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Tuesday, July 15, 2014

2nd MPJ Plantar Plate Tear: Email Advice

I'm a professional Rugby League player in England and have recently ruptured my Planter Plate Ligament under my 2nd toe. The toe keeps coming out of joint and under the 2nd metatarsal head is very painful. I have 8-10 games left of the season and would like to play in the remaining matches. i can have a local anaesthetic for games but during the week when training i can't. I've tried all sorts of taping trying to keep the toe from coming out of joint and pulled down toward the floor but haven't found a suitable one that allows me to train properly. I wondered if you had any advice on taping techniques or some kind of splint that may help me get through the next few weeks. I'm having orthotics made to offload the pressure on the 2nd met head.

i hope you can help


Dr Blake's comment: Glad to try to help. Please try to Budin Splints. You should get the single, double and triple loop ones and experiment. For the Single Loop, you can put the loop over the 2nd only, or over the 2nd and 3rd toes combined. With the double loop, you can try 2nd and 3rd or 2nd and 4th. With the triple loop, you only have 2/3/4 possibility. You can also first try taping the toe down (I found a picture for the first, but you would do 2nd in a similar fashion) and then using the splint.  I also have found adding 1/4 inch adhesive felt over the top of the toe before you put your sock on can help push the toe down when you play (could not find a quick image of that). Many times you also have to put as much metatarsal arch under the 2nd and 3rd metatarsals as possible to lift up the metatarsals while pulling down the toes.I like the small longitudinal medial arch Hapads for this purpose. And then probably, if there is any more room in your shoe, to add a float to accommodate the 2nd metatarsal head at weight bearing.  Hope this makes sense. Rich

Hapad used for metatarsal support with an extra piece to the side of the sore area. When you use these Hapads, I use the right on the left and the left on the right. Go to for ordering.

Besides hapads for metatarsal support, accommodative padding of various forms and amounts can help off weight the metatarsal head.

Here a single loop budin splint is seen which can be put over the 2nd alone, or both the 2nd and 3rd toes combined. You can tape first. Please check out

To prevent the toe splint from moving place a small piece of tape between the elastic band and the toe. 

Even though this shows the first toe, you can easily do the same for the 2nd. Use Kinesiotape, Rocktape or 3M Nexcare Waterproof tape. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.