Failed Plantar Plate Surgery…now what? Don’t worry there is still hope!

//Failed Plantar Plate Surgery…now what? Don’t worry there is still hope!

Hey Doc please help,
22 years old, thought I’d have chronic pain forever, it got worse. Doctor took interest, diagnosed plantar plate tear. Pain getting worse each day post-op. Same old distinctive pain. Please please please please please tell me there are other answers if the surgery doesn’t work!!!
From your description could have;
1. Mortons Neuroma
2. Plantar Plate Sprain/Tear
3. Capsulitis
4. Metatarsalgia
5. Stress Fracture
It is unfortunate that you have gone through surgery without resolution of the pain. This implies that either the surgery was not successful or that either the diagnosis was incorrect OR you have an overlapping condition. Either way there should be an answer.
If you could provide me with a few things I will be able to help you via a phone consult. The cost of this is $150 and afterwards I will provide you with a detailed plan. Can you email me;
1. Provide me with any x-ray or MRI reports. I do not need the actual images just the reports
2. Take a picture of your feet looking down at them while sitting and then again standing
3. Mark the Painful spot and take a picture of those
4. Send me a chronological list of when the pain started, what if any therapies you did either at home or at a therapy office. This would include such things as orthotics, icing, stretching, injections etc culminating in the surgery
5. What if any shoes are better or worse. Take a picture of those for me
6. Pictures of any orthotics or braces or pads you used or currently use
After I receive all of this I will contact you via email to set up the phone consultation. It will take approximately 1/2 hour and as I said following our call I will send you a very detailed plan on how to start healing this painful condition.
I have helped hundreds of people overcome this problem including myself. I partially ruptured my second plantar plate years ago. While it did take me 4-5 months to completely heal it without surgery I recovered enough that I have run and continued to run multiple 50 and 100 mile running races and continue to train and run 40-50 miles a week without incident.

Plantar plates can tear due to repetitive use such as running or overstretching which can happen in sport or even in yoga.

stretched plantar plate





Here is an illustration showing why your toe will deviate with a plantar plate tear

collateral ligament tear toe





Here is what a damaged plantar plate toe looks like looking down at your feet. Notice the deviation of the right second toe towards the big toe even though it is taped.

Notice the second toe deviating towards the big toe

Notice the second toe deviating towards the big toe

By | 2016-01-13T05:46:03+00:00 January 13th, 2016|Running Injuries|6 Comments

About the Author:

Dr. Runco is a U.S. Navy and Gulf War Veteran. He began private practice in 2000 primarily treating and fixing running injuries. He has been a professor of Anatomy, Physiology, and Biomechanics at various colleges and continues to teach continuing education in the fields of rehabilitation, custom orthotics and athletic taping. He is also a member of the American College of Sports Medicine, National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist. He has completed over 15 Marathons in 15 states and has run 11 50 mile Ultramarathons.


  1. Miriam February 5, 2016 at 8:45 pm - Reply

    Hi Dr. Runco

    I have been in pain with my right foot for over 1.5 years. I was first diagnosed with capsulitis, then received a cortisone shot and finally able to receive an MRI 8 months ago and diagnosed with a plantar plate tear and received another cortisone shot, as the first one only lasted one month. This last shot has lasted 6 months and the pain is coming back with a vengeance.

    I was told the only treatment was surgery, but am concerned that I may have a different type of pain with surgery and to be honest, was informed by one of the resident’s I work with to get another opinion. So here I am searching the web and came across your website.

    I would like the opportunity to speak with you about treatment options. I used to work out and now d/t the pain returning am finding it difficult to get back into my routine again.

    I will obtain copies of the MRI report; take pictures of my foot, which looks a lot like the pics your provided. The ball of my foot is swelling considerably and my toe is deviating more towards my great toe.

    I am desperately seeking help!


    • Dr. Runco February 8, 2016 at 6:29 am - Reply

      Hi Miriam,
      I can certainly help you. Email me directly at with all the information and I will schedule a consultation for us. No more cortisone please.

  2. Molly May 27, 2016 at 11:15 am - Reply

    Dr. Runco,

    I recently got an MRI on my right foot, am slightly confused by the results, and hoping you can help! I’m a collegiate runner; I broke my fourth metatarsal last fall while training and had been suffering with plantar fasciitis since starting up again this winter. I’m coming off of a 9 week break from running, so I decided getting an MRI would be wise before I start up again. Mostly everything is looking healthy, but there are a couple medical descriptions that I’m not entirely familiar with.

    One of them reads- Osseous: mid diaphysis in region of prior fracture shows superior cortical thickening, mild intramural hyper intense T2 signal (I’m not sure what mild intramural hyper intense T2 signal means exactly)

    For the IMPRESSION it reads- Fourth metatarsal remote fracture shows nearly healed appearance. Cortical thickening and some marrow edema remains. No aggressive features.

    In your professional opinion, do the results from this report make it seem like it would be okay for me to slowly start training again?

    I’d really appreciate your input!!

    Thank you,


    • Dr. Runco June 1, 2016 at 1:47 pm - Reply

      The break was last fall so the bone should be healed…unless something prevented it from healing. The MRI report is…well…..probably not accurate. You could get a second read by a different radiologist if you like but their description is consistent with a healed fracture

  3. Beverly Dyer June 14, 2016 at 8:14 am - Reply

    Dr. Runco,
    I’ll make this short:
    1 year foot pain thought to be stress fracture
    MRI arthrogram confirms plantar plate tear
    I work 2 days a week as a nurse and am on my feet 8 – 10 hours.
    I have an appt today with an orthopedic foot specialist.
    How long will I need to be off work to strive for conservative treatment?
    I am taping and exercising in the pool.
    Thank you,
    Beverly Dyer, MSN, RN

    • Dr. Runco June 14, 2016 at 2:58 pm - Reply

      Depending on the degree of tear will depend on the management and the time frame for healing. In my experience ligaments require much more time than say bone… have probably heard the phrase “you would have been better off breaking it”.
      In my experience a combination of healing interventions, immobilization and sound rehab principles need t obe applied if one wants to avoid surgery. I can elaborate on what I mean exactly after you see the ortho email me directly at

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