good luck to you.

    • Laura Bowers May 13, 2018, 11:37 am

      Hi Cecilia, first off–I’m so sorry to hear about your injury and I’m praying for your speedy recovery! I know it’s very frustrating, but the best thing you can do for your body now is just rest and allow your foot to heal.

      Unlike Caryn, I only had a partial plantar plate tear that was able to heal through conversative treatments such as taping down my second toe, wearing carbon graphite inserts with rocker-bottom shoes, (Hoka Arahi,) taking supplements such as turmeric cumin, horsetail, and beet root, and rest. I did do a lot of biking (about three months after my injury,) but I kept the pedal at the middle of my foot to keep the pressure off my metatarsal joint plus I wore my graphite insert to better distribute the weight.

      I didn’t get the go-ahead to run until mid-June, but it took me a long time to get used to wearing my custom orthodics. But in September 2017, I was able to run most of the Disneyland Half Marathon!

      I second Caryn’s thoughts that avoided another cortisone shot would be good. Also, have you had an MRI for an accurate diagnosis? This would show whether your tear is a partial or full one and will determine if surgery is your only option. Please keep me updated!

      Take care,
      Laura

  • Cecilia May 14, 2018, 1:52 pm

    Thank you Caryn and Laura. Yes, I had an MRI and it said that it was I’ll defined, but the foot expert at MGH viewed the MRI and diagnosed a PPT. I also has that same diagnosis from a Podiatrist. I’m now wearing Hokas with a Budin Splint and Superfeet orthotics. Still not weight bearing, will stay off for another two weeks. Hoping no surgery.

    Caryn, how are you feeling?
    Cecilia

    • Caryn May 14, 2018, 2:04 pm

      I am doing OK. I started weight baring with crutch support and I am not gonna lie, it hurts. But it is getting better every day. The hardest thing about this surgery is that this is my right foot so I cannot drive. I have my almost 4 week follow up next Monday and the goal is to have me walking in there in the boot without needing any support. From there they will fit me with a custom orthodox and in another 4-5 weeks get me starting to run again . I am really hoping that I can ride a bike or do some form of cross training. It’s hard for an active person to be laid up.

      I was happy to read nonsurgery for you. Take care.

      • Laura Bowers May 16, 2018, 7:45 pm

        Praying for you to be done with those crutches and back out on the road soon!!! Thanks for checking back in and be sure to let me know of your progress.

  • Joe May 26, 2018, 2:52 am

    Hi Laura,
    For starters, thank you for sharing your story and for giving me (and others in similar situation) an opportunity to pick your brain, vent, share, etc…I am SO glad to hear your experiences and realize there may be a light at the end of the tunnel.

    I too was diagnosed (finally) with a partial-plantar-plate-tear in April ’18. It took an MRI to do so but am glad to at least have a diagnosis. Much like you, mine came on with little to no noticeable trauma. I was doing a night trail run in January ’18, stumbled, caught myself…then kept on going. The next morning is when I noticed.

    I have re-read your story and am curious about a couple of things I hope you can shed some light on…

    1) How long did you wear the walking boot? Til January of ’17 when you found the Hokas?
    2) How did you know you were healed? Did you have a final MRI to confirm?
    3) Finally, how did you ease out of walking boots, met pads, and taping and subsequently ease back in to “normal” life (so to speak)? Crawl walk run if you will 🙂

    Again – thanks for sharing your story. Sucks being a runner that can’t run. You’ve given me inspiration that my day will come 🙂

  • Joe May 29, 2018, 6:28 pm

    Snap! I just saw your other blog PPT From Sidelined to Finish Lines…answers some of my previous questions. Six weeks in boot. Final MRI to determine there was no more tear 🙂

    After the walking boot, for how long did you tape, wear met pads, and wear your Hokas?

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