San Francisco Podiatry Video


Monday, January 9, 2012

When is Surgery Needed for a Ganglion Cyst in the Foot by San Francisco Running Foot Surgeon

A runner with a ganglion cyst called from San Francisco and had the simple question. "When should a runner consider ganglion surgery?" Here is the answer....

Whenever a patient has a big squishy lump on the top of the foot, big toe joint or the ankle joint, they want to know what will make it go away. The most common soft tissue mass in the foot is a ganglion cyst. Sometimes ganglion cysts will go away on their own. Sometimes the ganglion cyst needs to be drained. But sometimes a ganglion cyst in the foot needs surgery.

There are really 3 reasons that a ganglion cyst in the foot or ankle will need surgery

1. The ganglion cyst is painful.
2. The ganglion cyst is pushing directly on a nerve and can cause nerve damage.
3. The ganglion cyst is so big that it makes it difficult to wear shoes.

Unfortunately, many times ganglion cyst happen to develop in locations that are positioned close to nerves. This is really the best reason for a runner to think about ganglion surgery.

The tingling and burning pain that is often associated with a ganglion cyst is usually because the soft tissue mass is pushing against a nerve and causing the nerve to become irritated. If this continues for a long period of time, you can develop chronic pain or permanent nerve damage. The skin on the top of the foot is very thin and when a soft tissue mass develops the mass gets squished between the shoe and the bones that are close to the skin. The nerves that are located in that area can then get caught in the middle and cause pain. For this reason midfoot ganglion cysts often have to be removed surgically.

Dr. Christopher Segler is a runner, 6-Time Ironman finisher and a nationally recognized foot surgeon and sports medicine podiatrist who focuses on rapid recovery from running injuries. He is an internationally recognized expert in the treatment soft tissue masses that may appear to be ganglion cysts. His research and theories on PVNS (a dangerous soft tissue mass that is often mis-daignosed as a ganglion in young adults) have been published in the medically journals and were used as the basis for new treatment methods of these soft tissue masses. He practices podiatry, sports medicine and surgery in San Francisco.

You can learn more about the best treatment for ganglion cysts in the foot at and If you live out-of-state or abroad, you can arrange a remote consultation with a true running expert through


  1. Very nice post, i certainly love this website, keep on it

  2. I have been diagnosed using MRI. I have a ganglion cyst of the medial meniscus with no meniscal tear. Should I discontinue running? Wait and see? Surgery? Other? Thank you.

  3. Hello Fred,

    I am sorry to hear about the trouble with your knee. Unfortunately, I only treat foot and ankle issues. I would recommend seeking a consultation with an orthopedist who focuses specifically on the treatment of running injuries. Unfortunately, a lot of doctors will simply recommend that you discontinue running because it is one of the easiest ways to decrease stress to the lower extremities. That isn't necessarily the wrong advice, it's just not conducive to keeping you running. As a runner myself, I do not offer this advice very frequently. I think it is better to keep people running as long as possible. But one key is to make sure that you are seen by a specialist that understands running injuries and appreciates the desire to run. Provided that you do that you should keep moving in the right direction in a way that will maintain the integrity and health of your knee.

    Best of luck!
    Dr Segler.