Plantar Fasciitis Surgery

Plantar fasciitis surgery refers to procedures to treat painful plantar fasciitis. This disease is one of the most common causes of heel pain. Typically, nonsurgical treatments like physical therapy cure it. But 1 out of 10 people with this disease don’t feel better after months of nonsurgical treatment. This surgery may help.

Plantar fasciotomy is the most common type of plantar fasciitis surgery. It eases tension in your plantar fascia. This is a thick stretchy band of tissue that runs from your heels to your toes. Inflammation from overuse can make it tighten. Cutting into the band loosens it. The surgery is also called plantar fascia release.

Your foot and ankle surgeon may do open surgery or endoscopic surgery. Endoscopic surgery uses a thin tube with tiny tools. Your surgeon gets to your plantar fascia without making a large cut (incision). Plantar fasciitis may cause a heel spur. In that case, your surgeon will take out the spur after cutting your plantar fascia.

There are other types of plantar fasciitis surgeries, including:

Gastrocnemius recession: Tight calf muscles put pressure on your plantar fascia. The pressure makes it hard to flex your foot. Gastrocnemius recession eases pressure by lengthening your calf muscle.

Radiofrequency microtenotomy: This procedure uses radiofrequency to make very tiny cuts in your plantar fascia. Your surgeon makes a tiny hole in the bottom of your foot. They insert the probe into the hole. Radiofrequency energy makes tiny tears in your plantar fascia. The tears cause your body to make new tissue.

How should I prepare for plantar fasciotomy?

This surgery involves anesthesia. You may receive local anesthesia or regional anesthesia that numbs a section of your foot. But some people have general anesthesia so they sleep through the procedure.

Your surgeon will explain what you need to do if you’re having general anesthesia. For example, they’ll let you know if you need to stop eating several hours before surgery.

You should plan to stay off your feet entirely for at least a day after your surgery. You’ll be on crutches for several weeks. In short, you’ll likely have a hard time getting around. Planning ahead can help you recover. In general, you should:

• Arrange for someone to drive you home from the hospital or medical office after your surgery.
• Arrange for support at home. For example, you may want to order meal service or have someone make meals for you.
• Set up a recovery zone in your home. This is a spot where you can rest and have your everyday essentials within arm's reach. This could be your medication, snacks, television remote, phone, tablet or laptop, etc.
• Clear paths in your home so you can safely make your way to the bathroom or bed while you’re on crutches. For example, pick up area rugs and move furniture that may get in your way.

What happens during plantar fascia release surgery?

You’ll receive anesthesia before surgery. You may get a shot in your foot to numb the area if you have local or regional anesthesia.

Otherwise, you’ll receive anesthesia through an IV line. You’ll be asleep during the procedure.

Next:

1. Your surgeon will make a cut in your foot to get to your plantar fascia.
2. In open surgery, they’ll make a single long cut in the inner side or the bottom of your foot. In an endoscopic procedure, they’ll make smaller cuts in your heel. The cuts may be on one or both sides of your heel.
3. Your surgeon will then make a small cut in your plantar fascia.
4. They may remove a heel spur.
5. Your surgeon will close the cuts.

What are the potential benefits and risks of a fascia release surgery?

This procedure may help people who have chronic plantar fasciitis that doesn’t get better with nonsurgical treatment.

Some potential risks include:

• Infection
• Excessive bleeding
• Nerve injury
• Slow healing surgical wound

Your plantar fascia supports your foot arch. Cutting into your fascia can affect that support so your arch collapses.

What happens after plantar fasciotomy surgery?

Your surgeon may recommend that you rest for the first day. They may suggest you put ice on your foot and rest with your foot propped up on a pillow. Both steps will help reduce swelling after surgery.

Recovery time

Your recovery will depend on the type of surgery you have. Your surgeon will give you specific information. In general, you’ll wear a boot or foot cast for at least four weeks. Here’s a potential timeline:

• First two weeks: You’ll use crutches to get around so you don’t put weight on your foot.
• Third week: You can put some weight on your foot. You’ll wear devices in your shoe to support your arch and help you maintain balance.
• Fourth week: You’ll start physical therapy.

It takes time to fully heal. If you’re a runner, it may be weeks or months before you can hit the road or track. Your physical therapist may suggest low-impact activities, like cycling or swimming, so you can stay active.

When should I call my surgeon?

Contact your surgeon if you have:

• Chills and fever that’s greater than 101 degrees Fahrenheit or 38.4 degrees Celsius
• An open section in stitches
• Bleeding from the cut that’s more than you expected
• Pain that medication doesn’t ease
• Thick white or cream-colored pus draining from the surgery site