Table 2.
Postoperative rehabilitation for plantar plate injuries
| Phase | Rehabilitation Goals | Treatment Interventions | Timeline |
|---|---|---|---|
| Phase 1 | Protect repair Control pain, swelling, and inflammation Maintain core and hip strength Maintain skin integrity Ensure proper circulation and tissue healing Maintain cardiovascular conditioning |
Immobilization, anti-inflammatory medications Toe spica splint, CAM boot, bunion strap Anti-inflammatory medications Core exercises (TrA activation, marching, bridging) Leg raises, clamshells UBE |
4-6 weeks |
| Phase 2 | Decrease pain, swelling, and inflammation Improve ROM Increase core and hip strength Increase intrinsic muscle and ankle strength Progress weightbearing activities Normalize gait Improve conditioning |
Ice, E-stim for pain control (IFC, TENS) Grade 3-4 ankle, grade 1-2 hallux MP mobilizations Marble/towel and Theraband exercises Squats, controlled heel raises, band exercises, lunges Toe/foot taping, customized orthotics Carbon graphite shank Assisted (crutches)/unassisted gait training Bike, aquatic exercise |
6-10 weeks |
| Phase 3 | No pain or swelling with progressions Improve ROM Improve single leg strength and stability Progress conditioning Initiate agility and plyometric exercises |
Continued modalities, toe/foot taping as needed Customized orthotic, carbon graphite shank Grade 3-4 ankle, grade 3 hallux MP mobilizations Multidirectional lunges, single leg squats Bosu/foam pad balance exercises Bike, aqua jogging, elliptical, treadmill jogging Ladder drills, box jumps, bounds/hopping exercises |
10-12 weeks |
| Phase 4 | Advance agility and plyometric drills Include sports-specific drills and exercises Return to play |
Customized footwear Treadmill jogging/running Single leg squats/stability exercises Ladder/agility drills with multidirectional planting and cutting Circuit training/conditioning Sport participation |
12-20 weeks |
ROM, range of motion; hallux MP, first metatarsophalangeal joint; TrA, transversus abdominis; UBE, upper body ergometry; E-stim, electrical stimulation; IFC, interferential current; TENS, transcutaneous electrical nerve stimulation.