If you follow college football the way I follow college football then you will likely have no idea what I’m talking about, because I really don’t follow college football.  I do, however, follow college football ball of foot injuries, such as the one suffered by Taylor Martinez of Nebraska.  News emerged this week of Taylor’s injury, which apparently has been a problem for some time, and now has finally been determined to be a plantar plate tear of the second metatarsophalangeal joint, incorrectly defined in the media as a “ligament tear”.  So, let’s talk about this so-called plantar plate tear and how it affects the patients of my NYC podiatry practice.

As we’ve previously discussed, the metatarsal bones are the long bones of the foot, and the heads of the metatarsals are what comprises the bony structures in the ball of the foot.  Injuries and chronic pain in the area are very common, in what we like to describe as “Manhattanitis” and can also occur in conjunction with, or be confused with other foot maladies such as stress fractures and neuromas.  On the bottom, or plantar surface of the metatarsal heads, exists a soft tissue structure known as the plantar plate, which is a thick disc of connective tissue that serves to cushion the area and maintain the integrity of the interface between the metatarsal and the toe.  (zzzz… yes, I know, it gets better).  In some patients the plantar plate, most commonly in the second toe, develops a tear, either due to acute or repetitive trauma.  Over the past few years, this type of tear has been identified as a leading cause of an overlapping or elevated second hammertoe.  Based on what I’ve read, this seems to be the cause of the foot ball football injury in Taylor Martinez.

So far, the treatment rendered is pretty standard – immobilization, padding, orthotics and cortisone injections.  If these treatments fail, there are some novel surgical procedures that have been developed over the past few years to repair the tear.  And like all foot surgery, it’s considered a last resort.

So if you follow college football, or college foot ball, now you can sound that much more intelligent at parties.  And, along with saving lives, that is what my job is all about.

See you in the office.

Ernest Isaacson

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Ernest L Isaacson DPM PC
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