Unfortunately, a small percentage of people that develop plantar fasciitis will not have success with conservative therapies. We have an established treatment protocol for heel pain, making us a premier location for the treatment of plantar fasciitis. The standard of care is six months to a year of conservative therapy before surgical intervention should be considered. We have multiple surgical modalities available for patients with recalcitrant plantar fasciitis. These surgical procedures can be performed with mild sedation in our outpatient surgery center that can save you both time and money by not having to go to the hospital or ambulatory surgery centers. The procedures include:
- platelet-rich plasma injections
- gastrocnemius recession
- plantar fasciotomies
Platelet-rich plasma injections involves taking a small sample of the patient's blood and spinning it down to platelets and growth factors. This is then injected into the plantar fascia with ultrasound guidance. This utilizes the body's own ability to heal the damaged fascia. The post operative course requires a walking boot for about three weeks followed by a transition into proper shoe gear.
A gastrocnemius recession involves lengthening of the muscle in order to reduce the contracture. A large percentage of people with chronic plantar fascial pain have limited range of motion of the ankle. This limited range of motion often results in compensation via flattening of the arch, which leads to strain on the plantar fascia. The post operative course requires a walking boot for about three weeks followed by a transition into proper shoe gear.
The most common procedure for recalcitrant plantar fasciitis is a plantar fasciotomy. This procedure involves lengthening a section of the fascia. The idea is to reduce mechanical workload in the fascia thereby providing resolution of symptoms. This procedure takes about 15 minutes and usually requires a period of non-weightbearing for about three weeks and an additional two to three weeks of protected weightbearing.
