Surrounding each joint in the body is what is called a joint capsule. This capsule is what holds the bones each side of the joint together and keep the fluid in the joint which lubricates the joint in position. Portions of that joint capsule tend to be thicker and stronger. These thicker and stronger portions would be 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 underlying part of that joint capsule is typically known as the plantar plate. This will have to be thicker and stronger since we put such a lot of force through it whenever walking and running and it has to be able to resist it. Occasionally that force can be so high it may stress that plantar plate or ligament and it may become damaged. When this occurs, the technical name is plantar plate dysfunction and frequently it could progress to a minor tear in the plate, therefore gets called a plantar plate tear.
Usually the signs and symptoms for this are pain beneath the joint whenever walking or on palpation, with the pain being more common in the direction of the front side of the joint. It commonly only affects one joint but in some cases several might be affected. The toe may very well be somewhat elevated as the plantar plate is can not hold the toe down due to the injury to its strength from the strain or tear. Frequently the diagnosis is apparent, however, if not an ultrasound evaluation is commonly done to determine it. The treatment typically consists of taping the toe to hold it in a downward position so the plantar plate is relaxed to give it an opportunity to heal. A pad can also be used in the shoe to help keep weightbearing from the painful area. If these types of measures do not help, then a surgical repair of the plantar plate tear is usually necessary.