Plantar Fascia Surgery

What are the Surgical Treatments for Plantar Fasciitis?

Before reading this page, please see Plantar Fasciitis under the ACHILLES & HEEL menu for more information.

Note: there is a photograph of surgery below on this page.

There are three surgical treatments for plantar fasciitis that has not responded to non-surgical treatment:
  • endoscopic partial plantar fascia release +/- minimally invasive heel spur reduction ("keyhole" surgery)
  • calf lengthening
  • open plantar fascia release +/- Baxter's nerve release +/- heel spur reduction.
Most people undergo endoscopic partial plantar fascia release. Calf lengthening is a treatment option in people with tight calf muscles and plantar fasciitis. Open surgery is no longer common. 

Endoscopic Partial Plantar Fascia Release

This surgical procedure involves releasing the tight medial band of the plantar fascia.

One or two incisions (8 mm) are made on the side(s) of the heel. An endoscope is used to look inside to guide release of the plantar fascia (see image).

Surgery:
  • is Day Surgery
  • requires a general anaesthetic in most people
  • takes 30 minutes.
First 2 weeks:
  • bandage and post-op shoe (no "moon-boot")
  • weight bearing +/- crutches or a frame
  • rest, elevation and ice (RICE)
  • calf and foot stretches
  • post-operative appointment.
Next 8 weeks:
  • RICE as needed
  • physiotherapy-guided rehab program
  • exercise bike and pool-based activities
  • sports specific training and gym exercises.
Benefits and risks:
  • 90% of people are helped by surgery
  • start-up heel pain is usually relieved
  • end-of-day heel pain is less reliably improved
  • 10% of people are not helped by surgery
  • 1% of people are made worse by surgery.
Consequences and complications:

Calf Lengthening

This surgical procedure involves lengthening the calf (gastrocnemius) to reduce tightness in the plantar fascia. 

This has been shown to help 80% of people with plantar fasciitis and tight calves.

Two techniques are available:
  • proximal medial calf release behind the knee (see image - 10 days post-op)
  • mid calf release using an endoscope.
Both are effective. Neither needs a "moon-boot".

These procedures result in 10% loss in calf strength but this is not noticed by most people.

Other consequences and risk are discussed during the informed consent process.

Open Plantar Fascia +/- Baxter's Nerve Release

This surgical procedure involves open release of the tight medial band of the plantar fascia and release of Baxter's nerve.
It also allow reduction in the heel spur.

Dr Beamond rarely performs this procedure.

IMPORTANT

If you have any questions about your planned procedure, contact Dr Beamond before the day of surgery.

The information on this page is of a general nature and does not replace the informed consent process. Other consequences and risks specific (material) to the individual must be discussed prior to surgery.
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