Is there a brace or insert that can be used for painful plantar fibromatosis nodules?
I had an interesting question from a customer regarding the treatment of plantar fibromatosis. Plantar fibromatosis is a condition in which benign nodules form in the plantar fascia. Plantar fibromatosis has no predictable course. Some cases result in small, asymptomatic nodules while others proliferate rapidly, resulting in large nodules on the bottom of the foot that are painful to walk on.
There is no definitive conclusion in the literature regarding the reason why people develop plantar fibromatosis. Most authors in the literature feel that the origin is a small micro tear in the fascia that over proliferates into a fibrous nodule within the plantar fascia. The origin of these tears in the plantar fascia seem to be the result of tension on the fascia. Each time you apply body weight to the foot, the arch decreases in height placing tension on the fascia. Be sure to read our knowledge base article on plantar fibromatosis and treatment options.
So, if the origin of plantar fibromatosis is tension on the fascia, can an orthotic, shoe or brace help to decrease the pain? In most cases, the pain associated with plantar fibromatosis is due to the size of the nodule and how it is compressed by the floor with each step.
The conservative options for treating plantar fibromatosis are fairly limited. Treatment options include:
- Taping the foot to inhibit depression of the arch and tension on the plantar fascia.
- Soft orthotics with cut-outs specific to the plantar fibromatosis nodules.
- Shoe brace options that decrease load to the plantar surface of the foot (patellar tendon off-loading brace).
My reply to our customer was that most of the conservative methods of care for plantar fibromatosis are limited in their success. In cases of plantar fibromatosis where pain limits activities, the only long term solution is surgical excision of the nodules.