Plantar Fasciitis is a painful and very frequently encountered injury for athletes. It could become a recurrent issue without top care from a NY Bone and Joint Specialists podiatrist. Our foot surgeon treats conservatively whenever possible but is also a top rated specialist in Plantar Fasciotomies. Our best-in-class foot surgeon treats athletes with plantar faciitis from both the New York City area and abroad.
At NY Bone and Joint we are dedicated to providing you with the best orthopedic care in the most efficient and professional environment. The staff at our Upper East Side, and Midtown Manhattan locations are happy to schedule follow ups or procedures at your convenience and remind you of upcoming appointments. We take care of the hassle of dealing with insurance companies and ensure that you get the most efficient and highest rated orthopedic care in the New York City area without the wait or price of a hospital visit.
Your plantar fascia is a thick band of tissue that runs along the bottom of your foot from your heel bone to the base of your toes. It supports the arch of your foot, especially as we put pressure on it while standing. Plantar fasciitis is a very common condition that effects nearly 2 million people in America for various reasons. By putting pressure on your foot, your plantar fascia stretches, sometimes beyond its natural elasticity.
Plantar fasciitis usually develops gradually as consistent strain on the plantar fascia causes multiple tiny tears to form, eventually leading to an entire damaged area of tissue. Plantar fasciitis occurs when the tissues becomes irritated and inflamed, causing pain at the heel. Plantar fasciitis is often a sports injury that arises from repetitive athletics that heavily impact your foot, like running, or from an increase in activity. Other conditions can increase the risk of overstretching your plantar fascia, such as having very high arches or very flat feet, tight calf muscles that strain your tissues when you flex your foot, or obesity.
Plantar fasciitis will cause pain at your heel. This pain increases once you use your foot after a long period of rest, such as when you take your first steps in the morning. Though your foot may feel normal while exercising, the pain will increase once you rest again. When it is taken care of early, plantar fasciitis can usually be treated conservatively with anti-inflammatories and physical therapy. When inflammation does not subside and the tissue is damaged beyond natural repair, plantar fasciitis release may be necessary.
Your podiatrist will be able to diagnose your plantar fasciitis with a physical examination, and x ray imaging to ensure that there is no bone condition such as a fracture or heel spur. Once your foot doctor diagnoses your plantar fasciitis, you will work together to treat it conservatively. Resting your foot and routinely going to physical therapy is essential for healing the tissues. If you experience consistent pain, your podiatrist will prescribe you oral anti-inflammatory drugs or suggest a corticosteroid shot. These injections usually relieve inflammation and pain for a few months as the tissues heal. Custom foot orthotics can also be worn regularly to release the strain on your plantar fascia.
However, if your foot does not respond to twelve months of these treatments, you probably have a more severe case of plantar fasciitis that your podiatrist will follow up on. An MRI will then be ordered to take an image of the tissue. Your foot doctor can then determine the damaged areas of tissues and how severe or widespread the damage to your plantar fascia is. This will be a guide for surgical treatment.
PLANTAR FASCIA RELEASE
Plantar fascia release procedures can be performed in different ways. All surgeries have the goal of removing damaged portions of tissue that cause pain and instability of your plantar fascia.
OPEN PLANTAR FASCIOTOMY
Open Plantar Fasciotomies are done for more complicated cases of plantar fasciitis. After your surgeon discusses the procedure and how you will feel following the procedure, you will be given anesthesia. Your podiatrist will make an incision, usually near the base of your heel where damage to the plantar fascia is most commonly found. Using a camera scope, your podiatric surgeon will cut away dead tissue, relieving the strain on your plantar fascia. Your podiatric surgeon will also remove any heel spurs that may build up before suturing your incision.
You will be able to leave the hospital the night of your surgery with your foot wrapped in an ace bandage and post-operative care instructions from your foot doctor. You will not be able to put pressure on your foot for approximately three weeks. After a few days of rest, you will use crutches to move around and begin physical therapy. Physical therapy sessions will focus on stretching at first to prevent scarred tissue from building up and muscles or other tissues from becoming stiff. Weight bearing before your podiatrist says it is safe makes it likely that your scar will worsen and your plantar fasciitis will undergo more damage.
After these three weeks your skin will be fully healed and you can put slight pressure on your foot. Your podiatrist will prescribe you a boot or surgical shoe to be worn for about another two weeks. Gradually, your physical therapy regimens will include more strengthening exercises so your surrounding muscles can support your healing foot. Open surgeries require significant time to heal because they run a risk of nerve damage or infection. Your podiatrist will see you regularly for the weeks following your surgery to change your dressings and ensure there are no complications.
ENDOSCOPIC PLANTAR FASCIOTOMY
Endoscopic Plantar Fasciotomies are a less invasive option for a plantar fasciitis release. By using smaller incision methods, endoscopic plantar fasciitis releases require less recovery time and risk of complication. You may be under anesthesia or use a local anesthetic during an endoscopic plantar fasciotomy. Your surgeon will make two incisions, each less than a centimeter long, in the base of your foot. Through one incision your foot surgeon will insert an endoscope, or small camera for visualizing your plantar fascia. Through the other, special tools are positioned to cut away damaged tissue and release the tightness irritating your plantar fascia. The incisions are then sutured and leave tiny scars.
Endoscopic plantar fasciotomies are outpatient procedures, so you will be able to leave after the surgery with instructions from your podiatric surgeon. After the surgery, your podiatrist will wrap your foot in an ace bandage and prescribe you a surgical shoe. You can bear weight on your foot immediately after the endoscopic plantar fasciotomy with the help of the shoe. Within a few days, your podiatrist will see you for a follow up to change your bandage and determine if you are ready to walk without the surgical shoe. Physical therapy can start immediately to quickly heal your plantar fascia with stretching and to begin strengthening your foot muscles to support the tissue. You may still experience some soreness and pain a few weeks after the endoscopic plantar fasciotomy, but gradual exercise and physical therapy, along with taping methods if necessary, will cause this to subside.
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