Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Plantar fibromatosis — Ledderhose disease — is a benign fibroproliferative condition of the plantar fascia producing firm, non-tender or mildly tender nodules within the central band of the plantar fascia. Although benign, plantar fibromatosis can be locally invasive, recurs after incomplete excision, and in advanced cases produces nodules large enough to impair weight-bearing. The condition is related to Dupuytren’s contracture of the hand and Peyronie’s disease, sharing the same fibroblastic proliferation pathology.

Clinical Presentation and Diagnosis

Plantar fibromatosis presents as one or more firm, palpable, non-tender or mildly tender nodules within the medial band of the plantar fascia — typically at the mid-plantar foot between the heel and the ball of the foot. The nodules are fixed to the plantar fascia and do not move with toe dorsiflexion (distinguishing them from plantar warts, which are epidermal and move with the skin). MRI characterizes the lesion extent and confirms the diagnosis: the nodules appear as low-to-intermediate signal on T1 and T2 sequences (reflecting dense fibrous tissue) — this MRI pattern distinguishes plantar fibromatosis from malignant soft tissue tumors, which typically show high T2 signal.

Treatment

Conservative management: accommodative insoles with cut-outs beneath the nodule reduce direct weight-bearing pressure — the most appropriate initial management for asymptomatic or mildly symptomatic cases. Intralesional steroid injection: reduces nodule size in 60–70% of patients in short-term follow-up; effects may be temporary. Collagenase injection (Xiaflex): evidence from small series shows nodule reduction with intralesional collagenase — may be more durable than corticosteroid. Radiation therapy (low-dose): reduces nodule progression in early-stage disease. Surgical excision: reserved for large nodules causing functional limitation and failing conservative management; wide excision including the entire plantar fascia medial band reduces but does not eliminate recurrence risk (recurrence 25–50% after local excision alone). Dr. Biernacki at Balance Foot & Ankle evaluates plantar nodules with diagnostic ultrasound and MRI when needed, and provides conservative management and surgical consultation for plantar fibromatosis. Call (810) 206-1402 at our Bloomfield Hills or Howell office.

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Frequently Asked Questions

When should I see a podiatrist?

See a podiatrist for any foot or ankle pain that persists more than 2 weeks, doesn’t improve with rest, limits your daily activities, or is accompanied by swelling, numbness, or skin changes. People with diabetes or circulation problems should see a podiatrist regularly even without symptoms.

What does a podiatrist treat?

Podiatrists diagnose and treat all conditions of the foot, ankle, and lower leg including plantar fasciitis, bunions, hammertoes, toenail problems, heel pain, nerve pain, diabetic foot care, sports injuries, fractures, and foot deformities — both surgically and non-surgically.

What can I expect at my first podiatry visit?

Your first visit includes a full medical history, physical examination of your feet and gait, and in-office diagnostic imaging if needed (X-rays, ultrasound). We’ll discuss your diagnosis and create a personalized treatment plan. Most visits take 30–45 minutes.

Need Treatment at Balance Foot & Ankle?

Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

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Plantar Fibroma (Ledderhose Disease) Treatment in Michigan

Plantar fibromatosis causes firm, painful lumps in the arch that can make walking difficult. Our podiatrists offer comprehensive management from orthotic offloading and verapamil injections to surgical excision for fibromas that don’t respond to conservative care.

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Clinical References

1. Sammarco GJ, Mangone PG. Classification and treatment of plantar fibromatosis. Foot Ankle Int. 2000;21(7):563-569.
2. Donato RJ, Morrison WA. Dupuytren’s disease in the foot. J Hand Surg Br. 1996;21(3):364-366.
3. Young JR, Sternbach S, Willinger M, et al. The etiology, evaluation, and management of plantar fibromatosis. Orthop Res Rev. 2019;11:1-7.