Surrounding every joint in the body is what is known as a joint capsule. That capsule is what supports the bones either side of the joint together and keep the fluid in the joint that lubricates the joint in position. Parts of that joint capsule are usually thicker and stronger. These thicker and stronger areas would be the ligaments which give stability to the joint. In the joints on the base of the toes in the foot, the metatarsophalangeal joints, the thickened underside of that joint capsule is typically called the plantar plate. This needs to be thicker and stronger as we place a whole lot of force through it whenever walking and running and it has to be able to take it. From time to time that force may be so high it will strain that plantar plate or ligament and it will become painful. When this occurs, the technical name is plantar plate dysfunction and frequently it might go on to a minor tear in the plate, so will get known as a plantar plate tear.
Most of the symptoms for this plantar plate injury are pain under the joint whenever walking or on palpation, with the pain being more established toward the front edge of the joint. It generally only affects one joint but in some cases several may be affected. The toe can be moderatly raised as the plantar plate is not able to hold the toe down due to the injury to its integrity from the strain or tear. Quite often the diagnosis is obvious, however, if not an ultrasound assessment is commonly carried out to confirm it. The treatment for plantar plate injury normally includes taping the toe to hold it in a downward position so the plantar plate is under less load to give it a chance to recover. A metatarsal pad may also be used in the footwear to help keep weightbearing from the affected region. If these methods don't help, then a surgical repair of the plantar plate tear are usually necessary.
