The plantar plate is an area under the metatarsal heads of the foot on the base of the joint capsule that encapsulates the joints of the lessor toes. The plantar plate is a robust ligament system which offers firmness to the metatarsophalangeal joints and also is a connection portion of various other ligaments which surrounds these joints. At times that powerful ligament will get overused, which typically gets labelled plantar plate dysfunction. From time to time this may well develop to a minor split in the ligament and will become really painful to walk on. This is whats called a ‘plantar plate tear’. It’s a reasonably frequent musculoskeletal injury of the foot.
Commonly, it is painful under and just distal to the metatarsal joints to walk on and also when the area is palpated. When weight bearing the toe of the affected metatarsophalangeal joint is sometimes a bit elevated. There are a few distinct examinations or moves that health professionals can perform to the toe to test the integrity, function and strength of the plantar plate and also to determine just how extensive the partial tear is actually. The main cause of a plantar plate tear is not generally really apparent, however there are a variety of risk factors that do increase the possibility of getting it, however typically it is due to too much use with an excessive amount of dorsiflexion of the joint. A strange discomfort that some with this concern describe can be a feeling of their sock bunched up under the toes, however when they check out it’s just not.
The easiest way to deal with a plantar plate tear is to have the diagnosis accurate. It is obvious clinically. An ultrasound evaluation can be used to decide the magnitude with the tear and confirm the diagnosis. The typical primary therapy strategy is to use strapping for a plantar plate tear which is designed to hold the toe in a plantarflexed pose to restrict the amount of dorsiflexion with the joint when walking. A metatarsal dome which is positioned just posterior to the sore region could also be helpful to help minimize the load. A firmer or more rigid soled footwear or footwear with a rocker can also be used to help limit the stresses on the toe. Should this is done properly, this plantar plate tear should typically get better gradually. In the event it does not work then a surgical fix with the tear is usually an option.
Bunion correctors are a night splint or brace that are supposed to straighten the big toe when there is a hallux valgus present.
There is a lot of debate and discussion if they actually work or not. Opinion is divided and the research evidence for them is sparse. One study does show they they do help a small amount in the short term, but no research has looked at them over the long term.
The reason for the divided opinion is that a lot of force from the biomechanics and shoes during the day time goes into producing the valgus position of the toe and how can a splint just worn for the night over come that? Any good done during the night is likely to be undone the next day walking around. Obviously more research is needed to sort this put.
There is some commentary that they are still beneficial to use even if they do not correct the toe by much as they will keep the toe and joint mobile and flexible, which has to be a good thing.
In Australia, they call thongs what the rest of the world call flipflops. In Australia, such footwear is an important part of the lifestyle, so for those that need to wear foot orthotic, they either do not wear them or they do not wear this type of footwear. That is where these Archies Thongs come in. They were developed in Australia to provide some sort of arch support on a thong or flip flop:
They have about 2.5cm of arch support in them which is very similar to what most prefabricated or over-the-counter orthotics have in them, so they are a viable alternative or adjunct to foot orthotic therapy.
The Archies Arch Support Thongs are selling well in Australia and are highly recommended there by Podiatrists, who a lot of them use them for themselves and their families. For more on the Archies, see these links.
Pronation is a normal health motion of the foot when the ankle rolls inwards. Overpronation is an issue when there is too much of it. There is a lot of debate as to if overpronation is a problem or not and there is a lot of misunderstanding about the use of the term, especially in the running community where the amount of pronation is widely used as the decision making process for the prescription of running shoes. There is not a lot of support for that model, but it is still widely used. There are also a lot of people who overpronate and do not have problems and there are a lot of people that only overpronate a small amount and have significant problems. There are plenty of products for this such as foot orthotics and other types of interventions.
Chilblains are a common problem of the toes in colder climate. They are not exactly caused by the cold, but more by a too rapid warming after the skin get cold. The chilblain occurs when the blood vessels do not open up as rapidly as they should to supply blood and remove waste products from the skin. The chilblains is an inflammatory reaction to that build up of waste products Even though they are small, the chilblain can be quite painful and is also itchy. They start out as a red colored lesion, then develop into a darker blueish color as they become more chronic. The best treatment for chilblains is prevention, by not letting the feet get cold.
The toning shoes were all the rage a few years ago and still continue to be popular. The purpose of the toning shoes is to give the body and extra workout when wearing them. They achieve this by having features on the shoes, such as a rocker bottom that makes the muscles work hard as the shoes are unstable. There is certainly debate if this actually happens or not and if this is beneficial or not and there has been a number of legal settlements as a result of the marketing claims and hype not matching the scientific research. Having said that, many people find them useful and swear by them. Others don’t like them.