Surgery for Plantar Fasciitis
What is plantar fasciitis surgery?
Plantar fasciitis surgery is a procedure performed to relieve chronic pain caused by plantar fasciitis, a condition characterized by inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot from the heel to the toes. Surgery is typically considered only after conservative treatments, such as rest, physical therapy, stretching, orthotics and shockwave therapy have failed to provide relief over an extended period of time.
In some patients, an extremely tight calf muscle complex (ankle equines) is one of the contributing factors to heel pain. A proximal gastrocnemius recession is performed to release some of the superficial fibrous bands of the outer calf muscle.
What is the recovery after plantar fasciitis surgery?
Following plantar fascia surgery, patients are placed in a post-operative sandal for 2-4 weeks with minimal weight bearing. The foot is generally numb with local anaesthetic for 12 – 24 hours and simple painkillers such as paracetamol and anti-inflammatory medication are taken for the first week or two. Strong painkillers if required are only generally needed in the first week after surgery. Dressings and bandages must stay intact and dry until your 1 and 2 week review where your wounds are checked for healing, and your foot and ankle is checked for mobility.
What are some of the risk and complications of plantar fasciitis surgery?
During the preoperative consultations, Dr Abdel Kak will answer all your questions and discuss the potential risk and complications associated with plantar fasciitis surgery. Although they are usually rare, some of risks and complications include;
- Wound infection – with any surgical procedure, there is a small risk of getting an infection. This occurs in less then 1% of patients and the surgeon will give you antibiotics to treat or help prevent an infection from occurring
- Failure to reduce symptoms
- Scar formation – in most cases you are left with a faint line which gradually reduces with time. In some instances and skin types the scar can become thickened
- Injury to surrounding nerves
- Progressive collapse in the arch of the foot following the release/lengthening of the plantar fascia
- General risks and complications from any foot surgery which can include; continuous pain, deep vein thrombosis and a possibility of reacting to the anaesthesia (general and local)
Frequently Asked Questions
Plantar fasciitis surgery is usually performed as a day procedure and you are able to go home the same day.
Following the completion of your procedure, you are transferred to a recovery area and your vital signs monitored. You may experience some nausea, pain and be slightly disoriented while the general anaesthesia wears off. The medical staff will ensure you are comfortable, assist you to recommence eating and contact your support person to arrange your pickup. Prior to being discharged, the podiatric surgeon will talk to you briefly going over the procedure, post-operative medications and the post-operative instructions.
During the procedure, a local anaesthetic injection is given makes the foot numb for 12 – 24 hours. Simple painkillers such as paracetamol and an anti-inflammatory medication are taken for the first week or two. Strong painkillers are prescribed and if required are only generally needed in the first week after surgery.
After plantar fasciitis surgery you will typically be weight bearing in a post-operative sandal. Weight bearing will be kept at a minimum. Dressings and bandages must stay intact and dry until your 2 week review where your wounds are checked for healing, and your foot is checked for stability.
Yes – the foot and ankle are usually bandaged and you can weight bear/walk in a post-operative sandal.
Healing, recovery times and work circumstances vary for each individual. Generally, if your job involves predominantly you sitting, you can expect to return to work in 4 weeks. However if your job requires you to be more active, walking or long periods of standing then you can expect to be back at work in 8-12 weeks.
Following ankle stabilisation surgery, the typical post-operative appointments are:
- 1 week
- The bandage is changed and the wound and foot is reviewed
- 2 weeks
- The bandage are removed, the sutures removed and a smaller compression bandage is applied.
- 2-4 weeks
- A light dressing is applied on the wound, you are able to get the foot we and you will now transition into good fitting supportive footwear.
- 8 weeks
- The foot is assessed for pain and physical therapy is performed to strengthen the foot and ankle.
- 12 weeks
- You will still be expected to wear the ankle brace for 3-6 months after the procedure. The ankle may feel stiff with some residual swelling but you should be able to gradually return to physical activities.
- Some weakness may be felt at this point if the gastrocnemius recession is performed, but with this physical therapy this will strengthen and improve.
Disclaimer: The information provided here is for general educational purposes only. Individual circumstance can differ, please contact Dr Abdel Kak’s rooms to discuss if surgery is appropriate for you.