Plantar fibromatosis is a rare disease that is characterized by scarring of the fibers of the plantar aponeurosis. This is manifested by the formation of dense nodules on the plantar surface of the foot and flexion contracture of the toes.
The plantar or plantar aponeurosis is a dense structure consisting of collagen fibers. It originates from the heel bone and then goes to the fingers, dividing into rays to each finger, like a fan. By analogy with the palmar aponeurosis. This is why the fingers become bent in this disease.
The resulting nodes are dense structures that grow slowly, cicatricially changing mutant collagen fibers.
In the early stages of this disease, fibromatous nodules are small and do not limit the function of the foot. As the nodules continue to grow, curling the toes, walking becomes more difficult and painful. Dupuytren's disease is a similar condition that develops in the hand.
Plantar fibromatosis is more common in Caucasians, middle-aged and older adults, and is ten times more common in men than women. There is another condition called superficial plantar fibromatosis, which is more common in children than adults.
Plantar fibromatosis is also known as Ledderhose disease. Both one or both feet can be affected in 25% of cases.
About plantar fasciitis
The plantar fascia is a ligament (a band of tough tissue) that connects the heel bone to the ball of the foot (see Figure 1). The plantar fascia acts like an elastic band that stretches with every step. It also supports the arch of the foot.
Figure 1. Plantar fascia
When the plantar fascia is overused or damaged, it can become torn, weakened, swollen, or painful. This condition is called plantar fasciitis. Plantar fasciitis is one of the most common causes of heel pain.
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Causes of plantar fasciitis
Some causes of plantar fasciitis include:
- tight calf muscles or Achilles tendons (tight tissue that connects the calf muscles to the heel bone);
- prolonged walking, standing or running, especially on hard surfaces;
- wearing shoes that don't fit;
- wearing shoes that do not provide the necessary support for the foot;
- weakening of foot tissues with age;
- flat feet, high arches, or uneven gait;
- overweight;
- pregnancy or hormonal changes; under the influence of hormones, ligaments and tissues may become more mobile than usual.
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What are the symptoms of plantar fibromatosis?
Symptoms of this disease include:
- pain when walking is caused by constant pressure of dense aponeurosis nodules on the soft tissues of the plantar surface of the foot.
- Nodes in the projection of the longitudinal arch of the foot, which have an elastic consistency and can grow over time.
Pain is not always present when plantar fibroids begin to develop. Some patients complain of pain or discomfort when wearing shoes with thin or thick soles.
Treatment of plantar fasciitis
Although plantar fasciitis usually resolves without causing long-term problems, it can last anywhere from 6 to 18 months.
You may need to take medicine to reduce pain and swelling. Your doctor will tell you which of these drugs is best for you. You should always take your medications as directed by your doctor.
The most common medications taken for this condition are nonsteroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs:
- ibuprofen (Advil® and Motrin®);
- naproxen sodium (Aleve®);
- naproxen (Naprosyn®).
NSAIDs should be taken with food. Check with your doctor before taking NSAIDs if you:
- have previously consulted a doctor due to diseases of the stomach and intestines, liver or kidneys;
- have previously consulted a doctor due to bleeding disorders;
- are taking aspirin or other medicine that prevents blood clotting;
- are taking corticosteroids, which are steroid hormones produced by the adrenal cortex (the outer part of the adrenal glands).
For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (
Your doctor may also suggest applying tape to the arch of your foot or placing special support products in your shoes, such as heel insoles, orthotics (such as braces or splints), or arch supports. You may also need physical therapy.
If these treatments do not help, contact your doctor. You may be offered other methods, such as corticosteroid injections or surgery.
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How is Plantar Fibromatosis diagnosed?
Differential diagnosis is carried out with such diseases as:
- Post-traumatic neuroma;
- Fibrosarcoma;
- Synovial tumor.
Orthopedists use MRI (magnetic resonance imaging) to visualize the changed plantar fascia.
MRI will help the doctor determine the shape, size and depth of the aponeurosis lesion.
Your doctor should be aware of your lifestyle, what medications you take, your symptoms, and your family medical history. All this will help make the correct diagnosis.
How to Relieve Pain from Plantar Fasciitis
Here are some ways to relieve plantar fasciitis pain on your own:
- Wrap an ice block in a towel and apply it to your heels. This will help relieve swelling and reduce discomfort. Apply ice 4-6 times a day for 10 minutes.
- Wear shoes that support your feet. Do not wear mules, high heels, sandals, flip-flops, or go barefoot.
- When exercising, take adequate rest breaks. Don't stand, run or walk for long periods of time.
- Give your feet a rest. Try to reduce activities that put stress on your heels and balls of your feet, such as running, jumping, and walking.
Exercises to relieve pain from plantar fasciitis
In addition to these methods, there are also exercises you can do to help manage the pain of plantar fasciitis.
Curling your toes
You can perform toe curls with the help of a book or towel.
When using the book:
- Place the book on the floor. Stand on it.
- Curl your toes over the edge of the book (see Figure 2). Then straighten your fingers.
- Do this exercise for 2 minutes, 2 times a day.
Figure 2. Curling your fingers with a book
When using a towel:
- Place a towel on the floor and stand on it.
- Squeeze the towel with your toes and then release it (see Figure 3).
- Repeat this exercise for 1-2 minutes, 2 times a day.
Figure 3. Curling your fingers with a towel
Foot stretch
For this exercise you will need a towel. The towel should be long enough so that you can wrap it around your foot when sitting with your legs extended (see Figure 4).
- Sit on the floor and stretch your legs in front of you.
- Place the towel around your foot, keeping your leg straight out in front of you.
- Use a towel to pull the top of your foot toward you (see Figure 4). You should feel a stretch in your calf muscle.
- Stay in this position for 10–30 seconds. Then release your foot.
- Repeat this exercise 5 times per set. Do 2 sets per day.
Figure 4. Foot stretch
Causes of development, manifestations and therapy of plantar aponeurosis
Plantar aponeurosis is a foot condition that is common among those who spend a lot of time on their feet. Both medications and surgery are used for treatment. It all depends on the severity of the disease and the factors associated with it. It is for this reason that it is worth paying attention to the various manifestations of pain.
Description of the disease
Any pain should not be ignored. The thing is that this is how the body sends us signals that something is wrong with it. And if you ignore such signals and do not consult a doctor, you can become disabled forever.
In the case of plantar aponeurosis, inflammation occurs at the junction of the heel bone and toes. Initially, the first symptoms may be mistaken for flat feet,
however, if treatment is not started, the situation will only get worse. As a result, the pain in the heel area will only intensify. This will be especially noticeable in the morning. Moreover, throughout the day the pain will remind you of itself, if at all, it will not be so strong. Exceptions are cases when there is a load on the legs with increasing pain.
Main causes of the disease
When talking about the causes of the disease, we should not forget about the risk factors that contribute to the onset of the disease. So, in the case of aponeurosis of the sole, it all starts with such a common phenomenon among athletes as a sprain
. This is especially true for those that support the arch of the foot. The following categories of people may experience this disease:
- long-distance trekkers, such as hikers or race walkers;
- often organize long-distance races;
- those who are overweight;
- those who often wear tight or uncomfortable shoes;
- if there is shortening of the Achilles tendon;
- suffering from hypertonicity of the calf muscle.
The risk group for developing this pathology includes people aged 40 to 60 years and older. This disease is most often observed in women, while men, on the contrary, are practically protected from it.
In addition to runners, those who actively engage in aerobics or dance sports can get aponeurosis of the sole. It is for this reason that it is best for all those who strive to lead a healthy lifestyle to be attentive to their health, especially the stress on their legs.
The risk group also includes people of certain professions. Among them:
- factory workers;
- teachers;
- sellers;
- workers and specialists whose occupation requires them to be on their feet for long periods of time.
Main symptoms of the disease
The main symptom by which the appearance and development of a disease such as plantar aponeurosis can be determined is pain in the heel area. It is by this sign that the disease can be diagnosed almost at its very beginning. Moreover, in the absence of the necessary treatment, the pain will spread to the entire foot, turning walking into real torture. Very often, in advanced cases, inflammation occurs in the second leg.
The peculiarity of the disease is that by periodically allowing the legs to rest, the pain becomes less acute. This is precisely the danger of aponeurosis, since it can masquerade as ordinary fatigue and a person does not seek medical help for a long time.
Possible complications
When talking about the disease, it is worth telling about what complications may arise if you delay in seeing a doctor. These include:
- chronic pain syndrome - occurs if the patient uses the peculiarity of the disease and gives rest, thereby reducing the level of pain, as if getting used to it;
- Various diseases associated with the feet may occur;
- When the disease is advanced, inflammation can spread from the feet to the legs, thighs, and even the back.
How is it diagnosed?
For diagnosis, you should contact a professional and not self-medicate. The best way to determine the disease and its severity is to use MRI, CT or X-ray. With their help, the doctor will be able to see what is happening in the foot. The pain will be the result of plantar aponeurosis or another cause. For example, pain can be caused by injuries in the form of a crack due to an impact, a sprain or a pinched nerve.
How to treat
To achieve healing, you must strictly follow all the doctor’s recommendations. However, traditional medicine can also be used to help pharmacological drugs. They will not only allow you to get rid of the disease faster, but will also enhance the effect of medications.
For treatment, you can make compresses. To do this, you need to take a black radish, grind it on a grater, and then apply the resulting pulp to the heel, wrapping it in a plastic bag and bandaging it or putting on a warm sock. It is good to do such compresses at night. The recommended number of procedures is 5.
A compress of raw potatoes, grated, will help a lot. Here everything is done in the same way as in the radish recipe. Number of recommended procedures – 7.
A compress made from cabbage leaves and honey will help. Take fresh cabbage leaves. They need to be coated with honey and applied to the heel. After this, the foot should be wrapped in cellophane and bandaged or put on a warm sock. Repeat the procedure 8 times at night.
A good solution to relieve pain can be foot baths using sea or table salt: 3 teaspoons per 1 liter of warm water. 20 minutes is enough to achieve a positive effect.
You can use iodine baths.
To do this, take 3 liters of hot water and dissolve 4 tablespoons in it. Yoda. The procedure should be carried out before bed for 20 minutes. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr