NYU Langone doctors may talk to you about surgery to treat plantar fasciitis if nonsurgical therapies have not relieved pain within 6 to 12 months.
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Our highly trained orthopedic surgeons and podiatrists perform gastrocnemius recession surgery and plantar fascia release surgery to alleviate your symptoms. NYU Langone rehabilitation specialists can help you with postsurgical recovery.
Gastrocnemius recession surgery lengthens one of the two muscles in the calf. A tight calf muscle can interfere with ankle flexibility and strain and tighten the plantar fascia, causing pain and inflammation. The procedure may be beneficial in people who still have difficulty flexing their feet, despite months of calf stretches.
Lengthening one of the calf muscles can improve range of motion in the ankle. This enables you to flex your foot, helping the plantar fascia to stretch and relax. The procedure can be performed with a conventional open incision or with a small incision and an endoscope. An endoscope is a long, thin tube that contains a small camera that surgeons insert through a tiny incision to see the calf muscles. To lengthen the calf muscle, your doctor makes an incision through the fascia, the tight layer of connective tissue surrounding the muscle. This incision allows the muscle to relax and lengthen.
Incisions made in the skin for open surgery or endoscopic surgery are closed with sutures. After surgery, you may need to wear a walking boot to keep pressure off your calf and foot. It takes about six to eight weeks for the calf to heal. Physical therapy may be necessary to strengthen the calf muscle.
Plantar fascia release surgery may be an option if you have normal range of motion in your ankle, but you continue to have heel pain after nonsurgical therapies, especially plantar fascia stretches.
During plantar fascia release surgery, your orthopedic surgeon partially cuts the fascia ligament to loosen tension in the tissue band. If a bone spur is contributing to your discomfort, the surgeon may also remove it.
This outpatient surgery may be performed using an open incision on the bottom of the foot. Another option is for your surgeon to use an endoscope. This minimally invasive approach requires making a few small incisions on the ankle. Incisions for either procedure are closed with sutures.
After open surgery, the plantar fascia may take up to six weeks to heal, and your doctor may recommend that you wear a walking boot for two to three weeks to minimize pressure on the foot. Minimally invasive surgery may provide a shorter healing time, without the need for a walking boot. Physical therapy may be necessary to stretch the plantar fascia and calf after both types of surgery.
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