Around each joint in the body is what is known as a joint capsule. This capsule is what supports the bones either side of the joint together and keep the fluid in the joint which lubricates it in place. Portions of this joint capsule are thicker and stronger. These thicker and stronger areas would be the ligaments that give stability to the joint. In the joints on the base of the toes in the foot, the metatarsophalangeal joints, the thickened bottom part of that joint capsule is commonly referred to as the plantar plate. This really needs to be thicker and stronger because we place such a lot of force through it whenever running and walking and it has to be able to take it. Occasionally that force may be so great it can strain that plantar plate or ligament and it will become painful. When this happens, the medical name is plantar plate dysfunction and in some cases it might go on to a tiny tear in the plate, therefore will get termed as a plantar plate tear.
Often the symptoms for this are pain under the joint whenever walking or on palpation, with the pain being more established toward the front edge of the joint. It in most cases only affects one joint but sometimes several may be affected. The toe can be slightly raised as the plantar plate is unable to retain the toe down due to the injury to its integrity with the strain or rupture. Usually the diagnosis is pretty obvious, however, if not an ultrasound examination is commonly done to determine it. The treatment typically consists of taping the toe to hold it in a downward position so that the plantar plate is relaxed to give it an opportunity to heal. A metatarsal pad may also be used in the footwear to keep weightbearing from the affected area. If these methods do not help, then a surgical repair of the plantar plate tear are usually necesary.