One of the biggest decisions that sufferers of chronic plantar fasciitis face is whether or not to have surgery. And while it just may be the most talked-about topic in the world of plantar fasciitis, the cost, the potential complications, and the recovery process for plantar fasciitis surgery can still feel like big unknowns.
Sarah, who has suffered from plantar fasciitis for more than two years, has generously offered to share the details of her story with our audience. In our interview, we talked about her decision to have heel pain surgery, her expectations, the recovery process, the costs involved, and how she’s doing now, post-surgery. Sarah underwent plantar fascia release surgery as well as tarsal tunnel surgery for both feet, with one year between surgery on each foot.
Exhausting Non-Surgical Options for Heel Pain
Heel That Pain: What treatments did you try prior to making the decision to have tarsal tunnel and plantar fascia release surgery?
Sarah: I started having problems with my feet while training for a marathon (I can pretty much pinpoint when it happened, from increasing my mileage too quickly). The pain quickly escalated and I tried the following things:
First, I went to two different podiatrists and finally ended up at an orthopedist for a third opinion prior to my surgeries. I started with the most conventional/most conservative treatments first; rest, ice, stretching, and over-the-counter pain meds. After a visit to my podiatrist, I also got a prescription for anti-inflammatories.
I tried over-the-counter orthotics, cortisone shots, heel cups, LOTS of different shoes (so expensive!), chiropractic treatments, massage, night splints, and a wrap/taping treatment that the second podiatrist recommended. The first podiatrist took x-rays to confirm I didn’t have a bone spur or stress fracture. At this point, I had been suffering with the pain of plantar fasciitis for almost 9 months. It was absolutely all-consuming in my life. I know others can attest to the same experience. You are pretty much willing to try anything. My first podiatrist had said that if none of the conservative treatments helped, I would most likely need to consider surgery.
The orthopaedic surgeon who ultimately performed my surgery did an MRI and confirmed that I not only had plantar fasciitis, but also tarsal tunnel syndrome. Essentially, there was scar tissue wrapped around the nerve in my foot, which was causing the extreme pain I was experiencing. I had gone from running a marathon (I did complete it, by the way!) to not being able to walk around a grocery store. My orthopedist confirmed what the podiatrists had said. I could try physical therapy, but after so little success with conservative treatments, I was really just putting off the inevitable: surgery.
Facing Fears About Plantar Fasciitis Surgery
Heel That Pain: What concerns did you have about surgery–and how did you address those concerns?
Sarah: I was really concerned that I would have a LOT of pain post-surgery–that I would never feel “normal” again. I love to work out, and I was really concerned that I wouldn’t be able to enjoy those activities again for a very long time. When I looked online to research other people’s experiences, all I could find were the negative stories, the horror stories about failed surgeries. It was pretty disheartening to say the least. I finally did meet one person who had had actually had the surgery by my same doctor. She was amazing. Very active, close to my age, and the surgery really hadn’t slowed her down. That helped put my mind at ease. I scheduled my first surgery, on my left foot, in 2016.
Choosing the Right Doctor
Heel That Pain: What role did your relationship with your doctor play in this surgery? Pretty minimal, or significant?
Sarah: It was very significant. The orthopaedic surgeon I chose is an active person–he’s younger and a runner, and I felt like he really “got” me and respected my fears. He understood what my goals with the surgery were, took the time to talk to me about outcomes and realistic expectations, and I trusted him completely. He performed my first surgery in 2016, and I was so happy with the process. For my second surgery on my right foot, he was in the middle of moving to a new practice, and I had to wait a couple of months to get in to see him. I was in pain, and I could have seen someone else, but I opted to wait for him because I trusted him.
When I was in the process of choosing a doctor for surgery, I ultimately decided that I really wanted to have an orthopaedic surgeon who specialized in foot/ankle (rather than a podiatrist) perform the surgery. I really valued the additional specialization and expertise. That said, I think a big part of choosing a surgeon is a matter of trust. For me, an orthopaedic surgeon was the right decision, but others might have a different experience.
Heel Pain Surgery and Recovery
Heel That Pain: Can you tell us about the type of surgery you had?
Sarah: I had surgery twice, once on each foot (tarsal tunnel and plantar fascia release). After I developed the first case from marathon training, I had surgery in 2016. When I was completely healed and starting to walk/jog a little again, I got plantar fasciitis in the other foot. That was incredibly depressing! I suspect that the other foot was doing double-duty for a long time supporting the other one, and it finally had enough 🙂 Luckily, I don’t anticipate any further surgeries. My doctor told me that out of the hundreds of surgeries he’s done though, he’s only had to redo two and in both instances they were patients who had other health concerns/situations that impacted the surgical success.
My doctor recommended a slightly variation from the typical way this surgery is usually performed. He recommended an open (as opposed to laparoscopic) surgery to assess the scope of the problem. He then released my plantar fascia, and removed approximately a one-centimeter cube of tissue, which created a tunnel for the nerve to pass through. I would advise someone interested in this particular variation of plantar fascia surgery to ask around. My doctor also performed the surgery through an incision in the side of the foot, below the ankle. This helped with the healing process.
Heel That Pain: What was recovery like? Was it easier or more difficult than you expected?
Sarah: Honestly, recovery was SO much easier than I expected. I’m amazed after all the horror stories I read, but both times I had zero surgery pain. The hospital sent me home with a prescription for pain meds, and I’ve never even used it. Just a couple Tylenol here and there for mild discomfort, swelling, and bruising. In other words, pain wise, surgery was a piece of cake.
The hardest part, for me, during both recoveries, was the crutches. Crutching around is HARD WORK! If you have a job that will allow you to work from home, I’d really recommend you take advantage of it at this time.
The first two weeks I spent wrapped up in an ace bandage and a surgical shoe. I was allowed to do light toe touches while crutching. After two weeks, I was placed in a walking boot. I was told to stay in that walking boot until I felt like I could transition to a shoe. This timing would be different for every individual. After my first surgery on my left foot, it took me about 2-3 weeks. The second time, I was in a shoe in a week. Something to be aware of is that you tend to lose some flexibility in your foot/ankle/knee because of the position of your foot in the surgical shoe and boot. Getting that strength back takes some time.
Another difficult aspect of recovery, for me, was psychological. It was scary to think that I might start feeling the pain from plantar fasciitis again post-surgery. Trusting myself to walk without pain, as I began to recover, was a leap of faith. It was also difficult having to ask people to get me stuff or help me. I’m a pretty independent person, and it was hard to be so reliant on other people while I was recovering.
Heel That Pain: How long did it take for you to feel normal again after surgery?
Sarah: I really had no idea what to expect from the surgery recovery, or how long it would take for me to feel normal again. Stories online made it sound like I would be on bed rest for months, unable to do anything. My doctor made it sound like a breeze (He told me it would be a couple of weeks in an ace bandage, then I’d be walking around).
My experience was honestly somewhere in the middle. On my left foot, it took about 6 months before I was feeling truly “normal” again. (Meaning I could throw on sneakers, go for a walk and not feel any type of pain). On my other foot, the one I just had done in June 2017, I’m already there. So two months, and I’m back in business! I also learned from my first surgery and didn’t wait as long to take action and commit to surgery. I think that was key. I didn’t cause as much damage limping around that time.
Heel That Pain: Are there any complications from surgery that you’re still dealing with? How do you continue to keep your feet and fascia healthy?
Sarah: The only thing I really notice now is that my feet do tend to feel “achy” sometimes. Usually it’s first thing in the morning, or if I’ve been on them too long. It’s not pain, but it’s more like it takes my body more time to warm up. I listen to my body and take it easy when that happens, do I some stretches, etc. I also realize this could be happening because I’m getting older, too. 🙂
I stretch daily now, mainly calf and soleus stretches. I still use orthotics in my running shoes, and I make sure to wear good shoes with support. I also massage and use a roller ball on occasion. Staying active, walking, and working out seem to help too. I did physical therapy after the first surgery, but not the second one. Building up the strength and flexibility by simply using your feet as you can is really helpful.
Pain Relief from Plantar Fasciitis Surgery
Heel That Pain: If you had to quantify it, how much did the surgery help, pain-wise?
Sarah: Everyone will have a different experience. But for me, the pain is gone. And I mean 100%! Even right after the surgery, and during recovery, I could tell that the PF pain was GONE. It’s amazing.
Plantar Fasciitis Surgery Cost
Heel That Pain: Can you tell us about costs?
Sarah: My insurance covered my surgery completely the first time, since i had already met the deductible that year. I paid a couple of copays for office visits, and that was it. The second time, I had to pay a small portion since my deductible hadn’t been met. It was close to $200. This isn’t a cosmetic procedure, so the insurance companies will typically cover a significant percentage. Without insurance, or with a different type of insurance, things would obviously be difference.
A Few More Words of Advice
Heel That Pain: Is there anything you wish you had known prior to surgery? And what advice do you have for others who are considering plantar fasciitis surgery or tarsal tunnel surgery?
Sarah: I put off having the surgery the first time around because of my fear. I wish I’d had the first one sooner! Honestly, compared to the chronic, unaddressed pain of plantar fasciitis, the surgery was nothing.
My biggest recommendation is to find a REALLY good doctor, someone you trust, who has a good track record doing the surgery you need and specializes in it. It truly makes all the difference. Also, don’t be afraid. If you’ve given conservative treatments a true effort for months on end and your heel pain is to the point where it’s now a chronic condition, you can either feel the same in 6 months, feel worse, or give the surgery a try and potentially get a lot of relief.
Just keep in mind, while planning for your surgery, that you’ll likely be on crutches and a boot for a few weeks. The other foot will also be working harder–more pressure, more impact, and supporting you more. Keep wearing a good supportive shoe and orthotics on that other foot.
Share Your Story!
Do you have a story to share about surgery for plantar fasciitis? We’d love to hear about your experience and advice for others who are considering this step. Share below in the comments or email us at [email protected]!