Why is Plantar Fascia Release Surgery Performed?

Plantar fasciitis release surgery is a procedure required for only the most severe cases of plantar fasciitis. Many people suffering from plantar fasciitis (policeman's heel) can avoid surgery and relieve symptoms through non-surgical approaches, including medications, injections, braces, or orthotics. However, a physician may recommend surgery under the following conditions:

• Other approaches and medicines are ineffective and do not relieve chronic pain and instability.

• Symptoms cause debilitating pain and persist for at least 6 to 12 months.

• Tension on the ligament has accumulated to the point of degeneration where conservative approaches are not effective and cause more damage than relief.

• The condition has restricted your ability to work, or the condition is hindering your athletic performance.

During your procedure, the surgeon may need to detach or attach the irritated foot tissue. In some cases, your surgeon may also use the surgery as an opportunity to remove bone spurs related to the condition.

How to Prepare for Plantar Fascia Release Surgery

A physician will conduct a thorough examination of your injured foot to test sensitivity, mobility, and nerve impairment. Be prepared to experience some mild irritation as your doctor may ask you to replicate conditions that trigger your pain. Your doctor will also ask you questions about your family history and gather information about any related medical issues. Make sure that you have an open dialogue with your doctor during this process.

They may also take diagnostic tests to inspect anatomical problems and other possible complications, including bone spurs. In the case of other conflicting conditions near the plantar fascia, the surgeon may have to adjust their surgical treatment approach. These are necessary to help strategize your treatment.

Your doctor will also give you a breakdown of the surgical process, including where they will make an incision on the heel. If both feet have persistent plantar fasciitis issues, your doctor will discuss a suitable treatment timeline for you. It may be best for patients with problems in both feet to have each surgical procedure performed one at a time, and allow the first foot to heal entirely before moving on to the next one.

What Happens During Plantar Fascia Release Surgery?

Every procedure is different. However, a general overview of the workflow follows this outline.

• The physician administers anesthesia and positions the patient. The surgeon will make a small incision on the sole of the foot to access the plantar fascia.

• They will then make the proper incisions on the sides of the plantar fascia to release the tension on the compromised tissue and relieve inflammation on the ligament.

• For extreme cases, the surgeon may detach the plantar fascia from the heel or remove bony growths on the plantar fascia.

• Additionally, the physician may remove damaged tissue near the plantar fascia to diminish tension and work with the abductor hallucis to prevent nerve damage.

• Depending on the patient, the surgeon may operate on the plantar fascia directly or use instruments inserted in the small incisions or endoscopic surgery.

• After the surgeon completes the procedure, the incision will be closed, and the treated foot will be placed in a cast to heal.

Risks of Plantar Fascia Release Surgery

Possible risks from plantar fascia release surgery include:

• Nerve complications: Since the surgeon is operating on an area with a lot of nerve fibers, there is a possibility of nerve damage that may lead to numbness or weakness on the operated foot. Some patients may develop neuroma, or a benign tumor made of nerve cells and fibers, in extreme cases.

• Infection: With all surgical procedures, there is a possibility of infection. Make sure to keep your healed wound adequately cleaned, and if there is an infection, in most cases, antibiotics can be an effective remedy.

• Excessive release: Proceeding the surgery, the patient may experience an excessive release of the plantar fascia, which may reduce the height of the arch and increase the risk of foot injuries.

• Persistent symptoms: Some patients may continue to experience heel and foot pain after the surgery if it is unsuccessful.

These are only some of the risks associated with plantar fascia release surgery. Your physician will be able to give you a more thorough breakdown.

Post Plantar Fascia Release Surgery and Recovery

After surgery, patients will need to wear a cast, brace, splint, or postoperative shoe for two to three weeks to stabilize the afflicted foot and heel. Patients should refrain from putting pressure on the recovering foot and heel. After a couple of weeks, a physician will also remove sutures from the heel, and patients may begin to put weight on their recovering heel and foot.

The total recovery time post-surgery is typically between six to ten weeks, and more than 75% of patients experience significantly less pain after plantar fascia release surgery. To sufficiently promote recovery, patients should avoid any strenuous activities, stretch, and wear cushioned footwear.

Learn more about our ankle treatment options by visiting our Foot and Ankle Center.