I recently interviewed a new patient who had a 3 month history of pain in the ball of her foot near where the second toe meets the foot.   In anatomy speak we call this the Metatarsal region.  She struggled with this pain and eventually saw a podiatrist who told her she probably had Capsulitis and recommended expensive custom orthotics.  She chose to not go down that path and her problem worsened.  She then saw an Orthopedic Surgeon who ordered an MRI.  The MRI report came back showing a torn plantar plate along the lateral border of where the second toe meets the metatarsal bone.  To her astonishment the Orthopedic Surgeon said he did not know what the injury was as he had no experience with it.  She then called both her brother and father who are both orthopedic surgeons in other states.  To her dismay they too said they had little to no experience with this injury.  Though confused by this information she was determined to find out what a torn plantar plate was all about and what could be done to fix it other than surgery.

After scanning around the internet she found my webpage that explains plantar plate tears (http://www.sdri.net/running-injuries/plantar-plate-sprains/).  She quickly realized that I knew what this injury was and also how it could be corrected (better yet…my old business partner tore his plantar plate  years ago and fixed it without surgery.  In fact the follow up MRI 2 years later did not even show so much as a scar and he has  run multiple 50 mile Ultra Marathons since!).

Because she lived out of state she arranged a phone consult with me.  During the phone consultation I was able to correct the way she was taping it for proper alignment, advise her on the best type of tape to use, advise her on the type of shoe that would most likely help her foot the most, advise her on to properly place metatarsal supports on the existing insoles in her shoes thus avoiding custom orthotics and the expensive fees that accompany them as well as advise her on all of the treatments that would be both  appropriate and not appropriate for her condition.

This patient is going to get better and never need surgery. How do I know that?  Over the years I have diagnosed and treated hundreds of patients with plantar plate tears, neuromas, capsulitis, synovitis and stress fractures in the metatarsal region.  Because of this I have become better (that is why they call it being in practice) at not only recognizing the conditions and how to differentiate them but also how to treat them so that they improve and heal without surgery.  It is extremely common for me to examine patients that have been misdiagnosed and undertreated for their condition by well meaning, misinformed doctors that simply did not know what to do with this injury.

If you are struggling with foot p