Plantar Fascia Release

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1 Plantar Fascia Release Introduction Plantar fasciitis is a common condition that causes pain around the heel. It may be severe enough to affect regular activities. If other treatments are unsuccessful, healthcare providers may recommend surgery for people suffering from plantar fasciitis. If your healthcare provider recommends surgical treatment for your condition, the decision whether or not to have surgery is yours. This reference summary will help you understand the benefits and risks of plantar fascia release surgery. Feet Healthy feet are strong and flexible. They allow us to walk and run as they support the weight of the whole body. A ligament connects two bones or holds together a joint. The plantar fascia is a ligament. The plantar fascia is the thick band of tissue that connects your heel bone, also called the calcaneus, to your toes. The plantar fascia fans out as it gets closer to the toes. The arch of your foot is supported by the plantar fascia, absorbing the pressure from the body s weight. With each step, the plantar fascia contracts and loosens. It acts like a rubber band. Also connecting to the heel bone is the Achilles tendon, or heel cord. The Achilles tendon connects the calf muscles to the heel bone. The calf muscles are the muscles on the back of the lower leg. Heel Bone Plantar Fascia Toe Foot 1

2 Symptoms and their Causes Plantar fasciitis happens when the plantar fascia is overused. The plantar fascia becomes inflamed and you feel pain. When the plantar fascia is overused, it causes small tears. The body can usually repair one or a few such tears. But repeated tearing of the ligament can result in inflammation of the plantar fascia, causing pain. Pain associated with plantar fasciitis usually develops slowly over time and is centralized around the heel. The first steps after waking up may be the most painful. Pain may lessen throughout the day as the plantar fascia relaxes. The pain can return after long periods of standing or sitting. Usually only one foot is affected. However, plantar fasciitis can happen in both feet at the same time. Heel pain caused by plantar fasciitis may be severe enough to affect regular activities. It can cause a person to avoid walking and exercising. Alternative Treatments Healthcare providers will try conservative therapies first to treat plantar fasciitis. The first recommendation is to rest the foot from the activity causing the pain. This will allow your foot to heal the inflammation in the ligament. Other conservative therapies used to treat plantar fasciitis include physical therapy, shoe inserts and night splints. Your healthcare provider may also recommend medications to relieve pain and fight inflammation. Many people with plantar fasciitis improve within the first few months of treatment with medication and therapy. However, these conservative treatments may require a long period of time to work, ranging from 3 to 12 months. 2

3 If conservative treatments fail, your healthcare provider may recommend a new procedure called extracorporeal shock wave therapy. In this treatment, sound waves are used to stimulate healing from the skin of your foot. This therapy may not work for everyone. When non-surgical treatments do not work and pain is interfering with regular activities, your doctor may recommend surgery. Plantar Fascia Release The surgery to relieve pain and inflammation of the plantar fascia is called plantar fascia release. Its aim is to cut the ligament. It usually takes about a half hour. The operation is done through a skin incision. When the ligament is cut and released from the heel bone or cut into on either side, the tension is relieved. That is why this surgery is called plantar fascia release. The operation is usually done under local anesthesia. It can be done as an open or endoscopic surgery. An open surgery involves a larger incision than an endoscopic surgery. An endoscopic surgery uses instruments inserted through smaller incisions. Plantar fascia release is an outpatient operation where the patient goes home the same day of the operation. Risks and Complications Plantar fascia release is a safe operation. It provides good results for people with severe plantar fasciitis pain. There are, however, some possible risks and complications. These are unlikely but possible. You need to know about the risks and complications in case they happen. By being informed you may be able to help your healthcare provider detect complications early. Some risks and complications include those related to anesthesia and those related to any type of surgery. Risks related to anesthesia will be discussed with you in greater detail by your anesthesiologist. 3

4 Some risks of surgery include: Infection Bleeding Skin scars Blood clots Blood clots in the legs can happen due to inactivity during and after the surgery. These usually show up a few days after surgery. They cause the leg to swell and hurt. Blood clots can become dislodged from the leg and go to the lungs where they will cause shortness of breath, chest pain and possibly death. It is extremely important to let your healthcare provider know if any of these symptoms happen. Sometimes the shortness of breath can happen without warning. Getting out of bed shortly after surgery may help decrease the risk of blood clots in the legs. Other risks and complications are related specifically to plantar fascia release surgery. Again, these are very rare. However, it is important to know about them. Nerves in the foot may be injured during plantar fascia release. This may cause pain, weakness or loss of feeling. A neuroma may form as a result of the operation. A neuroma is a tumor that arises in nerve cells. After a plantar fascia release, there are the risks of slow healing of the incision and a delay in when you can return to your normal activities. There is also the possibility that the operation may not help symptoms or may even make them worse. After the Surgery Your healthcare provider will tell you how long it will take before you go back to work. This depends on your age, type of work and the type of surgery you had, as well as other factors. 4

5 Your activity level will be limited after surgery. You may need to wear a cast or brace. This depends on the type of surgery you had. Your healthcare provider will arrange for a follow-up visit to examine the incision and remove any sutures. Your healthcare provider will choose the foot rehabilitation program suitable for you. Summary Surgery to release the plantar fascia ligament can help relieve severe foot pain caused by plantar fasciitis. Surgery for plantar fasciitis is not common. However, it may be an option when other non-surgical treatments fail. Brace This operation is very safe with good results. However, as you have learned, complications may happen. Knowing about them may help you detect them early if they happen. 5

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