The plantar plate is a fibrous like framework that is located on the bottom side of the metatarsophalangeals (toe) joints of the feet. Anatomically these are like the meniscus from the knee meaning these are made to stand up to a lot of compressive forces and retain the joint surfaces. It is just a a thickening of the plantar surface of the capsule which is all around that joint to hold the joint lubricant inside the joint. Almost all the fibers in it are aligned longitudinally in the identical direction as the foot points, so it may stand up to lots of tension forces. The collateral ligaments on both sides of the joint also attach to the plantar plate, to help give the joint greater stability. The purpose 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 built to tolerate those great forces, from time to time the forces can be so high or the plate is weakened for several possible explanations, it could end up painful and even have a tiny tear in it. This isn't commonly a thing that occurs suddenly and builds up gradually over time. The pain sensation is usually on weightbearing under the joint at the bottom of the toe. Palpation of this location is frequently rather painful. Often the diagnosis may be confirmed by having an ultrasound evaluation. Previously the symptoms will often have just been dismissed as a metatarsalgia which is not truly a diagnosis and simply means pain throughout the metatarsals. Now more is understood concerning this plantar plate and the way it makes symptoms, the procedure can be far better directed to correct it. The key to solving this issue is to relieve force on the plantar plate and to do this the toe must be kept in a plantarflexed posture with strapping. This often manages most cases.