Surrounding every joint in the body is what is known as a joint capsule. That capsule is what holds the bones either side of the joint together and keep the fluid in the joint that lubricates it in place. Regions of that joint capsule tend to be thicker and stronger. These thicker and stronger portions are 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 bottom part of that joint capsule is commonly referred to as the plantar plate. This is required to be thicker and stronger because we put such a lot of force through it when running and walking and it has to be able to take it. Sometimes that force can be so high it could stress that plantar plate or ligament and it will become damaged. When this occurs, the technical name is plantar plate dysfunction and frequently it may progress to a tiny tear in the plate, therefore will get termed as a plantar plate tear .
Usually the symptoms for this are pain under the joint whenever walking or on deep touch or pressure, with the pain being more common in the direction of the distal part of the joint. It in most cases only impacts one joint but sometimes several may be affected. The toe may perhaps be somewhat raised as the plantar plate is can not secure the toe down due to the damage to its strength with the strain or tear. Typically the diagnosis is obvious, however, if not an ultrasound assessment is sometimes carried out to determine it. The treatment commonly consists of strapping the toe to hold it in a plantarflexed position so the plantar plate is relaxed to give it an opportunity to recover. A metatarsal pad can also be used in the shoe to help keep weightbearing from the affected area. If these procedures don't help, then a surgical repair of the plantar plate tear may be required.