What is the plantar plate?

The plantar plate is a fibrous like framework which is found on the bottom side of the metatarsophalangeals (toe) joints of the foot. Anatomically they are the same as the meniscus in the knee meaning they are meant to endure a lot of compressive forces and retain the joint surfaces. It's really a a thickening of the plantar surface of the capsule that surrounds that joint to help keep the joint lubricant inside the joint. Almost all the fibres within it are aligned longitudinally in the same path as the foot points, so it could withstand a lot of load forces. The collateral ligaments on both edges of the joint furthermore connect to the plantar plate, to help give the joint better stability. The purpose of the plantar plate is to try to support the weight of the body and limits dorsiflexion at the metatarsophalangeal joint.

Since this plantar plate is designed to hold up against those high forces, sometimes the forces can be so great or the ligament weakens for many different causes, it can become painful or perhaps have a little tear in it. This isn't typically something which comes about abruptly and builds up gradually with time. The pain is usually on weightbearing under the joint at the bottom of the toe. Palpation of this area is usually fairly painful. Usually the diagnosis can be confirmed with an ultrasound evaluation. In the past the symptoms could possibly have just been disregarded as a metatarsalgia which is not truly a diagnosis and simply indicates pain across the metatarsals. Now more is understood about this plantar plate and just how it produces symptoms, the procedure may be far better focused to correct it. The crucial element to repairing this problem is to relieve force on the plantar plate and to do that the toe really should be kept in a plantarflexed location with taping. This usually handles most instances.

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