Call to schedule an appointment today!

(907) 344-2155

Plantar Fasciitis (a.k.a. Heel Spur Syndrome)

Plantar fasciitis is one of the most common pathologies seen in podiatry. It is inflammation of the plantar fascia, a thick, inelastic band of tissue at the bottom of the foot. This tissue is very strong and helps to support the muscular and soft tissue structures that make up the arch of the foot (much as a truss supports the two ends of an arch).

Inflammation of the plantar fascia can occur for multiple reasons, most common of which are:

  • Poor and unsupportive shoe gear
  • Weight gain
  • Walking/standing for long periods on hard or concrete surfaces
  • Poor biomechanical functioning of the foot
  • Poor foot structure
  • Injury
  • Tight calf muscles/Achilles tendon
  • Any combination of the above

Plantar fasciitis presents as severe pain in the bottom of the heel that is often worse in the morning or after periods of rest, improves after a few minutes of walking, but may recur after extended periods of activity. Sometimes this may occur in combination with Achilles tendon or calf pain.

In many cases, x-rays taken of the affected foot will reveal a bone spur coming off of the heel bone and pointing out toward the toes. This spur is a result of the fascia pulling on and tearing at the heel bone and is not the cause of the pain.

Plantar fasciitis is often treated conservatively with a success rate of 90-95% remission with conservative care. Conservative care includes:

  • Stretching
  • Ice massage
  • Supportive shoes
  • Cortisone injections
  • Use of oral anti-inflammatory medications such as Ibuprofen
  • Use of custom orthotics
  • Night splints

Those who fail to improve with conservative care may require surgical intervention. This is an outpatient procedure which takes about 10-15 minutes (if done endoscopically) to complete, and includes releasing the tight fascia from its insertion on the heel bone. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on Endoscopic Plantar Fasciotomy, please follow this link:

“Endoscopic Plantar Fasciotomy” Thalia Oster

(This video includes live operative footage and may be disturbing to some audiences.)

Endoscopic Gastrocnemius Recession

An Endoscopic Gastrocnemius Recession is often performed in conjunction with the endoscopic plantar fasciotomy. This procedure serves to lengthen the gastrocnemius muscle (also referred to as the calf muscle), which in turn releases tension from the associated Achilles tendon. This is important in plantar fasciitis because the Achilles tendon, which inserts into the back of the heel bone, can limit the amount of motion available to the ankle when walking. If the Achilles tendon is tight, abnormal foot mechanics develop which can increase tension and stress on the plantar fascia and contribute to development and worsening of plantar fasciitis.

Stretching exercises targeting the calf muscle and its associated Achilles tendon may provide some benefit. However, in cases where stretching alone is not sufficient, surgical intervention may be pursued. This is an outpatient procedure which takes about 5-10 minutes to complete, and includes releasing the tight calf muscle (gastrocnemius muscle) from the Achilles tendon. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on Endoscopic Gastrocnemius Recession, please follow this link:

“Endoscopic Gastrocnemius Recession” Thalia Oster

(This video includes live operative footage and may be disturbing to some audiences.)