What is a plantar plate tear?

A plantar plate tear is a strain or small tear in the ligament plantar to one or more of the lessor metatarsophalgeal joints in the ball of the foot. It commonly is associated with a bunion or hallux valgus.

The symptoms of a plantar plate tear are typically pain under the ball of the foot when walking that is much more painful on palpation. On palpation, the pain is under and just distal to the joint. It normally starts off slowly, but progressively gets worse, especially if there are high levels of activity.

Often the best way to treat this problem is with taping to hold the toe plantarflexed to relieve the strain on the dysfunction or tear to that it can heal. Usually the taping or some sort of bracing does help, but occasionally surgery is needed to repair the tear. Sometime up to 3-6 months of the taping is needed. A rocker sole shoe can also help keep the load of the damaged area.

Do the “Bunion Correctors” actually work?

Bunion Correctors

Bunion Correctors

They probably do work somewhat.

The whole idea behind these bunion correctors (like these ones) is that you are supposed to wear them at night and doing so means that the toe is straightened. The evidence from published research is that they can reduce the angle by a few degrees after a month. No research has been done on a group of people for longer than a month so it is not known if any more can be achieved, though it probably can.

The issue with these that the forces from the shoe and from the way we walk that are producing the bunion or hallux valgus are substantial during the day and it is a bit difficult to think that wearing a splint or corrector at night when not walking around that this will magically overcome the angle, so the small correction after one month in that study is probably not surprising.

That small correct does not mean that they should not be used. As noted by this doctor, they are particularly useful at helping with pain in the joint and keeping the joint more mobile, so that is a good reason to use them. They are certainly recommended for that reason alone and the added bonus is that they may correct the angle of teh big toe.

The Short Foot Exercise for Bunions

Does it work?
A lot depends on how much you believe that muscle strength is involved in the development of bunions.
This is the short foot exercise (SFA):

The exercise is very effective for what it is designed for and that is to strengthen the intrinsic muscles of the foot. It is claimed to be an effective treatment for overpronation (its not). There is a bit of controversy around the SFA, most due to the extraordinary strength and number of claims that get made or what it can do, versus the lack of any actual evidence to support those claims.

Does it help those with bunions? Probably not. The problem with muscle strengthening in those with bunions is that due to the deformity (and the valgus of the hallux), the problem is not necessarily weak muscles, but a very poor lever arm that the intrinsic muscles have to exert their effect. This means that any gains from doing this exercise in those with bunions is going to be, at best, minimal in return for a extraordinary amount of effort and time needed to perform the exercise.

The exercise is a good adjunct to use in the treatment of plantar fasciitis.

Reflexology for Bunions

Reflexology is a non-nonsensical failed pseudoscience belief system that claims different organ systems can be mapped to the foot and stimulation of those zones on the foot can affect the health of those organs. There is no physiological or neurological or any sort of biological link between the organs and the bottom on the foot. Clinical trials of reflexology are badly done and all systematic reviews of the good published evidence clearly shows that reflexology is totally useless at treating everything. The only studies that show a results were either badly done or the intervention used was not “reflexology”, but just a foot massage.

In that context, there is absolutely nothing that reflexology can do for bunions, so don’t waste your money on it or fall or the non-nonsensical failed pseudoscience. On the other hand, a damn good foot massage will make everyone fell better …. it just won’t fix your bunion.

Kinesio Taping for Bunions

Remember all that brightly colored tape that athletes wear at the Olympics? It apparently can be used for bunions:

Kinesio taping has some controversy around it as to its effectiveness but discussion between those who do use it for bunions is that they do find it helpful. There is no research one way or the other as to its effectiveness.

It is unlikely that the taping method can actually fix bunions, as the forces making the bony changes are too great for a flexible tape to overcome, however, it may be helpful for the symptoms that are caused by bunions.