Plantar Fibromatosis
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Plantar fibromatosis, also called Ledderhose disease, is a rare, harmless overgrowth of tissue in the plantar fascia, the thick band under your foot. It forms firm lumps, usually along the arch, in one or both feet. The lumps grow slowly and are often painless at first, but some become sore and make walking or fitting shoes harder. Painless lumps can be left alone and watched. When they hurt, simple steps such as changing your footwear and using shoe inserts can help ease the pressure on them.
What is it?
Plantar fibromatosis is a harmless (benign) overgrowth of fibrous tissue in the plantar fascia. The plantar fascia is a thick band of tissue under your foot that runs from your heel bone to the base of your toes. The overgrowth forms firm lumps, called nodules, usually along the arch. You may have one lump or several, in one foot or both.
The condition is rare, and how common it really is isn't well understood. Plantar fibromas are usually not cancer, and the chance of one being cancer is very low. Many people have no pain at all, but in some people the lumps become sore and can limit what they do.
Who does it affect?
It mainly affects middle-aged people. Men are affected about twice as often as women. About 1 in 4 people with it have it in both feet. It is only very rarely seen in children.
Signs and symptoms
The main sign is a firm, round lump in the arch of your foot, often on the inner side. A typical lump is about 0.5 to 3.0 cm across. It usually doesn't move much when you press it.
The lumps grow slowly and are often painless at first. They can become painful as they get bigger or when they press on shoes or on nearby structures in your foot. Tight shoes, walking barefoot and standing for a long time can make the pain worse.
Some people find it uncomfortable to walk or hard to fit their shoes. Because the lumps change how pressure falls on your foot, standing, walking or running can become harder.
What causes it?
The cause isn't known. Several things have been linked to it, but none has been shown to cause it. They include:
- an injury to the foot, or repeated small injuries
- diabetes
- epilepsy, and the use of anti-seizure medicines (anticonvulsants)
- drinking a lot of alcohol
- liver disease
- smoking
It often occurs alongside Dupuytren's disease, a similar tissue condition in the hand. A family tendency may also play a part. Having one of these links doesn't mean you will get plantar fibromatosis, and many people with the condition have none of them.
How is it diagnosed?
Your podiatrist will ask when the lump appeared, how fast it has grown, whether it hurts, and what footwear and activities you do. They will feel the arch of your foot to find and measure the lumps, and they may check your other foot and your hands. In most cases the diagnosis comes from your story and this examination.
An X-ray isn't usually needed, but it can show whether bone is involved. An ultrasound or MRI scan can help confirm the diagnosis and show how deep a lump goes. Sometimes a small sample of tissue (a biopsy) is taken to rule out cancer.
Your podiatrist will also think about other causes of foot pain, which can occur at the same time. These include plantar fasciitis, a stress fracture (a small crack) in the heel bone, and tarsal tunnel syndrome (a nerve condition).
Not every lump on the sole of the foot is plantar fibromatosis, so please don't try to diagnose it yourself. A solid lump is treated carefully until it has been properly checked. This is a precaution, and most plantar fibromas turn out to be harmless.
Treatment
Care usually starts with simple steps. How well each option works isn't clear yet, so your podiatrist will talk through the choices with you.
Looking after it at home
If the lump doesn't cause pain, it can be left alone and watched. Check it now and then for growth or new pain.
If it is sore, choose supportive shoes that don't press on the lump, and avoid walking barefoot. Cut back on high-impact sports for now. If you have diabetes, avoid shoes with seams that can rub your foot.
Treatment from your podiatrist
Your podiatrist will usually start with advice about footwear and your activities. They may also suggest orthoses (shoe inserts, either ready-made or moulded to your foot). These take pressure off the painful lump and reduce the load under your foot.
Don't wear your orthoses for sport or vigorous activity until you have finished the wearing-in plan and feel fully comfortable in them. If the lump is limiting your activity, a podiatrist who works with muscle and joint problems can help.
Your podiatrist will check the lump again over time. If you aren't improving, they will check again for warning signs and may send you to a specialist.
Other options
If simple care isn't enough, shockwave therapy can be considered. It delivers pulses of energy through the skin to the sore area. How well it works isn't yet clear.
Radiotherapy (a low dose of radiation to the area) may stop early-stage disease from getting worse and ease symptoms, with a low chance of significant side effects. It is worth considering early on for early-stage disease. It is arranged through a specialist referral.
Surgery
Surgery is a specialist treatment for more advanced disease. Your specialist will explain the possible benefits and risks of any procedure before you decide.
Recovery
Plantar fibromatosis is harmless and usually slow-growing. Many people have little or no pain for a long time, while others find the lumps become sore and make standing, walking or running harder. Occasionally the disease is more aggressive and can bend the toes into fixed, curled positions (contractures).
It isn't yet clear how often lumps come back after treatment, or what stops the condition getting worse. For this reason it helps to keep an eye on your lump over time. If it grows or becomes painful, it needs further assessment, which may include a scan.
Preventing it
Because the cause isn't known, no way of preventing it, or of stopping it coming back after treatment, has been shown. What you can do is stay aware of your foot. Watch for growth, new pain, or changes in the lump or your toes, and see your podiatrist if these happen.
Keep your review appointments. Wearing comfortable, supportive shoes and adjusting your activity can help you stay comfortable day to day.
When to see a podiatrist
When to book
Book an appointment with your podiatrist if you notice a firm lump on the sole of your foot, even if it doesn't hurt, so it can be properly checked. Book too if a lump you already know about has become painful, makes it hard to fit your shoes or walk, or is stopping you doing your usual activities. If pain in the sole of your foot hasn't improved after 2 weeks of home care, or you have diabetes and pain in the sole of your foot, see your GP.
When to get help sooner
If you think your foot is infected and you also feel very unwell, with confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine, this could be sepsis: call your local emergency number.
These signs need urgent medical assessment: see your GP today, or go to an urgent care clinic or the nearest emergency department. They are a calf that is swollen, red, hot and painful, a foot that is red, hot and swollen, or, if you have nerve damage in your foot (for example from diabetes), unexpected pain or a sudden change in the shape of your foot.
See your GP soon if the lump is growing quickly or looks unusual, if you have lost weight and can't explain why, if you have pain at night that doesn't settle, or if you have numbness, tingling, pins and needles or weakness in your foot or leg. See your GP soon too if you have had cancer in the past, or if you have severe pain that doesn't ease or feel unwell with a fever.
Frequently asked questions
Is Ledderhose disease the same as plantar fasciitis?
No, though both involve the plantar fascia. Plantar fasciitis is the most common cause of heel pain and is especially common in people who run and jump. Plantar fibromatosis causes firm lumps in the arch. You can have both at the same time, so your podiatrist will check for each.
Which health professional treats it?
Your podiatrist can examine your foot, advise on footwear and activity, and fit orthoses (shoe inserts) to take pressure off the lump. If you need a scan, a biopsy, radiotherapy or surgery, your podiatrist or GP can refer you to a specialist.
Should I stretch or exercise my foot?
It isn't yet clear whether stretching helps plantar fibromatosis, so ask your podiatrist before you start. If any exercise causes pain or makes you feel unwell, stop straight away and let your podiatrist know.