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Plantar Fasciitis

Plantar Fasciitis

If you are experiencing pain that is worse first thing in the morning, or after you have been standing for long periods of time, then you may have Plantar Fasciitis.

Plantar Fasciitis

What is Plantar Fasciitis?

Plantar Fasciitis (or fasciopathy) is inflammation with/without degeneration at the origin of Plantar Fascia – a thick tissue band at the bottom of the foot that runs from the toes to the heel. The main role of the tissue is to support your foot, act as a shock absorber, and support walking.

People suffering from Plantar Fasciitis complain of heel pain. The pain is worse in the morning immediately after waking up, after long hours of sitting, or at the end of the day.

Heel pain reduces after a few minutes of walking or doing an activity that stretches the Fascia. However, for some people, the pain reduces and returns after spending hours on their feet.

Heel pain is one of the most common disorders that foot and ankles physicians treat, and fortunately conservative treatment is successful in roughly 90% of patients seeking treatment with plantar fasciitis.

Causes

Non-supportive footwear: wearing shoes without cushions or walking barefoot on hard surfaces.

Very high arched feet or very flat feet: can affect the weight distribution putting stress on the tendons.

Overweight or Obese: extra weight puts increased pressure on your plantar fascia ligaments.

Ageing: wear and tear on the plantar fascia over time.

Walking or standing for long periods on hard surfaces can damage the plantar fascia.

Injury or trauma to the heel.

Treatment

Conservative treatment

Stretching: Doing stretching exercises to ease pain.

Footwear: Wearing shoes with excellent arch support to reduce stress on Plantar Fascia. Avoid going barefoot.

Activity modification: Avoiding strenuous physical activities to rest your heel.

Custom orthotics / Night splint: 

Ultrasound guided Steroid injection (cortisone): To reduce inflammation and ease the pain.

Platelet rich plasma (PRP) injection: 

Radiofrequency ablation (Rhizotomy): 

Extracorporeal shockwave therapy: Sends high pressured acoustic shock waves through the skin to stimulate pain relief and tissue repair.

 

Surgical treatment

Plantar Fasciitis surgery (Plantar Fasciotomy) can be done as a day surgery procedure. A small incision (usually 2-3 cm in length) under the arch area is made directly on the sole of the foot. The tight band (plantar fascia) is then released 1/3 to 1/2 of the medial plantar fascia. Once the tightness in the plantar fascia is loosened, skin is closed with one or two sutures.

We also offer minimally invasive keyhole plantar fascia release surgery (instep fasciotomy) which releases a portion of the plantar fascia. Only requiring a small 1–2cm incision you will be up and walking the same day in a post-op shoe, and this surgery has a 93.6% success rate.

Minimally invasive keyhole surgery is also used to remove large heel spurs.
This unique procedure effectively treats the condition at its source, reducing significant downtime, scarring, or compromise to the other soft tissue structures around the heel area.

Appointment Information

Cost & Item Codes – Our fees are quoted on a case-by-case basis after your initial consultation with the surgeon as each patient presents differently and each surgery varies from patient to patient. Please book an initial consultation to discuss this further.

Scans – We recommend you have an ultrasound of the plantar fascia prior to your appointment.

Telehealth – We are unable to offer an initial telehealth appointment for this issue.

Surgery Information

Do I need surgery? – Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. Dr Kim will discuss both options with you to determine which approach would be most beneficial and it is your decision if you go ahead or not.

Duration – The operation usually takes around 20-30 minutes.

Anaesthesia – Surgery for plantar fasciitis is usually a day surgery procedure and can be done under local anaesthesia, twilight sedation, or general anaesthesia, depending on the surgeon’s and the patient’s preferences.

Medications – Severe pain after plantar fasciotomy is rare although pain is subjective. Many patients need only mild postoperative analgesics for 5-7 days after plantar fasciotomy.

Smoking – If you are a smoker, you need to stop the habit of smoking 4 weeks before your operation for normal healing and reduce postoperative complications.

Recovery Process

Patients must follow their surgeon’s instructions carefully during recovery to ensure proper healing and minimize the risk of complications.

As with any other surgical procedures, plantar fasciotomy is not without complications. Possible complications of plantar fasciotomy are –

Plantar scarring, Persistent pain, Arch pain, Lateral column pain, Burning or tingling in the ball of the foot.

The following should be adhered to in order to hasten your recovery from foot surgery. In general, the following timeline can be expected:

Immediately after surgery: Go home and rest. Elevate your foot as often and as much as possible to reduce swelling.

Bandages must be kept dry at all times and must not be removed before your first post-op consultation with Dr Kim.

Wear post-operative shoe all the time, even at bed for the first 2 weeks. Place a plastic bag over your foot when showering.

The first few days: When you are resting, keep your operated foot elevated. To reduce the risk of blood clots in your legs (DVT), exercise your leg muscle by rotating your ankles and flexing and extending your knees at regular intervals. Weight bearing is permitted in the post-op shoe with limited activities.

1-2 weeks: Although you are allowed to walk on your foot after surgery (in a post-operative shoe) it is best to completely rest your foot and elevation is encouraged in the first 1-2 weeks following surgery. In the first 2 weeks, keep the foot dry until stitches are removed. You may be able to gradually return to wearing comfortable tennis shoes between 2-3 weeks.

2-4 weeks: Continue as directed by your surgeon increasing movement. You may still have to elevate your foot as required. You will be guided by your surgeon regarding an Orthotic prescription around week 4. Your surgeon will advise if any further post-op appointments are needed.

Driving – Your surgeon will advise when you can start driving, usually 4-6 weeks after surgery.

You may drive if surgery is on the left foot, when you are off narcotics, and if your car is an automatic.

If surgery is on the right foot, you can drive when you are full weight bearing without aids and given clearance from your surgeon.

Flying – You should not fly in the first week after surgery. Check with your surgeon on individual circumstances.

Return to Work sedentary – If you work at a desk with minimal time on your feet and you are able to elevate your foot/feet, you may be able to return to work between 1-3 days.

Return to Work active – If you have a physical job or are standing a lot and unable to elevate your foot/feet, you may not be able to return to work until 4-6 weeks.

Low impact exercise – return to normal daily activities and gentle low impact exercise 4 weeks.

High impact exercise – should be avoided for 4-8 weeks.

Patients should contact their surgeon if –

  • You experience severe pain that is not relieved by rest, elevation, pain medication and/or applying an ice pack to the operated part.
  • Bandages become saturated with blood.
  • The colour of your toes appear abnormal.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Podiatric Surgeon Dr Kim is the leading surgeon for Foot Surgery in Brisbane and Gold Coast, book a consultation today to discuss which options are best for you.

No referral needed

Contact Us

A GP referral is welcome however it is not essential for your appointment

About

Dr Ji Soo Kim (Specialist Podiatric Surgeon) BPodM, DClinPod, FFPM RCPS(Glasg)

Book Appointment

Dr Kim has two offices, one located in Kelvin Grove, Brisbane. The other is in Southport, Gold Coast.

Please call 1300 522 096

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