Flexor (Plantar) Plate Strain

A form of metatarsaglia, a Flexor Plate strain is also known as a Capsular stretch

Flexor (Plantar) Plate Strain / Capsular stretch - Diagnosis

Flexor plate strains seem by far the most common condition to cause metatarsalgia. Symptoms usually start with vague discomfort under the ball of the foot in certain styles of shoes and/or longer walking distances. The narrower the toe box of the shoe, the higher the heel or the thinner the sole of the shoe, the more likely the symptoms will start.

Most commonly the symptoms are associated with the area where the 2nd toe joint joins with the ball of the foot (2nd metatarsophalangeal joint (MTP)), but the 3rd is also quite commonly affected, the 4th toe rarely. If left untreated symptoms gradually deteriorate and the pain will come on more severe in more styles of shoe and at less walking distance. As the pressure on the metatarsal head increases due to the soft tissues not doing their job correctly, it can start to feel bruised a bit like a stone in the shoe. Even barefoot walking on a hard floor starts to hurt, and the lumpy surfaces placed in front of crossings for the blind to feel can be particularly irritating in thin soled shoes.

You may start to notice callus developing under the tender area, although some people will have developed callus first, often years ahead of the deeper pain they have now developed. Also the timing of toe deformities varies. Some people start noticing changes in the position of the toes before the pain, others the toes look normal even after the pain starts. The reason for the variation in this phenomenon is not yet known.

Flexor (Plantar) Plate Strain - Treatment

Early symptoms can often be settled easily by just avoiding certain shoe styles! Choose shoes with cushioned soles, heels less than 1.5” (3cm) and pick a wide toe box. Lace-up shoes are certainly the best shoes to allow you lots of space for your toes. However, even if by changing the shoe solves the pain, consider this forefoot pain is a warning shot.

You probably should start to make an effort to strengthen your feet and vary your shoe style more.If the pain doesn’t settle or gets worse despite the shoe style change, try the exercise regime attached to this website.

If you are getting pain even in your lace up shoes, try our Healthystep Inlay which should reduce the pain at the very least. If you continue to experience pain in the lace up shoes with the Healthystep inlay we strongly recommend you see a clinician/therapist experienced with dealing with metatarsalgia.