3 Reasons to Say No to Plantar Fascia Release Surgery and Heel Injections
This is a guest post by Dr Meredith Warner, an orthopedic surgeon who made contact with me asking if she could warn my readers against considering surgery as a treatment for plantar fasciitis.
As I am not a qualified doctor, I am always glad to have a professional opinion published on this site.
1. Plantar Fascia Release surgery can cause bigger problems down the road.
Plantar fasciitis pain is so debilitating that it accounts for over one million doctor office visits in the United States alone each year.
Surgeons have been conducting plantar fascia release surgeries for years to treat foot pain. So, it’s surprising to find an orthopedic surgeon, like Dr. Meredith Warner, who strongly advises against the procedure.
"Visualize the arch in your foot. It’s shaped a lot like the Gateway Arch in St. Louis, Missouri," Dr. Warner says. "Then imagine putting a million-pound load on the arch – it needs a lot of reinforcement to keep from collapsing."
In the foot arch structure, the plantar fascia act as a tie rod, holding the two ends of the foot arch together on the bottom.
"Now imagine clipping the tie rod that reinforces the arch carrying that million-pound load," Dr. Warner adds. "Over time, the arch will collapse."
So, what is the treatment for a collapsed foot arch? More surgery.
The surgeries are not just physically painful, they come with a hefty price tag. It can cost up to $5,000 for the initial surgical intervention, not to mention the possible complications.
2. Heel injections carry risk of complications including chronic heel pain.
Besides being extremely painful, steroid injections to treat plantar fasciitis pain can cause more problems than they solve.
Steroid injections carry a risk of rupturing the plantar fascia. Also, the injection itself can cause irreversible damage to the heel pad which is made up of a honeycomb of tissue protecting the heel bone from striking the ground.
"When you inject a steroid into the heel pad’s honeycomb structure, it begins to break down that beautiful cushioning between your heel bone and solid concrete pavement," Dr. Warner warns.
A breakdown in the heel cushion can cause a lifetime of heel pain and may result in the need for additional surgeries to attempt a repair.
3. Alternative treatments are available which don’t require invading the body with surgery or injections.
A foot pain patient can try several non-invasive treatments before opting for surgery or injections: simply resting the foot for several weeks, stretching, orthotic inserts, orthotic shoes, and physical therapy, for example.
"If you can rest your foot for about six months, the plantar fascia will heal on its own. But not many people can stay completely off one foot for that period," Dr. Warner says.
Dr. Warner created The Healing Sole flip-flop to fill the treatment gap between simple shoe orthotics and heel injections or surgery.
She initially saw the opportunity to use a flip-flop design while treating soldier’s foot pain in Iraq and Afghanistan. "The soldiers I treated liked to wear flip-flops during their off time. So, I decided to test a flip-flop design with a structure that was biomechanically sophisticated and strong enough to promote long-term foot health."
Dr. Warner worked with her partner, Natalie Noel, and the Louisiana State University Innovation Park, to launch the product in 2015.
"Most physicians don’t believe that flip-flops are good shoes for the foot and should be avoided," Dr. Warner points out.
The Healing Sole flip-flop, however, uses about six different medical treatment methodologies in the shoe design which work synergistically to make the shoe, as well as the foot, stronger.
These methodologies include:
- Preventing plantar fascia contraction – (raised toe heel)
- Foot structure and joint stress reduction – (raised arch support)
- Muscle Tension reduction while in motion – (rocker bottom sole)
- Foot heel pressure reduction – (compressible inner heel)
- Forced correction in foot strike – (non-compressible outer heel)
- Reduced MTP joint pressure – (metatarsal bar)
Used by itself, each methodology is not that useful but used together; they are very effective. Many shoes that claim to treat plantar fasciitis include one of these methodologies, but none of the current market offerings include all six.
"Now you have the option of a cute flip-flop you can wear on a day-to-day basis to treat this problem, " Dr. Warner adds. "It's a consumer grade medical device -- that is also affordable."