Plantar Fibromatosis. Wow, that's a mouthful! What is it? A lump in your arch that is firm and doesn't move. They usually start out as a very small pea sized nodule that increases in size over time. Most people don't even notice them until they get big enough to be annoying in your shoes or when walking barefoot. They can happen to anyone, but are most commonly seen in middle-aged to older patients and are much more common in men than woman. It is also more common in the Caucasian population than other ethnicities.
Most people come into the office complaining of a painful lump in their arch and are very concerned it is cancer. It is actually just an exuberant growth in the plantar fascia (a.k.a. the ligament that holds up your arch) or extra fibrous tissue. We really don't know why they occur, but it is thought that some kind of trauma plays a role in the formation of the nodules. I often see them in pilots and runners who have constant repetitive trauma to this area. Family history is also a factor. As many as 50% of patient with plantar fibromas also have nodules in the palm of their hands known as Dupuytren's contractures. There has been some correlation with medications like beta-blockers and anti-seizure medications. One study even linked an excessive amount of vitamin C with fibrous disorders. Patients with a history of chronic liver problems, diabetes, seizures and alcohol abuse seem to have a higher rate of plantar fibromas.
Treatments vary, but fall into three categories:
1. Do nothing: the nodules are annoying but usually self-limiting. They do not grow indefinitely, so if you can put them down as life's minor annoyance, most patients choose to just leave them alone.
2. Conservative or Non-invasive: Vigorous stretching, accommodative orthotics, physical therapy, and topical transderamal Verapamil.
3. Surgery: injections with a corticosteroid can be helpful to decrease the inflammation around the nodule, but if they are large and painful; most go on to surgical excision.
What should you do? A personal question, that only you with the help of your doctor can answer. In my opinion, if the nodule is small, leave it alone. If it is increasing in size, then it should be addressed. If the nodule is of moderate size, with no intrasubstance calcifications on x-ray, and is annoying; a three to six month trial of transdermal verapamil coupled with an accommodative orthotic and physical therapy can be helpful. If it meets these criteria and is a little soft, then a steroid injection may also help decrease the size. If the lesion is large, painful, or has intrasubstance calcifications on x-ray; then excision is most likely your best option. Simple excision is not enough with these lesions, removal of not only the lesion, but a large margin is necessary to decrease recurrence rates.
If you have a painful lump in your arch, seek the advice of your podiatrist. Help is only a phone call or mouse-click away!
Foot and ankle athletic injuries are very common. We specialize in sports medicine getting you back to sports as soon as possible. The most common foot and ankle sports injuries are plantar fasciitis, ankle sprains, shin splints, Achilles tendonitis, peroneal tendonitis, stress fractures, posterior tibial tendonitis, anterior tibial tendonitis, neuromas, tarsal tunnel syndrome, ankle instability, and metatarsalgia. Gait problems can also cause ileotibial band syndrome, patella tendonitis, back pain, hip pain and piriformis syndrome. Medications, injections, splinting, orthotics and/or physical therapy are often quite helpful in treating most injuries. Our doctors will discuss your injury and prescribe a course of treatment that will return you to sport stronger than when you came into the office.
Fall down, go boom? Foot and ankle trauma is extremely common no matter how young or old you are. Fractures, torn ligaments and tendons, sprain and strains, puncture wounds and toenail trauma occurs every day. Our physicians can help put you back together so that you can recover from your accident as fast as possible. Don't wait too long to seek medical advice after your accident or injury. Delaying treatment often only worsens the problem!
Foot pain related to congenital and acquired foot and ankle deformities is extremely prevalent in our society. Pain can be from flat feet or a high arched foot and associated gait problems; or be from a progressive deformity like a bunion or a hammertoe. Our doctors are extensively trained to diagnose and treat the underlying deformity to help you function at your best. We want to prevent your problems from getting worse, no matter what you inherited from your family! God may have had a sense of humor when he created your feet, but we will work with you to optimize your biomechanical function and aesthetics! No one should suffer from ugly, painful feet!
Neurological foot and ankle issues can be a burning or shooting pain, numbness, weakness or just a "pins and needles" sensation. Nerve can be affected by compression at the spine level, knee level, ankle level or in your foot. Neuropathy can be a subtle nerve degeneration from aging, diabetes, and a myriad of other causes. Do not assume your nerve issues will go away or that nothing can be done. A proper diagnosis can lead to alleviation of your nerve troubles.
Healthy Steps Shoe Store and Spa welcomes patients and their families as well as the surrounding communities of Grapevine, Southlake, Colleyville and beyond to help them with their therapeutic shoe gear needs. A certified pedorthotist is always available by appointment for consultation, and safe pedicures by a licensed medical nail technician highlight your spa experience. An extensive array of prefabricated and custom orthotics as well as many foot care essentials are also readily available to compliment your shoe and sandal purchases. We carry a wide variety of comfort shoe gear that are as pretty as they are comfortable.