Surrounding every joint in the body is what is called 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 the joint in position. Regions of this joint capsule tend to be thicker and stronger. These thicker and stronger parts 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 generally referred to as the plantar plate. This is required to be thicker and stronger since we put a huge amount of force through it when walking and running and it has to be able to resist it. Occasionally that force can be so high it might strain that plantar plate or ligament and it will become damaged. When this occurs, the technical term is plantar plate dysfunction and in some cases it may go on to a tiny tear in the plate, so gets known as a plantar plate tear.
Most of the signs and symptoms for this are pain beneath the joint whenever walking or on deep touch or pressure, with the pain being more common in the direction of the front edge of the joint. It generally only impacts one joint but sometimes several might be affected. The toe could be slightly raised as the plantar plate is not able to secure the toe down due to the damage to its strength with the strain or rupture. Generally the diagnosis is evident, however, if not an ultrasound assessment is often done to verify it. The therapy typically includes strapping the toe to hold it in a plantarflexed position so that the plantar plate is rested to give it a chance to recover. A metatarsal pad may also be used in the shoe to help keep weightbearing from the affected location. If these types of steps don't help, then a surgical repair of the plantar plate tear are usually necesary.