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Endoscopic plantar fasciotomy

Plantar Fasciitis Surgery: When to Consider It & Recovery Times?

Oct 10, 2022

Pain on the bottom of your foot, usually around your heel and arch, is usually caused by plantar fasciitis. While the pain is more intense immediately after an exercise, it’s not unheard of for the pain in question to be intense even when there’s no pressure put on your heel. Usually, the pain is the most intense early in the morning and a lot of people claim the first few steps out of the bed to be the worst.

This is a serious issue and there are a lot of potential treatment options, one of which is plantar fasciitis surgery. Naturally, surgery is never an immediate response.

With all of this in mind, here are a couple of things you need to know about plantar fasciitis:

  • Why does it happen?
  • How do you recognize it?
  • What are lifestyle and home remedies that you can try?
  • What happens if surgery is your only choice?

With all of this in mind and without further ado, let’s start answering some of these questions.

Why Does Plantar Fasciitis Happen?

The plantar fascia is a band of tissue that connects the base of your toes to your heel bone and is a crucial part of your foot and ankle. It’s there to absorb the shock when walking, however, this doesn’t mean that it’s 100% immune to this pressure. Pushing it too far can cause pain. As we’ve mentioned in the introduction, the pain is more extreme early in the morning and right after an exercise.

Activities like jogging, running, walking, standing for a long time, and constantly being on your feet, in general, can result in the plantar fascia. Ignoring the damage, once it spawns, will only make things worse. If you don’t at least try to get some rest or fix the problem at home, the situation will quickly escalate and soon, surgery for plantar fasciitis will be your only option.

What Can You Do Before Needing Plantar Fasciitis Surgery?

While this surgery has a high success rate, the majority of people first try to ease the symptoms on their own, after consulting with their orthopedist. Here, there are a couple of methods you want to try out.

For instance, it’s a great idea to:

  • Try and cool a painful area (an ice pack in a towel is the best method)
  • Rest your foot for a while
  • Raise the foot on astool
  • Use heel pads in your shoes
  • Try some basic foot stretches
  • Add calf stretching to your routine

If none of this helps, you might want to consider some over-the-counter medication. Now, taking anti-inflammatory medications the first two days after an injury is advised against, seeing as how they can affect the healing process. Moreover, painkillers might make you push the injured foot past its limits, which already sets you back and increases the likelihood that you’ll need plantar fasciitis surgery.

In the long run, losing weight is also quite helpful, seeing as how it reduces the pressure that your plantar fascia is under.

What Are the Types of Plantar Fasciitis Surgery?

Generally speaking, there are two common surgical methods used for this problem – plantar fascia release and calf release.

Plantar fasciitis release surgery 

This method involves cutting your plantar fascia to release the built-up pressure.

Now, depending on where and by whom it’s performed, it can be done endoscopically or as open surgery. Endoscopic plantar fasciotomy is done by a surgeon who makes two small incisions on either side of the bottom of the heel. Then, they insert a tiny camera and instruments and operate through these (usually) half-an-inch long incisions.

Open surgery involves a surgeon making a small cut (usually not more than 1-2 inches) to release the plantar fascia. If they notice a trapped nerve, they may release it and remove a bone spur if they encounter it.

Another thing that worries a lot of people is the question – is plantar fasciitis surgery painful? When it comes to this, it’s worth mentioning that both of these surgery types can have a patient under general anesthetic or local anesthetic sedation. Also, while both are quite effective, endoscopic surgery is less invasive, which makes it more appealing to a lot of people.

Calf release surgery 

Calf release surgery reduces the ankle dorsiflexion (a scenario in which toes are pointing up). Now, the majority of people are concerned with the long-term effects of plantar fasciitis surgery and this is one of its biggest advantages, seeing as how it solves your ankle dorsiflexion problem for good.

What Makes You a Good Candidate for this Surgery?

Now, even if you believe you have a problem with your plantar fascia, this doesn’t automatically mean that you’re a surgery candidate. To qualify as such, you have to:

  • Have these symptoms for at least 6 months.
  • Be unable to participate in physical activities.
  • Have a pain that’s actively interfering with your work.
  • Still suffering from pain, regardless of which relief measures you’ve tried.

There are, however, a couple of factors that might pose an additional risk during plantar fasciitis surgery, cause complications, or delay recovery. The most common such factors are:

  • Diabetes
  • Peripheral neuropathy
  • Venous insufficiency

Provided that all of these have been taken into consideration, your physician will tell you how to proceed with the treatment.

How Long Is the Recovery Time from Plantar Fasciitis Surgery?

Depending on the type of surgery that you get, you can look forward to a different recovery speed. For instance, for the majority of people, after a standard plantar fasciitis release surgery, the recovery time is 6 to 10 weeks for open surgery and 3 to 6 weeks for endoscopic surgery. In the aftermath, you may be prescribed physical therapy to facilitate the recovery process.

If, on the other hand, we’re talking about a calf release surgery, the foot will likely be immobilized in a splint or boot. The ankle must remain in a proper position until the tendon is fully (or mostly) healed. This process will last for 2 weeks but the recovery process is not complete even after the removal of the splint. You still need to be immobilized for weeks to come.

How soon can you walk after plantar fasciitis surgery? 

After an endoscopic surgery you may be able to walk unassisted in 3 to 6 weeks, while after open surgery, this may take 6 to 10 weeks.

While the healing process can be over in as little as 6 weeks, the truth is that it may take as long as 3 full months before you can return to rigorous training activities and exercise.

Wrap Up

You should never suffer pain unnecessarily, however, seeing as how plantar fasciitis surgery is needed in only 5% of cases, assuming worse right away is not the best course of action. If the pain persists and no other methods help in relieving the pain, it’s worth keeping in mind that the surgery is safe and painless and that the recovery time is not that long.

Ideally, you should always consult a specialist, which is why contacting renowned foot surgeons in NJ and asking for a quote is always the best course of action.

This article was reviewed and approved by an orthopedic surgeon as we place a high premium on accuracy for our patients and potential patients.