Surrounding each joint in the body is what is known as a joint capsule. This kind of 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. Areas of this joint capsule are usually thicker and stronger. These thicker and stronger portions would be the ligaments that give stability to the joint. In the joints at the base of the toes in the foot, the metatarsophalangeal joints, the thickened lower part of that joint capsule is normally called the plantar plate. This ought to be thicker and stronger as we put a whole lot of force through it whenever walking and running and it has to be able to resist it. Sometimes that force may be so great it can strain that plantar plate or ligament and it can become damaged. When this occurs, the medical term is plantar plate dysfunction and in some cases it can progress to a minor tear in the plate, so gets termed as a plantar plate tear.
Typically the symptoms for this are pain underneath the joint when walking or on deep touch or pressure, with the pain being more established in the direction of the front side of the joint. It normally only affects one joint but sometimes several can be affected. The toe may very well be somewhat elevated as the plantar plate is unable to hold the toe down due to the damage to its strength from the strain or tear. Generally the diagnosis is evident, however, if not an ultrasound assessment is commonly done to determine it. The therapy usually includes strapping the toe to keep it in a downward position so the plantar plate is rested so it can have a chance to recover. A pad could also be used in the shoe to keep weightbearing from the painful area. If these steps don't help, then a surgical repair of the plantar plate tear are usually necesary.