partial excision of scarred plantar fascia

[Delre]

I had a planter release surgery in 2009, for planter fasciiattis.  The pain in my heal was gone but I had a new pain were the doctor made the cut.  About a year later and a couple of painful cortizone shots later to soften the scare tissue and the pain is still there.  My doctor is suggesting a partial excision of scarred planter fascia.  Is this a good IDE and what is the long term problems that come with this.  I am also a runner will I be able to continue to run after this?

[S. Kaul, MD]

Hi again!

Well, it’s just that with a surgical excision there is no guarantee that scar formation would not recur with the second surgery and could happen to be more extensive in sensitive individuals. Interventional techniques on the other hand may not gurantee a definite improvement in symptoms, however the scar is unlikely to worsen. Also though the former is preferred, the treatment option may depend on the location of the scar tissue, surrounding structures, ease of accessibility etc. Hence it is best advised to discuss the options in detail with your doctor before deciding on a management plan.
Hope this is useful.

Take care!

[Delre]

Thank you for the post, I talked to a ortho doc in my area and he said talk to a podiatrist, Dr Jones from healthpoint st Joseph's north in the Tampa area.  Can you tell me the negative aspects of excision?

[S. Kaul, MD]

Hi there!

Well, without a detailed clinical evaluation, it would be difficult to comment on the course of treatment in your case. If all other possibilities to the cause of pain have been ruled out and it is believed that your symptoms are due to scar formation; a trial of non-invasive techniques like steroid injection, laser ablation etc. or minimal invasive surgery may be preferred if possible, over surgical excision. I would suggest discussing the possibility with your orthopedician before deciding on a management plan.
Hope this helps.

Take care!