This article focuses on the plantar plate, a commonly overlooked yet prevalent injury.

One cause of crooked toes is predislocation syndrome, which occurs when the plantar plate elongates. In more severe cases, when the plantar plate ruptures, it is known as a plantar plate tear.

The plantar plate is a strong ligament located on the bottom of the foot that stabilizes the toe joint, especially the second and third toes. When this ligament becomes stretched or torn, the toe may gradually shift upward or sideways, sometimes forming a “V-sign.”

Common symptoms include:

• Pain in the ball of the foot
• Swelling around the joint
• A sensation of walking on a small pebble

If left untreated, the toes may continue to drift, and symptoms can worsen over time.

What Causes a Plantar Plate Injury?

1. Excess Pressure on the Ball of the Foot

Repeated pressure on the front of the foot is the most common cause. Activities involving walking, running, or jumping can overload the toe joints and strain the plantar plate. Repetitive upward bending (dorsiflexion) of the toes contributes significantly.

2. Foot Structure

Certain foot shapes increase stress on the plantar plate, including:

• A long second or third toe
• High arches
• Flat feet
• Short first metatarsal (Morton’s foot)

3. Bunions

Bunions can push the big toe inward, reducing its efficiency during walking. This often leads to a “low-gear push-off,” where smaller toes take on more pressure than they are designed for.

4. Tight Calf Muscles

Tight calves can limit ankle movement, increasing pressure on the forefoot during walking.

5. Improper Footwear

Certain shoes can contribute to plantar plate injuries, such as:

• High heels
• Tight or narrow shoes
• Shoes with little support or flexible soles

6. Toe Deformities

Conditions like hammer toes or claw toes alter pressure distribution across the forefoot, increasing stress on the plantar plate.

7. Aging and Tissue Wear

Over time, ligaments naturally weaken, making them more susceptible to injury.

Plantar Plate Injury: Treatment Options

Treatment focuses on reducing strain, supporting the foot, and restoring strength.

1. Footwear Changes

• Wear shoes with a wide toe box
• Use stiff-soled or rocker-bottom shoes
• Avoid high heels and overly flexible footwear

2. Padding and Offloading

• Metatarsal pads reduce pressure under the ball of the foot
• Toe separators help maintain alignment

3. Taping or Splinting

• Helps hold the toe in a better position
• Reduces strain while walking

4. Custom Foot Orthotics

• Redistribute pressure across the foot
• Support the arch
• Address individual biomechanics

5. Strengthening and Stretching Exercises

• Short foot exercises for arch strength
• Toe spreading and towel scrunches
• Calf stretching to reduce forefoot pressure

6. Activity Modification

• Limit high-impact activities
• Gradually return to normal activity

7. Medical Interventions

• Referral to an orthopedic specialist if needed
• Corticosteroid injections for inflammation
• Surgery in severe or chronic cases

8. Recovery Tips

• Early treatment improves outcomes
• Avoid barefoot walking on hard surfaces
• Use recovery sandals indoors
• Stay consistent with footwear and exercises

Final Thoughts

Early recognition and proper care are key to preventing crooked toes from worsening. Simple steps like wearing supportive shoes, using orthotics, and performing strengthening exercises can make a significant difference.

If you notice persistent pain, swelling, or your toe starting to drift, seek professional assessment. With timely intervention, most plantar plate injuries can be managed effectively—helping you maintain comfort, mobility, and healthy feet for years to come.

Traditional foot orthotics support and stabilize the foot to improve skeletal alignment and reduce pain. They are described as passive support in the sense that the orthotic is doing the work of correcting the foot by supporting the ligaments and bones. Traditional orthotics also work to distribute weight more effectively across the sole to alleviate pressure or impact related discomfort.

Sensorimotor orthotics aim to correct improper foot alignment by stimulating the muscles in the feet and lower legs. This stimulation causes the central nervous system to respond by relaxing or tensioning the muscles accordingly. This muscle activity works to improve joint alignment, thereby reducing pain. This is a significant difference from traditional foot orthotics in that sensorimotor orthotics provide more of an active support as the muscles are trained to function more effectively. In some cases this even allows for long-term correction of the biomechanical issue through the improvement of muscle function.

Traditional foot orthotics have been helping people reduce their pain and increase their activity level for decades, and for many people, they will continue to be an important part of their treatment plan. For some people, sensorimotor orthotics provide a viable alternative, one that has particularly exciting applications for children and people dealing with neurological conditions. This includes stroke patients as well as those suffering from Multiple Sclerosis, Parkinson’s Disease and other conditions.

An assessment with your Canadian Certified Pedorthist can help determine which treatment option would be best for you. Call Soles in Motion and book a mini-assessment to find out what is best for you.

Written by Canadian Certified Pedorthist Graham Gilbert

• Aetrex Flips – best indoor slipper with extreme cushioning, shock absorption and durability.  They have an arch support to help stabilize and align the feet and a metatarsal support to help reduce the ball of the foot discomfort
• OOfus  Sandals – known as the recovery sandal made with OOfoam technology absorbs impact and gives the perfect blend of cushion and stability.  They support the arch to reduce energy exertion in the ankles.
• Asics, Brooks, New Balance and Saucony are our top athletic brands and all have technology-specific to them for cushioning, support, stability and motion control.  Every style of every brand has unique qualities that are designed to help you perform better and recover faster.

The most important thing is to come in and be measured, let us watch your gait and try on as many styles as you like to see what makes your feet feel amazing.

And just a little more information, we have a 3D scanner named ‘Albert’ that will digitally scan and take pictures of your feet to determine not only the pressure points but the arch length, foot differentiation, instep girth and recommend solutions.  And best of all we have an amazing staff of experienced footwear specialists, two Canadian Certified Pedorthists and two bracing specialists!  Keeping you educated is on us!  

Come on into Soles in Motion, 133 Baker Drive, Dartmouth!

-Submitted by Jen Estabrooks, Co-Owner, Certified Brace Specialist

Custom-made orthotics provide individual correction specific for your foot problem. There are different types of orthotics. Functional orthotics are used to correct problems with a person’s foot mechanics such as overpronation (the foot rolls inward) or supination (the arch is too high and the foot rolls outward) Accommodative orthotics are designed to fit and protect the foot generally from where it functions via cushioning and specific unloading and to relieve pain and pressure in the foot. They improve tolerance for the weight bearing tasks of daily life and typically used with diabetic patients.

Generally speaking, your feet should NOT hurt. Pain indicates that something is wrong. Come in and see us at Soles in Motion and experience how we come up with the right solution for your individual needs.

Submitted by Jen Estabrooks, Co-owner, General Manager, Soles in Motion, 121 Ilsley Avenue soon to be moving to 133 Baker Drive, Dartmouth 902-468-7911 (solesinmotion.ca)

Happy Walking!