Do I Need Plantar Fasciitis Surgery?
Not every plantar fasciitis case or soft tissue injury in the foot will require surgery.
It's generally understood by doctors and surgeons, that plantar surgery will introduce more scar tissue into your foot. This added scar tissue will be problematic, requiring visits to a physical therapist (PT) and conservative treatment options post-surgery. If not dealt with properly, your injury could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort - basically for chronic (long term) conditions, full ruptures of the fascia, arthritis, and/or severe, continually recurring plantar fasciitis pain (in which case they may perform plantar fascia release surgery).
Surgery on soft tissue is generally not considered until all conservative treatment options have been exhausted... or there is an infection, or a large/full tear in one or more of your connective tissues. More than 90% of people with plantar fasciitis will improve within 10 months of starting non-surgical remedy with a conservative treatment plan (reference:). This is why most doctors, physicians and orthopaedic specialists will recommend that you try at least 3 to 6 or more months of conservative treatments with no sign of improvement before surgery will even be considered.
If You Haven't Done So Yet, Get a Proper Diagnosis
Some cases of torn muscles may be considered as Surgically Necessary (SN) and will require surgery. In cases where there is infection, which can quicly become very serious, you will most likely require antibiotic medications as well as surgery. This is why it is important to get to a physician and find out what is really going on - this is known as getting a proper diagnosis. Getting a proper diagnosis would also determine if your pain is a side effect from another condition or disease (Lyme disease is one example). This is less common but nonetheless, very serious. So yes, it is important to get a proper diagnosis.
Understand The Risks That Come From Having Surgery as well as Not Having Surgery
It is always highly recommended that anyone considering surgery always have a clear understanding of the risks as well as the benefits of elective surgery. In addition, one should be aware of the success rate of the particular surgery in question, combined with the post-surgical recommendations that will typically have an impact on your chances of success. I should say here that overall, the statistics for foot surgery are not great, which is one of the major reasons you may find a surgeon reticent to operate on your injured foot unless they are fully convinced it is necessary. Your surgeon should provide a treatment plan to help you regain use of the affected area as soon as possible.
As with any surgery there are risks to every procedure depending on a lot of factors, including your age, the severity of your injury and your level of health going into the procedure. It's always best to discuss all possible risks and complications with your doctor before the procedure. It's important to be aware of the risks you may face with any procedure intended to fix or relieve pain from your foot injury.
Full Ruptures (termed "avulsion") Can Worsen Quickly
One week after your muscle has ruptured, it will begin to travel away from the bone and/or separate from the remaining muscle. The ends of the tear begin to fill in with scar tissue as part of the healing process. This added scar tissue decreases the natural strength of connective tissue and will have a negative effect on your ability to do normal activities. Although not as quickly, more fibrous tissue such as tendons and ligaments will also shrink and weaken after a rupture.
Atrophy (wasting away of tissue) will start only after a few days of disuse. As time passes, connective tissue fibers shrink and weaken. If scar tissue is present then a more complicated procedure may be needed to clean out the presence of any scar tissue for optimal healing after the surgery. The tissue that has ruptured may need to be retrieved from inside your other tissue back to the original attachment point. Your surgeon may make a larger incision into your skin so they're able to retrieve this tissue.
An injury that is 4 to 6 weeks old is considered a chronic rupture. When you have a chronic tissue rupture, the tear continues to separate further over time, increasing the gap. A chronic rupture requires a difficult, drastic surgery - often times there may be a transfer of tissue ("grafting") needed to complete the surgery and a lengthy recovery period.
If Surgery Is Not Necessary....
If you are not at the surgery stage and your physician has opted to treat your injury with conservative treatment options, then you will find that many of our customers have had great success treating themselves with the powerful conservative treatment products such as the Plantar TShellz Wrap®. When used as directed, it is our opinion that the TShellz Wrap® when combined with an overall conservative treatment plan, will give you the best chances of healing your plantar fasciitis or related soft tissue injury at home without the need for surgery. If surgical intervention is required, you will be put on a post-surgery recovery plan by your surgeon or physician. We feel the TShellz Wrap® also plays a valuable role in post surgery recovery, but do not use them for at least 6 weeks after surgery, and only on approval from your physician or surgeon. (Basically do not use heat based treatments until the wound has healed, swelling has dropped and you have recovered enough to have been assigned a home stretching plan). The TShellz Wraps®, when used at this time should be quite effective at enhancing range of motion and minimizing scar tissue growth (which is a major problem when talking about foot surgery).
For acute (new or recent) plantar, or sesamoiditis injuries that have the ability to heal on their own - your doctor may even suggest use of a removable foot brace. A removable foot brace can be very helpful to prepare you for physical therapy sessions and mobility exercises.
However, prolonged use of a removable foot brace or long-term rest (restricted movement) without proper exercise or stretching can make your plantar condition worse. If your foot remains completely immobilized and at constant rest, the edges of your soft tissue tear will begin to fill in with scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling, inflammation, and even poor blood flow circulation.
Home Conservative Treatments For Plantar Fasciitis That Many of Our Clients Have Found to be Effective:
- Rest - This is important for initial healing to reduce risk of further injury, pain, swelling and inflammation in the early stage of your soft tissue injury. Too much rest can also be harmful as joint immobility can actually cause stiffening, overcompensation and atrophy (wasting away of soft tissue). This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
- Avoid Activity that caused your Plantar Fasciitis [PF]. - While resting the area, it's also important to avoid all activities that may have caused your symptoms - including any repetitive movements (possibly work or hobby related). This pretty much includes any type of sport, and may very well include reduced activities in your job if that has caused your injury - especially if your job means being on your feet all day. Continuing on with regular activities can increase the severity of an injury, turning a mild to moderate case of foot strain into a downward spiral of atrophic damage that may eventually severely impact your life. Also, trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body (like your opposite foot, or hip & knee pain due to your limping gait).
- Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation, although statistically, there is usually very little inflammation associated with plantar fasciitis. Notwithstanding - if there is swelling, apply cold.
- Use a Plantar TShellz® Circulatory Boost Wrap - Once swelling has been reduced, you can use your own blood flow to maximize your rehabilitation. Knowing the body uses blood flow to heal soft tissue, this wrap is intended to introduce heat and an increase in blood flow to the application area at the bottom of the foot (where the fascia is). This in turn, will assist the body in its own repair process, helping decrease recovery time while reducing re-injury risk. Promoting blood flow and heat to the fascia will help to minimize the growth of scar tissue, increase tissue flexibility and help reduce onset of atrophy. This is why we recommend a TShellz Wrap treatment before undergoing activity - an increase in flexibility should help reduce risk of further injury while also assisting in the battle against atrophy (what we are saying is that you want to keep your fascia flexible so the strain/tear won't worsen). Many of our clients find heat via the Plantar TShellz Wrap® to be especially helpful in dealing with chronic PF injuries or when there is a flare-up of pain and stiffness in the foot.
- Use a Support Wrap or Brace (depending on the area). To increase comfort and prevent further damage you may want to use a support sleeve or brace to help support the area, reduce risk of further injury and reduce stress on the injured tissue. They can be used until your injury is gone or during active sports for additional stability. Note that these should not be worn at all times as they can limit muscle development, cut off circulation and impede healing of muscle tissue.
- For reducing discomfort while resting, (or to get some sleep) consider a High Quality Back Pillow and/or Knee Pillow for comfort while sleeping or sitting
- Rehabilitative stretching under supervision of a PT or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the surrounding tissue of the joint. Caution: aggressive stretching or massage can be harmful - when dealing with a joint that has very limited range of motion, there is risk of further damage to weak connective tissue. This could lead to the need for surgery, and this is why you need to seek out a PT or physician as they can determine safe stretching parameters for you.
- Stretching - Stretching your joint in PT and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key for maintaining good Range of Motion (ROM) in your foot, and stretching can be made much easier with use of a TShellz Wrap® before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to deal with flare-ups of inflammation.
What Happens When You Are Not Using Conservative Treatment Methods (as Outlined Above)
Plantar Fasciitis is painful - so painful, that it cannot really be ignored. If you choose to ignore the injury, then this means you will still be be trying to do certain tasks one of two ways:
- You will be in a lot of pain, putting weight on your bad foot - using connective tissue that is already compromised. This means it will inevitably get worse. Here is what to expect:
- Since the tissue is probably inflamed, lack of proper blood flow will drop your healing rate to a crawl.
- Continually straining the soft tissue (just by doing daily tasks such as cooking or driving) worsens the injury and will introduce more scar tissue.
- Increased scar tissue buildup will tighten the soft tissue in the foot, decreasing your already limited flexibility (reduced range of motion). After a week or more of limited flexibility in the joint, you may start to experience atrophy - a wasting away of soft tissue that inevitably weakens the foot further.
- You will try not to use your bad foot, and start to overstress other parts of your body by changing the way you walk - most likely the opposite foot, your knees and hips (this is termed overcompensation)
Trying to use your joints once they have tightened up due to disuse for a week or more can introduce more scar tissue, cause pain, freeze you up again and happen again and again... As you can see this is a cycle that just gets worse and worse, eventually becoming a chronic (long term) injury. This is the cycle you need to stop or you will probably wind up having surgery once your injury becomes chronic. This is why you need to treat your injury with the TShellz Wrap® every single day, at least twice per day.
The Two Biggest "Gotchas" When Treating Soft Tissue Injuries of the Foot
1: The Absence of Pain Does Not Mean Your Injury is Gone
After resting and using a Cold Compress or Ice Pack for a couple days, pain will often drop significantly. This where most people wrongly associate the pain with the injury, whereas in truth, much of the pain often comes from inflammation and swelling. Once the inflammation is gone, do not assume you are fully healed.
2: Time Is Not Your Friend
So you have used a Cold Compress or Ice Pack and most of the pain is gone, but it's been a couple of weeks and the injury keeps flaring up. If this is you, then you probably know why this is happening now... the injury was never full healed. To really heal a soft tissue injury, you really need to rest until it is healed, and you don't need me to tell you this is a pain in the butt! This is why the TShellz Wrap® is such an important tool, as it introduces the concept of enhancing localized blood circulation - giving the body's own healing process a kickstart. With this accelerated blood flow, you increase your odds of getting back on your feet more quickly, thus reducing your risk of re-injury.
When the swelling has gone down and the pain has reduced, this is the perfect time to use the TShellz Wrap®. A treatment with a TShellz Wrap® is intended to substantially increase blood-flow to the treatment area - an increased blood flow helps maximize your body's rate of healing. We also highly recommend that our clients treat themselves with the T•Shellz first thing in the morning before getting out of bed. We feel it is important, as heat is known to increase elasticity and flexibility in soft tissue; when getting out of bed, your soft tissue is likely at its least flexible point throughout the day. Not only will this treatment combat atrophy, it will also decrease the chance of re-straining connective tissue in the foot at its most vulnerable time - after a long period of inactivity.
Why Your Plantar Fasciitis Won't Heal
If our body is designed to heal our own injuries, why does it take so long to heal?
Plantar fasciitis means there is tearing in the fascia - a thick layer of connective tissue that attaches at the bottom of the heel and (mostly) spreads out toward the toes. When tearing of fascia occurs, it basically means that you have put too much tension on the fascia - this could happen in a quick instant (acute trauma) or could have happened over a long period of time (ie. this happens freqently with runners). There are multitudes of reasons this could happen, but often an underlying factor is that your plantar fascia is not as flexible as it once was - as is often the cause due to aging or other diseases that reduce blood circulation in the foot (diabetes, for example).
A key aspect of a soft tissue injury is the understanding that good healthy blood flow is what your body requires to heal soft tissue, and normally this happens when we are active. Once injured, we can no longer be active, and due to this, you experience lower blood flow in the area due to inactivity.
There are also significant problems with swelling and inflammation in regard to healing rate though for plantar fasciitis this is less of an issue (as there is typically very little inflammation associated with a plantar fasciitis injury). Once soft tissue is inflamed, blood-flow is restricted. The body heals itself by sending nutrients through the blood to the injured tissue, and if the injured tissue is swollen, the blood-flow is greatly decreased.
When there is swelling, there is decreased blood-flow. Decreased blood flow in injured tissue prevents the damaged tissue from healing as fast as it could if the area was not swollen.
Once the Pain is Gone, We Think Our Soft Tissue Injury is Healed.
So we start using it more and more for common tasks, and then "boom" we get a sharp pain and then it starts all over. When this happens, the injury was never fully healed - and now it is worse! More scar tissue grows in the new tissue micro-tears and well, lets talk about scar tissue.
Scar Tissue - We Need It For Kick-Starting Soft Tissue Repair But After That It is Nasty Stuff
Tendons, ligaments, muscle and fascia are all meant to be durable and flexible, ready to work and move extreme forces in everyday activities. When I say extreme force, I mean try to imagine the amount of force that plantar fascia is under even when you are just walking, let alone running or jumping. Once there is a strain or tear, these same extreme forces can easily make the injury worse - this why pain exists - it conveniently helps the body by preventing you from worsening the injury.
Scar tissue grows in damaged tissue when it tries to heal; little tiny band-aids that overlap each other to bind tiny tissue tears together. With this added scar tissue, muscles & tendons & ligaments become rigid, less flexible and unable to handle the forces that it once could. If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness and pain in the area. So much pain that you don't want to move it!
On-going issues with scar tissue can result in repetitive tissue tearing and increased chances of strain to nearby tendons or ligaments (as they are now handling higher forces due to overcompensation).
Scar tissue is one of the MAIN reasons why a chronic injury has not healed and your Range of Motion (ROM) is reduced from what it once was.
Scar tissue will form fast to deal with a soft tissue injury, and this scar tissue will also attach to everything in the area, including the surrounding healthy tissue as well. This can result in a fusing together of soft tissue that shouldn't be fused together, causing extreme pain when you try to move your joint - it is literally ripping scar tissue. This is why PT is often painful - the therapist stretches the joint, forcing the scar tissue bonds to break so you can regain your range of motion.
Scar tissue is a major problem as it is difficult to treat and can cause your injury to become chronic - taking months or even YEARS to completely heal!
Minimize scar tissue growth and reduce risk of re-injury to your connective tissue by:
- (1) increasing blood flow to the area and
- (2) increasing the elasticity of soft tissue in the area and
- (3) elongating soft tissue in the area.
You can accomplish all three of the above goals by treating yourself consistently, every day with a TShellz Wrap.. Overall, continued treatment with the TShellz Wrap® will maintain good health in the treatment area and significantly reduce risk of reinjury.
When to use a TShellz Wrap®:
- Once the swelling is gone (usually after applying cold compression to the injury over 24 to 72 hr period).
- BEFORE getting out of bed in the morning. BEFORE going to bed at night.
- BEFORE exercise, workouts or activity of any kind to increase joint elasticity (tendons,ligaments,muscles) and decrease the chance of re-injury.
- AFTER surgery (once the skin wound has healed over) to increase post-surgery healing rate and minimize scar tissue growth at the surgery location.
- Anytime BEFORE you feel you might undertake activity that will put significant strain on the injury area.
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MendMeShop Sesamoid TShellz Wrap®
This wrap is designed to:
- increase extensibility & flexibility of metatarsals/sesamoid/toe areas during treatment & for a short while after
- increase blood flow in the application area
- be used on the TOP or BOTTOM of the foot
MendMeShop Plantar TShellz Wrap®
Augment your recovery while reducing risk of re-injury. A Plantar TShellz application is intended to:
- increase extensibility & flexibility of bottom foot fascia during treatment & for a short while after
- increase blood flow in the application area
Who Should Use the Plantar TShellz Wrap®
We recommend the use of a Plantar TShellz Wrap®:
- If you have injured soft tissue in the bottom of the foot such as the plantar and metacarparal areas.
- If you are dealing with conditions affecting your range of motion such as impingement or even arthritis.
- If you have a chronic foot condition that has lasted for years- this device is intended to kick start the recovery process and help strengthen the surrounding and supporting tissues. Many of our past clients had suffered for years, then were completely amazed at the results only after a few months of treatments.
- If you are still working with an injured plantar, the TShellz Wrap® will help relax injured soft tissue prior to work and after a day at the job.
- If you are still trying to enjoy your favorite activities such as gardening, tennis, golf, etc - use the TShellz Wrap® prior to activity to help reduce chances of re-injuring or re-aggravating those targeted tissues.
- If you are experiencing atrophy in base of the foot and want to reduce the chance of re-injury - we recommend this to use on a regular basis for enhancing blood flow and elongating soft tissue.
- If you have been to a clinic for some form of massage or stretching and your PT or physician has recommended conservative treatments for home.
- If you have injured your foot and need surgery, then you will find a blood circulation booster to be a powerful tool after surgery to help surgically repaired tissues recover for long-term health. (once the surgery wound has healed and your physician has given the ok)
- If you are experiencing tightness in your soft tissue(s) and want to reduce the chance of re-injury while stretching - we recommend the use of a TShellz Wrap® before you stretch.
Minimize Your Chance of Surgery with these Effective Conservative Treatment Options
If your doctor thinks you might be able to avoid surgery by using conservative treatments, you can join our many customers who have had great success treating themselves with the powerful TShellz Wraps® that we offer through AidMyPlantar.
Our online shop accepts Visa & Mastercard as well as a Paypal Payment option.
We also encourage your to Call Our Office at 1-866-237-9608 (toll free continental NA) where we can answer any questions you have and/or take your order via phone.
Soft Tissue Injuries are common and can happen to anyone. Right now there are thousands of doctors and physical therapists dealing with patients that require a solution to treat their injury fast and heal it (where possible). If you want to be pro-active about properly addressing your soft tissue injury by using the best conservative treatments, then you need to use AidMyPlantar's system utilizing TShellz Wraps® and accessory products.
If Surgery is Required
Ok, well the good news is that our TShellz Wraps® are intended to be highly effective treatments for post-surgery recovery. Learn more about how to get started with recovery after surgery.
4 Key Points To Keep in Mind When Treating Plantar Fasciitis & Other Connective Tissue Injuries in the Foot
1: Make Sure That Complete Healing is Your #1 Goal
We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.
Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, never equates to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.
This is why we recommend for people to continue with their doctor or therapist recommended exercises and to continue with mild treatments of the TShellz Wrap® for a period of time - to better ensure complete healing.
Ongoing treatments to enhance circulation are intended to soothe, relax and promote healing of damaged soft tissue in the application area. T•Shellz treatment also results in the ability of soft tissue to extend further due to the effect of heat on soft tissue. The more extensible your tissues are, the less likely they are to strain or sprain.
Soft tissue injuries are a race against time. The faster and stronger you heal tissue in your foot, the less chance there is for re-injury or other problems later on.
2: Resting Your Feet Will Help, But Only Temporarily
People tell us all the time, "I was told that if I rest for a few weeks, the pain will disappear for good." The truth is, pain is often a culmination of numerous factors, which often include repetitive stress, high load issues due to excess weight, and/or overcompensation issues resulting from other muscle and soft tissue ailments (ie. short leg syndrome). It may take weeks or months for these pain triggers to surface, but when they do, merely resting will not solve the underlying issues. You need to utilize options that actually treat the source of the pain and help reverse the damage that has been done.
Resting has a role to play, but it is only one small factor in a recovery plan.
3: Determine if There is A Deeper Underlying Cause To Your Problem & Fix It. Otherwise, It May Come Back
In order to get lasting relief, you need to identify all the factors that are contributing to your foot pain. An example of some factors that may or may not be relevant are:
- muscle imbalances
- pinched nerve(s) in the knee, ankle, hip or lower back
- short leg syndrome
- flat footedness
4: Know that Pain isn't the Only Proof You're Still Injured
Would you know you injured yourself if there was no pain? Probably not! Pain and swelling perform a useful role in letting you know that you did, in fact, injure yourself. Pain and swelling are what get you to seek out medical attention in the hopes of finding a way to reduce the pain and heal your injury.
Plantar fasciitis (PF) will likely cause extreme pain and according to studies, it is an indicator of chronic morbidity [meaning that PF is a statistical predictor of long term foot problems]. Be careful with pain-killers that mask the pain as overuse can give you a false sense that your injury is gone. Strive to reduce the inflammation and maintain or improve flexibility in the foot while avoiding re-injury to see a reduction in pain.
On-going TShellz Wrap® treatments at home, every day, are intended soothe, relax and promote blood flow to soft tissue. Consistent TShellz® Circulatory Boost Wrap treatments before activity or work will help warm up the area, increasing soft tissue elasticity & flexibility; this in turn will also reduce the risk of re-injury.
The Next Step Is Up To You!
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after an intensive surgery and lengthy rehabilitation period can be even harder! What is more important than taking your best shot at trying to heal your foot injury before signing up for surgery?
Doctors and Surgeons are always improving the technologies used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from some surgeries can be disappointing; to be blunt, outcomes from foot surgery are often disappointing . If you do wind up getting surgery, know that rehabilitation at-home while attending regular PT or doctor appointments is vital for your overall recovery. It is especially vital to critical joints that consistently handle extreme forces (body weight). Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or physical therapist is key - and this is why you should seriously consider maximizing your recovery by using the TShellz Wrap® at home once you are approved for PT.
AidMyPlantar stands out in this regard as our goal is to help you keep your body healthy for the long-term in a cost effective manner. This might mean getting a soft tissue injury cleared up using home conservative treatments - eliminating the need for surgery. If surgery is unavoidable, then our home treatment medical devices can also help you recover from surgery more quickly and completely..
We strongly believe that we can help you, and we have thousands of happy clients to back this claim. You are welcome to try our products for a 60 day period.. If you are committed to following the treatments outlined in the product instructions we are very confident that our TShellz Wraps will aid you immensely. If you do not receive the benefits that countless of our other customers have experienced from our products, call us, mail the product back to us and we will provide you with a full product refund.
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If any question or concern arises, call us or simply send us an email at any time (we check our emails constantly all throughout the day and night.. even on holidays!). We will respond as soon as possible.
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Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. All testimonials and comments reflect the real life experiences of individuals that used our products, however, individual results may vary. Always seek the advice of your physician or other qualified health provider before using any of our outstanding products to make sure they are right for you and your condition or if you have any questions regarding a medical condition.
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1. (2010) http://orthoinfo.aaos.org/topic.cfm?topic=a00149/
2. Craig C Young, MD (2023) Plantar Fasciitis Treatment & Management: Approach Considerations, Icing, Rest and Activity Modification. Retrieved May 03, 2023, from https://emedicine.medscape.com/article/86143-treatment