Muscle Knot in Arch of Foot: Cause, Diagnosis & Treatment

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The bottom of your foot can take a lot of pounding, especially for runners, and there might not be a way to get around that, but if your start feeling something like a knot forming on the bottom of your foot, then it’s time to take a break from the daily runs. Foot muscle pain can be felt in either the top, sides, or bottom of the foot, and different muscles can contribute to the foot pain.

Muscle knots in your calf muscles can result in pain in your Achilles Tendon, and muscles in the tibialis posterior causes pain directly above your heel bone or Achilles Tendon. The discomfort or pain can also be felt on the sole or arch of your foot, and all these can be due to hyper pronation, a common foot problem that causes weight to transfer to the foot’s inside. Additionally, muscle knots in the Tibialis Anterior may cause shin splits where the Tibialis Anterior is the foot muscle that runs along the shinbone and connects to the bone behind your big toe joint.

A knot or nodule in the arch of your foot is known as a Plantar Fibroma, where the nodule is lodged in the Plantar Fascia, a tissue band that extends from your heel to the toes on the bottom of the feet. Read on to understand more about the muscle knot in the arch of your foot.

What is a Plantar Fibroma?

The condition can affect one or both of your feet simultaneously, and even though they are gentle, they don’t go away unless they are treated. A fibroma is a knot of connective tissue and can be anywhere in your body, and because the knots are benign, they won’t spread to other body parts but won’t disappear without treatment. Plantar fibroma forms a lump on the arch of the foot, which can result in pain, and the pain may intensify the more you are applying pressure or stepping on it, or by particular shoes, you may be wearing, which may cause daily discomfort that may eventually become unbearable.

A plantar fibroma can be very large as the size of a golf ball in some cases and can also be very small, almost like BBs, and it’s not considered malignant, meaning it’s not cancerous. However, to be 100% sure, you can get a biopsy, especially if it has other suspicious characteristics.

Causes of the Plantar Fibroma Condition

There is no exact cause of the nodule on your foot, but some experts think it begins with small tears in the plantar fascia from trauma and the nodules result from the scar tissue forming from the healing of the tears. Some people also think that it’s the scar tissue that develops in the band of the tissue, and the more stress and fraying of the plantar fascia, the more likely it will be associated with plantar fibroma.

The knot on the bottom of your foot can occur at any age, but it is a common complaint in middle-aged and older people, with men getting them twice as often as women, with the exact cause still being unclear.

What is the Difference between a Plantar Fibroma and a Plantar Fasciitis?

Most people, especially runners, are familiar with plantar fasciitis, and before seeking treatment, many people would like to know the difference between the two. Plantar Fasciitis is an inflamed tissue not associated with the presence of a mass, and it is more connected to heel pain, while Plantar Fibroma is pain felt in the middle part of the foot.

A plantar fibroma is also the name of the growth, knot, nodule, or trigger point found on the plantar fascia on the bottom of your foot. In contrast, a plantar fascia is the band of tissue under the bottom of your foot that extends from the toes to your heel.

The Plantar fibroma condition results from plantar fascia tightening up, and they are not that common as most runners are affected by plantar fasciitis more than fibromas. Notably, you can experience Plantar pain without experiencing or developing a plantar fibroma because most people who experience plantar fasciitis don’t develop a plantar fibroma.

Signs and Symptoms of a Plantar Fibroma

The biggest characteristic of the Plantar Fibroma is a firm noticeable lump on the arch of your foot, and the nodule or lump can get larger over time or remain the same size. You may not experience pain when you have a plantar fibroma because the pain occurs from the shoes pushing against the nodule and not the nodule causing the pain, but some people may experience some pain. Plantar fibroma may feel firm when touching, and it can be movable when you press it with your fingers and thumbs.

Some other symptoms include:

  • Morning stiffness when taking the first step out of bed
  • Pain when you are walking barefoot
  • Tightness of the bottom of the foot
  • Calf tightness
  • Stiffness and pain when you are walking

Diagnosis of Muscle Knot in your Foot

It is relatively easy to get a plantar fibroma diagnosis, and you may need to see a foot specialist who will rule out any other conditions and determine if the lump on your foot is benign. You will need to visit a foot and ankle surgeon to get a diagnosis, and they will examine your foot and press the affected area where sometimes the pain may reach the toes and provide medical advice. By assessing the consistency of the fibrous knot, a podiatrist can be able to tell whether it’s a true nodule.

You might need to take an X-ray or MRI, and on very rare occasions, you might be needed to get a biopsy of the lump to examine the lump further. This is because the nodule on your feet most likely will have redness, no swelling, or have an increased warmth, and during the examination, they might be looking for signs of other conditions.

Other reasons that may cause soft tissue masses may include fatty tumors, cysts, nerve tumors, or tendons. The specialists may also rule out foreign body reactions to shin splints that may cause an infection or a swelling.

What are the Treatment Options?

1. Nonsurgical treatments

Nonsurgical treatment may help to relieve the pain caused by a plantar fibroma, but it may not cause the mass to disappear, and therefore, a foot and ankle surgeon may choose one or several non-surgical options:

a). Steroid injections

Injecting a corticosteroid injection into the trigger point may help to shrink it and may reduce the pain that may occur when walking. However, a corticosteroid shot is a temporary solution, and the plantar fibromas could return to their original size and not stop the fibroma from growing.

b). Physical therapy

The pain can sometimes be treated through physical therapy methods that will deliver anti-inflammatory medication into the fibroma without necessarily needing the injection. A physical therapist can come up with a program of exercises for people suffering from the plantar fibroma.

The strengthening and stretching exercises developed by physical therapists will help your muscles and leg by:

  • Reducing inflammation
  • Encouraging the growth of new cells
  • Increasing the circulation of blood to your foot

c). Shoe inserts

These custom orthotic devices may relieve your pain by distributing the weight away from the fibroma, but this only works with a stable fibroma that does not change in size. The redistributing of body weight throughout your foot will reduce pressure on the fibroma and the arch and reduce pain. Orthotics can be custom-made or purchased over-the-counter (OTC).

d). Topical Gel

A topical gel is said to treat Plantar Fibroma by stopping the growth of the fibrous knot tissue, and some gels claim to relieve pain within a few months of use. However, the evidence is limited for its effectiveness.

2. Surgical Option

The surgery option is only considered after the mass is still increasing in pain or size, so the surgical treatment will remove the fibroma after the non-surgical approaches don’t work. The surgical removal may result in the arch flattening or development of hammertoes, and recovery from surgery may take up to 8 weeks. The orthotic devices may be prescribed to offer support to your feet, and due to the high chances of recurrence, you may need to have a continued follow-up with your foot and ankle surgeon.

3. Home Remedies

Some home remedies can help in reducing your muscle pain and discomfort, and they include:

a). Ice

Applying an ice pack to your foot can cause reduce foot pain and swelling. To make your ice pack, wrap some ice cubes in a thin cloth and place them on the foot’s arch for about 15 minutes. Repeat the treatment several times in a day or as much as you may need to relieve pain.

b). Elevation

Elevation involves raising the affected foot above your heart level, and this will reduce inflammation and swelling. You can do elevation by lying down and propping your feet up on your pillows whenever possible.

c). Over-the-counter pain relief

OTC non-steroidal anti-inflammatory drugs (NSAIDs) are another home remedy to help people with foot and muscle pain. Some of these medications may include:

  • naproxen sodium (Aleve)
  • ibuprofen (Advil, Motrin)
  • naproxen sodium (Aleve)

However, these NSAIDs should not be taken for a long period as overuse can result in serious side effects.

Can Runners Prevent Plantar Fibroma?

Even though it’s unknown what causes plantar fibroma, specialists have some ideas on how runners can prevent them. For example, they can switch out their running shoes or invest in custom orthotics that will prevent the nodule from growing by supporting the muscles as much as possible to avoid any running trauma.

Why choose foot and ankle surgeons?

Foot and ankle surgeons are the experts in foot and ankle care currently. They are board-certified surgical specialists in the podiatric profession. They are sometimes known as podiatrists, DPM, or just “foot and ankle doctors.” They are the best because they have more education, knowledge, and training, foot and ankle specific, more than all other healthcare providers.

The podiatrists will treat all conditions that affect your foot and ankle, ranging from simple ones to complex ones, including plantar fibromas, in patients of all ages. The intensive training and education allow foot and ankle surgeons to perform different surgeries, including any surgery recommended for treating plantar fibromas.

Frequently Asked Questions

1. Can you massage out a plantar fibroma?

Yes, but it will only help to shrink the nodule. Physical therapy is a conservative route that breaks down the scar tissue to minimize inflammation, increase blood flow and stimulate the growth of a healthy plantar fascia. For example, you can promote the breaking down of scar tissues by massaging the bottom of your feet.

2. How long will it take for the plantar fascia to heal?

The condition affects a tissue located under the arch of the foot, which can cause stabbing pain on your heel. It will heal within six to eighteen months without seeking any treatment but will take around six months with consistent and non-surgical treatment. People with Plantar Fasciitis are said to recover 97% of the time, which is a promising statistic for anyone with the condition.

3. What causes foot pain in the inner arch?

The inner arch pain is caused by Plantar fasciitis, according to many orthopedic complaints. The foot pain is caused by overuse, acute inflammation, or injury to the plantar fascia, where it is the part that connects your foot front to your heel. Notably, because the condition is the most common cause of pain, other causes of heel pain are sometimes confused. Therefore, a doctor should rule out any other problems that may produce pain, such as a broken heel, Shin Splints, Achilles tendonitis, or nerve entrapment.

4. Is plantar fibroma a disability?

Plantar fibromatosis, also known as Ledderhose disease, is a benign and rare fibrous tissue disorder that causes the formation of nodules around the bottom of the foot, causing pressure and producing pain at the bottom foot and leg in general. However, the condition can be aggressive and often result in functional disability, pain, and decreased quality of life.

5. Can Plantar fasciitis cause hip pain?

Yes, when you ignore the condition, it may result in chronic heel pain that may affect your day-to-day activities. For example, altering the walk, you walk to relieve plantar fasciitis may develop pain in the muscle knots, foot, knee, or low back pain problems.

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About the author


Hi, I’m Brian Bradshaw. I’m a super duper mega hiking enthusiast, with a love for everything that has to do with outdoors, hiking, gear, footwear and more.

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