What is the plantar plate?
The plantar plate is a fibrous like structure that is situated on the bottom side of the metatarsophalangeals (toe) joints of the foot. Anatomically these are just like the meniscus within the knee meaning these are meant to withstand lots of compressive forces and retain the joint surfaces. It is a a thickening of the underside of the capsule that is all around that joint to keep the joint fluid inside the joint. The vast majority of fibers inside it are oriented longitudinally in the similar direction as the foot points, so it could hold up against a lot of tension forces. The collateral ligaments on both edges of the joint also connect to the plantar plate, to help give the joint improved stability. The function of the plantar plate is to support the weight of the body and restricts dorsiflexion at the metatarsophalangeal joint.
Since this plantar plate is made to tolerate those great forces, from time to time the forces can be so great or the ligament weakens for many different causes, it may end up painful or even have a tiny split in it. This is not ordinarily something which comes about suddenly and builds up gradually with time. The pain sensation is frequently on weightbearing underneath the joint at the base of the toe. Palpation of this region is usually fairly painful if there is a plantar plate tear. Usually the diagnosis might be verified by having an ultrasound examination. In the past the signs and symptoms could possibly have just been disregarded as a metatarsalgia which is not really a diagnosis and just implies pain across the metatarsals. Currently much more is understood regarding this plantar plate and just how it produces symptoms, the procedure could be far better directed to correct it. The key to solving this problem is to relieve force on the plantar plate and to do this the toe should be kept in a plantarflexed location with strapping. This usually takes care of most all cases.