Soft Tissue Masses
Lumps and masses in the foot or around the ankle are rarely dangerous tumours. Only about one in one thousand are malignant tumours capable of spreading to other parts of the body. More common are bursas, ganglion cysts, inclusion cysts, fibromas or lipomas. Ganglion cysts are best thought of as contained leaks of lubricating fluid of tendons or joints. While they are not generally harmful, they can be painful. Bursas are small sacs of fluid that the body produces to cushion prominent bones or protect tendons from irritation. On occasion they can become inflamed and irritated themselves. Inclusion cysts form when the body walls off a foreign body. These can often form from splinters and pet hairs.
There are many other kinds of masses. It is difficult to definitely diagnose a mass without microscopic examination. Certain types of masses occur in certain areas and this can be a clue to the diagnosis, but to be sure about the mass, excision is often necessary. MRI can sometimes be used, but the diagnosis is often inconclusive.
What You Can Do:
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•If you have a mass, have it examined.
What Your Doctor May Do:
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•Aspirate or drain the mass if it appears to be fluid-filled.
•Inject the mass with a steroid, which may shrink it.
•Order an MRI.
•Recommend and perform excision. The mass can then be examined by a pathologist and diagnosis can be definitely made.
Causes
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•Excessive foot pronation or pronated foot structure (e.g. flatfoot)
•Poor conditioning and/ or inadequate stretching
•Running on a slanted or hard surface
•Excessive downhill running
•Abnormal alignment of the joints of the lower extremity
•Unsupportive shoes and poor shock absorption
•Tight calf muscles
•Muscle imbalance
•Overtraining
What you can do
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•Decrease activity immediately, gradually resume when symptoms have subsided
•Maintain fitness with non-weight bearing exercises
•Wear shoes with a good cushioning and arch support
•Apply a tensor bandage to the foot and lower leg, with only moderate compression decreasing as you wrap up the leg
•Control body weight to decrease load on the feet
•Ice the tender area three times daily, especially after activity
•When not painful, strengthening exercises of the muscles that invert the foot
•Stretch the muscles of the lower leg
•If tolerated, OTC anti-inflammatory medication (e.g. aspirin, ibuprofen)
•In mild cases, OTC arch supports may be of benefit
What the doctor may do
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•Prescribe physical therapy modalities
•Recommend shoes
•Evaluate your training routine
•Initiate exercise and stretching programs
•Recommend shoes
•Perform a thorough biomechanical examination
•Prescribe functional foot orthotic devices to control foot pronation, these are very effective for this disorder
•Surgically correct a severely pronated foot.
Other causes of lower leg pain
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•Compartment syndrome, exercised induced increased compartment pressure, which may occlude blood supply
•Tibial stress fracture may be confused with shin splints, and can be ruled out with a bone scan
•Occlusion of a vein by blood clot (venous thrombosis)
•"Bruised" muscle from blunt trauma
There are many other kinds of masses. It is difficult to definitely diagnose a mass without microscopic examination. Certain types of masses occur in certain areas and this can be a clue to the diagnosis, but to be sure about the mass, excision is often necessary. MRI can sometimes be used, but the diagnosis is often inconclusive.
What You Can Do:
---------------------------------------------------
•If you have a mass, have it examined.
What Your Doctor May Do:
---------------------------------------------------
•Aspirate or drain the mass if it appears to be fluid-filled.
•Inject the mass with a steroid, which may shrink it.
•Order an MRI.
•Recommend and perform excision. The mass can then be examined by a pathologist and diagnosis can be definitely made.
Causes
---------------------------------------------------
•Excessive foot pronation or pronated foot structure (e.g. flatfoot)
•Poor conditioning and/ or inadequate stretching
•Running on a slanted or hard surface
•Excessive downhill running
•Abnormal alignment of the joints of the lower extremity
•Unsupportive shoes and poor shock absorption
•Tight calf muscles
•Muscle imbalance
•Overtraining
What you can do
---------------------------------------------------
•Decrease activity immediately, gradually resume when symptoms have subsided
•Maintain fitness with non-weight bearing exercises
•Wear shoes with a good cushioning and arch support
•Apply a tensor bandage to the foot and lower leg, with only moderate compression decreasing as you wrap up the leg
•Control body weight to decrease load on the feet
•Ice the tender area three times daily, especially after activity
•When not painful, strengthening exercises of the muscles that invert the foot
•Stretch the muscles of the lower leg
•If tolerated, OTC anti-inflammatory medication (e.g. aspirin, ibuprofen)
•In mild cases, OTC arch supports may be of benefit
What the doctor may do
---------------------------------------------------
•Prescribe physical therapy modalities
•Recommend shoes
•Evaluate your training routine
•Initiate exercise and stretching programs
•Recommend shoes
•Perform a thorough biomechanical examination
•Prescribe functional foot orthotic devices to control foot pronation, these are very effective for this disorder
•Surgically correct a severely pronated foot.
Other causes of lower leg pain
---------------------------------------------------
•Compartment syndrome, exercised induced increased compartment pressure, which may occlude blood supply
•Tibial stress fracture may be confused with shin splints, and can be ruled out with a bone scan
•Occlusion of a vein by blood clot (venous thrombosis)
•"Bruised" muscle from blunt trauma