Can an endoscopic plantar fascia release surgery get me back to running faster? Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.
Every runner who has heel pain that’s not going away wants it fixed and if you’ve been told you have chronic plantar fasciitis and you’ve tried night splints, injections and stretches and physical therapy and icing, and all the other stuff that we normally do that gets it better, but you’re not better, you probably want it fixed.
A lot of us think about this in the way that we fix automobiles. The alternator goes out in your car, you go get a new one put in. Your battery dies, you go get a new battery. But your foot doesn’t work this way. So unfortunately, when you have surgery, you’re trading one problem for another.
I have done lots of endoscopic plantar fascia release surgeries and in the right patient it’s a great thing. But I will tell you and you should hear this that I have not done one on any runner in more than a decade. Why do you think that is? The way that I think about it, if you think about the fact that the ligament itself, the plantar fascia ligament is under enough stress that you’re stretching it, straining it, it’s getting inflamed and it’s hurting, or you’ve stretched it and stressed it enough that it actually has become not just irritated but maybe partially torn. Well, what do you think is causing that stress? What is the ligament absorbing that stress? There’s a point to that right.
So biomechanically, you’re built to hold certain things in place, your bones hold you up, the ligaments hold the bones together, the tendons hold the muscles to the tendons so that they can pull on the bones and you can have movement across the joint. Everything has its place and its purpose and when you take a ligament that has been put under so much stress that it actually tears and then we cut it and release it so it doesn’t have any stress and strain, where’s that stress and strain going to go after surgery, something else.
So, you may just wind up with a different injury later. You may get calcaneal cuboid pain, you might get cuboid syndrome, you might get any lateral stress fracture, you might get spring ligament pain, posterior tibial tendon pain, you could get a different problem. So, you have to realize that when we do surgery to release that ligament, we’re releasing the stress and letting it go run amok inside your foot.
Make sure you discuss this at length with your doctor so you can really understand the risk but you have to make it clear to your doctor that you have to say I’m going to run after surgery. The goal is not to make the heel pain go away. The goal is to run without heel pain/ That will get them thinking differently about it.
If you have plantar fasciitis or heel pain and you’re not sure what to do in terms of your running, you might want to check out the heel pain masterclass. It’s a deep dive in all these topics specific for runners, you can get it for free www.docontherun.com/heelpainmasterclass. So go check it out, and I’ll see you in the training.