Plantar Fibroma and Fibromatosis
Author: Thomas C. Weiss : Contact: Disabled World
Published: 2010-12-10 : (Rev. 2018-10-03)
Plantar fibroma also called plantar fibromatosis is a hardened condensed and non-cancerous mass of fibrous tissue that occurs at the bottom of a persons foot.
What Is Plantar Fibroma?
A plantar fibroma is a benign nodule that grows on the bottom of the foot and usually appears in the second through sixth decade of life. Plantar fibroma is usually slow growing and measures less than an inch in size. More invasive, rapid-growing and multi-planar fibromas are considered plantar fibromatosis. Both are benign tumors made up of cells found in ligaments.
A plantar fibroma may occur as either a single mass, or in a cluster, although it often occurs within a ligament in the arch of the person's foot referred to as the, 'plantar fascia.' The mass grows and as it does it can cause discomfort and pain for the person as they walk.
While the exact cause or causes of a plantar fibroma are not known, trauma and people who take phenytoin are believed to be potential reasons for the development of the masses. People who experience diabetes mellitus, hypothyroidism, epilepsy, and cirrhosis of the liver are also believed to have higher rates of planar fibromas.
A diagnosis of a plantar fibroma is commonly achieved through a clinical examination. A biopsy is usually not recommended because it has the potential to enlarge the fibroma. If the fibroma is removed, it can be examined under a microscope and provide a doctor with a more detailed diagnosis. If the pain associated with the mass is not too painful, a doctor might recommend taking no action. If the pain related to the fibroma reaches a point where it is an issue, treatment commonly follows.
Is Plantar Fibroma Considered a Disability?
Once the surgery to remove a plantar fibroma and the plantar fascia has been performed there is no chance that a person will be standing until at least three-to-four week after their surgery. The tumor itself is present among tendons that provide them with structure to their foot. It is highly-important that the person heal fully and with no weight bearing on the foot as they heal. The person will be using crutches all the time they are healing and until a doctor releases them to walk again. It will most likely be two months before the person is able to fully walk on both feet again.
Therefore, for a period of approximately two months, people who have undergone a surgery to remove a plantar fibroma will experience a disability. If the tumor or tumors are larger, or if there are more of them, the person may have a disability for a longer period of time. The walking ability of the person will be altered for the remainder of their life.
Treatment of Plantar Fibroma
Treatment of a plantar fibroma commonly involves the use of padding in order to reduce the pain and pressure in the area where it is located. Foot orthotics may be used to provide relief to the plantar fascia area, and it might also be useful to wear a splint or night brace with the intention of stretching the plantar fascia ligament, as well as reducing the size of the mass. Use of cortisone injections are not recommended or useful and may be extremely painful. If these forms of treatment do not provide relief from the pain, surgical intervention to remove the plantar fibroma might be pursued. The surgery should be considered a treatment of last resort because it has the potential to give rise to a number of complications.
Surgical treatment to remove a plantar fibroma also requires the removal of most of the health plantar fascia ligament because if you remove the mass without it, re-growth of the mass is very probable. Due to this fact, there is a potential problem with not having the ligament in use to maintain the arch of the person's foot. Additionally, there is another risk involving the incision made by the surgeon on the bottom of the person's foot which extends from the heel to the ball of the foot. Scar tissue forms and can be painful once it has healed.
Once the surgery has been performed, and the plantar fascia ligament removed, doctors recommend that the person does not place any weight whatsoever on the affected foot for a period of at least four weeks. When the person's foot has completely healed and a doctor has authorized it, the person will be given gentle calf muscle strengthening exercises and gentle weight bearing exercises to perform. The person should also wear a foot orthodontic to provide foot arch support and stability.
So What is Plantar Fasciitis Then?
Plantar fasciitis involves an inflammation of the ligament that connects a person's heel to the base of their toes.
Plantar fasciitis causes the affected person to experience severe pain in the bottom of their feet, particularly after resting - such as upon waking up in the morning. Plantar fasciitis is caused by the overuse or injury to a person's plantar fascia. The name, 'plantar fascia,' springs from, 'plantar,' meaning the bottom of the sole and, 'fascia,' in reference to the fibrous band of tissue.
Plantar fasciitis has also been referred to as, 'policeman's heel,' although a number of people who have jobs requiring them to walk or stand on hard surfaces, such as nurses, are susceptible to the condition. The name is derived from the time that policemen used to walk the streets for the majority of their shifts.
Other names for plantar fasciitis include, 'jogger's heel,' or, 'tennis heel.'
High arches or flat feet can also cause plantar fasciitis, which used to be called, 'gonorrheal heel.' People at one time thought plantar fasciitis was somehow related to this particular form of sexually-transmitted disease for some reason. Running or walking consistently for exercise may cause a person to be prone to the condition because of the stress on their plantar fascia. The person will experience pain after exercising instead of during their period of exercise. Swimming and bicycling are both better alternatives for exercising for people who have plantar fasciitis because the activities do not put stress on the plantar fascia.
Plantar fasciitis may start as a slight pain in a person's heel; something called, 'stone bruise.' The condition is a progressive form of disorder, meaning that it will get worse if it is left untreated. The condition can lead to pain in a person's hips, legs, and back, as well as changes in the way they walk in order to relieve pain. Untreated plantar fasciitis might lead to a torn ligament, which can then lead to the development of a heel spur. A heel spur is a piece of bone that develops in the area of an injured plantar fascia. Not only should people with plantar fasciitis wear shoes with arch and heel supports, they should avoid walking barefoot because it puts stress on their plantar fascia.
Treatment of Plantar Fasciitis
Treatment of plantar fasciitis can include exercise.
When a person experiences pain related to their plantar fascia, stretching exercises can be performed. Stretching the Achilles tendon can assist in reducing the pain related to taking the first steps of the day and can be done while lying on your back while still in bed. Gently make the letters of the alphabet with your big toe prior to getting out of bed.
Another form of treatment for plantar fasciitis involves extra-corporeal shock wave therapy.
Massages, night splints, taping, and oral medications may also help. Over-the-counter medication might help to reduce the pain. Resting while elevating the affected foot and application of ice packs several time per day can assist as well. A doctor might administer corticosteroid injections with the intention of providing the person with some relief.
Approximately ninety-percent of people who receive treatment for plantar fasciitis improve significantly.
Those who do not find relief through non-surgical forms of treatment may require surgical intervention via a procedure known as a, 'plantar fascia release.' The surgery is rarely performed and may lead to additional complications; fallen arches, for example.
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