Plantar fasciitis surgery, often called a fasciectomy or release, treats chronic, debilitating heel pain that has failed to improve with conservative treatments. The surgery involves partially cutting the tight band of tissue along the bottom of the foot to relieve tension on the heel bone. Understanding the expected timeline and care protocols is necessary for a smooth return to daily life and restoring foot function.
Immediate Post-Operative Management
The first seven to ten days following a plantar fasciitis release focus on controlling swelling, managing discomfort, and protecting the surgical site. The foot is typically immobilized immediately after the procedure in a bulky soft dressing, a splint, or a non-weight-bearing cast to ensure the newly released tissue begins to heal without strain. Strict non-weight bearing status is usually mandated during this initial period, requiring the use of crutches or a knee scooter for mobility, though some minimally invasive procedures may permit early weight bearing.
Controlling post-surgical swelling (edema) and pain is important, aligning with the principles of Rest, Ice, Compression, and Elevation (R.I.C.E.). The foot should be elevated above the level of the heart as frequently as possible, especially for the first 48 to 72 hours, to facilitate fluid drainage. Pain management involves prescription medications, which often include a narcotic for the initial, most painful days, but patients should be aware of potential side effects like constipation.
The initial dressing must be kept clean and dry until the first post-operative appointment, which usually occurs between seven and fourteen days after surgery. At this visit, the surgeon typically removes the sutures and transitions the patient from the splint to a removable walking boot or similar protective device. The surgical site will be evaluated for signs of proper wound healing.
Physical Therapy and Restoring Mobility
The transition into physical therapy marks the phase of restoring strength and movement, typically beginning around the two-week mark and continuing for about three months. The primary goal of rehabilitation is the safe transition from non-weight bearing to partial weight bearing, often utilizing a controlled ankle motion (CAM) boot or walking cast. Patients generally progress to full weight bearing in the protective boot between two and six weeks after surgery, depending on the surgical technique and individual healing rate.
Physical therapy sessions, which may occur two to three times per week, are tailored to achieve specific functional goals. Initial exercises focus on restoring ankle and toe range of motion, such as performing the “ankle alphabet” and gentle, non-resistive movements. As healing progresses, the focus shifts to strengthening the calf muscles and the intrinsic foot muscles to stabilize the arch.
An important component of this phase involves gait training, where therapists help the patient correct compensatory walking patterns developed from chronic pain. Consistent adherence to a prescribed home exercise program, which includes stretching and strengthening, is necessary for optimal recovery. Failure to perform these exercises can delay the restoration of normal foot mechanics and compromise the long-term success of the surgery.
Timeline for Returning to Full Activity
The final phase of recovery centers on a cautious return to pre-injury activity levels, beginning around month three and potentially extending for up to a year. Driving can often be resumed approximately two weeks post-surgery, provided the patient is no longer taking narcotic pain medication and the operated foot is not used for the accelerator and brake pedal. Most patients can return to light desk work within a few weeks, but jobs requiring prolonged standing or walking may require an absence of up to six weeks.
High-impact activities, such as running and jumping, must be avoided during the initial three to six months to prevent excessive stress on the healing fascia. A gradual reintroduction to these demanding activities is typically permitted after the three-month mark, contingent upon the patient demonstrating adequate strength, range of motion, and a pain-free gait. Complete resolution of residual swelling and soreness can be prolonged, sometimes taking nine months to a full year.
Long-term management involves continued vigilance to prevent a recurrence of heel pain, often through the consistent use of supportive footwear and custom or over-the-counter orthotics. Maintaining flexibility and strength through a continued home exercise program remains important long after formal physical therapy concludes, ensuring the foot remains properly supported and conditioned.