I wonder if my recurring pain in front of my heel is the same thing, but just farther back?

Dr. Paul Cooper is very well known and runs a fellowship program in the DC area. He would be a great place to start.

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

rroof,
Thanks for suggestion. I actually see him on Friday.

RRoof, I've been reading through many, many plantar plate/ neuroma/ capsulitis threads on here, and appreciate all the advice you've given. I've been trying to find the right dx/ treatment for more than a year here in Philly. (And it's been that long since I've run-- barely can walk the dog at this point.) Do you have a doc you'd recommend in this region? I have ultrasound and MRI films which draw conflicting opinions (bursitis, possible plantar plate damage/ partial tear, neuroma). Thank you!

Not here much anymore, but summoned ...

No one likes plantar plate repairs (from a surgeon's perspective that is - obviously awful from a patient's perspective). They are highly variable, difficult and have mixed outcomes.

There should be plenty of specialists in Philly for an opinion - and get a couple. I don't know anyone personally there I'd recommend.

I will say if your MRI is not conclusive for a high grade plantar plate tear, that is good and makes surgical options a little easier.

Best of luck!

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

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 :-)

Post-plantar plate surgery question: 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. Anyone have experience or guidance?

Any recommendations for surgeons in the Seattle area/PNW? I tore my plantar plate 2.5 years ago on a 4 week hike. I've since tried rest, PT, tape, orthotics and a PRP injection and I've plateaued to a point where I can only run minimal mileage, walk my dog or hike wearing Hoka Bondis with orthotics that have a metatarsal pad + cut out. My MRI has shown a small tear on my 3rd MTP joint without other complications. I've been on a racing hiatus due to the pandemic and a pregnancy, but I'd love to finally get this taken care of and get back to training (and wearing something other than Hoka Bondis in everyday life) in a year or two.

Would also love to getting a better sense of post surgical recommendations others have had-- I've seen a mix of weight bearing in a boot the first 3-4 weeks vs. non-weight bearing, and the prior would be a huge convenience to me given that I have a little one at home.

I'd recommend Drs. Mark Reed or Jeff Christensen. Best of luck.

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

Hi, I am really interested in your case. Did yours ever heal properly without surgery?

I have had an injury for months with several different dx and am so frustrated.

1st MRI in December 2022 states soft tissue inflammation. Podiatrist saw bursitis. I have been wearing a met. pad and have Hoka Bondi's.

X-ray in June 2023 negative for fracture and 2nd met. not longer than1st.

2nd MRI in July 2023, no change still soft tissue inflammation. All signs point to no neuroma.

Had diagnostic US and 3rd podiatrist stated effusion next to 2nd MTP tendon.

I have read that MRI's may miss plantar plate tear. I also do not have a toe that is swaying nor do I have a bunion. I don't want to chase an issue that is not there but just confused as to where to go.

I was advised to try EPAT 3x's and Amniotic injection for tenosynovitis based on US results. Was told that these are 85% in fixing my issue.

I am in Boston and would certainly travel to CA. to NOT have a feeling like walking on a pebble behind 2nd. met. head.

I have a call into Dr. Kirby's office as I am desperate at this point.

I was diagnosed with a plantar plate tear in July 2021 (no MRI, just based on the professional opinion of my sports med guy). He put me in insoles with the met pad for pretty much anytime I was on my feet and I could NOT be barefoot and walking at any time. (which made my 200 hour Yoga Teacher Training class super fun b/c the lead instructor freaked out over the thought of me needing to wear shoes).

eventuallly, the pain has lessened. I can practice yoga barefoot and am ok walking barefoot on hardwood floors for short amounts of time. I only wear the met pad insoles for running / cycling. Foot pain is nearly gone.

Ugh. When you say eventually, it sounds like months to years potentially, based on strictness of Dr. orders. I put myself in Cam Boot and believe it or not, I may order a chair for the shower. I have tried Oofos sandals but they also hurt.

yeah, eventually means probably about 2 years. (not based on Dr orders, just based on symptoms)

My wife thinks I’m crazy for ordering a shower chair. I’m at the point I don’t want to put any pressure on the area.

Was yours a complete or partial tear?