Plantar Fasciitis Surgery and
Information About Surgery &
How to Improve Your Recovery from Surgery
More than 90% of people with plantar fasciitis will improve within 10 months of starting non-surgical remedy with a conservative treatment plan (reference: 1, 2). This is why most doctors, physicians and orthopaedic specialists will recommend conservative therapy for minor foot injuries before considering surgery.
If you are unsure about whether you will need surgery, click here.
If Surgery is Required...
Whether you need to have surgery and the type of surgery you'll have depends on the severity of your plantar fasciitis, the type of tearing that you have and whether you've suffered from a full rupture of the tissue. The longer you've waited to have surgery or try conservative treatment methods will also be a factor when deciding if you need to have surgery.
Has it been weeks or months since the injury?
With an acute (recent) injury the pain and symptoms you experience are likely to be minimal. You may not experience any pain, or feel pain, achy-ness or tightness in your foot before or after exercise or activity (walking, running or standing for long periods of time). For this type of injury, all conservative treatment methods will need to be used before surgery is even considered. If surgery is needed, your surgeon will likely choose a shorter, less invasive procedure if it's possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the plantar fascia (like an Endoscopic Plantar Fascia Release) and a much quicker rate of recovery after the surgery.
When you start experiencing chronic pain that happens during activity or pain that just won't go away (even when resting your foot) then you're likely suffering from a more severe case of plantar fasciitis. At this point the ends of the tears in your plantar fascia are filling in with scar tissue as part of the healing process. The addition of this scar tissue restricts your plantar fascia even more, tightening the tissue and reducing flexibility.
In some situations a chronic case of plantar fasciitis also means that you're suffering from a heel spur as well. Your body will naturally grow bone spurs (calcium deposits) in areas where you're suffering from injury or there isn't enough soft tissue available to operate normally. In these situations the bone spur will form as your body's way to relieve stress from the plantar fascia. The bone spur however can cause additional pain and discomfort in your foot. If you're suffering from massive amount of scar tissue and/or a bone spur from chronic plantar fasciitis then you may need to undergo a more invasive surgical procedure (like an Open Plantar Fasciomtomy, Heel Spur Resection and/or Neurolysis).
It's possible to suffer from pain in your plantar fascia due to tightness in the tissue in your lower leg (your calf muscle or plantaris tendon). For this type of pain there's a surgical procedure available (Gastrocnemius Recession) to release the pressure placed on your plantar fascia by releasing tissue in your lower leg.
As with any surgery there are risks to every procedure depending on a lot of factors, including your age, the severity of your injury and your level of health going into the procedure. It's always best to discuss all possible risks and complications with your doctor, orthopaedic specialist and/or surgeon before the procedure. It's important to be aware of the risks you may face with any procedure intended to fix or relieve pain from injuries such as plantar fasciitis, sesamoiditis, tarsal tunnel or even heel spur removal.
Endoscopic Plantar Fascia Release
Endoscopic surgery has become the 'gold standard' for plantar release (fasciotomy). This procedure is normally a day surgery that only requires local anesthesia. The surgeon will use 1 or 2 small incisions (approx. 1 cm in length) on either side of the heel below the ankle bone. A small camera and scalpel are then inserted into the incisions and a portion of the plantar fascia is cut from the heel bone. Calcium deposits and/or bone spurs aren't removed during this kind of procedure.
After your plantar fascia is cut the surgeon will flex your foot in an upward motion to ensure the 'release' of the tissue. Your skin is then sutured close and you're sent home. You can begin limited weight-bearing immediately and wear normal shoes again as soon as you're comfortable. Most people can return to normal activities in 3 to 6 weeks.
Unlike the traditional method of an open surgery, this procedure has less risks and complications involved. To learn about all risks you may face be sure to speak to your doctor.
Open Plantar Fasciotomy / Heel Spur Resection
Traditional open surgery involves the surgeon making 1 incision (approx. 4 cm in length) under the heel of your foot. The surgeon will then partially cut your plantar fascia close to your heel bone. A surgical retractor is used to further widen the 'gap' of the incision.
After the plantar fascia is 'released', the surgeon may address your calcium deposits and/or bone spurs if you have them.
If the surgeon still feels your plantar fascia is 'tight' and your range of motion hasn't improved with the first cut, then they will make another small 2 cm incision at the base of the ball of your foot. With the fascia exposed more cuts are placed in the ligament and the surgeon will manually push you foot in an upward motion to ensure the 'release' of the tissue. Once the 'release' is complete your skin is sutured close. After the surgery you will be fitted for a non-weight-bearing cast or brace for 2 to 3 weeks allowing the tissue to heal.
Neurolysis involves cutting the sheath (casing) of the nerve of the abductor digiti minimi muscle and breaking up adhesions (scar tissue) to free the nerve and relieve the pressure and pain from inflammation. Radio frequency, heat, or chemical injection, have also been used.
When normal range of motion is not possible of flexing your feet, despite a year of calf stretches. Your doctor may recommend this type of surgery to lengthening (weaken the lever force of the leg) the calf muscles (gastrocnemius). When the calf muscles become tight increased stress is placed on the plantar fascia.
During the gastrocnemius recession surgery, a 4-7 cm incision is made on the back inside part of the lower leg. Controlled depth incisions are made in the Medial gastrocnemius muscle (or complete release) and plantaris tendon. A surgical retractor is used to further widen the 'gap' of the incisions. The surgeon will move the foot and ankle to see the results in the new range of motion and or if more incisions will be needed to 'release' the tissue. The skin is then sutured close and you are placed in a right angle cast, brace or splint for the first two weeks. Then moving to a walking boot it is important to strengthen the calf since you will lose strength in the short term. By the 6-8 week mark, you can usually walk normally, it may take 8-12 months to regain 90-95% of the original calf strength.
Modified Endoscope surgery can be preformed for gastrocnemius recession, depending on the surgeons skill of the operation.
What Happens After the Surgery?
Even after you've had surgery your overall injury healing isn't over. There's a recovery process you'll have to go through after surgery that's no different than the recovery process you went through after your initial injury. You'll experience some of the same symptoms in the beginning (right after surgery) - pain, swelling and inflammation. A few weeks after the procedure stiffness, soreness and lack of mobility may set in; including atrophy or wasting away of the soft tissue in the foot and lower leg.
Most surgeries for plantar fasciitis require a total recovery period of approximately 1.5 months. Sometimes a removable cast will be used to support and immobilize the foot. Occasionally crutches or a cane will be used to minimize weight bearing.
Conservative Treatment Methods are also Recommended for Recovery after Your Surgery
Your rate of recovery after the surgery will depend on how dedicated you are to the conservative treatment methods recommended by your doctor, the type of procedure that you had and your efforts in physical therapy.
No two rehabilitation plans are alike - Generally speaking the less invasive your surgery is, the quicker your road to recovery will be.
If surgical intervention is required, talk to your physician about using the Plantar/Spur Freezie Wrap® & Inferno Wrap® for post-surgery recovery as you'll find them to be effective for reducing post-surgery inflammation, enhancing range of motion and minimizing scar tissue growth.
Thinking about Plantar Fasciitis Surgery?
We Have Answers That Can Help...
Most cases of plantar fasciitis respond well to conservative treatments, however, surgery will be needed in a small number cases. Being presented with a recommendation for surgery is certainly a scary thought for most.
The Internet provides a wealth of information and details on the surgery itself, however, it is a challenge to find quality information on how to prepare for surgery and what to do to speed recovery after the surgery is completed.
Surgery in itself is not the end of the journey,
it is merely the beginning of a new chapter.
It truly takes a comprehensive approach (both before and after surgery) to ensure a complete recovery takes hold. There is no single answer and each individual situation is different.
We here at AidMyPlantar provide suggestions and options for people to help get them through this life changing event. We assist many people in shaping an individual course of action to help them prepare for surgery and to heal afterwards.
If you are thinking about surgery and you would like to ask us questions on steps needed to ensure a more complete healing process, then call our office toll free:
We are available on weekdays between 8:00am and 10:00pm or on weekends between 11:00am and 6:00pm (Eastern Standard Time).
Getting Started with Your Post-Operative Rehabilitation
If you have undergone surgery for your plantar fasciitis then your physician will quickly get you on the path to rehabilitation. The aggressiveness of your rehabilitation efforts and your injury's ability to heal will depend on a variety of factors including (but not limited to):
- your age, overall health and activity level
- the state of your injury before surgery (severe injuries like a ligament rupture, open wound, bone damage or fracture will require more intense surgery)
- the type of surgery you have undergone
- how soon you need to return to normal activity
The goal of a rehabilitation plan is to manage pain and swelling while improving function, strength, and range of motion. Ultimately, you'll regain enough strength in your foot (and plantar fascia ligament) to be able to walk normally and return to full activity. You'll most likely spend a lot of time with a physical therapist after your surgery, but as your healing progresses emphasis will be placed on your personal at-home treatment. The success of your rehabilitation will depend on your dedication to working with your doctor and physical therapist while also managing your recovery on a daily basis at home.
Regardless of what type of surgery you've had (or even if you don't need surgery) your home therapy routine can be improved by controlling initial and on-going pain/swelling, and increasing blood flow to heal your plantar fascia ligament so that you can achieve long-term positive results. This can easily be done by incorporating an Plantar/Spur Freezie Wrap® and Inferno Wrap® into your rehabilitation routine and regular treatment will decrease your time spent in recovery.
Speak to your doctor, surgeon or physical therapist about incorporating Freezie Wrap® and Inferno Wrap® treatments into your post-operative rehabilitation program to boost your overall recovery process.
Post-OP Phase 1: Protect your Plantar Fascia Ligament
Rehabilitation after your surgery will first focus on protecting your foot from further damage and starting simple movement. The level of protection needed for your foot will depend on the type of surgery you've had. Soon after surgery your foot will become tender, swollen, red and hot to the touch. These are all symptoms of inflammation.
After Endoscopic Plantar Fascia Release Surgery - You'll be allowed to walk on the foot in a walking cast immediately but should lessen your activities. Your doctor will recommend that you stay off your feet and rest for at least 7 days. This will protect your incisions and give your skin time to heal. The stitches will be removed after 7 days and depending on your doctor (and the degree of surgery) you may be allowed to wear a good supportive walking boot. Wait at least 3 weeks before you start walking normally. It might take longer for some patients. You may be allowed to return to work within 1 week if there is limited walking and standing at your job. If you need to do a lot of standing, walking, jumping or kneeling you might have to wait 3 weeks or longer. Avoid all running and impact sports for at least 3 months after this procedure.
After Open Heel Spur Surgery / Plantar Fasciotomy Surgery - Depending on how much damage was repaired, your foot will be immobilized in a short or below-the-knee non-weight bearing cast for 2 to 3 weeks. You'll also need to use crutches while you're wearing the cast so your foot has enough time to heal. The sutures are removed 10 - 14 days after surgery and you'll be allowed to bathe the foot after that point. It may take up to 3 weeks after the procedure for you to be able to walk normally with little pain. Your doctor may recommend you wear orthotics following surgery to reduce the chance of re-injury to your heel. This is especially true if you had the orthotics to correct the rolling of the foot inward or outward. Avoid all running and impact sports for at least 3 months after this surgery.
After Gastrocnemius Recession Surgery - Your lower leg will be in a cast, splint or brace for 2 weeks with your foot in a permanent flexed position. Your doctor may recast or change to a CAM boot (walking boot) for the 3 - 6 weeks. You'll have mild pain at first after surgery (mostly in your calf), but this will settle down in the first couple of weeks. After the pain has settled in the calf, it's important to strengthen the calf muscles. You'll lose strength in the short term after surgery and the healing process. By the 6 - 8 week mark, you can usually walk normally; however, it may take 8 - 12 months to regain 90 - 95% of the original calf strength.
To reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first 2 - 3 weeks after your surgery (or for however long it's needed depending on your pain level). Your surgeon will also recommend cold compression therapy if you're wearing a removable brace. If you're not wearing a cast right after the surgery, you can use an Plantar/Spur Freezie Wrap® for 15 to 20 minutes at a time, several times a day, to control your inflammation and reduce your pain.
Rest is also vital to your rehabilitation plan, depending on the surgery you have undergone. When it comes to plantar fascia surgery recovery, your surgeon or physical therapist will expect you to rest your foot as needed to prepare for the physical therapy and exercise to come. Usually rehabilitation with a physical therapist will begin 3 - 6 weeks after surgery.
Post-OP Phase 2: Start Physical Therapy
After surgery your tissue will be in a weakened state and will not be as strong as healthy tissue for some time. This is why you need to be on "re-injury watch" and make the most of your physical therapy appointments & at home treatments.
Your surgeon will recommend regular physical therapy or at home stretching and strengthening exercises. You'll be encouraged to gain back some of your range of motion (ROM) and increase the stability of your injured foot.
You might start with gentle active toe extensions and flexion exercises with your cast on at 0 - 14 days. In weeks 2 & 3, when you're out of you hard cast and in a walking boot; pain is the guiding factor with tolerance of weight-bearing or any exercises.
Strengthening exercises will slowly increase in difficulty (with more resistance) around 3 - 8 weeks after your surgery. Your foot and leg will be stiff and painful at first, and simple, easy movements may seem challenging in the beginning. Don't be discouraged!
Some of this pain and stiffness can be treated by increasing healthy blood flow to your foot before you exercise, with a Plantar/Spur Inferno Wrap®. The Inferno Wrap® will reduce any lingering stiffness in your foot and increase the amount of oxygen, nutrients, antibodies and energy that travel to your injured tissue. Using a Plantar/Spur Inferno Wrap® for approximately 15 to 20 minutes (finishing 15 minutes before exercise or your physical therapy appointment) will relax your foot and boost flexibility of your tissue.
Controlling post-exercise swelling and inflammation is crucial during any phase of rehabilitation. Any sign of swelling or inflammation after exercise may be an indication of minor re-injury to your foot or the surrounding tissues and muscles. Controlling your inflammation immediately after exercise, for at least 15 to 20 minutes, with a Plantar/Spur Freezie Wrap® may prevent the chance of re-injury to your plantar fascia. If you don't treat your swelling immediately after finishing exercise, you will likely experience a setback in your recovery.
Post-OP Phase 3: Return to Regular Activities
Depending on your injury, the type of surgery you've had, and your level of commitment to your post-operative rehabilitation program, you may be able to return to walking around 3 - 8 weeks after your surgery.
Most people won't be able to return to other regular activities, like driving, until 8 weeks after surgery. This time-frame is of course different for everyone, and depends on the advice of your surgeon and/or physical therapist. Athletes may take up to 3 months to heal before they are ready to begin their sport again.
Expectations for Long-term Recovery
Why Treat Injury after Injury when You can
Prepare Your Body for Lifelong Health?
Rehabilitation after your plantar fasciitis surgery is just the beginning of your recovery process. Even after you've had surgery to fix your plantar fascia and deal with the build-up of scar tissue, it is improbable that your soft tissue will heal 100%. From this point forward, it is more important than ever to be careful with your foot. The plantar fascias is probably weaker now, and your risk of re-injury is much higher.
Manage your symptoms on a daily basis to prevent re-injury.
It's simple to manage long-term healing of your foot and the plantar fascia with conservative treatment methods that can be used in the comfort of your own home. If you're looking for an all-natural form of pain management and long-term healing solution for long-lasting relief, speak to your doctor today about incorporating the Plantar/Spur Freezie Wrap® and Inferno Wrap® into your treatment plan.
ColdCure Technology® can help you to decrease post-operative pain and swelling while also managing any pain from occasional inflammatory flare-ups (re-injury). The Plantar/Spur Freezie Wrap® effectively targets cold compression therapy right at the source of your pain. Consistent treatment with a Plantar/Spur Freezie Wrap® will effectively reduce your inflammation, draw the pain out of your foot and gently numb the nerve endings in your tissue for rapid, long-lasting pain relief.
A Freezie Wrap® allows you to treat your foot in an effective and convenient way. Our Freezie Wraps® will wrap around your foot keeping the cold right over your plantar injury for the entire length of your treatment. Our food-grade, non-toxic gel packs can be chilled in the fridge or freezer to tailor the amount of cold that you need for your injury. It doesn't matter how you cool it down, because our gel packs are chock full of gel that's designed to cool down into millions of tiny snowflakes. The cushioned gel will wrap around your foot and it won't budge for the entire treatment period. You'll no longer have to deal with annoying pooling around your foot or have to hold a hard block of ice on your injury!
During your last few stages of rehabilitation, while you're undergoing physical therapy and focusing on improvements to your range of motion, it's important to maintain healthy blood flow in your plantar fascia ligament. Strong and healthy tissues need a solid foundation of good recovery methods. While tissue's healing, blood flow can sometimes reduce to a trickle if on-going swelling and inflammation is experienced. It also takes time for your veins to carry blood flow needed to help your tissue to heal after a traumatic event or surgery.
Reduced blood flow slows down your recovery process. If your tissue remains in this condition, you'll always be at risk of re-injury that will severely set back your healing progress.
Use Blood Flow Stimulation Therapy BFST® regularly to prevent re-injury and allow your body to heal naturally. Healthy blood flow is vital to the healing process after plantar fasciitis surgery. Your blood flow is what brings oxygen, nutrients, anti-bodies and energy (things needed to heal) into your damaged tissue. It promotes the re-growth of your tissue to strengthen the delicate work your surgeon has done.
Regular treatments with Blood Flow Stimulation Therapy™ via the Plantar/Spur Inferno Wrap® will help you increase blood flow for up to 4 hours with just one 20 minute application! There simply isn't a better product on the market to increase your body's natural healing process and provide long-term health benefits.
Dealing with Scar Tissue After
Plantar Fasciitis Surgery
How Scar Tissue Affects Your Rehabilitation
Scar tissue is something that will be in your injury before and after your surgery. The growth of scar tissue is what causes stiffening in the bottom of your foot, restricting movement and flexibility. Scar Tissue is something that can't be avoided during surgery. Your surgeon will determine if the anticipated outcome from surgery will be successful even with the build-up of scar tissue that will happen after the procedure. Overall the surgeon may be able to remove a lot of the initial buildup of scar tissue around the injury and in doing so, view a positive outcome from the surgery.
Unfortunately, scar tissue may plague you for weeks, months and maybe even years after your surgery depending on your level of activity and the amount of conservative treatments you have done during your rehabilitation.
When dealing with scar tissue it's always important to:
- listen well to your physician and if conservative treatments are recommended, remember to stick to your (daily) treatment plan using these therapies, to avoid further surgery or avoid surgery altogether!
- if surgery can't be avoided, know that frequent use of the Plantar/Spur Freezie Wrap® after your surgery will help reduce the swelling very quickly. Much of the pain you feel will be from the swelling, and you'll be surprised how fast the pain drops off once the swelling is down. Using the Plantar/Spur Freezie Wrap® is also recommended as a conservative treatment option to help increase your chances of avoiding surgery altogether.
- the Plantar/Spur Inferno Wrap® is an electromagnetic energy device that will help reduce scar tissue and increase blood flow to the area (thereby accelerating the body's own healing process). Treating your plantar fascia with this device after surgery is probably the easiest and most effective way to accelerate your recovery.
- when applied before stretching, the Plantar/Spur Inferno Wrap® will help the connective tissue in your foot and improve your range of motion and reduce stiffness and tightness.
- repeated motion through exercise will help to get rid of scar tissue and promote growth of healthy, flexible tissue.
Overall, continued treatment with the Plantar/Spur Inferno Wrap® and Freezie Wrap® will maintain good health in your plantar fascia ligament and significantly reduce your risk of re-injury.
It may seem hard to believe, but regardless of what type of surgery you've undergone (or are trying to prevent), our Plantar/Spur Freezie Wrap® and Plantar/Spur Inferno Wrap® home therapy products will assist you in recovering from your injury faster and reduce the chance of degenerative foot conditions by maximizing blood flow where it's needed most and reducing the swelling / inflammation induced pain.
Prevention and Promotion of Lifelong Health
If you want to prevent the return of plantar fasciitis, a full rupture, avoid re-injury, or manage pain and increase circulation for lifelong health benefits, the Plantar/Spur Freezie Wrap® and Inferno Wrap® will provide exceptional results. Why spend time in pain, off from work, and missing out on your active lifestyle when you can be proactive about your injury and the health of your body? Talk to your doctor about incorporating a regular routine of Freezie Wrap® and Blood Flow Stimulation Therapy™ into your everyday health regimen.
Learn More About SUPERIOR Plantar Fasciitis Treatments
Learn more about how the Plantar/Spur Freezie Wrap® is designed to be the most effective cold compression wrap on the market today.
Learn more about how the Plantar/Spur Inferno Wrap® helps with the healing process.