Plantar Fibromatosis: What It Is, What It Feels Like, and What You Can Do About It

If you've noticed a firm, slow-growing lump on the bottom of your foot — particularly along the arch or instep — you may be dealing with a condition called plantar fibromatosis. It's not as well known as plantar fasciitis, but for the people who have it, it can be just as disruptive to daily life.

Plantar fibromatosis is a benign (non-cancerous) condition in which fibrous nodules develop within the plantar fascia — the thick band of tissue that runs along the bottom of your foot from heel to toes. These nodules can start small and painless, but over time they may grow, multiply, and become painful enough to affect how you walk, stand, and go about your day.

This guide covers everything you need to know: what plantar fibromatosis is, what causes it, how it's different from other foot conditions, what treatment options are currently available, and what role clinical research may play in finding better solutions.

What Exactly Is Plantar Fibromatosis?

Plantar fibromatosis — also known as Ledderhose disease — is a type of fibromatosis, which means it involves an abnormal overgrowth of fibrous connective tissue. In this case, the overgrowth happens in the plantar fascia, creating one or more hard, rubbery nodules embedded in the tissue along the sole of the foot.

The condition is named after Georg Ledderhose, a German surgeon who first described it in 1894. It belongs to the same family of conditions as Dupuytren's contracture, which affects the hand. In fact, some people refer to plantar fibromatosis as "Dupuytren's of the foot" — and it's not uncommon for someone to develop both conditions, either simultaneously or at different points in their life.

The nodules themselves are made up of densely packed collagen fibres produced by cells called myofibroblasts. They're not tumours in the traditional sense — they don't spread to other parts of the body — but they can be locally aggressive, growing into surrounding tissue and becoming difficult to remove completely.

How common is it?

Plantar fibromatosis is considered relatively uncommon, but exact prevalence is hard to pin down because many people with small, painless nodules never seek medical attention. It's more frequently diagnosed in men than women, and tends to appear most often between the ages of 30 and 60. People of Northern European descent appear to be at higher risk, which aligns with the genetic patterns seen in Dupuytren's disease.

What Does Plantar Fibromatosis Feel Like?

The experience of plantar fibromatosis varies considerably from person to person. Some people discover a small, firm lump on the bottom of their foot and never experience any pain. Others find that the nodules grow steadily, becoming a constant source of discomfort that interferes with walking, standing, exercising, and even sleeping.

In the early stages, you might notice:

A small, hard lump on the arch or instep of your foot, typically between the heel and the ball of the foot
The lump feels firm and rubbery, almost like a marble embedded under the skin
It may be painless at first, or only noticeable when pressing on it directly
You might feel it more when walking barefoot on hard surfaces

As the condition progresses, symptoms can include:

The nodule growing larger, or additional nodules appearing nearby
Pain when walking, particularly on hard surfaces or when wearing shoes that press against the lump
A feeling of walking on a pebble or a folded sock
Difficulty finding comfortable footwear
Changes in how you walk (gait changes) as you unconsciously shift weight away from the painful area
Pain that persists even at rest, in more advanced cases

One of the frustrating aspects of plantar fibromatosis is its unpredictability. Nodules can remain stable for months or years and then suddenly begin growing. Some people develop a single nodule; others develop multiple nodules in one or both feet. There's no reliable way to predict how the condition will behave in any individual case.

What Causes Plantar Fibromatosis?

The honest answer is that researchers don't fully understand what triggers plantar fibromatosis. Unlike many foot conditions, it isn't caused by overuse, poor footwear, or a specific injury — though trauma to the foot may play a role in some cases.

What is known is that certain factors appear to increase risk:

Genetics. This is likely the strongest factor. Plantar fibromatosis runs in families and shares genetic overlap with Dupuytren's contracture. If you have a close relative with either condition, your risk is higher. The connection to Northern European ancestry further supports a genetic component.

Age and sex. The condition is more common in middle-aged and older adults, and is diagnosed more frequently in men — though women can certainly develop it too.

Other fibromatosis conditions. People with Dupuytren's contracture (thickening of tissue in the hand) are significantly more likely to develop plantar fibromatosis. Some people also develop Peyronie's disease, another related fibromatosis condition. When multiple fibromatosis conditions occur together, it's sometimes referred to as Dupuytren's diathesis.

Chronic liver disease and diabetes. Some studies have found associations between plantar fibromatosis and liver disease (particularly those related to alcohol use) as well as diabetes, though the mechanisms aren't fully understood.

Repeated trauma or micro-injury. There's a theory that repeated minor trauma to the plantar fascia — from high-impact activities, hard surfaces, or certain occupations — may trigger the abnormal healing response that leads to nodule formation. This hasn't been conclusively proven, but it's a plausible contributing factor.

Medications. Some research has suggested a possible link between long-term use of certain medications (including some anti-seizure drugs and beta-blockers) and the development of fibromatosis conditions, though evidence is limited.

Plantar Fibromatosis vs. Plantar Fasciitis: What's the Difference?

This is one of the most common sources of confusion, and understandably so — the names sound almost identical, and both conditions affect the plantar fascia. But they're fundamentally different problems.

Plantar fasciitis is an inflammatory condition. It occurs when the plantar fascia becomes irritated, inflamed, and micro-torn — typically at the point where it attaches to the heel bone. The hallmark symptom is heel pain, especially with the first steps in the morning or after long periods of sitting. Plantar fasciitis is extremely common (affecting roughly 1 in 10 people at some point in their lives), is usually caused by overuse or biomechanical issues, and typically responds well to conservative treatments like stretching, orthotics, and rest.

Plantar fibromatosis is a growth condition. It involves the formation of fibrous nodules within the plantar fascia itself — not at the heel, but usually along the arch or midfoot. The pain comes from the nodule pressing against surrounding tissue and the ground, not from inflammation of the fascia. It's much less common than plantar fasciitis, doesn't reliably respond to the same treatments, and has a tendency to recur even after surgical removal.

If you have a firm, palpable lump on the bottom of your foot — something you can feel with your fingers — it's more likely to be a plantar fibroma than plantar fasciitis. If your primary symptom is heel pain without a noticeable lump, plantar fasciitis is the more likely culprit. Of course, only a medical professional can give you a definitive diagnosis.

How Is Plantar Fibromatosis Diagnosed?

Diagnosis usually begins with a physical examination. A doctor will feel the bottom of your foot for nodules, assess their size and location, and ask about your symptoms. In many cases, the combination of a palpable firm lump along the plantar fascia and characteristic symptoms is enough for a clinical diagnosis.

To confirm the diagnosis or rule out other conditions, imaging may be used:

Ultrasound is often the first imaging tool. It can clearly show the size, shape, and location of plantar fibromas and distinguish them from other types of soft tissue masses.

MRI provides more detailed information and is particularly useful for surgical planning. It can show the extent of the fibroma within the plantar fascia and its relationship to surrounding structures.

In rare cases where the diagnosis is uncertain, a biopsy may be performed — though this is uncommon for plantar fibromas, which have a distinctive appearance on imaging.

Current Treatment Options for Plantar Fibromatosis

Treatment for plantar fibromatosis generally follows a stepwise approach, starting with conservative (non-surgical) options and escalating to more invasive interventions if symptoms warrant it.

Conservative (Non-Surgical) Approaches

Orthotics and padding. Custom or over-the-counter orthotic insoles can help redistribute pressure away from the nodule, reducing pain during walking and standing. Some people find relief from simple padding — a doughnut-shaped pad placed around the nodule can take direct pressure off it. This doesn't shrink the fibroma, but it can make daily life significantly more comfortable.

Stretching and physical therapy. Gentle stretching of the plantar fascia and calf muscles can help manage discomfort, though it won't address the nodule itself. Some physiotherapists use techniques like soft tissue mobilisation around (not directly on) the fibroma.

Steroid injections. Corticosteroid injections into or near the fibroma can reduce pain and may temporarily shrink the nodule. However, the effects are often short-lived — the nodule typically returns to its original size within weeks or months. Repeated steroid injections also carry risks, including weakening of the plantar fascia.

Topical treatments. Verapamil gel (a calcium channel blocker applied topically) has been used by some practitioners with the aim of softening and shrinking fibromas. Evidence for its effectiveness is mixed — some patients report improvement, while clinical studies have produced inconsistent results.

More Aggressive Approaches

Radiation therapy. Low-dose radiation therapy applied to the plantar fascia has shown promise in some studies for preventing further growth of fibromas, particularly in the early stages. It's more commonly used in European countries than in the United States. The treatment typically involves a series of short sessions over one to two weeks.

Cryotherapy and shockwave therapy. Some providers offer cryosurgery (freezing) or extracorporeal shockwave therapy (ESWT) for plantar fibromas. Evidence for these approaches is limited, and they're not widely considered standard treatments.

Surgery. Surgical removal of the fibroma — or in some cases, the entire affected section of plantar fascia (a fasciotomy or fasciectomy) — is generally considered a last resort. Surgery can be effective, but it comes with significant caveats:

High recurrence rates. This is the biggest challenge. Plantar fibromas recur after surgery in a significant percentage of cases — some studies report recurrence rates of 50% or higher. The more aggressive the growth, the more likely it is to come back.
Recovery time. Depending on the extent of surgery, recovery can take weeks to months, during which weight-bearing may be restricted.
Potential complications. Removing part of the plantar fascia can alter foot mechanics, potentially leading to new problems like flat foot, nerve damage, or chronic pain at the surgical site.

Because of these challenges, most foot specialists recommend exhausting conservative options before considering surgery — and many patients are understandably reluctant to undergo a procedure with a high chance of the problem returning.

Home Remedies and Self-Management

Given the limitations of current treatments, many people with plantar fibromatosis look for ways to manage their symptoms at home. While no home remedy can eliminate a plantar fibroma, several approaches may help with comfort and quality of life:

Supportive footwear. Shoes with a cushioned sole, good arch support, and a wide toe box can reduce pressure on the nodule. Avoid walking barefoot on hard surfaces, and consider shoes with a rocker-bottom sole that reduces pressure on the midfoot during walking.

Ice. Applying ice to the affected area after prolonged standing or walking may help with pain and any associated inflammation in surrounding tissue.

Over-the-counter pain relief. NSAIDs (such as ibuprofen) can help manage pain, though they won't affect the fibroma itself. These should be used as needed rather than continuously, and always according to the label or your doctor's guidance.

Massage and foam rolling. Gentle massage of the foot — avoiding direct, forceful pressure on the nodule — may help with overall foot tension and comfort. Rolling the foot over a tennis ball or foam roller can stretch the plantar fascia, though you should avoid rolling directly over the fibroma.

Weight management. Excess body weight increases the load on the plantar fascia with every step. While weight loss won't shrink a fibroma, it can reduce the pressure and pain associated with it.

It's important to be realistic about what home management can achieve. These strategies are about comfort and maintaining function — they're not cures. If your fibroma is growing, becoming more painful, or significantly affecting your ability to walk, it's worth discussing other options with a specialist.

Living With Plantar Fibromatosis

One of the most challenging aspects of plantar fibromatosis is the uncertainty. The condition doesn't follow a predictable pattern — it can remain stable for years, grow gradually, or change suddenly. For many people, the psychological burden of not knowing what to expect is almost as difficult as the physical symptoms.

Some practical tips from people who live with the condition:

Find a knowledgeable specialist. Not all foot doctors are experienced with plantar fibromatosis. Look for a podiatrist or orthopaedic surgeon who has specific experience with fibromatosis conditions.
Track changes. Keep a simple record of your nodule's size, pain level, and how it affects your activities. This helps you and your doctor make informed decisions about when and whether to escalate treatment.
Adapt your activities. You may need to modify rather than eliminate physical activities. Swimming, cycling, and yoga are generally easier on the feet than running or high-impact sports.
Connect with others. Online communities and forums for plantar fibromatosis and Ledderhose disease can be surprisingly helpful — both for practical advice and for the reassurance of knowing you're not alone.

The Role of Clinical Research

For a condition where current treatments are limited and recurrence after surgery is high, clinical research plays a particularly important role. Researchers are actively studying new approaches to managing plantar fibromatosis, including investigational medications that aim to address the fibrous tissue itself rather than just managing symptoms.

Clinical research studies give people with plantar fibromatosis an opportunity to access new approaches that aren't yet widely available — while contributing to the broader medical understanding of the condition. Study-related care is typically provided at no cost to participants, and participation is always voluntary.

If you've been diagnosed with plantar fibromatosis and current treatments haven't provided lasting relief, exploring what clinical research studies are available may be worth your time.

A clinical research study for plantar fibromatosis is currently enrolling. See if you may qualify →

Frequently Asked Questions

Is plantar fibromatosis the same as plantar fasciitis?

No. Plantar fasciitis is inflammation of the plantar fascia, typically causing heel pain. Plantar fibromatosis involves fibrous nodules growing within the plantar fascia, usually along the arch. They're different conditions that require different approaches.

Is a plantar fibroma cancerous?

No. Plantar fibromas are benign (non-cancerous). They don't spread to other parts of the body. However, they can be locally aggressive — meaning they can grow into surrounding tissue and be difficult to remove completely.

Can plantar fibromatosis be cured?

As of today, there is no definitive cure for plantar fibromatosis. Current treatments focus on managing symptoms and slowing or preventing growth. Surgical removal is possible, but recurrence rates are high. This is one of the reasons clinical research into new approaches is so important.

Will my plantar fibroma keep growing?

It's impossible to predict with certainty. Some fibromas remain stable for years. Others grow slowly over time, and some can grow more rapidly. Regular monitoring by a specialist can help you stay ahead of changes.

What's the connection between plantar fibromatosis and Dupuytren's contracture?

Both are fibromatosis conditions involving abnormal collagen growth in connective tissue. Dupuytren's affects the hand, plantar fibromatosis affects the foot. They share genetic and biological similarities, and some people develop both. Having one increases your risk of developing the other.

Should I see a podiatrist or an orthopaedic surgeon?

Either can diagnose and manage plantar fibromatosis. The most important factor is finding someone with experience treating fibromatosis conditions specifically. Ask whether they've treated other patients with plantar fibromas and what outcomes they've seen.

This article is for informational purposes only and is not intended as medical advice. Always consult a qualified healthcare provider for questions about your health or before making decisions about treatment.

Last updated: February 2026