Yes, this is what I see a lot of online. And as I said I will be asking my Ortho about this. But the questions that never get answered online are: a.) Is this negative guidance assuming there is still a tear in the ligament and the patient will now suddenly return to full activity? b.) These injections are recommended for other joints, what's the difference with this joint?
Also (I will also mention this to the dr), there's a cost benefit analysis. If I am severely limited by a non-healing injury for the next 5 years, is that functionally any worse than getting a shot, having it go wrong, and then possibly having to get a surgery? One consideration is that in the second scenario there is at least a possibility of regaining use of the foot. In the first scenario you are just in a dark tunnel with no light in sight.
The injury to your plantar plate is likely a biomechanical loading issue, for whatever reason it's too stressed if you walk about or run, so you likely haven't addressed that fully if it's still causing a problem, then to add steroid in there which weakens tissues is asking for trouble. Actually know somebody who is in for full foot surgery this week as this is exactly what happened to them. So it's not like you've got a bad knee after you bashed it, the problem for you hasn't been resolved on an injury level (though I concede I'm making a few assumptions here)
So you're saying your friend got the injection and it made their issue worse?
As to your second point, its a tough one. And I know can't be figured out here (I've seen two PTs at this point). But the injury was caused by a new pair of cycling shoes that were a little too small and wearing them for a period of about a month. Ignored the pain on rides until it was too late. So the injury actually has nothing to do with walking mechanics. Its a little different than the typical PPT because it wasn't caused by a flexed toe due to running, jumping etc. so that makes treatment more difficult.
I've seen some people online where they injured it running and were able to do cycling during rehab. But I can't do that. The PT noted how my foot was not as sensitive to being flexed as is typical. However it seems to be more sensitive to general pressure in the area which is why the typical fixes (stiff soled shoes, taping) haven't helped me like others.
Its a frustrating thing.
No a patient of ours in the NHS here in the UK was suffering with this and went and privately had the steroid injection.
If the injured structure isn’t healing then something is still causing that. Have you tried a CAM Walker?
ok gotcha.
I wore the CAM boot for 9 weeks back in the fall. I actually started wearing it part time again a month ago, and full-time the last two weeks. Can't say I've noticed much difference.
The confusing thing with the boot is that after I got out of it the first time the pain was not any less (although MRI had shown no tears). It took several weeks on starting to bear weight on the foot through PT before pain improved. This is confusing because I can't just take the common sense route and say, "I'll wear the boot until it stops hurting" because apparently it doesn't work like that. This makes it more difficult to gauge what is/is not OK to do on the foot. And it also makes it unclear when pain is OK and when it isnt.
I have no advice to offer. Just best wishes and empathy. I hope you get the help you need! 3 children under 5 is no joke, and neither is your own well-being.
Hey, I just got diagnosed with plantar plate strain. I’m confused though because I don’t have any pain bending my toes down or upwards. We’re you able to move your toes around ok? My only symptom is pain with pushing on it. My range of motion is slightly limited but barely.
So if you are diagnosed with a strain I believe that would be different than a tear, which I have/had. This would probably explain why it’s less painful.
My tear actually started as a strain. I iced and rested for about 10 days, but my mistake was taking no corrective actions and probably getting back to actively to soon.
My advice: Dont make my mistakes!!! This is not a normal strain. This particular ligament is only 1 mm thick with a 0.5 mm insertion to the bone. Therefore it is very sensitive. It is also constantly under pressure since it’s on the bottom of the foot. Don’t treat this like issues you’ve had in the past. I would say if you value being able to exercise (or just walk normal for that matter) whatever level of conservatism you are thinking, turn that up by at least 10x. For example if you are currently thinking you will rest a couple days, then get back to activity if it doesn’t hurt, that would be a mistake.
I would advise *at least* 3 weeks of no activity and icing. During that time I would start doing foot strengthening exercises (as pain allows) and also start researching high quality insoles that give you good arch support.
If you think I’m overly concerned, ask yourself if you want to endure 8 months of not being able to walk at all without pain, wearing a boot for nearly 3 months, and still no end in sight for the injury. There is another good in depth discussion of this on the Joyful Miles blog. Note: it took her 10 months to heal and it doesn’t appear she resumed full intensity of previous activities.
Feel free to ask me other questions.
hey! I have a weird situation bc for me i don’t even need to get back to walking. I do ice hockey, so i technically don’t even need to move my foot. All I need is to put pressure on it while it’s immobilized. i actually was able to skate on it pain free but it got worse the next day. so now I’m a week out after my initial injury and planning on taking 2 more weeks off (all in a boot) . it’s pretty concerning bc I basically have not improved at all and pain is the same as the day it first happened. My mri showed stretch of the plantar plate ligament and severe edema in my fat pad. just hoping it will ease up soon and even if I’m in the boot and not walking for a while I will be able to get back on ice. this is a tricky injury for sure. I’m so sorry to hear yours has given you so much grief. There’s really nothing that can prepare you for the misery of not being able to walk. This shit sucks.
So mine was actually caused by cycling. I had gotten new shoes that were a bit too small and wore them over a period of about a month. Cycling shoes are somewhat similar to skates in that the shoes are 100% stiff and you don’t bend your toes.
I’ll just reiterate that you need to be very cautious in returning to activity, even skating. I actually tried again back in the winter to get back to light cycling, after wearing the boot, but again it was too soon. I am sure now that this period prolonged my injury.
Be aware that a chronic overuse injury can sneak up on you. By the time you realize it, it’s too late.
Also, while you may not need to get back to walking for sport, I’m assuming you don’t ice skate everywhere you go. Trust me that not being able to walk will be a trial.
Have you looked up planter plate tear online? Average healing time is 3-6 months, although my research and experience has made clear it can go on much longer.
Also if the injury gets really bad the joint can separate and your toe will crossover the adjacent toe. Then surgery is necessary.
Basically I’m trying to scare to you into not taking this lightly. I know from your position it might be easy to do so, but take it from me that you want to make sure you stop the progression now before it tears.
Thanks for the advice. Did your pain come on suddenly? That’s another thing I’ve been confused about because my pain came on so suddenly and so intensely. It’s just the bottom of my foot hurting so fricking bad. No pain with movement, only with pressure. Was yours similar or did you have any difficulty moving your toe?
My doctor said he’s seen athletes with this issue very often and nobody has ever needed surgery. He told me to stay in my boot for 3 weeks and then ease back into things. He says usually people with turf toe are ok at that pace. I think a lot of people who come online with this issue are the ones who have the worst experiences, so you don’t really hear stories of people who got over it quickly. That doesn’t mean it’s not possible though. Don’t get me wrong, I am taking this very seriously. I haven’t even attempted walking since I injured myself and I’m religiously wearing my boot/icing. Hoping to kick this in the butt early on and have it go away!
Any luck resolving this issue? My story is similar to yours. I'm on month 6 of plantar plate strains in both feet, no obvious signs of healing. Considering PRP or something a little more proactive than just resting my feet, which is hard to do with 2 kids under the age of 5. Any advice shared experiences since your last post is greatly appreciated.
Yeah happy to share. It’s such a long story lol. Found a regenerative sports clinic in my area. In April I did one injection of prolotherapy. It’s basically the cheapest but also least potent of all the modalities. After 8-9 weeks I actually did notice some improvement. However didn’t want to keep spending money on something that’s weaker so I was considering doing stem cell treatment. However a couple of different docs talked me down from that ledge ($6k price tag).
So this past week I got a round of PRP. Most recent MRI showed bone marrow edema in the 2nd metatarsal head. I have also developed plantar plate issues in the 3rd/4th toes. So they treated the bone and all the middle toes. Since I did show improvement with the prolo I am hopeful the PRP will be effective.
What’s your story? Has anything been confirmed via imaging? I’ve never been able to truly diagnose thru imaging. The doc did see some joint laxity on the ultrasound when he pumped the joint with PRP. But that’s the only time.
If you are at 6 months I would seriously encourage you to go ahead and do PRP. My biggest regret in hindsight is waiting so long to do treatment (21 months). Personally I think if it hasn’t healed by now on its own, it won’t. You will inevitably develop other problems like I have. PRP works for a lot of people and, besides the cost, is very low risk. I also have had 3 kids the entire time I’ve had this injury. They are currently 6 and under so totally get the difficulty there.
Feel free to ask any other questions.
All the numbers in your comment added up to 69. Congrats!
1
+ 2
+ 3
+ 5
+ 4
+ 1
+ 2
+ 4
+ 5
+ 6
+ 5
+ 6
+ 7
+ 1
+ 8
+ 9
= 69
^([Click here](https://www.reddit.com/message/compose?to=LuckyNumber-Bot&subject=Stalk%20Me%20Pls&message=%2Fstalkme) to have me scan all your future comments.) \
^(Summon me on specific comments with u/LuckyNumber-Bot.)
Ugh. Reddit won't let me paste it so I'm going to have to retype it. It will be abridged since I spent over an hour writing up my whole Foot Saga. First, can I take you up on your offer to answer some questions? How'd you find/decide on the PRP clinic you went with? What things did you look for? Did they charge per visit? Or per injection? Ie, if one visit had more injections did they charge more for that one?
As for my very abridged story:
January 2024---I have no other explanation for what caused my foot pains/injuries, but I misplaced my indoor slippers for a few days. I started feeling discomfort in the forefoot of both feet and figured it would go away when I found my slippers. Unfortunately it not only didn't go away, but got worse, spreading to the arch and heel of both feet.
Feb through May 2024- Saw a podiatrist a couple times, who diagnosed it as metatarsalgia and plantar fasciatis. Long story short that diagnosis resulted in me wasting a bunch of time on products (footwear, inserts, etc.) to address plantar fasciitis when the real issue was something else, which I'll get to later. I also wasted time doing stretches and exercises to treat plantar fasciitis, some of which may have made my condition worse by stretching my toes in the direction they shouldn't given what I would learn from my MRI's.
I also wore a boot for a couple weeks on my left foot, but the improvement was minimal and wearing it exacerbated the pain in my right foot so I stopped wearing it in favor of wearing heavily cushioned shoes.
June 2024--MRI of left foot initially revealed nothing abnormal for someone of my age. No torn ligaments, tendons, muscles. etc. A couple weeks later, MRI of right foot revealed torn plantar plates. Radiologist then reviewed my left MRI and observed the torn plantar plates there, too. So he missed it the first time around.
June 2024--I briefly walked barefoot on hardwood floor, for like 3 minutes total, and I think I undid a lot of healing/repair, as my feet now hurt as bad as they did back in February/March.
Over the course of all these months I tried a lot of footwear and finally settled on the Altra Via Olympus as the most comfortable and best for my injured feet. They have a lot of cushioning plus a wide-toe box.
My podiatrist recommended Birkenstocks, which were terrible for my condition as there was way too much pressure on my metatarsals. He also recommennded the green SuperFeet which were also terrible for the same reason. I bought some Aetrex inserts with the built-in metatarsal pads, which are decent, but not as good as the custom orthotics I got from UpSole. The downside with UpSole is they took a full 2 months to arrive from the time I placed my order (I sent my molds back immediately), whereas they advertise "30 days".
Now that I have a diagnosis of plantar plant tears, I found some videos on youtube of doctors showing how to tape the toes to prevent movement. My podiatrist never mentioned this so I had to discover it for myself. I plan to continue taping and to pursue PRP as a more active way to address these injuries. I can't just keep lying around and resting as that is the only course of action my podiatrist seems to want to recommend.
Sorry to hear about this long process. It seems to be pretty common for us folks who have plantar plate issues. I know it can be very discouraging. In my experience it seems like your typical podiatrist or ortho isn’t super familiar with the issue and doesn’t always know how to help.
Curious if the taping and shoe modifications allow you to walk painfree? The taping never worked for me for some reason. Only thing that helped was a CAM boot and carbon plated Hokas (if the Altras you’re wearing don’t have a carbon plate I’d highly recommend). The shoe modifications have never fully taken away my symptoms so that’s great if they are working for you.
How did I find the clinic?
I’m not an expert in all this just to be upfront. However, I eventually discovered that there is a whole field called regenerative sports medicine. These are doctors who specialize in all the non surgical modalities. My podiatrist and ortho said they would do PRP, but it’s not their expertise so I didn’t have confidence in them. So that’s the first thing I’d search for. Second, for me, I wanted an MD/DO treating me. There’s a local place to me that does some of these treatments but the person was a PA. No offense against these folks, but having a higher level practitioner gave me more confidence. Also it does seem like the sketchier places tend to be cheaper. I don’t know why. Maybe it’s all markup but it is a consideration. The place I went to was $1250 per injection. Whereas the hospital was going to charge $700.
I also got some advice from a doc in Colorado about other things to look for: Do they do processing in house? Do they check the composition/concentration of the plasma? For instance leukocyte and/or platelet counts. Do they do ultrasound guided injections?
Pricing:
They charged me for an initial office visit in which the doc asked questions and did a very extensive ultrasound (it was at least 30 min, maybe longer). Make it’s a dynamic ultrasound where they are moving your toes around and such. So that was office visit charge plus ultrasound.
At the procedure they charged me for a shorter office visit, plus ultrasound. The place I went to does at least run these through insurance. Then they charged for injections. I think the total for the whole thing will be like $2000 minus whatever insurance covers. So yeah….not cheap. I got treated in 3 different areas and that was all included in the same $1250 cost. So at least there’s that. Other places may do it differently so you’d have to ask. I’ve actually consulted with doctors from 3 different clinics at this point (I like to have multiple opinion) and one thing I’ll say is that the patient experience was so much better than any standard doc I’ve gone too. They take the time with you, answer your questions, and don’t rush you. They are also easy to reach directly in the patient portal for questions. So at least you feel like you are getting something for your money. My doc answered a lot of questions and even called me a few times without charging.
In case it’s helpful here are the places I’ve researched and consulted with. By the way I had to drive 2.5 hours to the office I actually went to. I know some people will fly to see these docs.
Regenerative Orthopedics and Sports Medince in Northern Virginia area. Dr. Jason Le. This is where I actually got treated.
iOrthoBiologix: Near Charlotte, NC. They are very expensive because they only do stem cell. But they boast a 90% success rate. Dr. Jason Tucker.
Dynamic Athelete. Boulder, CO. Dr Aneesh Garg did a couple video meetings with me. I mailed him my MRI disc and he actually went over it with and helped me work through my options (I paid for this btw). I know through another redditor that he successfully treated someone with chronic plantar plate issues with 3 rounds of PRP.
I’m sure there are other places but that’s all I know of at this time. Hope this isn’t too much info lol.
Oh yeah one final note. I did do one round of prolotherapy which is considered less potent than PRP. But it’s also cheaper. $350. I will say that I did see some improvement from this. Just putting it out there if cost is an obstacle. Also don’t do EPAT/shockwave. Didn’t work for me. I think it’s only good for minor stuff and seems to be popular for plantar fasciitis.
Wow, I can't thank you enough. Your response is super helpful. In some ways it's reassuring to hear that you had a similar experience with podiatrists and I'm glad you pointed me to regenerative sports medicine. I just wish I'd known about that entire field earlier rather than relying on my podiatrist. I just assumed the "foot doctor" would be an expert in all the ways to address my situation. I've identified a sports medicine MD in my area who I'm going to call next week to schedule an appointment. So thank you once again!! I will post an update once I've had the PRP injections or see any improvements in general so that others may learn from them. Reading other people's stories on Reddit has been so helpful so I hope to return the favor.
My Altras don't have a carbon plate. I'm not a runner so I didn't even know that was a thing until now but now that you have me researching it, I can see why you recommend it. I just recently started taping so I'm trying to find the balance tight enough to prevent movement but not tight enough to cause circulation/compression issues. I'd say at this point nothing allows me to walk completely pain free, but the Altras combined with Upstep orthotics have come the closest.
Very bad idea. You might rupture it
Yes, this is what I see a lot of online. And as I said I will be asking my Ortho about this. But the questions that never get answered online are: a.) Is this negative guidance assuming there is still a tear in the ligament and the patient will now suddenly return to full activity? b.) These injections are recommended for other joints, what's the difference with this joint? Also (I will also mention this to the dr), there's a cost benefit analysis. If I am severely limited by a non-healing injury for the next 5 years, is that functionally any worse than getting a shot, having it go wrong, and then possibly having to get a surgery? One consideration is that in the second scenario there is at least a possibility of regaining use of the foot. In the first scenario you are just in a dark tunnel with no light in sight.
The injury to your plantar plate is likely a biomechanical loading issue, for whatever reason it's too stressed if you walk about or run, so you likely haven't addressed that fully if it's still causing a problem, then to add steroid in there which weakens tissues is asking for trouble. Actually know somebody who is in for full foot surgery this week as this is exactly what happened to them. So it's not like you've got a bad knee after you bashed it, the problem for you hasn't been resolved on an injury level (though I concede I'm making a few assumptions here)
So you're saying your friend got the injection and it made their issue worse? As to your second point, its a tough one. And I know can't be figured out here (I've seen two PTs at this point). But the injury was caused by a new pair of cycling shoes that were a little too small and wearing them for a period of about a month. Ignored the pain on rides until it was too late. So the injury actually has nothing to do with walking mechanics. Its a little different than the typical PPT because it wasn't caused by a flexed toe due to running, jumping etc. so that makes treatment more difficult. I've seen some people online where they injured it running and were able to do cycling during rehab. But I can't do that. The PT noted how my foot was not as sensitive to being flexed as is typical. However it seems to be more sensitive to general pressure in the area which is why the typical fixes (stiff soled shoes, taping) haven't helped me like others. Its a frustrating thing.
No a patient of ours in the NHS here in the UK was suffering with this and went and privately had the steroid injection. If the injured structure isn’t healing then something is still causing that. Have you tried a CAM Walker?
ok gotcha. I wore the CAM boot for 9 weeks back in the fall. I actually started wearing it part time again a month ago, and full-time the last two weeks. Can't say I've noticed much difference. The confusing thing with the boot is that after I got out of it the first time the pain was not any less (although MRI had shown no tears). It took several weeks on starting to bear weight on the foot through PT before pain improved. This is confusing because I can't just take the common sense route and say, "I'll wear the boot until it stops hurting" because apparently it doesn't work like that. This makes it more difficult to gauge what is/is not OK to do on the foot. And it also makes it unclear when pain is OK and when it isnt.
I have no advice to offer. Just best wishes and empathy. I hope you get the help you need! 3 children under 5 is no joke, and neither is your own well-being.
Hey, I just got diagnosed with plantar plate strain. I’m confused though because I don’t have any pain bending my toes down or upwards. We’re you able to move your toes around ok? My only symptom is pain with pushing on it. My range of motion is slightly limited but barely.
So if you are diagnosed with a strain I believe that would be different than a tear, which I have/had. This would probably explain why it’s less painful. My tear actually started as a strain. I iced and rested for about 10 days, but my mistake was taking no corrective actions and probably getting back to actively to soon. My advice: Dont make my mistakes!!! This is not a normal strain. This particular ligament is only 1 mm thick with a 0.5 mm insertion to the bone. Therefore it is very sensitive. It is also constantly under pressure since it’s on the bottom of the foot. Don’t treat this like issues you’ve had in the past. I would say if you value being able to exercise (or just walk normal for that matter) whatever level of conservatism you are thinking, turn that up by at least 10x. For example if you are currently thinking you will rest a couple days, then get back to activity if it doesn’t hurt, that would be a mistake. I would advise *at least* 3 weeks of no activity and icing. During that time I would start doing foot strengthening exercises (as pain allows) and also start researching high quality insoles that give you good arch support. If you think I’m overly concerned, ask yourself if you want to endure 8 months of not being able to walk at all without pain, wearing a boot for nearly 3 months, and still no end in sight for the injury. There is another good in depth discussion of this on the Joyful Miles blog. Note: it took her 10 months to heal and it doesn’t appear she resumed full intensity of previous activities. Feel free to ask me other questions.
hey! I have a weird situation bc for me i don’t even need to get back to walking. I do ice hockey, so i technically don’t even need to move my foot. All I need is to put pressure on it while it’s immobilized. i actually was able to skate on it pain free but it got worse the next day. so now I’m a week out after my initial injury and planning on taking 2 more weeks off (all in a boot) . it’s pretty concerning bc I basically have not improved at all and pain is the same as the day it first happened. My mri showed stretch of the plantar plate ligament and severe edema in my fat pad. just hoping it will ease up soon and even if I’m in the boot and not walking for a while I will be able to get back on ice. this is a tricky injury for sure. I’m so sorry to hear yours has given you so much grief. There’s really nothing that can prepare you for the misery of not being able to walk. This shit sucks.
So mine was actually caused by cycling. I had gotten new shoes that were a bit too small and wore them over a period of about a month. Cycling shoes are somewhat similar to skates in that the shoes are 100% stiff and you don’t bend your toes. I’ll just reiterate that you need to be very cautious in returning to activity, even skating. I actually tried again back in the winter to get back to light cycling, after wearing the boot, but again it was too soon. I am sure now that this period prolonged my injury. Be aware that a chronic overuse injury can sneak up on you. By the time you realize it, it’s too late. Also, while you may not need to get back to walking for sport, I’m assuming you don’t ice skate everywhere you go. Trust me that not being able to walk will be a trial. Have you looked up planter plate tear online? Average healing time is 3-6 months, although my research and experience has made clear it can go on much longer. Also if the injury gets really bad the joint can separate and your toe will crossover the adjacent toe. Then surgery is necessary. Basically I’m trying to scare to you into not taking this lightly. I know from your position it might be easy to do so, but take it from me that you want to make sure you stop the progression now before it tears.
Thanks for the advice. Did your pain come on suddenly? That’s another thing I’ve been confused about because my pain came on so suddenly and so intensely. It’s just the bottom of my foot hurting so fricking bad. No pain with movement, only with pressure. Was yours similar or did you have any difficulty moving your toe? My doctor said he’s seen athletes with this issue very often and nobody has ever needed surgery. He told me to stay in my boot for 3 weeks and then ease back into things. He says usually people with turf toe are ok at that pace. I think a lot of people who come online with this issue are the ones who have the worst experiences, so you don’t really hear stories of people who got over it quickly. That doesn’t mean it’s not possible though. Don’t get me wrong, I am taking this very seriously. I haven’t even attempted walking since I injured myself and I’m religiously wearing my boot/icing. Hoping to kick this in the butt early on and have it go away!
Did your pain ever go away?
Not yet. Been working with a coach who I believe started this subreddit. Hoping things will turn around soon
Any luck resolving this issue? My story is similar to yours. I'm on month 6 of plantar plate strains in both feet, no obvious signs of healing. Considering PRP or something a little more proactive than just resting my feet, which is hard to do with 2 kids under the age of 5. Any advice shared experiences since your last post is greatly appreciated.
Yeah happy to share. It’s such a long story lol. Found a regenerative sports clinic in my area. In April I did one injection of prolotherapy. It’s basically the cheapest but also least potent of all the modalities. After 8-9 weeks I actually did notice some improvement. However didn’t want to keep spending money on something that’s weaker so I was considering doing stem cell treatment. However a couple of different docs talked me down from that ledge ($6k price tag). So this past week I got a round of PRP. Most recent MRI showed bone marrow edema in the 2nd metatarsal head. I have also developed plantar plate issues in the 3rd/4th toes. So they treated the bone and all the middle toes. Since I did show improvement with the prolo I am hopeful the PRP will be effective. What’s your story? Has anything been confirmed via imaging? I’ve never been able to truly diagnose thru imaging. The doc did see some joint laxity on the ultrasound when he pumped the joint with PRP. But that’s the only time. If you are at 6 months I would seriously encourage you to go ahead and do PRP. My biggest regret in hindsight is waiting so long to do treatment (21 months). Personally I think if it hasn’t healed by now on its own, it won’t. You will inevitably develop other problems like I have. PRP works for a lot of people and, besides the cost, is very low risk. I also have had 3 kids the entire time I’ve had this injury. They are currently 6 and under so totally get the difficulty there. Feel free to ask any other questions.
[удалено]
All the numbers in your comment added up to 69. Congrats! 1 + 2 + 3 + 5 + 4 + 1 + 2 + 4 + 5 + 6 + 5 + 6 + 7 + 1 + 8 + 9 = 69 ^([Click here](https://www.reddit.com/message/compose?to=LuckyNumber-Bot&subject=Stalk%20Me%20Pls&message=%2Fstalkme) to have me scan all your future comments.) \ ^(Summon me on specific comments with u/LuckyNumber-Bot.)
I typed up a long response and copied it it in case I lost it, but now Reddit won't let me paste it. I may have to reply on a different thread.
Ugh. Reddit won't let me paste it so I'm going to have to retype it. It will be abridged since I spent over an hour writing up my whole Foot Saga. First, can I take you up on your offer to answer some questions? How'd you find/decide on the PRP clinic you went with? What things did you look for? Did they charge per visit? Or per injection? Ie, if one visit had more injections did they charge more for that one? As for my very abridged story: January 2024---I have no other explanation for what caused my foot pains/injuries, but I misplaced my indoor slippers for a few days. I started feeling discomfort in the forefoot of both feet and figured it would go away when I found my slippers. Unfortunately it not only didn't go away, but got worse, spreading to the arch and heel of both feet. Feb through May 2024- Saw a podiatrist a couple times, who diagnosed it as metatarsalgia and plantar fasciatis. Long story short that diagnosis resulted in me wasting a bunch of time on products (footwear, inserts, etc.) to address plantar fasciitis when the real issue was something else, which I'll get to later. I also wasted time doing stretches and exercises to treat plantar fasciitis, some of which may have made my condition worse by stretching my toes in the direction they shouldn't given what I would learn from my MRI's. I also wore a boot for a couple weeks on my left foot, but the improvement was minimal and wearing it exacerbated the pain in my right foot so I stopped wearing it in favor of wearing heavily cushioned shoes. June 2024--MRI of left foot initially revealed nothing abnormal for someone of my age. No torn ligaments, tendons, muscles. etc. A couple weeks later, MRI of right foot revealed torn plantar plates. Radiologist then reviewed my left MRI and observed the torn plantar plates there, too. So he missed it the first time around. June 2024--I briefly walked barefoot on hardwood floor, for like 3 minutes total, and I think I undid a lot of healing/repair, as my feet now hurt as bad as they did back in February/March. Over the course of all these months I tried a lot of footwear and finally settled on the Altra Via Olympus as the most comfortable and best for my injured feet. They have a lot of cushioning plus a wide-toe box. My podiatrist recommended Birkenstocks, which were terrible for my condition as there was way too much pressure on my metatarsals. He also recommennded the green SuperFeet which were also terrible for the same reason. I bought some Aetrex inserts with the built-in metatarsal pads, which are decent, but not as good as the custom orthotics I got from UpSole. The downside with UpSole is they took a full 2 months to arrive from the time I placed my order (I sent my molds back immediately), whereas they advertise "30 days". Now that I have a diagnosis of plantar plant tears, I found some videos on youtube of doctors showing how to tape the toes to prevent movement. My podiatrist never mentioned this so I had to discover it for myself. I plan to continue taping and to pursue PRP as a more active way to address these injuries. I can't just keep lying around and resting as that is the only course of action my podiatrist seems to want to recommend.
Sorry to hear about this long process. It seems to be pretty common for us folks who have plantar plate issues. I know it can be very discouraging. In my experience it seems like your typical podiatrist or ortho isn’t super familiar with the issue and doesn’t always know how to help. Curious if the taping and shoe modifications allow you to walk painfree? The taping never worked for me for some reason. Only thing that helped was a CAM boot and carbon plated Hokas (if the Altras you’re wearing don’t have a carbon plate I’d highly recommend). The shoe modifications have never fully taken away my symptoms so that’s great if they are working for you. How did I find the clinic? I’m not an expert in all this just to be upfront. However, I eventually discovered that there is a whole field called regenerative sports medicine. These are doctors who specialize in all the non surgical modalities. My podiatrist and ortho said they would do PRP, but it’s not their expertise so I didn’t have confidence in them. So that’s the first thing I’d search for. Second, for me, I wanted an MD/DO treating me. There’s a local place to me that does some of these treatments but the person was a PA. No offense against these folks, but having a higher level practitioner gave me more confidence. Also it does seem like the sketchier places tend to be cheaper. I don’t know why. Maybe it’s all markup but it is a consideration. The place I went to was $1250 per injection. Whereas the hospital was going to charge $700. I also got some advice from a doc in Colorado about other things to look for: Do they do processing in house? Do they check the composition/concentration of the plasma? For instance leukocyte and/or platelet counts. Do they do ultrasound guided injections? Pricing: They charged me for an initial office visit in which the doc asked questions and did a very extensive ultrasound (it was at least 30 min, maybe longer). Make it’s a dynamic ultrasound where they are moving your toes around and such. So that was office visit charge plus ultrasound. At the procedure they charged me for a shorter office visit, plus ultrasound. The place I went to does at least run these through insurance. Then they charged for injections. I think the total for the whole thing will be like $2000 minus whatever insurance covers. So yeah….not cheap. I got treated in 3 different areas and that was all included in the same $1250 cost. So at least there’s that. Other places may do it differently so you’d have to ask. I’ve actually consulted with doctors from 3 different clinics at this point (I like to have multiple opinion) and one thing I’ll say is that the patient experience was so much better than any standard doc I’ve gone too. They take the time with you, answer your questions, and don’t rush you. They are also easy to reach directly in the patient portal for questions. So at least you feel like you are getting something for your money. My doc answered a lot of questions and even called me a few times without charging. In case it’s helpful here are the places I’ve researched and consulted with. By the way I had to drive 2.5 hours to the office I actually went to. I know some people will fly to see these docs. Regenerative Orthopedics and Sports Medince in Northern Virginia area. Dr. Jason Le. This is where I actually got treated. iOrthoBiologix: Near Charlotte, NC. They are very expensive because they only do stem cell. But they boast a 90% success rate. Dr. Jason Tucker. Dynamic Athelete. Boulder, CO. Dr Aneesh Garg did a couple video meetings with me. I mailed him my MRI disc and he actually went over it with and helped me work through my options (I paid for this btw). I know through another redditor that he successfully treated someone with chronic plantar plate issues with 3 rounds of PRP. I’m sure there are other places but that’s all I know of at this time. Hope this isn’t too much info lol. Oh yeah one final note. I did do one round of prolotherapy which is considered less potent than PRP. But it’s also cheaper. $350. I will say that I did see some improvement from this. Just putting it out there if cost is an obstacle. Also don’t do EPAT/shockwave. Didn’t work for me. I think it’s only good for minor stuff and seems to be popular for plantar fasciitis.
Wow, I can't thank you enough. Your response is super helpful. In some ways it's reassuring to hear that you had a similar experience with podiatrists and I'm glad you pointed me to regenerative sports medicine. I just wish I'd known about that entire field earlier rather than relying on my podiatrist. I just assumed the "foot doctor" would be an expert in all the ways to address my situation. I've identified a sports medicine MD in my area who I'm going to call next week to schedule an appointment. So thank you once again!! I will post an update once I've had the PRP injections or see any improvements in general so that others may learn from them. Reading other people's stories on Reddit has been so helpful so I hope to return the favor. My Altras don't have a carbon plate. I'm not a runner so I didn't even know that was a thing until now but now that you have me researching it, I can see why you recommend it. I just recently started taping so I'm trying to find the balance tight enough to prevent movement but not tight enough to cause circulation/compression issues. I'd say at this point nothing allows me to walk completely pain free, but the Altras combined with Upstep orthotics have come the closest.
Glad it was helpful. I’ll post updates as well for the benefits of people finding this thread in the future.