Dr. Rodney Roof (rroof here on ST) is a frequent poster so he will certainly chime in once he sees this thread but here is a search of his username and plantar plate. It would probably be worthwhile reading for you.


http://forum.slowtwitch.com/...=post_time&mh=50

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Favorite Gear: Dimond | Cadex | Desoto Sport | Hoka One One

I do a fair number of these and as you have discovered, they aren't pretty. One of my least favorite surgeries, though my residents I teach seem to love them (probably because they don't have to see the patients after). Outcomes do vary wildly (I've done winners of major marathons after to fair/poor results). I will say that by the time most get to surgery, there really isn't much of an option though as this will NOT improve in my experience with any type of conservative therapy.

Definitely try to find someone in your area with experience with these (this might be difficult if you are not in a major metro area). A couple of "keywords" to ask is if they prefer dorsal versus plantar approach. Do they like the "Viper" versus "Scorpion" etc. If they can't answer that, look elsewhere ...

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

Thanks for the quick response. I have read the previous posts but I was hoping to hear from others who have had the surgery or possibly recovered in other ways. I have consulted a few orthopedic surgeons across the country. I consulted with Dr. Coughlin in ID who does a lot of these but he didn't want to take my case on. I am/was a professional triathlete, haven't been able to race for over a year because I can't run, and he felt my expectations were too high for what I was hoping to accomplish after the surgery. He was also concerned that too much time had passed since the tear (about 7 months at that time) and he suggested a local Dr just fix my hammer toe with a tendon transfer that has developed as a result of the torn plantar plate. That didn't make much sense to me so I bypassed that plan and started just focusing on bike racing but I miss running...

I have found a well known surgeon in Boston, Dr. DiGiovanni, like you it's one of his least favorite surgeries and he was far from optimistic on the outcomes but he is willing to do it. He will fix my bunion, the plantar plate and my hammer toe all at once. He suggested I try to just live with it because of the potential downside of surgeries. You say you have done a number of these, what are some of the negative outcomes you see? I understand that I may not be able to return to running if the surgery doesn't go well but if it gets worse could that be in a way that would take away cycling? Just trying to wrap my head around the potential negative outcomes of the surgery as he was very vague on those. He also said that if I came back to him in 5 years and said ok, I can't take it anymore, I want the surgery it would be less likely to be able to repaired at that time, would you agree? I'm about 11 months post tear at this point. Thanks in advance for your take on these questions! Where do you practice? Maybe I should fly there :-)
Jessie

Jessie - go to Cincinnati. Let Dr. Roof examine you, your foot, your other foot, your gait, review your x-rays and other studies, see if he agrees with the diagnosis in the first place. This will be an excellent learning experience for you such that you can balance that which you've learned from medical care to date with what you learn in Rod's office. It may be that you simply decide that the down side to this over the long haul isn't worth the short term risk. Or maybe it is. You're facing a very personal decision made much easier when you have the information needed to make that decision.

Go to http://www.aa.com today.

And best of luck from all of us.

John

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John H. Post, III, MD
Orthopedic Surgeon
Charlottesville, VA

Sorry to hear about your issue. I've been there. I tore mine in 2008. It was diagnosed as metatarsalgia, so I ran on it for 5 years and did plenty of races (marathons to 100 miler) using a met pad and modified orthotics. It always bothered me. I finally got it fixed in 2013 along with the requisite bunionectomy. The doc even had to do a plantar incision (not the ideal) to fix the torn plantar plate because in his words "it was pretty messed up." I had another subsequent surgery in 2014 to fix an issue with my 3rd metatarsal. The only minor issue I have experienced since then is loss of flexibility in my 2nd toe. Either way, since the second surgery, I've not had any issues and am running 30 - 60 MPW. My only limiter at this point is my time.

In the beginning I got similar conservative guidance, but in hindsight, I wish I would have fixed sooner. I had an excellent surgeon, and that makes all the difference.

As far as conservative therapy goes. I used superfeet orthotics with a met pad to relieve the pressure on the 2nd met. When it got too painful, I used a crossover taping technique that proved to be helpful.

Rroof was really helpful throughout the process, and I can honestly say that I would have gone to see him if I didn't have a great doc here in Minneapolis, MN (Chris Coetzee) at Twin Cities Orthopedics. Feel free to PM me if you have any other questions or want to understand the recovery process.

Jdonovan,
Did you have the surgery? If you did how do you feel now? I am also finding out doctors do not want to touch this. I have been told to sit and wait...i have a rupture which i kow will not heal on its own:-( but still waiting in the walking boot. If you had the surgery who was the surgeon?

Thank you

Also i have a question if anyone knws if the plate will heal at the 5th metatarsal.

Is your plantar plate torn at both the 2nd met as well as the 5th met? I am no Dr but that would seem like two separate tears, no? ( and also unusual)

I am following your thread here bc I was diagnosed with a plantar plate tear a few years back via symptoms then diagnostic ultrasound. I have the drifting 2nd metatarsal at the MP joint, and initially started with serious pain underneath the ball of the foot but since then am asymptomatic except for the typical 2nd hammer toe and drifting. Contemplating the surgery as well since it is problematic when running longer distances...

Edit: sorry- I thought you were the OP

Are you still running? Did you have to change running shoes? I am looking at surgery in two weeks and it scares me to hear the doctor say "you will never run again". Though, I've heard that before from other injuries, this seems much different.