Our goal at Southern Oregon Foot & Ankle is always to treat medical conditions with conservative, nonsurgical care. Sometimes, though, surgery is a necessary option for your optimal recovery from a foot or ankle injury or condition. Most causes of heel pain are successfully resolved without surgery, but you can rest assured knowing that our staff has the experience and skill you want from a surgeon when it is a necessary option.
Types of Heel Surgery
Plantar fasciitis is the leading cause of heel pain for adults. Fortunately, conservative care is often quite effective at addressing the problem. When conservative options do not provide the desired results and pain relief we would hope to see, we may need to use a surgical procedure as a last resort.
Most surgical procedures are aimed at detaching the plantar fascial ligament from its attachment into the heel bone. This can be accomplished with a small incision on the bottom of the heel or on the side of the heel. The procedure is performed by “feel”. Our surgeons will insert the scalpel blade and feel for the plantar fascia. Once they are confident that they have identified the plantar fascia they cut the ligament free from the heel bone.
For some patients, we need to perform surgery for Achilles tendon injuries. These can include:
- Achilles tendon ruptures. There are a variety of ways to repair an Achilles tendon rupture. The most common method is an open repair. This starts with an incision made on the back of the lower leg starting just above the heel bone. After we find the two ends of the ruptured tendon, these ends are sewn together with sutures. The incision is then closed.
- Achilles tendinosis. We make an incision in the back of the ankle directly over the Achilles tendon and then remove the diseased portion of the tendon. If the problem involves the end of the tendon where it inserts on the heel bone, we may need to lift the tendon off the heel bone. The bump at the back of the bone is then removed, and the tendon is repaired back down to the remaining bone.
Another source of heel pain that might require surgery is a calcaneus fracture. This kind of procedure can restore the normal shape of the bone and allow for proper healing to commence. If the swelling has not gone down, we may elect to wait until it does before operating.
Heel Surgery Recovery
Most patients are able to walk on the foot immediately afterwards but are encouraged to limit their activities. The first week, it is usually recommended that you stay off your feet except to use the restroom or have something to eat. After the first 3 – 7 days the bandage is removed and Band-Aids are placed over the incision site. At this point, you may attempt to wear a good, supportive walking shoe if allowed by your surgeon here at Southern Oregon Foot & Ankle.
We may protect your foot with a cast or have you use crutches. In 10 – 14 days, the sutures are removed and you will be allowed to bath the foot. It generally takes a minimum of three weeks before you are able to walk normally, with minimal discomfort. If you have them, you should return to wearing your orthotics as soon as you are comfortable to wear them in your shoes.
The amount of time needed to be off from work depends upon the demands of your job and the type of shoes that must be worn. If a limited amount of walking is required for the job, and you are able to return to work wearing a cast, you may be able to return to work in one week. If the job requires a lot of time standing, walking, climbing, or kneeling you may need to be off work for three weeks or longer. These are general guidelines and it is important that the patient follow our doctors’ instructions and guidance.