A plantar fasciotomy is a last resort at the Washington Heel Pain Center. We have perfected conservative care and have such high levels of success that we rarely need to perform these procedures.
What and where is the plantar fascia?
The plantar fascia is located on the bottom of your foot. It actually is composed of three bands of tissue that work in conjunction with tendons, bones, and ligaments to stabilize and support your foot structure. It can become overused like many structures of the human body and become painful and inflamed. In addition, some foot structures are predisposed to developing plantar fasciitis.
What is the purpose of a plantar fasciotomy?
The goal of a plantar fasciotomy is to eliminate or reduce pain. This is done by relieving tension on the plantar fascia by cutting or lengthening a portion of the fascia. Most surgeons lengthen or cut the medial third of the fascia.
What are the indications for a plantar fasciotomy?
At the Washington Heel Pain Center, the indications for a plantar fasciotomy are when a patient has failed conservative measures. We have some of the most advanced conservative techniques and protocols with outstanding success rates, but regardless, some patients will continue to have pain and discomfort and these patients may elect to have a plantar fasciotomy. Before a fasciotomy is considered, a lengthy discussion will occur with your foot and ankle physician.
The plantar fasciotomy is a surgical procedure that involves making an incision on the inside of the foot near the heel. The subcutaneous tissues are then retracted out of the way to expose the plantar fascia. The fascia typically appears as a thickened white structure similar to a tendon. We then cut the medial third of the tendon until muscle belly under the fascia can be seen. The goal is to relieve tension or pressure on the fascia itself.
There are many different types of fasciotomies that can be performed: endoscopic, mini, open, instep heel type, and combinations with tarsal tunnel or porta pedis release. Washington Heel Pain Center carefully analyzes each patient to determine which procedure is most appropriate if a plantar fasciotomy is needed.
The post-operative course for a plantar fasciotomy is dependent upon any other procedures that are performed and what type of plantar fasciotomy occurs. The typical range of recovery can be weeks to months. Some patients may require no weight bearing activity for a period of time, while others may bear weight in a boot post-operatively. What is most important is having the procedure performed by a physician who has a great deal of experience doing them and who knows when other procedures are needed.
All surgical procedures have potential complications. The most common include infections and scarring. We have protocols in place to minimize side effects and maximize results. There is a complication that is discussed in the literature called “lateral column pain,” which can occur if the surgeon allows weight bearing too early or lengthens too much of the fascia.
•Can I drive after surgery? Yes, most people are able to still drive in a stiff shoe.
• Can I exercise after surgery? Yes, we recommend it. You may need to wear a special boot to protect your foot.
• How long does the procedure take? The plantar fasciotomy is a quick procedure and can typically be performed in about 30 minutes.