There’s a strange sensation that might occur beneath the forefoot that is frequently described as a feeling that the sock is scrunched up beneath the toes, but if you looked at it, it is not the sock. The feeling is frequently complained of and it is often puzzling to people with it and clinicians looking at it. Most likely the feeling or sensation is due to a problem with a ligament on the base of one or more of the metatarsophalangeal (toe) joints of the feet known as plantar plate dysfunction. Around each joint, there is a strong covering known as the joint capsule. Areas of each joint capsule are thicker and these are the ligaments which protect and stabilise the joints. Underneath the bottom of the metatarsophalangeal joints, that joint capsule is thicker to make what is known as the plantar plate. It’s possible to strain and even get a small tear in that plantar plate, which creates that experience of a sock which feels as though its bunched up beneath the toes.
Pain usually starts off slowly below the ball of the foot and might be preceded with that peculiar bunched sock sensation. The most common sign of plantar plate dysfunction is soreness on palpation of the vicinity of the plantar plate. An expert clinician can slowly move the joint in a manner to detect when the plantar plate is impaired. A conclusive diagnosis can be performed with a diagnostic ultrasound, however it is really obvious to a experienced clinician on assessment. Normally the primary treatment solutions are strapping to hold the toe directed down to ease the load on the ligament. A metatarsal pad can be commonly used to help in reducing the strain on the. This often helps most cases of plantar plate dysfunction and get rid of that odd experience of a scrunched up sock below the ball of the foot. If those conservative methods really don’t help, surgical repair of the partial or complete split of the plantar plate is frequently done.