The disease known as Ledderhose disease (named after its first discoverer) is a plantar fibromatosis. Translated this means plantar – concerning the sole of the foot, fibro – fiber/tissue fiber and matose – proliferation or growth, i.e. a proliferation of cells in the sole of the foot. The disease belongs to the rheumatic diseases.
It is a benign tumor, whereby tumor is merely the Latin word for a swelling or growth in the tissue. Small nodules develop in the tissue of the tendon, which is called plantar fascia and forms the sole of the foot. From the heel bone it moves as a broad tendon plate to the small bones of the toes, thus providing an important structure for tensioning the longitudinal arch of the foot.
The plantar fascia is easily palpable and visible from the outside due to its superficial course, as are the nodules in the case of Ledderhose disease. Symptomatically, in addition to the palpable nodules, feelings of tension and pain occur especially when walking or running, since the sole of the foot continuously stretches and contracts during these movements and is loaded with the entire body weight. If the nodules are only very slightly pronounced, the disease can even progress without symptoms.
Exercises
In addition to passive measures to keep the plantar fascia mobile in opposition to the tissue contracture, there are some exercises and measures that the patient can perform himself. Some examples of these are presented below. Important exercises in the active therapy of lederhosen contracture are stretches.
On the one hand, the sole of the foot itself must be stretched, on the other hand, the entire muscle or fascial chain in which the plantar fascia is integrated must be stretched. A simple exercise to train mobility and stretch at the same time is to tiptoe up on a stair step: 1). To do this, stand with both forefeet parallel on a stair step, looking up the stairs, one hand holding the banister.
Now slowly alternately press up to tiptoe and just as slowly lower again and press your heels further down until a slight feeling of stretching is felt in the soles of your feet. Practice this over three sets of 10 repetitions each. 2.)
For another exercise, use a Thera band to help you. Sit down on the floor in a long seat, bend your knees slightly, wrap the band around one foot and hold the ends with your right and left hand. Now the forefoot is pulled towards the body under tension of the Theraband until a stretching sensation occurs in the sole of the foot.
Hold this stretch for about 30 seconds to achieve an effect in the tissue. 3.) To stretch the entire fascial chain, stand upright and use a tennis ball, which is placed under the leg to be stretched, below the forefoot.
The other foot now makes a small step forward, the buttocks are tensed and the pelvis is tilted slightly backwards and pushed forward. By changing the step size you can vary the intensity of the stretch. Hold this position for 30 seconds and apply the same procedure on the other side.
4.) Finally, it is important to strengthen the small foot muscles in order to counteract a malposition and to compensate for imbalances. A simple exercise for this is to put newspaper on the floor and pick it up with your toes or crumple it up into a ball.
In the seat, the toes can be bent and stretched alternately. Another simple training of the foot muscles is walking barefoot on different surfaces. Self-massage of the sole of the foot and foot muscles can be performed with a tennis ball or a small fascial roller. However, these should not hurt or irritate the nodules even more. Together with the physiotherapist in charge, you should put together a small exercise program for everyday life, which should be carried out regularly and realistically.
