Hard Nodule on the Bottom of My Foot: [Causes & Best Treatment]
What Is the hard nodule on the bottom of my foot? 90%+ of the this is a plantar fibroma. This is related to the #1 overall cause: plantar fasciitis.
- One of the top causes of heel pain is plantar fasciitis, this is damage to a ligament that holds your heel to your toes.
- There are also photos of heel spurs that can occur to the bottom of your heel (plantar fascia insertion) and the back of your heel (Achilles tendon insertion).
- Baxter’s nerve entrapment can also happen at the bottom of the heel.
- An underlying cause is an over pronated flatfoot, or an over supinated high arched foot.
- This can lead to the formation of a heel stress fracture( AKA calcaneus stress fracture.
Please click on the gallery for a guided tour through heel pain conditions!
What Is the hard nodule on the bottom of my foot overview:
- What Is the hard nodule on the bottom of my foot? 90%+ of the this is a plantar fibroma. This is a thickening somewhat related to plantar fasciitis.
- A plantar fibroma is a thickening of a tissue called the plantar fascia.
- Plantar fasciitis is usually related to this as this means inflammation of the plantar fascia.
- We go over the best overall treatment and products for fixing this challenging problem!
What Is A Plantar Fibroma?
- The hard nodule on the bottom of your foot is something referred to as a plantar fibroma. This is also known as plantar fascial fibromatosis.
- This fibroma is a benign fibrous tissue tumor or growth, it can occur anywhere else in the body. For example, these also occur in the uterus and they are called uterine fibroids. On the bottom of the foot, this is called a plantar fibroma. The term “benign” means that it is not cancerous. But to be nearly 100% safe sometimes a sample is needed to make 100% sure. It is very difficult to sometimes get rid of a plantar fibroma.
- These plantar fibromas are deep within the tissue, they are part of ethic fibrous band called the plantar fascia. This is different than a war for example, which will grow in the skin and not deep under the skin. A fibroma is a bump on the bottom of the foot that will make it hurt to walk. This is a thick concentration of connective tissue that can feel like a “pebble” or even larger or even many off them.
- Unfortunately this disorder will not go away on its own or in get smaller without any treatment. The clear definitive cause for this condition has not been clearly identified.
- This hard nodule is deep below the skin, it is usually not dangerous.
Around the world there is many different names that this is known by many different names around world. The most common name is a plantar fibroma or plantar fascial fibromatosis. The other names are listed below.
- Benign foot tumor.
- Foot fibroma.
- Plantar fascia fibromatosis.
- Letter hose disease (Dupuytren’s contracture of the feet)
- Hard lump on the bottom of the foot.
- Knot in the arch of the foot.
- A painful lump under the foot.
- Lump in arch of the foot.
- A Ganglion cyst on the bottom of the foot (more evaluation does have to be done to evaluate assistant verse this. A plantar fibroma is not a true cyst.)
These nodules are almost never dangerous as they are just thickening of the connective tissue and not a dangerous cancer of any type. They are extremely slow growing and have probably been developing for months or years before you have even noticed them, and they likely will continue growing slowly if they grow at all.
- Usually family history – it is a genetic connective tissue disorder.
- Can be associated with nodules in the palms and penis.
- Can be associated with Diabetes Mellitus
- Not painful itself, but painful on walking.
- The nodule is basically nothing more than a benign pebble stuck under your skin that can be removed.
- Can irritate you while walking on it.
- The single biggest sign of a plantar fibroma is the fact that it is an noticeable lump or bump an arch of the foot.
- The fibroma can remain the same size or even get larger as time goes on.
- It may turn into many additional surrounding fibromas.
- Some people who have a plantar fibroma may have pain, whereas other people may not have any pain at all.
- When pain does occur, it is usually as it is pressing against the hard surface.
- This can be your shoe, or the floor This bump will likely make it hurt to walk on a hard floor.
- To confirm the plantar fibroma, your podiatrist or foot specialist will examine the foot.
- Sometimes by evaluating manually and with an x-ray, we had most of the information we need that it is likely a plantar fibroma.
- Sometimes if there is any question, or if the situation is very painful and resistant, an MRI or even a biopsy may be performed to make sure that this is in fact the correct diagnosis.
- The odds are very low that this is something dangerous, but nothing is ever 100% medicine.
- The only way to 100% confirm the and nodule is in fact a plantar fibroma, is to get a soft tissue biopsy of this lesion.
Plantar Fibroma Treatment:
- In our clinic we have had a lot of success treating this non-surgically. In fact the good news is 95% of people tend to get better without any surgery at all.
- The podiatrists at our office have success with the following methods:
- If you are having significant pain and you need to get feeling better in a hurry, a storage injection could be a good solution. The main downside of a steroid injection is that it can be painful!
- The benefits of a steroid injection is that almost immediately within about 10 seconds you start getting some relief, the downside is that studies show that a steroid injection may be temporary, and is not a permanent solution in some cases.
Best Plantar Fascia Orthotics:
- This is my personal favorite treatment option, if you like with a modified orthotic with a cut out for the fibroma, we can make the pain go away 90% of the time.
- As enough time goes by the fibroma should start to relieve by itself with the pain decreasing to the site.
- The goal of the orthotic is to redistribute the pain away from the patients nodule on the bottom of their foot, and as there is less stress, there is then less inflammation and pain.
Shockwave therapy in the office:
- We have had a lot of success utilizing shockwave therapy in the office, although this is something where there is not a ton of evidence just yet.
- With medicine we generally do want to have published studies to confirm treatment option, and as a result shockwave therapy does not have a lot of evidence for insurance approval is a procedure just yet.
- But while utilizing this on a plantar factual nodule, we have found the risk to be almost nothing, you can walk almost right away, and as time goes on these nodules can start to disappear.
- Anecdotally we have had a lot of success, I would even say over 75% of the time the start to improve.
- If the nodule is too large, you will not have this solved with shockwave therapy alone.
Surgery plantar fibroma:
- Surgical treatment for the removal of this plantar fibroma can be considered if it continues to grow.
- The removal of the plantar fibroma is an in-hospital surgical procedure. The downside is that there is a high incidence of recurrence with this condition.
- The best bet is to work with your podiatrist and foot and ankle specialist to see what types of treatment options are recommended.
- Even after the surgery is performed it is still recommended that you a good foot orthotic to keep pressure off the site. Even with surgical resection there’s still a chance that this could still have some recurrence.
- It takes about three months to resume normal activity after surgery like this.
Plantar Fibroma excision surgery recovery time:
Weeks 1 to 2:
- For the first two weeks you will have a dressing in place, sutures are generally still in place during this time.
- We will go over your biopsy results at this point, we will confirm that nothing dangerous is going on through this site.
- At the end of two weeks we tend to remove the sutures, if it is a bigger incision site and is only healing, it may be three.
Weeks 3 to 4:
- At weeks 3 to 4 if you incision site is well healed, we can transition you into a walking boot, you will wear this walking boot for weeks three through about six.
- At about six weeks or incision sites are well healed, and you can get out of the walking yearbook.
- At this point people generally tolerated good supportive soft orthotic to take pressure off the site.
- If the knot is not that big or is just irritating the bottom of your foot, but you don’t want to get it removed then just treat the condition as if though it was plantar fasciitis and follow our four stage treatment guide:
Best Plantar Fibroma Products:
- There are usually two phases to treating plantar fasciitis pain.
- The two phases of treatment include controlling the acute inflammation, and correcting the biomechanics which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the bio-mechanical causes to ensure that they can never become over worked and inflamed again!
- This doesn’t matter whether it’s plantar fasciitis, plantar fibroma, sore bottom of foot, or even Achilles tendon pain. Treatment is all roughly very similar.
Plantar Fibroma Cure & Natural Treatment:
Massage & Ice Products:
- Ice is the an excellent option that can be safe for almost everyone.
- There is some debate whether icing is worth doing, but for chronic pain this can help limit the need for medications and keep your options open.
- This works great for your arch, less for the ball of the foot.
- Manual massage on the plantar fibroma is a natural treatment that can also be considered physical therapy for your plantar fibroma.
- This works to break up the plantar fascia nodule. This works well for small plantar fibroma nodules.
- The more muscle and ligament tissue there is, the better ice will work there.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for pain relief, but this will not make the actual nodule go away.
- These can work great for loosening your muscles.
- This allows less tightness and pressure onto the plantar fascia and heel.
- This is very effective for the arch, the gastrocnemius or calf muscle and for the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
- The massage stick can break up lumps in your plantar fascia and small plantar fibroma nodules.
Remove the Plantar Fascia Stress:
- The key is to prevent future pain stress and trauma to the plantar fibroma nodule.
- This means keeping you active while keeping stress off of your plantar fascia tendon. This will prevent future re-injury and development of plantar fasciitis.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Best Shoes for Plantar Fibroma Pain:
- Getting a great supportive pair of plantar fibroma shoes will make sure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain or Achilles tendonitis as well.
- Consider plantar fibroma shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Plantar Fibroma Insoles:
- These are our recommended orthotics for plantar fibroma pain.
- Custom orthotics can work very well, but they should not be a first line of treatment due to the cost.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full length orthotic.
- A further home remedy tip for plantar fibroma pain is to cut out a hole where the nodule is using scissors or a knife. Be careful and start with a very low cost orthotic.
Best Full Length Plantar Fibroma Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats or most women’s dress shoes.
Best Dress Shoe Plantar Fibroma Orthotics:
- These are a great choice for dress orthotics.
Best 3/4 Length Plantar Fibroma Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- This is a for of plantar fibromatosis physical therapy that breaks up the scar tissue.
- We personally prefer this method of stretching.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This is a very good plantar fibroma physical therapy that you can do at home.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- It can be used while watching TV or at night time.
Best Heel Compression Brace:
- A good compression brace can stabilize your foot from turning outward.
- This prevents your foot from pronated.
- Pronated foot will turn your foot outward in your foot will rub on the outside of the shoe.
- For many of her patients this has solved their pain and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.
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Best Heel Stability Brace:
- Stability brace goes little bit further than the compression brace to stop your foot from turning out.
- This takes pressure off of your heel and plantar fascia.
- At the same time this is a little bit bulkier and does not affect every shoe.
- We find people are little bit happier trying the compression brace before the stability brace.
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Severe Plantar Fibroma Pain:
- If you think you might have a broken heel, a calcaneal stress fracture or something of similar severity, these products might help!
- Always remember to see a foot and ankle specialist like a podiatrist if you are having plantar fasciitis or more severe pain!
Plantar Fascia Tear, Broken Heel Bone, Achilles Tendon Tear:
- If you have a traumatic injury such as a torn plantar fascia ligament, calcaneus stress fracture, heel fracture or insertional Achilles tendon injury: consider protecting your foot!
- The best way to do this is of course to see your podiatrist and get evaluated with an x-ray, ultrasound and potentially even an MRI or CT scan.
- If you are unable to do so it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long period of time when they suffer a traumatic injury, unfortunately there is no other way around us in labor jobs.
- If you have a sit down job there are ways to get people back to work quicker, but this can be very difficult otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. If you are immobilized too long the cons are that you will gradually become stiff and overworked to your other leg. The Pros are that you injured heel will hopefully have a chance to gradually heal!
- Our favorite fracture boots and their supplies:
Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices.
- If your plantar fibroma pain is severe, offloading it can be very effective until the pain calms down.