Plantar Fasciitis - Is surgery my ONLY option?

Hi Jason,

4 months is not long to have to start resorting to surgery, that is the last option after all else fails unless there is a growth like heel spurs that are causing inflammation. The recovery time after surgery is 6 months so consider this very carefully and give stretching exercises time to work. The causes of pf are many and can be due to tightening of the calf muscles due to age, over 50 or injury from too much running or jumping.

Some find warm foot bathes before the exercises helps, others find icing helps but |I feel this just knumbs the pain. Try rubbing anti inflammation cream into the heel and sole which often works better than taking pain killers as the inflammation is in tissue where there is little blood flow.

I found cushioning the heel with gel heel pads worked well allowing me to walk and carry on but gel insoles are also good as they cushion the heel and spread your weight over the whole sole. These were recommended to me by my podiatrist after the doctor said he could not help it was just a matter of resting and waiting for it to go away, not many of us can do that for weeks.

Before having surgery I would want scans done to find what the cause may be as there is no going back if the surgery does not work, it may make it worse.

Hope this helps and remember it can disappear overnight if you find the option that suits you we are all different.

Jason, I am a retired physician, a plantar fasciitis patient, and I say "don't have surgery."  I got plantar fasciitis around February 2016.  After about four months, it completely resolved. 

Here's what I think.  Plantar fasciitis is inflammation of the attachment of the plantar fascia to the heel bone, and/or some minimal tearing of the plantar fascia - just a few fibers - that results, naturally, in inflammation . . .   like a "pulled muscle."   Inflammation hurts until it heals and resolves.  So what's so difficult about curing P.F.?  Well we walk on it!!!  Let's say we take 5000 steps a day.  Imagine inflammation of your elbow, (i.e. tennis elbow).  Imagine taking your sore "tennis elbow" and wacking it against the wall, 5000 times a day.  Think it would heal quickly?  I don't either.

So my cure for plantar fasciitis is cushion, cushion and cushion!!!  That's right - cushion the heel.  Here's what I did.  First, I wore the plantar fasciitis "relief bridge" gel-heel innersole in my shoes - that I got at Walgreen's for about $11.  Make sure your innersoles are soft and preferably made of gel.  (I plan to use mine indefinitely in my shoes.)  Then I wore a pair (usually) of nice thickish sox.  On my heel I wore fasciitis therapy wrap padded supports that I got on the internet for about $13.  (I don't wear them any more.)  So when I had my PF, under my heels I had 3 cushion layers.  I wore this about 24 hours a day - except when in the shower or swimming.  And after about 4 months, the PF was totally gone.  And I would suggest to you, have patience, not surgery.

Jason, that's what I think.  I hope this helps you and the many other sufferers of plantar fasciitis.  Good Luck to you, doknabox/JerryR

Maybe a Change of shoes may provide temporary relief

I have. Had it 8. Months now! Spent thousands on therapies

Ultrasound , laser , icing, massage, 5 injections in each foot, on knee scooter for months, stretching, Epson salts soaks, art therapy, now I'm doing graston! Done by a chiro...makes most sense to me now knowing that you must break up adhesions /scar tissue !! Kind of like steak.... healthy tissue is like tender fall apart steak..... dead tissue (fasciosis) ..is the chewy hard steak! Blood flow can not get in to help heal!

Everyone has their own way of Injury... females ..my sake ..I was in high heels all day everyday for years and also a dance and fitness instructor....my feet never saw a couch lol.... but.... I pray after 10 session of graston i will have much more relief as the scar tissue breaks.down!!!! My next venture is PRP injections and then surgery!!! Yikes!! So I'm praying this works! Patience is key! As a dancer, I feel like I have lost my lifeline! Take my feet, take my heart good luck!!!!

I am a retired physician and former and possibly future PF patient. The only surgery I would consider at this time is to cut loose this physician who suggests surgery. 4 months of suffering seems like a lot but if you look at some of these posts, you are no where near a surgical option. Your PF is injured. You need to find a way to rest and protect your PF from further injury. Cushion it and tape it - on youtube you can find "Plantar Fasciitis taping that works". Protect it during the day and then try to slowly stretch it when you have time - get the rockers or stand on a step or anything that allows you to stand on your toes but in a relaxed position. Stand on a step and slowly let you foot down. The rockers are easier to use and are cheap. Through millions of years of evolution, you have developed a plantar fascia for good reason - you can't simply cut it away without severe consequences.

Hi John,

Thank you for your reply correspondence and valuable advise.

I have just one question and have taken your advise on board and have read numerous other posts on this forum.  

Isn't stretching the PF going against what is already elongated and stretched anyway, that's why there is a problem in the first place?

There's just so much information and yet very few answers.

To me everything feels as though it's a hit and miss type scenario.   

good question but the answer is that no one really knows. You will find some information that the PF should not be stretched, that it is supposed to be tight. I disagree based on other opinions and I think that the problem may be that it gets a little too tight and little micro injuries and tears form scar tissue which is less plastic and then because it is so tight, it tears just enough to become inflamed and make you miserable. I first thought that must be true and I avoided stretching it and I got worse. I then decided that was not working and I needed to try another approach. You don't get better because you continue to walk on it and don't adequately rest it so I learned how to tape it ( the tape off loads the weight bearing forces on to the tape and off the PF so it can rest to some degree ) so I could be functional during the day and walk and play golf and I slowly stretched it in the evening and I even tried those devices that stretch it while you are sleeping. I think they helped but it was hard to sleep and given the choice, I chose sleep. I tried different combinations of arch supports and often used two or even three at the same time. I wanted to off load the weight bearing onto my arch and away from my heel and distal metatarsals. This also stretches the PF if you think about it. I really liked the arch supports with the PF ridge. I still have them in my golf shoes. They were the biggest help for me but please know that we are all a little different- different anatomy with different injuries. I am also an advocate of oral NSAIDS in very moderate doses like ibuprofen and naprosyn which reduce pain and decrease inflammation. BTW, if you do use these drugs, take some milk thistle and N-Acetyl cysteine ( NAC ) to protect your liver and kidneys - look them up if you don't believe me. I massaged my foot in the evening and used a TENS unit for hours. I think it may have improved the blood supply and blood flow since the PF has a very poor circulation which makes it heal slowly. BTW, you can try the cold bottle trick but that will only make it numb for a while and it actually reduces blood flow. I would rather see you use a hot tub and put your foot right in the jet. This will massage your foot and increase blood flow which you really need to heal your PF. It will get better without surgery, just give it time and the right combinations.

I hope this helps !

Hey John, 

Thank you for your time in answering my question. 

Most of all literature I’ve read and including some of the information you’ve given me in your posts here

all seems to only ever address the resulting symptoms.

Such as taking NSAID’s – which will mask the pain and are not good long term.

Stretching, Hot baths, Ice, Massage, Strength work, Exercises, TENS Machine (Transcutaneous Electrical Nerve Stimulator). Acupuncture – Dry Needling, Creams, Lotions and Potions..I mean the list goes on. 

The list for Causes of this condition is as long as the list for potential cures.

Yet, how do we avoid all of these factors for causes and of course continue to walk on hard flat surfaces? 

In my opinion, and I know my opinion doesn’t count for much….but aren’t we maybe viewing this condition in the wrong light? I mean any and all causes I’ve read about are more so TRIGGERS for the pain and discomfort of plantar fasciitis and not, I believe are the true underlying causes. 

The argument of having the PF muscle tight and particularly supporting body weight, it has to be tight to some degree so this is of course is plausible. But wouldn’t this go against the trend that any healthy tissue requires a good supply of blood and oxygen to function correctly.

Therefore, I agree with you here that it shouldn’t be stretched, particularly routinely and rigorously, at least.   

You mentioned arch supports being of some help to you, and you get some temporary relief, but why are they not a total solution? I believe the answer to this may in fact lie with the fact that the arch supports or any orthotic device moves, flexes and depresses as we walk, under our foot. 

Finally most pain and discomfort is only ever managed and I’m really curious to know why?

But I suppose the answer to this is why you stated that, ‘you suppose no one really knows’.

 

I think arch supports are a very, very big part of the solution and you should plan on wearing them forever. I even put them in my sandals. Cushioning is a big help but does not address the underlying problem. The arch supports do address it, they support your foot and off load the weight bearing onto your arch and they also give your PF a little stretch. The earliest humans walked barefoot on dirt and sand and grasses. They did not walk on flat rock, tile or concrete. If they did, I bet they would get Plantar Fasciitis. Maybe that is why they developed sandals They used their arches by default. With modern shoes, we walk on our heels and metatarsals and constantly traumatize our PF, so what should we expect. PF like a lot of things is a much more common problem now than it has ever been. If you reverse engineer the problem you might figure out why it is happening and how to cure or prevent it. Common sense often beats modern medicine and surgery and I admit this even though I am an M.D.

Hi Jason

Before i type a bunch of repetition, i looked at the previous replies to you and i agree. I will add one more thing that they didnt say...the majority of folks who have had surgery say it was a horrible experience and it didnt work!! Its true that PF "umbrella's" many foot issues that will take you down even lower if have a surgery. It just takes time. Sadly...its debilatating and our Mamas never told us about PF while growing up! It seems to be so common yet no one talks about it. Long story short....i.would NOT have surgery.

Ladyjack51 in Dallas

PF can be around for quite sometime... I have had issues for close to 2 years. Surgery is no picnic... you’ll be scootering for quite awhile! I suggest you see an orthopedist, as I have....insist on an MRI, in case of a tear that would need surgery. Also see a physical therapist and have as much ultrasound as possible to release the tightness. Cortisone shot did not help me. Do suggested home exercises. And, don’t buy any orthotics... I have 4 pairs and seen 2 podiatrists. Until the PF is cured/ passes, they are useless. If your heels hurt, purchase  gel pads. It will take time! Wish you well.