Surrounding every joint in the body is what is known as a joint capsule. This capsule is what holds the bones each side of the joint together and keep the fluid in the joint which lubricates the joint in place. Regions of that joint capsule are thicker and stronger. These thicker and stronger parts would be the ligaments that provides stability to the joint. In the joints on the base of the toes in the feet, the metatarsophalangeal joints, the thickened underside of that joint capsule is frequently known as the plantar plate. This ought to be thicker and stronger since we put such a lot of force through it whenever walking and running and it has to be able to take it. Occasionally that force can be so high it might strain that plantar plate or ligament and it will become painful. When this occurs, the medical name is plantar plate dysfunction and sometimes it may progress to a small tear in the plate, so will get termed as a plantar plate tear.
Typically the symptoms for this are pain underneath the joint when walking or on palpation, with the pain being more established in the direction of the front edge of the joint. It normally only affects one joint but sometimes several can be affected. The toe is often slightly raised as the plantar plate is can not retain the toe down as a result of damage to its strength with the strain or tear. Generally the diagnosis is clear, but if not an ultrasound assessment is commonly carried out to determine it. The therapy commonly consists of taping the toe to hold it in a downward position so that the plantar plate is less stressed so it can have a chance to recover. A pad could also be used in the shoe to help keep weightbearing from the damaged region. If these kinds of methods do not help, then a surgical repair of the plantar plate tear is usually necessary.