Plantar Plate Tear
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
A plantar plate tear is damage to a strong band of tissue under the joint at the base of a toe. It is a common cause of pain in the ball of the foot, most often at the second toe, though it isn't clear exactly how many people have it. The pain usually builds slowly, and it can feel like walking on a stone. The toe may drift upwards or sideways, or start to curl. Finding it early and using simple care, such as rest, taping, supportive shoes and padded insoles, can help you get back to your usual activities and avoid surgery. Left untreated, it can lead to a deformed toe.
What is it?
The plantar plate is a strong band of tissue (a ligament) under the joints at the base of your toes. It anchors each toe down and stops it drifting upwards. It also helps keep the toe joint steady when you put weight on your foot.
A plantar plate tear is damage to this band. The tear can be partial, which means it goes part of the way through, or full, which means it goes right through. You may also hear it called a plantar plate injury, or toe joint instability.
A tear can happen in any toe, but the second toe is the one most often affected. The third, fourth and fifth toes are rarely involved.
Who does it affect?
A plantar plate tear is a common cause of pain in the ball of the foot. It isn't yet clear how many people are affected overall. Most of what is known is about adults.
Tears are often missed. The pain is not very specific, and it looks like many other causes of ball-of-foot pain. That is one reason it is worth having ongoing pain assessed rather than guessing the cause.
Signs and symptoms
The usual first sign is pain in the ball of your foot, often under the joint at the base of your second toe. It often comes on gradually. You may feel as if you are walking on a stone or pebble, and pushing up onto your tiptoes can hurt.
You may also notice swelling or redness around the joint. As the plate weakens, the toe may drift upwards or sideways, or it may suddenly start to curl (a clawed toe).
What causes it?
Most tears develop slowly. Repeated overload wears the plantar plate and weakens it over time. Sometimes a tear happens suddenly with an injury.
Things that can add to the load on the plate include:
- a sudden or recent change in activity, such as more running or jumping
- high-heeled shoes
- foot mechanics that put extra load on the ball of the foot
- long periods of standing, walking or running, especially after a sudden increase
- narrow or thin-soled shoes
Other problems that go with forefoot pain include bunions, hammer toes (toes that bend at the middle joint), inflammatory arthritis such as rheumatoid or psoriatic arthritis, and an earlier foot injury. How much each of these raises your risk of a tear hasn't been measured.
Steroid injections near the toe joint are linked with further weakening of the ligaments that hold the joint steady. It isn't clear whether they cause tears, but they shouldn't be treated as risk-free.
How is it diagnosed?
Diagnosis is mostly based on your story and an examination. Your podiatrist will ask how and when the pain started, how long you've had it, whether it is changing, what it stops you doing, and whether the toes have changed shape. They will look at your toes while you stand and while you rest, and press on the ball of your foot.
They will also do a hands-on test of the toe joint, called the drawer test. They gently move the toe up and down to check how steady the plantar plate and the joint capsule (the tissue around the joint) are.
Because many conditions cause ball-of-foot pain, your podiatrist may also think about a nerve problem such as Morton's neuroma, inflammation of the joint lining or of a small fluid sac (bursitis), a stress fracture, an infection, a problem with the blood supply to the bone, or arthritis. Imaging or blood tests are sometimes used to check for these.
Treatment
Care usually starts with simple, non-surgical steps. How well each step works compared with the others isn't clear yet, but together they can settle the pain and protect the toe.
Looking after it at home
If the area is red, hot or swollen, rest until the inflammation settles. This typically takes around 6 to 8 weeks. Walk less where you can, and avoid high-impact activity such as running and jumping. Swimming is a good choice because no weight goes through your foot.
Wear a firm, supportive shoe. The ideal is a firm trainer or a walking boot. Avoid high heels and very soft, unsupportive shoes.
Simple padded insoles and metatarsal pads (small pads that sit just behind the ball of your foot) can be bought from a chemist. They can take load off the plantar plate and often reduce pain.
Treatment from your podiatrist
Your podiatrist may tape your toe down. This is called anchor taping. It takes load off the plantar plate and stops the toe drifting upwards. If it is done early enough, the plate may heal without the toe changing position.
If simple insoles and pads don't reduce your pain, your podiatrist can make custom foot orthoses (shoe inserts made for your feet).
Your podiatrist or physiotherapist can also show you how to stretch your calf muscles, which can reduce the pressure on the ball of your foot when you walk. They can also show you how to strengthen the muscles that bring your toe down to the ground. Which exercise programme works best isn't clear yet.
Other options
Splinting, offloading and injections into the joint can ease symptoms. Once the problem is advanced, though, they are not effective.
A steroid injection can reduce inflammation, but it is linked with further weakening of the ligaments that steady the toe joint. Talk through this risk with your doctor before agreeing to one near the joint.
Surgery
Your GP or podiatrist will refer you to a foot and ankle specialist if simple care hasn't worked, if the cause of your pain is still unclear, or if your symptoms are getting worse. Repairing the plantar plate with surgery is the main option at that point. Reliable figures on how well repair works aren't available yet, and neither is a clear point at which surgery should replace continued non-surgical care.
If surgery is suggested, ask about the risks and benefits, and how long recovery may take.
Recovery
Finding the problem early makes a real difference. Early care, including resting the joint and then returning to activity gradually with taping and metatarsal pads, can help people get back to their previous level of activity and avoid surgery.
Delay can make things harder. Without treatment, the pain can get worse and the toe can become deformed. A toe that has dislocated can become arthritic and harder to realign with surgery.
How long recovery takes without surgery isn't clear yet, and it can vary from person to person. Ask your podiatrist what to expect in your case.
Preventing it
It isn't yet clear whether changes to footwear or activity stop a tear coming back. Sensible habits are still worth following, because they take load off the ball of your foot.
- Build up running, jumping and time on your feet gradually.
- Avoid high heels, and shoes that are narrow, thin-soled or very soft.
- Keep wearing supportive shoes after your symptoms settle.
- Use taping or metatarsal pads if your podiatrist advises them when you return to sport.
- If you have a bunion, hammer toes or inflammatory arthritis and start to get pain in the ball of your foot, have it checked.
When to see a podiatrist
Book an appointment if
Book an appointment with your podiatrist if you have pain in the ball of your foot that is stopping your normal activities, getting worse, or coming back. Book too if it hasn't improved after 2 weeks of home care, or if your toe is drifting upwards, sideways or curling. Don't wait it out, because a tear that isn't treated can lead to a deformed toe. Go back to your podiatrist or GP if simple care isn't working, or if the cause of your pain is still unclear.
Seek prompt assessment if
If you have a foot wound or infection and you also feel very unwell, with confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine, this could be sepsis: call your local emergency number.
See your GP or another doctor today if you have severe pain, swelling and bruising and can hardly move your foot, because a bone may be broken. Don't try to treat it yourself. See a doctor today too if the pain came on suddenly after an injury and you can't use your foot properly, because a tendon may have torn. The same goes for redness, warmth, swelling or a fever in the foot, because these can be signs of infection. If you have diabetes, see a doctor today if you notice a new wound or spreading redness on your foot. If your GP can't see you today, go to an urgent care clinic or an after-hours GP.
See your GP or podiatrist soon if your foot pain comes with tingling or loss of feeling. If you have diabetes, see your GP or podiatrist soon about any foot pain, because foot problems can be more serious.
Frequently asked questions
Why is my second toe drifting up or curling?
The plantar plate holds your toe down and gives it much of its stability. Once it is damaged, the toe can lift and may start to curl like a claw. Getting it assessed early gives you the best chance of stopping the change in shape, and taping can help if it is started early enough.
Will I need a scan?
Not always. The diagnosis is usually made from your story and a hands-on test of the toe joint. An MRI can help if the diagnosis is still in doubt. An X-ray is used if a bone problem is suspected, and an ultrasound may be used to look at the joint capsule or inflammation. Blood tests are used if infection or inflammatory arthritis is suspected.
Is it the same as Morton's neuroma?
No, but they can feel alike. Morton's neuroma is a nerve problem in the ball of the foot, with redness, swelling and a dull aching pain. A plantar plate tear can also cause swelling and redness, so it is hard to tell them apart yourself. Your podiatrist can examine your foot and work out which one fits.