The plantar plate is a fibrous like structure which is situated on the bottom side of the metatarsophalangeals (toe) joints of the feet. Anatomically they are like the meniscus from the knee meaning these are created to stand up to a lot of compressive loads and retain the joint surfaces. It is a a thickening of the bottom part of the joint capsule that is all around that joint to hold the joint lubricant inside the joint. Most of the fibres within it are oriented longitudinally in the same path as the foot points, so it may endure a lot of tension forces. The collateral ligaments on both sides of the joint also attach to the plantar plate, to help provide the joint improved stability. The function of the plantar plate is to support the weight of the body and restricts dorsiflexion of the metatarsophalangeal joint.
Because this plantar plate is designed to tolerate those high forces, in some cases the forces can be so high or the plate is weakened for several different causes, it might turn out to be painful and even have a tiny split in it. This is not commonly a thing that takes place quickly and develops gradually with time. The pain sensation is normally on weightbearing beneath the joint at the bottom of the toe. Palpation of that region is frequently rather painful. Often the diagnosis may be verified with an ultrasound examination. Previously the symptoms may have just been dismissed as a metatarsalgia which isn't really a diagnosis and just means pain throughout the metatarsals. Now a lot more is understood concerning this plantar plate and the way it makes symptoms, the procedure can be better aimed to remedy it. The main element to solving this condition is to reduce force on the plantar plate and to do this the toe really should be held in a plantarflexed placement with strapping. This usually takes care of many cases.