Flexor (Plantar) Plate Ruptures
Sudden sharp foot pain can be caused by ruptures in the metatarsophangel area of the foot's flexor plate.
Flexor (Plantar) Plate Ruptures / Joint Capsule tear (Pre Dislocation Syndrome)
Very sudden sharp onset of metatarsalgia is often caused by rupture of the metatarsophalangeal joint tear or rupture of the flexor plate. This often accompanied with a toe suddenly spreading away from its neighbour towards the other, suddenly drawing upwards, or a combination of both.
Recent studies with Magnetic Resonance Imaging (MRI) has shown that metatarsophalangeal joint tears are most common at the distal lateral border of the flexor plate. With this injury it is common for damage to occur with the adjacent interosseous muscle tendon. The interossei muscles make sure toes move straight up and down. It they become damaged the toe it associates with will tend to pull up and away from its lateral neighbour. This causes what we politely call a ‘Y’ sign, although it looks like a ‘V’ really, as the toes spread away from each other.
The flexor plate itself can also rupture, but this is less common. Both injuries cause a loss in the ability for the muscles to keep the toe stable, and the result is the toe starts to dislocate upwards or upwards and to one side. Left untreated the toe can completely dislocate and start to be pulled up over the top of the foot.
Flexor (Plantar) Plate Ruptures - Treatment
Once this dislocation has happened the only way to put it back is surgery and that is not easy.
However the pain on the forefoot can still be helped by following advice on flexor plate strains. If you notice your toes changing shape see a clinician or therapist experienced in metatarsalgia.