Plantar Fascia Release
In patients with recalcitrant plantar fasciitis, and who have tried non operative treatments for more than 9-12 months, surgical release of the plantar fascia can provide relief of symptoms.
This is typically done under a keyhole procedure with two small incisions on either side of the foot just in front of the heel bone.
In patients with tight calf muscles, this procedure is combined with a release of the tight calf muscle up near the knee. Which has been shown to be a more effective long term treatment for persistent plantar fasciitis than stretching the tight calf muscle alone [1].
Figure 1: diagram showing instrumentation and incision placement for endoscopic plantar fascia release
Figure 2: location of release of the proximal medial head of gastrocnemius
Success rates: up to 75% of patients are satisfied with the procedure and have improvement of symptoms.
Post-operative plan:
Surgery is typically a day case
Local anaesthetic administered to help with post-operative pain
0-2 weeks: elevation at home, but weight bearing in a CAMboot is allowed
2-6 weeks: full weight bearing and weaning out of the CAMboot, ongoing physiotherapy required.
6 weeks onwards: continued rehabilitation, symptoms can sometimes take up to 6 months or longer to resolve fully.
Download post operative care guide
Risks of surgery
Swelling, stiffness
Infection
Wound healing problems
Scar sensitivity
Ongoing pain
[1] Riiser MO, Husebye EE, Hellesnes J, Molund M. Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up. Foot Ankle Int. 2024 Jan;45(1):1–9.