A common problem patients encounter is a gradual soft tissue growth seen on the top of the foot or ankle. While this can be a troubling site, the condition is benign and can resolve on it’s own. This is known as a ganglion cyst.

A ganglion cyst is an encapsulated “knot” filled with jellylike fluid that originates from a joint capsule or tendon sheath. The mass starts as soft, mobile and pain-free, but quickly becomes firm and hardens into a more solid structure if untreated.


The most common cause for ganglion cysts is trauma, either a single event or repetitive micro-trauma. There are multiple joints and tendons in the foot, each held together by a capsule that has jellylike fluid inside. This fluid is important to keep the joints and tendons lubricated, so that movement can be done in a smooth and pain-free fashion.

Due to trauma, the capsule becomes injured and small microscopic holes form. This promotes the jellylike fluid to “leak” out and form the mass seen under the skin. The mass becomes larger and firmer as more fluid forms outside of the capsule.


  • Visual lump on top of foot or ankle
  • Dull pain or ache when cyst presses on joint or tendon
  • Possible burning or tingling when cyst presses a nerve
  • Difficult wearing shoes
  • Swelling and excessive tenderness with possible bump formed at back of the heel or on the tendon


A ganglion cyst is diagnosed through clinical exam. An x-ray is often taken to rule out damage to the joint overlying the cyst. There are many conservative options that can be done to help alleviate the condition.

  • Shoe modifications with padding
  • In-office procedure to drain the mass
  • Steroid injection
  • Compressive dressings

Unfortunately, there is a high recurrence rate for ganglion cysts. Although conservative treatment options are successful, there is a tendency for the cyst to return due to continuous movement at the joint or tendon. At this point, surgery may be indicated which involves removing the entire cyst including the stalk it grows from. An MRI would usually be ordered to determine the size and consistency of the mass for surgical planning.

If you are exhibiting early indication of pain or discomfort, visit your podiatrist at Premier Foot & Ankle for care!.


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