Pain under the ball of your foot, and a toe that is starting to drift

Location is the biggest clue. A plantar plate tear is tender directly under the toe joint, while a neuroma is tender between the toe bones and often causes burning, numbness or tingling into the toes. Squeezing the forefoot sideways tends to reproduce neuroma pain, whereas lifting and stressing the toe reproduces plantar plate pain. Your podiatrist uses both tests, plus toe position, to tell them apart.

The plantar plate is the main structure stopping that toe from lifting and sliding. Once it stretches or tears, the tendons on top of the toe pull unopposed, so the toe rises and gradually angles towards the big toe. It is a mechanical consequence of the injury rather than a separate problem, and it usually appears months after the pain starts.

Both, though gradual onset is far more common. Most people describe a vague ache under the ball of the foot that builds over weeks after a change in training, footwear or standing hours. A smaller number tear it sharply, usually pushing off hard in sport or landing awkwardly with the toe bent upwards. Sudden tears tend to swell quickly and bruise.

Often, yes. When the big toe angles inwards, it stops carrying its share of push-off load and can press against the second toe. That extra pressure is transferred to the second toe joint, where the plantar plate takes the strain. This is why treating the tear may also involve managing the bunion, and why the two conditions frequently appear on the same foot.

Pain may fluctuate, but the toe position rarely improves on its own. The joint can keep spreading, allowing the toe to sit higher and cross over. A raised toe rubs on shoes, forms corns and pushes even more load onto the neighbouring joints. Earlier treatment gives conservative options a better chance, which is the main reason not to wait it out.

Taping is effective at reducing pain and protecting the joint, but it works as part of a plan rather than a standalone fix. It needs to be applied in the right position, reapplied regularly, and paired with footwear and offloading changes so the joint is not reloaded the moment the tape comes off. Your podiatrist will show you the technique to use at home.