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Does anyone have any good ideas or pictures of taping techniques they like to use for plantar plate tears?
For example, what tape works best? Rigid or stretch (Kineso/ rocktape).
How do you do it? Start under the foot, loop over affected toe, back under the foot?
Do you accompany it with some low dye taping? Do you add any felt padding?
Lots of questions, i know. I'm asking because I don't think my style is very good. Patients routinely say it's uncomfortable/ unhelpful.
And yes, i've read all the plantar plate threads.
I've attached picture of the diagram in this paper. Is this pretty standard?
Plantar plate rupture
Matthew C Dilnot, B Pod (Hons)
Thomas C Michaud, DC
Australasian Journal of Podiatric Medicine
2003; Vol 37, No.2 : 43-46
I use the "V" style taping as illustrated in your diagram. I prefer to use three pieces of 1/2" cloth adhesive tape and instruct the patient on how to vary the tension in the tape by altering the sagittal plane position at the metatarsophalangeal joint of the toe during taping. If the tape is uncomfortable, you are likely taping the patient's digit too plantarflexed (i.e. not dorsiflexed enough). I generally have the patient's toe dorsiflexed 10 degrees to the weightbearing surface when I tape it to avoid excessive tape pressure and dorsal digital pain during ambulation.
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
Similar to Kevin I use the cross over tape method with the toe plantarflexed. Again, if the toe is plantarflexed too far patients will find it uncomfortable. Tape choice is usually something that is very slightly stretchy but a non-stretch type will do. I found patients preferred the very slightly stretchy type. To date I have not found additional padding to be any more preferable with patients sometime removing it themselves.
As a patient (not a doctor) who experimented with different "taping" methods on my own plantar plate tear for a good four months, I can tell you the most comfortable by far was one-inch medical wrap. I don't know exactly what you call it, but I do know you have all seen it and probably have it. It's tan, flexible, comes in rolls, and it may or may not be stretchy or "self-adhesive". I got mine at the drug store as something like "athletic wrap". You get the idea...
So it doesn't have to be stretchy or adhesive - maybe better if it's not. Mine was both when I got it but soon lost those properties. It got easier to use after a week or so. If you have a nice durable cloth material that is porous, soft, and comfortable...that'll work.
So I find the middle of an approximately 4-foot section of the cloth and drape it over the toe to be taped. I cross the foot on the bottom to just before the heel, bring the material up toward (but a little below) the ankle, wrap it behind the heel, then spiral up the shin a couple times - similar to how a Roman gladiator's sandal would be tied. Then I essentially do the same thing with the other side, but this time I create and maintain the angle of plantarflexion that I want as well as the tension. I cross the material to the opposite side of the foot on the bottom, below the ankle and back around the heel, then spiral up the ankle/shin. This fixes the first side that I wrapped, so all that's needed to tie the whole thing down is a little bow in the back.
The benefits over tape are many. Once you set it up it lasts until you untie it, it's fast and easy to affix, remove, and adjust, it leaves no residue and won't collect dirt and grime like tape, one piece of cloth can last months, the material is soft and does not chafe/irritate/dig into the skin, and generally, the feeling of having it on is far superior to that of tape. It's comfortable. These things need periodic adjustment, and constantly ripping sticky tape off your skin and reapplying gets old fast. I can wear this all day knowing that when/if I need to take it off, it's not going to cause me frustration.
I hope this helps make someone else's recovery from a plantar plate tear a little more comfortable. I pretty much gave up using adhesive tape in favor of what I described.
Last edited by andrew547 : 24th April 2013 at 01:42 PM.
Reason: additional information added
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