The plantar plate is an important structure of the first metatarsophalangeal joints in the foot. The plantar plate is part of the plantar fascia and is a thickening of the plantar aspect of the joint capsule. Plantar plate dysfunction is a common cause of pain under the first metatarsophalangeal joint. Ultrasound often demonstrates a plantar plate tear that may need surgical repair. The treatment of a plantar plate dysfunction is initially to use something like a metatarsal pad or strapping to plantarflex the toe to allow it to heal. Often a metatarsal pad may need to be used long term.