Plantar Facia release and heel spur removal - One month ago

by April
(Upland CA)

This is just sort of an FYI, because I know a lot of people have plantar fasciitis and heel spurs.

I'm writing this because these are things that doctors don't tell you. All my doctor told me about recovery was "crutches for 4 days, then the boot". They simply don't have time to spell out what you need.

So I was thinking I could go back to "normal" after the first week. Nope. It's been a month and it's just now getting back to "normal" (AKA pain similar to what I had before surgery).

I spent 2 years getting cortisone injections, buying orthotics, stretching, icing, trying to rest... I finally gave up and had surgery. At this point, I don't regret it. I'm in about as much pain now as I was before surgery, and it's getting a little better each week.

Its been 1 full month since my surgery. At this point I can wear my new balance cross trainers. I can walk about 5 minutes (slowly) before taking a 5 minute break due to pain and exhaustion. My leg muscles are weak on my right side, so they cramp easily.

I can walk with shoes for about a half-day and then I have to switch to the cam walker boot. Then I can finish out the day on the 5up/5down schedule.

Just in case you are considering plantar fasciitis / heel spur surgery, here is how it went for me:

Surgery went fine. No pain, because I was asleep. ;-) It was an outpatient procedure. Surgery took about 45 minutes. Wear cotton shorts so you can get dressed easily in recovery afterwards, and bring your boot to wear afterwards (mainly to protect your foot from getting bumped - it's not really for walking, yet). You won't have a cast.

Immediate Recovery/ In Hospital: Foot is numb. Covered with dressing and ace bandage. Throat is sore because of the breathing tube. ( I was asleep when they put it in - but awake when they took it out. It didnt hurt to remove - but I was sore afterwards)


Week 1: Total bed rest except bathroom & hygiene trips. Pain fairly intense even while lying down. Advil & tylenol PM work better than codiene. I recommend Tylenol PM so you can sleep, and the time goes by faster. If you want to stay awake, regular tylenol works too. Ice and elevation is a must due to swelling. Ice behind the knee and at the ankle. My toes swelled to the point of immobility if not constantly elevated.

Walking: no weight 4 days, then walk with crutches and boot... Very short distances - about 1 min max. When you can put some weight on it, a boot and one crutch on the opposite side seems to work fine...that way you can carry your own medications and washcloth and maybe a phone in the other hand. Sponge bath only. Everything takes forever...and ever..and ever..

Week 2: Able to sit up some- about an hour, twice a day. Balance good enough to get into the bath tub with foot hanging out the side. A handheld showerhead is very helpful. (just remember to bring it down to tub level before you sit down in the tub...lol) Tip: Wear a sock on your good foot - the sock will get wet, but will help with leverage when you are trying to get out of a wet tub. Keep your cam walker boot on the other foot - it has a non-skid bottom and it will also help keep your foot from getting splashed. A hand rail would have come in handy, too. Still mostly bedrest. Only trip away from home is to go to the doctor. Not much pain at this point - but I'm not really walking, either. Swelling is the main problem.

Week 3: Retention stitches removed at the beginning of this week. Get your physical therapy referral at this time. Sometimes it takes a while to go through, and it would be helpful to start this right at week 4. Getting the retention stitches out offers little relief. Makes me nervous to walk just with the incision stitches. Risk of overdoing because swelling is reduced. Can sit up a couple of hours at a time. This is when my back started hurting due to being in bed and the "off balance walking" (the boot makes one leg about 2 inches longer which causes a sort of waddle.. Hard on the lower back). However at this point I'm going stir-crazy and will put up with pain in order to be up and doing things. Just know that the usual back pain exercises on the floor are almost impossible because you can't get the right leverage on one side. For me, this is the time that everything started going bad and I needed help with laundry, housework, dog care.

The family gets tired of waiting on you, and the home starts to look dirty. Just plan on hiring some help at this point - even if it's just the neighbor kid to pick up your floors so you can walk from the bed to the bathroom without tripping.

Week 4: All stitches removed at the beginning of this week. Did not provide immediate relief. Still swollen some. It took a couple of days before a shoe felt comfortable. The incision was very hard to the touch and still required butterfly closures for 3 days. Can shower but no soaking foot in tub for 2 more weeks. Showers are more difficult than I had imagined, because being barefoot on hard surfaces is very painful. Day 4, I can drive and run short errands. This is the one improvement I've seen. Before surgery, I couldn't drive without pain, and now I can.

Today (end of week 4): I think I've overdone, and my foot (both feet, actually) are very sore. I'm supposed to start physical therapy soon... until then I'm not sure what's safe. My incision isn't totally closed and healed yet. It's not bloody or anything, but there's still a small gap. I'm trying to wear my boot as much as possible to keep my foot stretched out (I've heard the facia can actually re-attach itself! Good grief, I would hate to have done this for nothing).

Bottom line is this: You'll need to stay in bed for the better part of a month. I thought I would be able to be on the sofa, but that didn't work for the first two weeks because of the effort required to get UP out of the sofa. The bed is high enough that I could stand up and still have the bed for support. Get a TV in position that you can see while lying on your back and some sort of small mobile internet device to keep in touch, and for entertainment (laptop isn't really that practical). Arrange for someone to take care of the pets, kids and housework. You wont be doing it.

No driving for a month if your surgery is on your right foot (like mine). The main reason is because you have to wear a boot, and you can't drive with the boot. If it's on your left, you can probably drive after 3 weeks as long as you aren't on pain meds. Very light housework in week 4. If you have a job, work is out of the question if your recovery is like mine. After one month you can probably do a desk job...wear your boot and take a crutch.



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Joshua Answers:

Hi April.

Thank you so much for sharing your experience!

Plantar Fasciitis specifically and Tendonitis in general can be bad news, and obviously can get even worse when someone goes cutting around in there.

What exactly did they do in there, surgery wise?

How big is the incision? Just one?





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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com