Crazy word…fibromatosis. 

But this condition can cause large knots on the bottom of the feet that can be very painful. Plantar fibromatosis refers to the condition where firm, nodular masses appear on the bottom of the feet usually in the arch. This is one of those conditions that we are not sure why it occurs. For some reason, the ligament on the bottom of the foot called the plantar fascia develops thickened areas. These areas can be very small and go undetected or become quite large and painful to walk on. This may occur for no reason, from trauma to the foot or genetic reasons.

The best treatment for plantar fibromas is conservative.

1.Try wearing soft soled shoes or padding around the nodules to reduce pressure. 

2.Deep tissue massage may reduce the size of the nodules and physical therapy can aid in this process with ultrasound therapy. 

3.If the nodule is painful, a steroid injection can reduce the inflammation and sometimes resolve it completely. 

4.If the fibromas are large enough, custom orthotics may be made to completely offload the painful areas. 

5.There is a topical medication, verapimil, that can be applied to the fibromas. This is considered experimental by most insurance companies, but has been shown to improve or resolve the nodules completely in 3-6 months. 

Xrays will be taken to ensure the lump or knot is not a foreign body stuck in the soft tissues or from a bone spur. An MRI can also be useful when the nodule does not respond to usual treatment.

If conservative treatment fails, and the nodules are painful, then surgery may be your next option. To remove the fibromas, an incision is made on the bottom of the foot and a large section of the plantar fascia is removed. This requires at least 3-4 weeks of no weight on the foot and attempt at reducing a painful scar must be made by using Mederma or physical therapy. But even taking this out, there is a 20% chance it can return. This is why we try all conservative treatments possible.

If you think you have plantar fibromas, see your podiatrist for treatment. In this case, they earlier the treatment, the better the outcome could be.