Plantar Fibromas

“It feels like I have a rock in my shoe and it’s driving me CRAZY!”

If you feel like you have a growing rock or pebble in the arch of your foot, it could be a plantar fibroma. We see these boring little annoyances often in our office and offer a variety of treatment options to meet your individual needs and lifestyle.

A plantar fibroma (plantar fibromatosis or Ledderhose disease) is a benign (non-cancerous) growth within the large thick ligament of the foot, the plantar fascia. The primary function of the plantar fascia is to maintain the longitudinal plantar arch of the foot. Plantar fibromas affect primarily those in their middle age, although several cases have been described in children under 16 years of age, and even as young as 9 months. Men are more often affected than women and both feet can be affected ~25% of the time.

Nobody knows exactly why fibromas occur, but we do know that you have done nothing to cause it, and you could not have prevented it. They may appear concomitantly with similar conditions of other areas, such as Dupuytren’s disease in the hands, Peyronie’s disease in the penis, or keloid formation more generally. Other associated conditions include frozen shoulder, alcohol addiction, diabetes, epilepsy, smoking, repeated trauma, and long-term phenobarbital use. One recent study has suggested a possible genetic predisposition to plantar fascial disorders, including fibromas.

Even though they often don’t cause pain or limitation, they may become a bother when they become around 1cm in diameter. Then they can be aggravated by restrictive shoes, direct pressure on the mass, walking barefoot, standing for long periods of time, and how your foot uniquely moves with each step (biomechanics). Multiple fibromas may develop over time and can contribute to increased pain and limitations, scar formation, and even tissue contracture.

Some tests may be helpful is further characterizing your suspected plantar fibroma like ultrasound, MRI, and even biopsy to verify that you actually have a plantar fibroma and not something else like a malignancy (very rare).

There are more treatments for suspected plantar fibromas in the medical research than patients and many medical professionals realize. These treatments all vary in their methods, success rates, side effects, availability, insurance coverage, and timeline of treatment. The treatments in the scientific literature (alone or in combination) include, but are not limited to:

    1. watchful waiting by patient and medical professionals regularly
    2. offloading pads with orthotics with cutouts
    3. steroid injections- 5 injections administered 4 weeks apart
    4. verapamil- cream twice a day for 9 months, or 5 injections administered 2 weeks apart
    5. radiation- weekly dose for 5 to 11 weeks
    6. extracorporeal shock wave therapy- twice a week for 6 weeks
    7. tamoxifen- an antiestrogen pill taken for several months
    8. collagenase- 1 injection administered 4 weeks apart for several months

If your individualized conservative treatments fail to meet your goals of minimizing pain and maximizing function after adequate time, then removal of “the rock” may be needed. Your foot will tell you if it’s satisfied or not, you just have to listen to it! There is always a risk of reoccurrence with fibromas, but this risk can be minimized with proper surgical principles and techniques.

We urge you to discuss your concerns with your doctor and seek out a specialist who sees plantar fibromas frequently, will listen to you and answer all your questions, and often has had success with fibroma conservative therapies, therefore avoiding the risks and hassle of surgery.

If I can answer any questions you may have, feel free to reach out by calling (626) 821-9323.

Dr. Charles J. Hastings, DPM, FACFAS, FFPM RCPS(Glasg)


Dr Sung and his staff are personable and consummate professionals. I highly recommend Dr Sung. He’ll take good care of you.

Aileen T.

SO glad I visited Dr. Sung. Visited him for the first time to get another opinion. Based on a different doctor, I absolutely needed surgery. Dr. Sung gave me plenty of options and found alternative ways to both manage the pain and prevent it from getting worse rather than jumping into surgery. Saved me thousands and more importantly, saved me the hassle of being in a boot for 2-3 months. Highly recommend as he is an honest, knowledgeable, polite, kind, and professional doctor.

Katia M.

I had a broken sewing needle tip stuck inside the bottom of my foot and a friend of mine recommended I see Dr. Sung. I was expecting a long sit-down and a talk about where and when to schedule a surgery, but when I met him he just went straight to business and started the small procedure on the spot. He took it out in about 10 minutes (including the wait time for the anesthesia to kick in). He is personable, explains everything, and is fast!

Theo C.

Dr. Sung was very kind and personable. He spent a lot of time explaining possible treatment options . I was definitely impressed by he and his staff. I would absolutely recommend Dr. Sung.

Jennifer H.

Awesome doctor and staff! My daughter went to FOUR other doctors (MD, DO, DPM, DC) and nobody could figure out her pain, stiffness, and cause for her limitations. But, Dr Hastings did in about 10 minutes! MRI confirmed his initial diagnosis and custom rigid inserts got her back to life and soccer. Thank you so much! Highly recommended!!!

May 04, 2019

He is a fantastic Dr. He is extremely knowledgeable. He is more about prevention and treatment and not quick to do surgery. I will recommend him to all my hairdresser friends or anyone that works on their feet for long periods of time!! Thank you Laura for the recommendation.

April 26, 2019

I’ve been going to Dr Hastings for years for my flat feet. He’s been patient and kind and really detailed in always examining my arches, ankles, knees and lower back. Every visit he is thorough! I’ve never been to a better doctor than him. Highly recommended.

December 25, 2018

Dr. Hastings is a very skilled, very knowledgeable practitioner. He also takes the time to answer your questions and explain different treatment options with you. I recommend Dr. Hastings without any reservation!

December 25, 2018

This guy knows his stuff. Got me on the road to recovery and told me exactly what I needed to do and what not to do to finish my treatment. His experience with sports injuries translate into knowing just what to do for an old cogger like me. Back on the golf course in 3 months.

October 31, 2018

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