Surrounding each joint in the body is what is called a joint capsule. This kind of capsule is what holds the bones each side of the joint together and keep the fluid in the joint which lubricates it in place. Parts of this joint capsule are usually thicker and stronger. These thicker and stronger portions are the ligaments that give stability to the joint. In the joints at the base of the toes in the feet, the metatarsophalangeal joints, the thickened underside of that joint capsule is commonly known as the plantar plate. This will have to be thicker and stronger since we place a whole lot of force through it whenever running and walking and it has to be able to resist it. In some cases that force can be so great it might stress that plantar plate or ligament and it can become damaged. When this happens, the technical name is plantar plate dysfunction and frequently it may progress to a minor tear in the plate, therefore gets termed as a plantar plate tear.
Typically the signs and symptoms for this are pain under 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 sometimes several can be affected. The toe might be somewhat elevated as the plantar plate is can not retain the toe down because of the injury to its strength with the strain or rupture. Commonly the diagnosis is evident, however, if not an ultrasound examination is sometimes done to verify it. The treatment generally includes strapping the toe to keep it in a plantarflexed position so that the plantar plate is less stressed to give it an opportunity to get better. A metatarsal pad can also be used in the footwear to keep weightbearing from the damaged location. If these procedures don't help, then a surgical repair of the plantar plate tear is usually necessary.