Surrounding each joint in the body is what is known as a joint capsule. This capsule is what supports the bones each side of the joint together and keep the fluid in the joint that lubricates the joint in place. Parts of this joint capsule are usually 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 feet, the metatarsophalangeal joints, the thickened underside of that joint capsule is normally referred to as the plantar plate. This really needs to be thicker and stronger since we place such a lot of force through it when running and walking and it has to be able to resist it. Sometimes that force can be so great it can strain that plantar plate or ligament and it will become painful. When this occurs, the technical term is plantar plate dysfunction and frequently it may go on to a small tear in the plate, therefore will get called a plantar plate tear.
Typically the signs and symptoms for this are pain beneath the joint when walking or on deep touch or pressure, with the pain being more established towards the front edge of the joint. It frequently only affects one joint but in some cases several may be affected. The toe may very well be somewhat raised as the plantar plate is can not secure the toe down because of the injury to its integrity with the strain or tear. Frequently the diagnosis is evident, but if not an ultrasound evaluation can often be done to verify it. The treatment normally includes taping the toe to hold it in a downward position so the plantar plate is rested so it can have an opportunity to heal. A pad can also be used in the footwear to keep weightbearing from the damaged location. If these types of methods don't help, then a surgical repair of the plantar plate tear may be needed.