The plantar plate is a ligament under the joints at the base of the toes in the foot. A plantar plate tear is when there is a small tear in that ligament. In the past this condition might have been called metatarsalgia, but that was a pretty generic term for any pain in the foot associated with the metatarsals. As more become known about the anatomy of the region and the role of the anatomy in different painful conditions the terms plantar plate dysfunction and plantar pate tear become better known to describe this condition. The condition typically starts with an ache under the metatarsal head in the foot that comes on gradually. Later it can be quite painful to touch. In some cases, the toe might become elevated as the tear means that the ligament has trouble holding the toe down which is one of the functions of that ligament. An ultrasound examination can be used to confirm the diagnosis.
The cause of this condition is not clear but is related to overuse and overstretching of the ligament. Some foot types also appear to get this more often. The usual initial treatment for a plantar plate tear is often strapping to hold the toe down to relieve the load on the ligament that has the tear. A metatarsal pad is often used as well or instead of the strapping to further relieve strain on that ligament. Sometimes padding to offload the painful area can give a lot of relief. Additionally, a stiff soled shoe can be used to further prevent the toe from bending can also be added to the above. Generally, this treatment needs to be used for at least a few months to see if it help. Generally, this works well in most cases. However, if it does not help, then surgical options need to be considered to repair the tear.