I had a 2nd MTP plantar plate tear in November 2015. My Arthropod suggested against surgery from the very start. I was 4-months out from Boston and had already registered, hotel and plane tickets paid. So I developed a realistic plan and stuck with it.

It was really painful to run for about 4-weeks (so I only walked). At (post injury) week 5 I was running about 18K for the entire week. My goal was to add 5k per week until I got up to 90K. It was very hard and I ended up injuring my plantar fascia on my other foot but I got it done.

This is what I found. My injury was caused by (1) running in high drop shoes with an extreme toe spring (Vomero 10) and (2) nordic skiing too much. I recommend the following:

1. Birkenstocks - because they have have zero drop (which relieves stress on the plantar plates) and they are super stiff (low and stiff are your friends). I have both the London and Boston models.
2. Low drop running shoes. I started with Atra's at first (I had trouble adapting to the zero drop and this is how I ended up injuring my plantar fascia on the other foot), I later moved over to 2-5mm drop Hoka's.
3. If - like me - you also injured your 2nd MTP, then you'll want to use a toe pad as described here: http://www.footcare4u.com/...-it-how-to-treat-it/

Good Luck!

I tore mine in 2008. It was diagnosed as metatarsalgia, and I ran on it for 5 years and plenty of races (marathons to 100 miler) using a met pad and modified orthotics. I finally got it fixed in 2013 along with a bunionectomy and another subsequent surgery in 2014 to fix an issue in my 3rd metatarsal. The doc even had to do a plantar incision (not the ideal) to fix the torn plantar plate because it couldn't be fixed dorsally. Since 2014 I've not had any issues and am running normally.

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.

Let me know if you have more questions.

Thank you for the info-
I am currently running ( I use the word run very loosely) in the HOKA Bondi- and seems to be the only shoe that allows a little activity- quite honestly even daily walking is not comfortable. I use a wide clog for work use- and big fluffy wool socks ( very stylin for sure)

My concern is that I get a Dr who is confident and proficient in treating this- I am set up to get custom orthotics- I have been using the meta pad- but does not seem to make much difference.
I have been referred to Dr Michael Coughlin in Idaho- I live in NH- any feedback on the Dr choice? Looking for hindsight here- as I figure this out-
My current Dr will not touch the bunion he says " unless you are ready to not run at your current ability" and as I read and research- the bunion and metatarsal are often a "hand in hand" The Dr is a super guy ( works on the boston Celtics players) So I am anxious that is a guy like this wont touch it- more because he said "I just am not proficient at the plantar plate work; which I have to respect as he could just practice on me- instead he referred me-
My full diagnosis is this: bunion, plantar plate tear, likely causing visible neuroma. Exciting stuff- I would rather be posting about the best place to stay in Kona for the World Championships! sigh-

I had a plantar plate tear from late 2011 until late 2012. It was about 18 months of running hell. I did basically zero run training in the five months prior to IMAZ in 2012.

I had plenty of visits to orthos and other specialists trying to remedy the problem. We went through basically every non-surgical option imaginable. I had already been running in low drop shoes so the high heel wasn't the cause... it just seemed to be some biomechanical/overuse issue. There were some things that made it feel a little better but nothing cured the problem. I was getting "this" close to either a surgical option or stopping running.

Then I read about Hokas for the first time and thought why not give them a try. They really were magic shoes for me. Cured all my issues in a matter of a month or two. No issues since beginning of 2013 when I first started with Hoka. I do 100% of my running in Hokas.

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

Not the plate, but I tore my plantar fascia several years ago mid run. I felt and heard it pop (while in driving rain) and thought I snapped a bone. It stopped me immediately and I had to walk home in the middle of a thunderstorm. I went to a really good sports doc who works with pro athletes and believes in aggressive therapy. He said a podiatrist would have cast my foot leading to long term scar tissue and permanent problems. He sent me to a sports PT and they started immediately with ultrasound on the foot plus painful metal scraping to ensure scar tissue aligned in the proper direction. Lots of various rehab exercises plus k-tape on the foot. I was able to work-out on an orbital and other non-impact running machines...back to running after two months off.

I'm drafting along here because I had a bad Plantar problem a couple of weeks ago and it's not healing up too well. I went out on a 6 mile run and was working on more of a mid foot / for foot strike and by mile 5 my heel and mid foot was on fire, I stopped and limped home, it is still tender. I've tried Hokas and they're ok, but why Hoka? Is it strictly due to the low drop? or something else. Would any low drop shoe work?

Plate tear here too. Hoka's are preferred b/c of the stiffness of the shoe. Any old hoka might not do it. Most specifically rec the Bondi b/c it's the most stiff shoe they have. This has worked for me but I definitely still have some pain after about 2 months. I can get away with Cliftons but Bondi's were much better int he beginning. This is if what you have is a plantar plate injury. It will prevent the dorsiflexion of the forefoot to a degree.

No running for me now until pain free. I run train in other ways that have worked for me in the past.

Heal up soon,
Jamie

Just curious of the volume of training you do- I am pretty focused on a Kona slot- so I am willing to go forward with this surgery now- do you feel you are 100% without limitations after the procedure was done and healing rehab?

My running volume ranges from 35 - 65 miles/week depending on where I am in training. I'm at 100%, the only thing holding me back are pesky things like family, job, etc ;).

Rodney Roof, a frequent poster on the board (username = rroof), is also a podiatrist and was really helpful answering my pre-surgical questions.

Tony

I've been sidelined from running for more than a year with a neuroma and plantar plate damage (although Dr opinions differ here). I've tried just about everything short of surgery, currently in a boot as a last resort. The surgeon I saw recommended a plantar approach for my issues as well, and I'm curious what your experience was with the surgery. I'm at the end of my rope and am willing to try it -- but am terrified it may make things worse.

Plantar plate tear in 2nd metatarsal of left foot in March 2019
1) I did a nationwide search for a doctor, and found Dr Kevin Kirby in Sacramento, Ca. He is a Dr in podiatry and also a PhD in bio mechanics, specializing in foot movement, and lectures worldwide. He is extremely knowledgeable in plantar plate tears. I live near Los Angeles, and did everything virtually, even pre pandemic.
2) They can take a LONG time to fully heal. I am 1 month shy of 2 years and consider myself 99.99% :-)
Progress
- 1st month could barely walk, mostly in boot, months 2-3 could walk and run very short in Bondi, and bike with a special insert he designed (made from standard insert and modified with scissors, padding... DYI).
- Month 3-12 gradual progression culminating in an actual 70.3 race in which I placed AG second and qualified for 70.3 worlds, I was definitely NOT ready for this, so had a minor set back in recovery. By month 15-16 I could bike with no discomfort, and no special insert. By month 18, I could run shorter mileage in my preferred shoes with standard inserts. Month 20-24 I would rate at 95% recovery to current VERY close to full recovery. Functionally I have been able to ride and run normally, with no compensation and no discomfort since month 20. I now only notice residual tightness, presumed from scar tissue?, when doing hand range of motion manipulations around the area of the 2nd and 3rd metatarsal.
I highly recommend you at least schedule a virtual consult with Dr Kirby. Nobody knows more about plantar plate tears :-)

I didn't have any issues with surgery. I was riding the trainer with a bunion boot on after 2 weeks, and back to running in about 8 weeks. My surgeon (Chris Coetzee) in MN is excellent. That made all of the difference. I think you are seeing a common denominator in the advice to find a really, really, really good surgeon. Ask how many runners they have operated on, and follow their post surgical protocol to the letter. There are no prizes in being the quickest back from surgery with set backs.

Hi - Wondering, post-plantar plate surgery does your foot/toe still flex with full range of motion. I have limited dorsiflexion when attempting a push-up. I had a Weil Osteotomy and CPR plantar plate repair from a dorsal approach 3.5 months ago. I'm back running with lots of joint stiffness on the second toe that was operated on. Toe doesn't flex. Wondering if this is permanent? I don't want to re-injure myself. I feel some numbness and discomfort after I run, not during runs. Any experience or guidance you can share is appreciated?

Did this ever resolve for you? I’m looking at all options to correct my PPT.

I’m sorry you are injured and may need surgery. Don’t be afraid to get a second opinion/ find a doc w a history of treating triathletes.
If you are near Portland, ME, message me for the name of a really good foot and ankle surgeon.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Thank you. I’m just north of Boston and Portland is about an hour and 15 minutes away. Definitely not far. I’ll be in touch if needed. Thank you. Did you need surgery?

I had foot surgery to fix a Jones Fracture in 2021. I have not had a plantar plate tear.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

I had a PPT 2 years ago and we treated it with PRP followed by 4 weeks in walking boot. I was able to ease back into light running about 6 weeks post PRP.

Dr. McAllister based in Scottsdale was fantastic.

All the best. Message me if you have any Q's

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Toro Performance

I’m looking at PRP and EPAT now and trying to ensure I don’t have a rupture/complete tear vs. partial tear. It’s been months. Just started taping and out myself in a boot. Was wearing met pads before with Hokas.