Plantar Fascia Release Surgery
Plantar fascia release surgery involves surgically cutting the plantar fascia to relieve plantar fascia tension and load. Most surgeons do not fully release the plantar fascia, but instead release two thirds of the plantar fascia, leaving the lateral third intact. The rationale behind this is that the plantar fascia is integral in supporting the structure of the foot and has many important biomechanical functions. You can learn more about 10 crucial functions of the plantar fascia here. There are two main approaches a surgeon may choose to perform the surgery including:
Open plantar fascia release - this is the oldest and traditional method. An open approach means that the surgeon make an incision wide enough to directly visualise the plantar fascia prior to releasing it. This approach causes more tissue trauma than more modern approaches and requires sutures to close the skin wound.
Minimally invasive plantar fascia release - This is a more modern approach to plantar fascia release surgery with the aid of guided imaging such as endoscopy, which involves the use of a small camera with a special blade to release the plantar fascia. Alternatively, minimally invasive surgery may also be peformed under ultrasound guidance. The benefit is minimally invasive approaches is less local tissue trauma and faster recovery time.
Plantar fascia release surgery should be a last resort procedure, having fully exhausted a wide range of well established, evidence based treatment options. It is best to avoid this procedure if possible due to the potential detrimental effects on the foot following the surgery. The plantar fascia is an incredibly important tissue needed for normal foot function. Sacrificing the plantar facia may help pain associated with plantar fasciitis, but may lead to pain elsewhere in the foot or other regions of the body due to increased stress placed on other structures. I do not recommend this procedure. If one is considering surgical intervention, I would recommend calf muscle release surgery as a preference to plantar fascia release surgery. If you would like to learn why calf muscle release surgery may be a better option, you can listen to my podcast episode here