Surrounding each joint in the body is what is known as a joint capsule. This kind of capsule is what holds the bones either side of the joint together and keep the fluid in the joint which lubricates the joint in position. Parts of that joint capsule are thicker and stronger. These thicker and stronger areas are the ligaments that provides stability to the joint. In the joints at the base of the toes in the foot, the metatarsophalangeal joints, the thickened underlying part of that joint capsule is typically called the plantar plate. This is required to be thicker and stronger as we place such a lot of force through it when running and walking and it has to be able to take it. In some cases that force may be so great it might stress that plantar plate or ligament and it may become damaged. When this happens, the technical term is plantar plate dysfunction and frequently it might progress to a tiny tear in the plate, so gets called a plantar plate tear.
Most of the symptoms for this are pain under the joint whenever walking or on palpation, with the pain being more established in the direction of the front side of the joint. It generally only affects one joint but sometimes several may be affected. The toe may perhaps be moderatly raised as the plantar plate is not able to retain the toe down as a result of damage to its strength with the strain or rupture. Usually the diagnosis is evident, however, if not an ultrasound examination is usually carried out to determine it. The treatment commonly consists of strapping the toe to keep it in a plantarflexed position so that the plantar plate is less stressed so it can have a chance to recover. A metatarsal pad could also be used in the footwear to help keep weightbearing from the damaged location. If these methods do not help, then a surgical repair of the plantar plate tear may be needed.