Plantar Fascia Release
Surgery Overview
Plantar fascia release surgery involves
cutting part of the
plantar fascia ligament to release tension and relieve inflammation of the
ligament (plantar fasciitis). Your doctor can use medicine
that numbs the area (local anesthetic) for the procedure. Plantar fascia
release can be done by cutting the area (open surgery) or by inserting
instruments through small incisions (endoscopic surgery).
- The surgeon will make an incision on the foot
above the heel pad, where the thicker skin of the sole meets the thinner skin
of the back of the heel, or he or she may make an incision on the bottom of the
foot. If the surgery is done endoscopically, the surgeon will make a small
incision on either side of the heel below the ankle bone.
- The
surgeon may detach the plantar fascia from the heel bone or make incisions on
either side to release tension.
- The surgeon may remove and smooth
the bone surface to allow the plantar fascia to heal under less tension.
Sometimes the surgeon removes a small wedge of damaged tissue.
- The
surgeon may also free the thickest part of a foot muscle (abductor hallucis) to prevent nerves from becoming
trapped as a result of the surgery. If a heel spur is present, it may be
removed.
What To Expect After Surgery
If you have traditional open surgery,
you may wear a non-weight-bearing cast or brace, such as an equalizer brace or
a CAM walker (which resembles a long ski boot), for 2 to 3 weeks after surgery
to allow tissues to heal.
If you have endoscopic surgery, you can
begin limited weight-bearing immediately and can begin wearing normal shoes
again as soon as it is comfortable. Most people return to their normal
activities in 3 to 6 weeks.
You will begin a gradual strengthening
and flexibility program after surgery. Running or jumping is restricted for at
least 3 months after surgery.
Why It Is Done
Surgery may be appropriate for only
5% of people with plantar fasciitis.1 Some foot
experts may recommend surgery more often. Generally, your doctor may recommend
surgery if:
- You continue to have severe, disabling symptoms
despite careful attention to home and other nonsurgical
treatment.
- You have had symptoms for at least 6 to 12
months.
- You are an athlete and symptoms are affecting your
performance or ability to take part in a reasonable athletic
program.
- Your ability to work is limited despite nonsurgical
treatment.
-
Plantar Fasciitis: Should I Have Surgery for Heel Pain?
How Well It Works
Most people (over 75 out of 100)
have less pain after plantar fascia release surgery. Up to 25 out of 100 people
who have surgery continue to have pain.2
Risks
Risks of plantar fascia release include:
- Nerve problems, including nerve entrapment or
tarsal tunnel syndrome.
- Recurring heel
pain.
- Neuroma, a benign tumor made of nerve cells and nerve
fibers.
- Delayed wound healing.
- Infection.
- Risks of anesthesia.
- Possibility that symptoms could get worse after surgery
(rare).
What To Think About
Endoscopic surgery should be done
by a surgeon who is specially trained in the technique and who has experience
doing the surgery. Ask how many endoscopic surgeries the surgeon has done and
how successful they were.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
-
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Plantar fasciitis chapter of Foot
and ankle section. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 839–844. Rosemont, IL: American
Academy of Orthopaedic Surgeons.
-
Mann JA, et al. (2006). Heel pain section of Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 502–504. New York: McGraw-Hill.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
|
Specialist Medical Reviewer
|
Barry L. Scurran, DPM - Podiatry and Podiatric Surgery |
|
Last Revised
|
July 14, 2011 |
Last Revised:
July 14, 2011
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Plantar fasciitis chapter of Foot
and ankle section. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 839–844. Rosemont, IL: American
Academy of Orthopaedic Surgeons.
Mann JA, et al. (2006). Heel pain section of Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 502–504. New York: McGraw-Hill.