The plantar plate is a fibrous like framework which is situated on the plantar side of the metatarsophalangeals (toe) joints of the foot. Structurally these are similar to the meniscus from the knee indicating they are meant to withstand a lot of compressive loads and retain the joint surfaces. It's really a a thickening of the bottom part of the capsule that is all around that joint to help keep the joint lubricant within the joint. Almost all the fibers within it are aligned longitudinally in the similar direction as the foot points, so it will be able to resist a lot of load forces. The collateral ligaments on both edges of the joint also attach to the plantar plate, to help provide the joint better stability. The function of the plantar plate is to try to support the weight of the body and restricts dorsiflexion of the metatarsophalangeal joint.
As this plantar plate is designed to stand up to those high forces, in some cases the forces may be so great or the structure is weakened for many possible reasons, it can become painful and even have a little split in it. This is not typically something which occurs suddenly and builds up slowly with time. The discomfort is usually on weightbearing beneath the joint at the base of the toe. Palpation of this area is invariably rather painful. Frequently the diagnosis may be validated with an ultrasound examination. Previously the symptoms will often have just been dismissed as a metatarsalgia which is not actually a diagnosis and just signifies pain across the metatarsals. Now far more is known regarding this plantar plate and just how it produces symptoms, the treatment could be far better focused to repair it. The main element to repairing this problem is to relieve stress on the plantar plate and to do that the toe ought to be kept in a plantarflexed posture with strapping. This usually takes care of many cases.