Plantar fibromas are benign soft tissue growth within the plantar fascia. This often present as a nodular bump in the instep. These are often painful especially with direct pressure. Patients will sometimes also have Dupuytren's contractu affecting their hands. They also often have a high arch foot structure. These are often diagnosed and confirmed with diagnostic ultrasound imaging and physical exam.

 

These can be difficult to treat. Typical treatments include prescription orthotics, cortisone injections, shockwave therapy, and ultrasound therapy. Surgical excision can be done, however there is a high recurrence rate. Prescription orthotics are particularly effective. These orthotics work by supporting the longitudinal arch to decrease the strain within the fascia. In addition prescription orthotics can have a plantar fascial groove.  This is where the Doctor marks the foot to show where the band of the plantar fascia bowstrings out especially when the great toe is raised or dorsiflexed.  This marked area will then transfer to either a plaster cast or the 3-D optical scanner. In addition, we often mark the plantar fibroma to make further create a depression within the orthotic here that is filled with soft but supportive foam. This way the foot has support but the areas that are most sensitive have much softer support and the orthotics do not "dig in to the arch". Other treatments such as cortisone injections ultrasound shockwave therapy are all helpful but are even more effective when combined with a special orthotics that have a "sweet spot".