Plantar fasciitis is a degenerative change in the fascia that spans the bottom of your feet from the ball of the foot to the heel. This condition affects 10 – 15% of the population and usually manifests as pain when you start walking after an extended period of time at rest. Surgery to relieve plantar fasciitis is recommended for only a small number of patients when all conservative treatment has failed.[1] Surgery is usually done as an outpatient procedure. The recovery time can vary depending on whether it was open or endoscopic fascia release surgery. The type of surgery often depends on the surgeon, but a recent study has found that endoscopic fascia release surgery is a safer alternative that is associated with faster recovery times and greater patient satisfaction.[2]
EditSteps
EditRecovering from Endoscopic Surgery
- Wear your postoperative shoe or walking cast. Since an endoscopic procedure is less invasive than an open surgery, the recovery time is shorter as well. Your surgeon will bandage your foot after the surgery, and she will then wrap it in a walking cast or postoperative boot. You can expect to wear this for three to seven days after the surgery.[3]
- Your doctor may end up recommending you wear the boot or cast for longer. Always wear it according to your surgeon’s postoperative directions.
- Stay off your feet for the first week. While you are not forbidden from walking, your surgeon will recommend that you stay off the foot as much as possible for the first week after the surgery.[4] This will limit your pain, recovery period, and potential for complications such as soft tissue damage around the site.[5]
- Use supportive walking shoes once your surgeon removes the cast or boot. At your first follow-up appointment, your surgeon will decide whether or not to remove your cast/boot yet. If your surgeon removes it, then he will recommend that you wear shoes with plenty of arch support for the next several weeks while still minimizing the amount of weight you place on your foot.[8]
- Podiatrists and surgeons will typically prescribe custom orthotic shoe inserts before ever performing plantar fasciitis surgery. Return to using your orthotics as directed to provide the additional support as your foot heals.[9]
- Have your surgeon remove your sutures. Your surgeon will remove any sutures from the procedure at your next appointment, which will likely be anywhere from 10 to 14 days after your initial procedure.[10] Once the sutures are out, you are free to resume bathing your foot. You can also resume placing your full weight on the foot.[11]
- Do not try to resume your normal walking routine for at least three weeks. Even with your sutures out and using your orthotics, you are likely to experience some discomfort from walking for around three weeks.[12]
- If your job requires you to spend long hours on your feet, then you may have to take this time off work.[13] You should arrange this with your employer before scheduling your plantar fasciitis surgery.
- When you do have to be on your feet, you may find relief from discomfort in icing and elevating your foot afterward. By placing a frozen water bottle on the floor and using your foot to roll across it, you can perform a good stretch on the area as well as icing it.[14][15]
- Go to all of your doctor and physical therapy appointments. You will have additional follow-up appointments with your doctor at her discretion. You can also expect to meet with a physical therapist who will teach you how to stretch the muscles and tendons in your foot safely for the best outcome after your surgery. Always schedule these appointments based on the suggestions of these professional providers and attend each appointment.
- Consult your physical therapist before resuming any strenuous exercise routines. Even after you’re walking normally without any discomfort, your doctor or physical therapist may recommend easing yourself back into high-impact exercise routines. Consult them about the best exercises and schedule for resuming your workout regimen.
- Don’t be surprised if they suggest switching to lower impact exercises, such as swimming and cycling, for several months after your procedure.
EditRecovering from Open Surgery
- Wear your cast or brace for the entire time designated by your surgeon. Consistent use of your cast or brace is necessary in order to allow your fascia to fully recover. Even if you feel better and there is little to no pain when you put your full weight on your feet, it is still necessary to allow complete recovery. No pain and increased mobility does not mean your body has healed 100 percent. You can expect to wear the cast or boot for two to three weeks. [20]
- Use the crutches provided. Though you should stay off your feet completely as often as you can manage it, your doctor will provide crutches for you to use when you must get up.[23] Use them consistently to help aid you in keeping weight off your foot.
- Take any pain meds prescribed by your doctor. Though not highly invasive, the open nature of the procedure will still result in pain during your recovery. Your doctor will likely prescribe pain medication to help keep you more comfortable during the initial recovery time. Take your pain meds as directed when you are experiencing pain. If the pain is unrelieved, contact your doctor.
- Your doctor will have you switch to over-the-counter pain medication once your prescription runs out. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help manage pain.[24]
- Schedule and attend your follow-up appointments. Your surgeon will schedule follow-up appointments to monitor the progress of your recovery and to determine when to remove the cast or boot on your foot. Make sure you attend these appointments, and do not remove the cast or boot before your doctor gives the okay.
- Start wearing shoes with proper support. Once your doctor removes the cast/boot, he will give the okay for you to start wearing shoes again as soon as it’s comfortable for you to do so. Since surgery is a last resort, you will likely already have custom orthotic inserts for your shoes. Continue to use them after the surgery to provide the proper form and support to your foot as it continues to heal.[25]
- Use ice to reduce discomfort. Once your foot is out of the cast, you can also ice it to help reduce discomfort, especially after being on your feet for a long period of time. One method is to place a frozen water bottle under your foot while rolling your foot along it. This stretches the area around your plantar fascia while icing it at the same time.[26]
- Attend any physical therapy appointments. If your doctor sees the potential for complications or evidence that you’ve been putting too much weight on your foot, she may schedule more appointments to monitor your foot. However, you will likely only have to meet with a physical therapist at this point to learn some stretches and exercises to aid in your recovery time.
- These types of stretches include massaging your plantar fascia by using a small, hard object such as a golf ball to roll under your foot.[27][28]
- Another easy way to exercise the corresponding muscles and tendons is to flex your toes down and in to grasp a towel or even the carpet beneath your feet.[29][30]
- Restrict all running and impact sports for at least three months. Even after you can walk normally without any discomfort, your doctor or physical therapist may recommend easing yourself back into high-impact exercise routines. You’ll want to restrict high-impact running and jumping for as long as three months.[31] Consult them about the best exercises and schedule for resuming your workout regimen.
- They won’t stop you from exercising completely, but they will likely suggest low-impact routines such as swimming.
EditWarnings
- This article covers a general set of guidelines for plantar fascia release surgery. You should always follow your own doctor's advice and instructions.
- Contact your doctor immediately if you have severe pain or signs of infection after surgery. Signs of infection include redness, swelling, drainage from the wound, and fever.
EditSources and Citations
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source How to of the Day http://ift.tt/2bsoD7n
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