Some people describe a sensation under the ball of their foot that is like a sock being bunched up, but when they check the sock is not bunched up. The sensation is commonly mentioned to and is frequently perplexing to people with teh sensation and clinicians. Most probably the sensation is due to a problem with a ligament at the base of one or more of the metatarsophalangeal (toe) joints of the foot termed plantar plate dysfunction. About each joint, there is a strong covering known as the joint capsule. Parts of each joint capsule are thicker which are the ligaments which guard and stabilise the joints. Under the bottom of the metatarsophalangeal joints, that joint capsule is thicker to create what is called the plantar plate. It is possible to strain or even get a minor tear in that plantar plate, which creates that experience of a sock which seems like its bunched up below the toes.
The symptoms usually commences slowly and gradually below the ball of the foot and can be preceded by that peculiar bunched sock sensation. The most common characteristic of plantar plate dysfunction is pain on palpation in the vicinity of the plantar plate. A competent clinician will be able to move the joint in a manner to identify when the plantar plate is impaired. A conclusive diagnosis may be possible with a diagnostic ultrasound, but it can be really clear to a expert clinician on examination. Normally the first treatment solutions are taping to hold the toe pointing downwards to relieve the strain on the ligament. A metatarsal pad is also commonly used to help reduce the strain on the plantar plate. This usually improves most cases of plantar plate dysfunction and get rid of that weird experience of a bunched up sock beneath the ball of the foot. If those conservative steps do not help, surgical repair of a partial or complete split of the plantar plate is commonly performed.