On the underside of the foot and heel is a tight band of tissue called the plantar fascia. Sometimes the plantar fascia become inflamed or injured as a result of trauma, infection, or constant strain (long periods on one's feet, being overweight, or wearing shoes that do not support the foot well). This inflammation produces pain in the heel - a condition known as plantar fasciitis (sometimes called a heel spur or stone bruise).
One way to treat plantar fasciitis is through plantar fasciotomy, a surgery to reduce the tension on the plantar fascia. The procedure can be performed openly or endoscopically. Endoscopic fasciotomy (considered minimally invasive) has no large incision, and is usually less painful than open surgery, with faster recovery times (limited weight-bearing can begin immediately). Open procedure has increased risk of infection, calcaneal fracture, and nerve entrapment.
With endoscopic surgery, the surgeon inserts a thin, flexible tube and camera through one or more small incisions in the skin, typically on the side(s) of the heel below the ankle bone. The surgeon can examine and release/remove a portion of the fascia through this tube. The incisions are then closed.
Surgery is generally only performed for severe, chronic plantar fasciitis / heel spur syndrome, where symptoms have continued for at least 6 to 12 months, and after home and other nonsurgical treatments have proven unsuccessful. Both open and endoscopic methods are typically done as same-day procedures under anesthesia. Most patients return to their normal activities in 3 to 6 weeks.
Plantar fasciitis (PF) is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. It is often caused by overuse of the plantar fascia or arch tendon of the foot. It is a very common condition and can be difficult to treat if not looked after properly. Another common term for the affliction is “policeman’s heel”.
Longstanding cases of plantar fasciitis often demonstrate more degenerative changes than inflammatory changes, in which case they are termed plantar fasciosis. The suffix “osis” implies a pathology of chronic degeneration without inflammation. Since tendons and ligaments do not contain blood vessels, they do not actually become inflamed. Instead, injury to the tendon is usually the result of an accumulation over time of microscopic tears at the cellular level.
The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes. It has been reported that plantar fasciitis occurs in two million Americans a year and in 10% of the U.S. population over a lifetime. It is commonly associated with long periods of weight bearing. Among non-athletic populations, it is associated with a high body mass index. The pain is usually felt on the underside of the heel and is often most intense with the first steps of the day. Another symptom is that the sufferer has difficulty bending the foot so that the toes are brought toward the shin (decreased dorsiflexion of the ankle). A symptom commonly recognized among sufferers of plantar fasciitis is an increased probability of knee pains, especially among runners.