Plantar Plate tears are an often overlooked and misdiagnosed sports injury.  We assume competence in our doctors ability to critically think and accurately diagnose are condition.  In this case not only did the doctor misdiagnose the torn plantar plate but missed 2 stress fractures in this patients foot declaring the MRI clear!  Luckily for the patient the MRI report showed up just as they were leaving……proving the doctor incompetent.

Doc please help!,

While playing soccer (I played through college and continue to play on a women’s team-I’m 38 years old), I was slide tackled and kicked in the foot by another player attempting to shoot after I had already slid and cleared the ball away (essentially she “shot” my foot). My foot both received trauma of being kicked and more importantly was hyperextended. I immediately felt burning pain and hopped off the field. I had an X-ray the next day, which was negative for a fracture and was told to use a wood-soled post-op shoe to allow the “sprain” of my foot to heal for several week. I did this, and following the first three weeks, prior to heading out on a two-week trip to Australia, I went to a podiatric foot and ankle clinic where I was given a cortisone shot at the doctor’s advice essentially for pain management and was told time would heal whatever issue was happening. I went to Australia, I did some walking but always in the type of shoes that I had been told to wear (solid soles, roomy toe box, roll through a step to minimize bending at 1st MTP joint.

I came home from Australia two weeks later and by this time, all bruising and much of the swelling had disappeared (it had bruised and swollen all around the joint where your big toe meets your foot and down to the arch). Thinking I was on the mend, I continued to stay off of the foot (missing match after match of soccer and tennis and having to skip yoga and going for a jog or walk all together), more swelling dissipated until I was really left only with very localized swelling. However, upon trying to walk completely normally I was get a burning pain under the MTP joint. Attempting to jog was like being stabbed in that spot. 

I went to a recommended orthopaedic foot and ankle specialist, and he expressed concern of a plantar plate injury at my big toe. He took another Xray, this time of both feet to compare the position of my sesamoid bones, and as he expected there was noticeable retraction of the sesamoids in the right (injured) foot. This was now 11 weeks post-injury. He sent me for a MRI of the foot, which I had. 

Nearly a month later I returned for further consultation (I had a long fight with my insurance company about the MRI–very hard to get approved), and the orthopaedic team’s read of my MRI was that there was no tear, just swelling. Hmmm….confusing but seemed like better information. As I was walking out of the exam room, the radiologist’s report arrived. Ooops! The actual read of the MRI is that there is a near complete tear of the plantar plate in the 1st MTP joint AND two stress fractures in the 2nd metatarsal (which had never been mentioned and frankly I was less worried about but how were they still present after 3 months of inactivity). I was told to “rest” for another two months and come back. 

I am now 16 weeks post-injury with very little information and even less hope on how to treat this injury as all I have read is frankly dire. Surgery seems to have unpredictable results. No one seems to know how to “treat” the injury, and I feel like I am doing nothing about it. My desire is to return to the things I love to do as I am 38, not 75, and I do not see how just doing nothing forever is much of an option. I’m getting desperate for any information and am looking for someone who actually knows about this injury. Anything would be helpful–thanks in advance!
The stress fractures will heal over time…..the plantar plate tear will not.  A “near complete tear of the 1st MTP” is serious but it can be fixed without surgery.  I have helped many patients all over the country with injuries like yours.  What you need is a specific plan to help the ligament grow and reattach.  This will require a very strict and precise protocol that will take roughly 8-12 weeks (probably closer to 12 realistically).  If you would like my help and expertise please fill out this new patient form and respond to my email.  I will have a secure invoice sent to you and we can set up a phone consultation.  Following our consult I will email you a very specific plan from A-Z which will outline exactly what you need to do.  By the way the Orthopedic “Specialist” you saw is a knucklehead and almost sent you on your way by completely missing everything there was to see on your MRI.  Whether you choose to allow me to help you or not you need to run far away from that incompetent Dr.

If you send me a chronological history

anything you tried that helped or hurt

any MRI’s, X-rays etc

I can review everything and offer you a phone consultation.  The cost is $237 and afterwards I will send you

  1. a written treatment plan
  2. any necessary video rehabilitation tutorials