The plantar plate is a fibrous like structure that is located on the plantar side of the metatarsophalangeals (toe) joints of the foot. Anatomically these are similar to the meniscus in the knee which means they are meant to withstand a great deal of compressive loads and support the joint surfaces. It is a a thickening of the bottom part of the joint capsule that is all around that joint to help keep the joint lubricant within the joint. Almost all the fibres within it are oriented longitudinally in the identical path as the foot points, so it will be able to stand up to lots of load forces. The collateral ligaments on both edges of the joint additionally connect to the plantar plate, to help provide the joint increased stability. The role of the plantar plate is to support the weight of the body and limits dorsiflexion of the metatarsophalangeal joint.
Because this plantar plate is designed to hold up against those high forces, sometimes the forces can be so great or the ligament is weakened for several different causes, it may become painful or maybe have a small tear in it. This is not usually something that happens suddenly and develops slowly with time. The pain is invariably on weightbearing under the joint at the bottom of the toe. Palpation of that place is frequently fairly painful. Often the diagnosis might be validated with an ultrasound assessment. Previously the symptoms could possibly have just been disregarded as a metatarsalgia which is not really a diagnosis and simply means pain throughout the metatarsals. Now more is understood about this plantar plate and just how it produces symptoms, the treatment may be far better aimed to make it better. The main element to solving this condition is to relieve force on the plantar plate and to do this the toe should be kept in a plantarflexed placement with taping. This usually handles many cases.