When is Heel Pain Surgery an Option?

To an athlete, surgery is a subject generally considered taboo.  It’s a word often associated with extended periods of recovery and rehabilitation with a questionable return to full function. One of the exceptions to this rule is for someone dealing with a chronic case of plantar fasciitis, or heel pain lasting one year or longer.

Conservative management of plantar fasciitis is generally considered successful 80-90% of the time.

This includes:

• Arch Supports

• Stretching

• Ice

• Cryosurgery

• Physical Therapy

• Medications (including local steroid injections)

It is not unusual for 10-20% of plantar fasciitis patients to be unresponsive to conservative treatments, or have repeated bouts of this painful condition over time. These patients may have waited too long for treatment, had mechanical issues unresponsive to orthotics, or have plantar fasciosis.

Plantar fasciosis is a chronic form of plantar fasciitis involving fibrosis and fascial deterioration that does not respond to conservative treatment. To the athlete already spending considerable time away from their sport, surgery (with a fairly short recovery of 4-6 weeks) could be a welcome option.

A plantar fasciotomy (plantar fascial release) is a relatively simple procedure that releases a small portion of the plantar fascia from the heel.  A small 1/2” incision is made just in front of the heel on the bottom of the foot. The surgery generally takes less than 10 minutes and will usually alleviate the tension in the heel and arch causing the chronic pain. The patient is allowed to walk immediately and can return to running or activity in 3-4 weeks, depending on the amount of inflammation and tenderness. Recurrence is very rare and complications are minimal.

Although surgery should only be considered as a last resort when other more conservative care has failed, a plantar fasciotomy can be a highly effective and permanent solution for chronic heel pain after risks and complications have been examined fully by the patient and their podiatrist.

Here at the Plaza Footcare Center in Kansas City, our goal is to return all athletes -recreational or professional- to full function as quickly as possible.

Call us today for a consultation.

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