Endoscopic Plantar Fasciitis Release Surgery - Still Have Heel Pain After 8 Weeks - Still Hope

by Tom
(Pearland, Texas USA)

After years of heel pain, I finally decided to see a doctor. All the usual Non - Surgical methods performed without success. (Night Splints, Stretching, Shots, custom orthotics , etc)


On 12/8/11, I had Endoscopic Plantar Fasciitis Release surgery on both heels. Surgery was simple. Thirty minutes tops. I was in walking boots for three weeks then started PT. PT lasted a month and involved stretching, massaging, electronic stimulation(TENS unit).

Once PT ended, I still continued with stretching/TENS unit daily along with wearing my orthotics.

I am now a little over 8 wks post surgery and heel pain is still evident and I also have a "stiffness" in the top of both feet only after a resting period. The right foot more than the left. However, once I start to walk the stiffness goes away. ie, when i first get up..stiffness. After resting...stiffness.

Then, once I get up and start walking again, the stiffness will go away. My two questions are:

1. Will my heel pain subside? I am a little over 8 wks post op and I have read where recovery can take up to a year.

2. Will the stiffness go away completely. Could the stiffness be caused by the alteration of my fascia. (i.e not as tight.)

I am 43 years old and experienced heel pain for `10 years prior to seeing a doctor. Yes, I am stubborn.

P.S. Very happy with small incisions on inside of heels. You cannot even tell I was cut. I do, however, still have some minor soreness around incisions and they are a bit hard.



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Joshua Answers:

Hi Tom.

Ok good; quick easy surgery, minor remnants of the incisions.

But not good, still have heel pain and stiffness on top of the foot.


Will My Heel Pain Subside?

I don't know. It just all depends. See my questions below.


Will the stiffness go away completely?

I don't know. It just all depends. See my questions below.


Could the stiffness be caused by the alteration of my fascia. (i.e not as tight.)

Absolutely yes. Plantar Fasciitis Surgery consists of the surgeon cutting the connective tissue structures that are designed to support your foot and literally hold it
together.

To whatever degree those have been cut/severed, to whatever degree the stability of your foot has been weakened, your entire structure must learn to adapt as best it can.

Plantar Fasciitis Symptoms exist for a reason. And the surgery didn't fix, cure, reverse, nor eliminate that reason. So you still have all the original causes of your pain, plus now you have an at best different and at worst weakened foot structure.

And of course one of the main factors in every case of Tendonitis is the Process of Inflammation.


See: What Is Tendonitis?


So at this point I don't know enough about your situation to have much of an opinion as to the how and why of your post-surgery heel pain.


See related I Still Have Foot Pain 2 years After My Plantar Fasciotomy



QUESTIONS:

1. Is it the same heel pain as before the surgery? Or is it a new/different pain. If it's different, describe pre and post surgery symptoms.

2. Did you have stiffness in your feet before surgeon, such that once you walked around a bit the stiffness went away.

3. Describe the stiffness 'in the top of your feet'.

4. What exactly did the surgeon do in there?

5. Did you have anything other than heel pain before surgery?

6. More relevant details.


P.S. Minor soreness around the incisions is to be expected, and the hardness is scar tissue build up. Rub them, lots and often, to keep that tissue soft and pliable.





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Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.
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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Endoscopic Plantar Fasciitis Release Surgery - Still Have Heel Pain After 8 Weeks - Still Hope

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Nov 30, 2014
Rating
starstarstarstarstar 		Keeping the faith...hope excruciating plantar fasciitis release works
by: Laura

I had Plantar Fascitis release surgery in March 2014...from the moment I woke up the pain has been excrutiating.

I wanted to be optimistic so i did 4 months of Physical Therapy, lived in a boot for 6 months, had multiple cortizone shots at the incision site with no pain relief.

The PT stated she could no longer help me and now I am waiting to see an orthopedic foot surgeon. I dont understand what is wrong? I have done everything right and now I am on crutches 24/7. I have orthopedic inserts...I wear the night splints...I rub the anti inflammatory cream on daily with no relief....

Hope to have some answers soon....:)


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Joshua Comments:

Hi Laura.

It's not necessarily that you did anything wrong, it's that: A. the surgery didn't actually target the problem and B. the surgery causes major trauma to your structure (which causes predictible pain responses/dynamics).

You had a Pain Causing Dynamic in place, and surgery gets in there and makes it worse.

And it sounds like your pre-existing Process of Inflammation got dialed up way worse. Anti-inflammatory drugs like Ibuprofen will help get you through the day but aren't a cure at all.

Some bodies easily recover to some degree from that, some bodies go the other direction.

If you're consulting another surgeon and they recommend a follow up surgery, here's some important questions to ask: Quiz Your Doctor


You need to dial down the inflammation. You should probably consider some therapeutic supplementation.

See: Inflammation Causes Vitamin B6 Deficiency

See: Magnesium For Tendonitis


Ultimately:
A. the surgery caused damage
B. the surgeon neglected to give you adequate/effective self care regimen (because they don't know one other than 'rest, anti-inflammatories, PT, and good luck with all that'.
C. the surgery did not address all the original factors that caused your plantar fasciitis pain/problem, and those factors are still in play and probably worse than they were before.


What exactly did the surgeon do? What was cut, how much was cut, etc?
Apr 08, 2012
Rating
starstarstarstarstar 		Joshua Replies to Tom - Endoscopic Plantar Fasciitis Release Surgery - Still Have Heel Pain After 8 Weeks
by: The Tendonitis Expert

Joshua Replies to Tom

Hey Tom. You're welcome, no problem.


1. "It's the exact same pain" is bad news to a doctor, because that means his surgery didn't affect 'the problem'. If you have a different pain, then mentally he's off the hook. It is good information, though.

3. Stiffness is to be expected. The surgery injured the tissue, the body responds with tightness.

You might think it would subside, but that's because you're assuming that A. the body heals back to normal and B. surgery fixed/fixes the problem.

4. Do ask how much was cut. The fascia was tight for a reason. If there is too much load on a structure, the body will strengthen/thicken/tighten tissue in an attempt to help resist the load.

It's like putting a couple more pillars under a bridge. And then a surgeon goes 'Hey look, there's too much support on that bridge. Let's pull all but one of the pillars out.'

Surgeons, unfortunately, don't address the cause of the extra load. They are trained to cut tight things without asking why those tight things are tight.

5. Good!

6. That makes sense. It is bruised in there. The sheets of supporting tissue was cut. Now it's not holding things together. So as you've been walking etc things have been pulling apart, moving as they've never moved before, etc. So kind of like doing squats for the first time in your life with way too much weight, you get sore, unhappy tissue, etc.


7. What are you doing for post-surgery recovery/self care? What did your doctor give you for self care?


See Related for more on topic: Failed Plantar Fasciitis Release Surgery
Feb 27, 2012
Rating
starstarstarstarstar 		Answer to Question
by: Tom

Joshua:

Thanks for taking the time to respond to my post. For your specific questions:

1. Yes it is the same heel pain. (I am laughing because it is the same question my doctor keeps asking me....."but is it a different pain.") The best way to describe it is it feels as if I am standing on pure bone. A very deep bruise feeling. The pain is directly on the heels. (Both Feet) However, there is one difference pre/post surgery. Prior to surgery when I was on my feet for hours, the pain would continue for an hour or two after I sat down. This pain would be a throbbing pain and would eventually subside. Post surgery, the pain stops immediately once I am off of my feet. (Hopefully a good sign)


2. No. I never had stiffness prior to surgery. Nor did I have the common "first step pain" in the morning most folks have with PF. My pain is strictly related to when I am on my feet.

3. It does not hurt. Its as if my feet will not allow a full heel to toe/ball of foot step until they loosen up. A good comparison would be the feeling after a cast has been removed from your hands and feet. (broke my ankle when I was younger) The feeling you get because a particular body part was immobile for a period of time. At first I thought the issue was related to wearing walkiing boots for three weeks.

However, after almost 3 months, I would think that would subside.


4. The doctor released my fascia. He quoted the measured amount he released but I was still coming to from anesthesia and I do not remember. I do remember it was quite a bit because he stated the fascia was "very tight." I will ask on my next follow up in April.


5. No, no other pain other than the heel pain described above.


6. One other item that may help. If I am sitting down and I try to lift my toes only, I can feel a soreness on the bottom of my feet right around ball of my foot to about the middle of my foot. Again, the discomfort feels more like a deep bruise.

Thanks again for taking the time to read the post.




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