While drying after showering, I noticed a tender spot (roughly the size of a BB) on my arch when my toes were flexed back/up, exposing the tendon (ligament?) that runs from my big toe to my heel, through my arch. Here is a pic showing the approx. location and size of the bump…
It doesn’t bother me while running/cycling/etc. or when my foot is relaxed. However, it’s a visible bump and tender to the touch when my big toe is flexed back/up.
The fibroma itself doesn’t usually hurt, but they can get quite large (I’ve taken them out damn near the size of a golf ball on a memorable local CSI Sheriff investigator). As they get bigger (and based on location), they get painful as the fibroma pushes on other structures.
Etiology is largely unknown, though I tend to see them more in high arch people or in people with true collagen disease states (they also can occur in the palm of the hand).
There are lots of treatment modalities from doing nothing, deep/aggressive tissue massage, corticosteroid injections and topical calcium channel blockers (i.e. verapamil) or Tranilast.
FWIW, I got one of these about 10 years ago, a little bigger than the size of a pea. I have very high arches and it didn’t bother me unless I wore shoes with a lot of support in that area (and few did). Eventually I switched to minimalist shoes, so there wasn’t an issue. It started shrinking a couple years ago and now is almost unnoticable.
I recently switched to a cycling insole with noticeably more arch support than I had been using (E-Soles with the blue arch). I wonder if that could be a factor.
FWIW, I used Steve Hogg’s recommendation of the arch support feeling “mildly intrusive” when standing. You can read more about it here, if interested…
Hi, I have those little pea size fibromas on both feet and they are somewhat painful. They do bother me when I excercise and very tender to the touch… I’ve tired deep tissue and rest and have not really gone away…
I definitely dont want to do surgery, I read recovery is long as reincidence is very common…
Is Verapamil a good option?
What about prolotherapy? my sport chiropractic recommended I see a doctor who is having success with this tecnique, have you heard about this?
Jury still out on topical verapamil/calcium channel blocker therapy, but no hard in that at all. Supposed to be “driven” through the skin with a elctrophoresis though for best effectiveness. I’ve had a compounding pharmacy mix up a topical concoction that seems to help with topical bupivacaine, verapamil, and diclofenac that seems to help some.
Prolotherapy injections? Painful injection, so might as well inject a local corticosteroid into the lesion which I do find somewhat helpful (for both symptoms/pain and shrinking), but rarely does any injection “cure” the fibroma.
I rarely recommend surgical excision unless very large/debilitating (just did a case on a Russian ballerina/dancer as large as a golf ball and obviously interfering with her work). Yes, recurrence rates are very high.
What about prolotherapy? my sport chiropractic recommended I see a doctor who is having success with this tecnique, have you heard about this?
Any input is welcome please.
FWIW, the jury is out on the actual efficacy of prolotherapy, but I’ve seen it recommended for just about everything from a hangnail to a separated shoulder. I’m wondering when it became the newest “wonder cure”.
I agree. I don’t really do “prolotherapy”, though for some select cases of unresponsive, chronic ligament/tendinosis type issues, it may be helpful. It certainly seems anecdotal evidence does support it somewhat.
I do find that practitioners who routinely employ prolotherapy are the ones that are, uh, expanding on its use …
I agree. I don’t really do “prolotherapy”, though for some select cases of unresponsive, chronic ligament/tendinosis type issues, it may be helpful. It certainly seems anecdotal evidence does support it somewhat.
I do find that practitioners who routinely employ prolotherapy are the ones that are, uh, expanding on its use …
Of course. It’s pretty safe, no adverse reactions that I’ve read about, it might work, and it’s more $$ from the insurance and billings.
Noticed that this thread got bumped, so thought I’d give a follow-up.
I noticed this fibroma very soon after switching to insoles with aggressive arch support in my cycling shoes. Fortunately, the insoles I purchases (e-Soles Supportive) come with multiple interchangeable arch inserts. I went down one size from what I originally chose after reading the article I linked above and, after ~5 weeks, the bump was no longer noticeable and hasn’t returned. So I’m blaming it on having too high an arch support in my cycling shoes.
On a related topic…
Since switching to the arch support insoles in my cycling shoes, I’ve been able to completely remove the forefoot shims I previously required on my cleats to keep my knees tracking straight. Apparently, without my arch supported, it would collapse and allow my ankle to roll inward a bit. This, in turn, allowed my knee to collapse inward a bit, too. (A better explanation is given in the article I linked above.)