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Difference between EPF and Endoscopic Plantar Fascia Release

Posted by MichelleB on 12/27/00 at 18:48 (035457)

In the summer of 1996, I injured both my heels while walking(or at least I think that's what caused it). I began having heel pain all of the time. At the time I was in rehearsals for a musical that required a good bit of dancing. On the advice of the director, I tried some heel stretching and self-diagnosed my problem as plantar fasciitis. I refused to go to a podiatrist because I thought it would cost too much. Silly me! By 1998 I could not take a few steps without severe pain in my heels. I was literally limping across my classroom. I then finally went to a highly recommended podiatrist, who took x-rays and confirmed that I indeed had plantar fasciitis, with bone spurs being the result. He offered a cortisone shot, which me, being the chicken that I am, declined. After I left his office, I talked myself into going back and having them because I was going on an out-of-town field trip. And, yes, they did hurt like the devil! I had another shot in May when I couldn't walk around again. I had my final shots in April of this year when I felt like my foot was broken. I had been taking Celebrex, and it worked for a while, but by June I was in pain again. Oh, yes, I also have orthotics, and they make the toes of my right foot numb, so I don't wear them that often. I've worn them for over a year, and they didn't seem to work. I asked my doctor what other form of treatment than surgery should I consider, and he referred me to a physical therapist. I started treatment at the end of June. I tried everything they told me to do, but guess what?? I was still in a lot of pain. Only now it wasn't just my heel, it was my whole foot. My toes felt numb, the top of my foot hurt, etc. So, we scheduled the surgery for Dec. 15. I had the surgery, and am now on my second week of recovery. At first my doctor told me that it would be a four-week recovery period. So I scheduled two weeks out of work. I had my second post-op appt. today, he removed the stitches, and told me I could start bearing weight on my foot. The truth is I'm scared to put weight on it. After reading some of the previous posts about EPF, I wondered if I should have done something else instead--or is the Endoscopic Plantar Fascia Release totally different from EPF? I really couldn't tell by the posts, and the posters' surgeries sure sounded a lot like mine. I have to admit--my toes still feel numb(which my dr. said was normal), and I had some bruising near the incision site, which I suppose is normal also. I guess what I'm asking is should I even be considering putting weight on that foot? It hasn't been quite two weeks now. My principal was very understanding in scheduling my leave--he even said that I could start back half-days if I need to after the four weeks. I've read some things that said you could walk after three days, and that a lot of doctors wanted you to put weight on the foot. I just don't feel ready. After reading those posts, I'm scared that what has happened to a lot of people may happen to me.
Sorry this was so long, but I need the advice.

Thanks!
Michelle

Re: Difference between EPF and Endoscopic Plantar Fascia Release

ABBY on 12/27/00 at 21:12 (035475)

I had EPF surgery about 10 weeks ago. Not sure, but I think the release is the same surgery. I've only heard the word release mentioned here on this website. My podiatrist told me I should walk about for about 5 minutes every hour after 3 days. This was very difficult, it hurt and my knee and the ball of my foot ached for weeks. If I had it to do over again, I would get crutches or a cain. I don't see what good there is in walking on the heel at that point. I couldn't put weight on my heel or arch at all and by the 3rd week, my doctor told me to stop babying my foot and walk on it. This was very difficult though. For me it seemed to take a full week to feel I was making progress in healing after the 4th or 5th week. I limped and walked very slowly (very unusual for me) up until the 5th week. I have now just recently started walking on my treadmill for 20 minutes a day. It hurts in the evening a little, depending on how much I've walked around or stood for long periods of time, but before the surgery I was like you, I practically crawled around to get things done. Ask your doctor lots of questions. I used to write them all down and he would smile and diligently answere each one. Everyone handles this pain differently and seems to experience the pain in different degrees. I really think it takes a good 2 months post op before you start feel back to normal and then you're still caucious, I bet at least until 6 months post op. I'll let you know. For now, here's to a speedy recovery.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Dr. Biehler on 12/27/00 at 21:22 (035476)

EPF is the abreviation for the endoscopic plantar fasia release procedure. There are several dfferent surgeries that can be done for PF. Every peson heals at their own individuale rate and the outcomes of the procedures can vary between patients. If you doctor said you could start bearing weight, go ahead and try it. Just remember to let pain be your guide. You do not want to work throgh the pain. Do not be afraid to take it easy for awhile. I hope you heal soon. Dr. B.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Bob W on 12/29/00 at 13:18 (035564)

The Dr. says there are several surgeries available for PF. I know of EPF, open release, and possibly minimal incision surgery done from the bottom of the foot. What are the others?

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Dr. Biehler on 12/29/00 at 18:45 (035593)

The three you named covers the basic typpe of surgeries done for PF. There can be many differences on where the incission is made and where the fascia band is cut ( ie. at attachment vs. high in the arch ) and how much of the band is cut or removed. Dr. B.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Shawn on 2/05/01 at 01:03 (038205)

I am about to go in for consultation regarding surgery for both my feet. I don't know much about what is to be expected yet because I refused to listen to it when the doctor tried to explain the process to me. I have trying to follow all of my doctor's orders and treatments to avoid even considering surgery. However, I feel that is my next move. My doctor told me that he will make a small incision and cut the nerve. I have bilateral PF and due to recent employment I damaged my feet to the point of constant discomfort. My doctor is away at seminars so my curiosity led me to the internet to see what I should prepare myself for. So far I think I have a pretty good idea of what to expect. The problem is that I now notice that a doctor said there are several operations you can do for PF. I would like to know what they are, and are they covered by insurance companies? What is the estimated time for recovery for the procedure I described? How soon after doing the first foot would they want to do the other?

I know this is multiple questions but I am very nervous and haven't slept all week. I worry what my doctor will tell me and will I be able to be apart of the living again. I am a young lady thats tired of bed rest off and on and barely going out the house because of the discomfort of walking short distances. Any and all information will be greatly appreciated!!!!

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Julie on 2/05/01 at 01:47 (038211)

Shawn, while you're waiting for everyone in the U.S. to wake up, go to the Home Page of the heelspurs.com website and click on 'Surgery'. There you will find a detailed description of the different types of surgery you are asking about. You can also use the search facility to learn more about each type.

Your post re ESWT: the 'surgery' link I mentioned above gives a little info, but if you click on 'ESWT' on the Home Page you'll find lots more. You can also search the site for members' experiences. Most of them have been positive about this non-invasive treatment which you should certainly investigate before agreeing to surgery. You may be a candidate for it.

I don't think there are single answers to your queries about recovery time and insurance. Different people have had different experiences, but the doctors can probably give you some guidance. May I suggest that you post your questions on a new thread, on the Ask the Doctors message board, in case they don't see your first one, which is now fairly far down the thread you've put it on.

Also: please read the PF Book, where you will find a great deal of useful information about PF and related foot problems.

All the best

Julie

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Julie on 2/05/01 at 01:50 (038213)

PS

Apologies for duplication. I re-posted my message because I couldn't find it on the board when I checked and thought it hadn't gone through. In fact it was on the 'next set' page - the thread was started in December! So, Shawn, do please re-post your questions on the 'Ask the Drs' board so they'll be sure to see them.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Shawn on 2/06/01 at 20:20 (038317)

Thanks Julie for responding. I will go and try those references right now. Thanks for taking the time to help me. I will keep my progress posted.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

ABBY on 12/27/00 at 21:12 (035475)

I had EPF surgery about 10 weeks ago. Not sure, but I think the release is the same surgery. I've only heard the word release mentioned here on this website. My podiatrist told me I should walk about for about 5 minutes every hour after 3 days. This was very difficult, it hurt and my knee and the ball of my foot ached for weeks. If I had it to do over again, I would get crutches or a cain. I don't see what good there is in walking on the heel at that point. I couldn't put weight on my heel or arch at all and by the 3rd week, my doctor told me to stop babying my foot and walk on it. This was very difficult though. For me it seemed to take a full week to feel I was making progress in healing after the 4th or 5th week. I limped and walked very slowly (very unusual for me) up until the 5th week. I have now just recently started walking on my treadmill for 20 minutes a day. It hurts in the evening a little, depending on how much I've walked around or stood for long periods of time, but before the surgery I was like you, I practically crawled around to get things done. Ask your doctor lots of questions. I used to write them all down and he would smile and diligently answere each one. Everyone handles this pain differently and seems to experience the pain in different degrees. I really think it takes a good 2 months post op before you start feel back to normal and then you're still caucious, I bet at least until 6 months post op. I'll let you know. For now, here's to a speedy recovery.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Dr. Biehler on 12/27/00 at 21:22 (035476)

EPF is the abreviation for the endoscopic plantar fasia release procedure. There are several dfferent surgeries that can be done for PF. Every peson heals at their own individuale rate and the outcomes of the procedures can vary between patients. If you doctor said you could start bearing weight, go ahead and try it. Just remember to let pain be your guide. You do not want to work throgh the pain. Do not be afraid to take it easy for awhile. I hope you heal soon. Dr. B.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Bob W on 12/29/00 at 13:18 (035564)

The Dr. says there are several surgeries available for PF. I know of EPF, open release, and possibly minimal incision surgery done from the bottom of the foot. What are the others?

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Dr. Biehler on 12/29/00 at 18:45 (035593)

The three you named covers the basic typpe of surgeries done for PF. There can be many differences on where the incission is made and where the fascia band is cut ( ie. at attachment vs. high in the arch ) and how much of the band is cut or removed. Dr. B.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Shawn on 2/05/01 at 01:03 (038205)

I am about to go in for consultation regarding surgery for both my feet. I don't know much about what is to be expected yet because I refused to listen to it when the doctor tried to explain the process to me. I have trying to follow all of my doctor's orders and treatments to avoid even considering surgery. However, I feel that is my next move. My doctor told me that he will make a small incision and cut the nerve. I have bilateral PF and due to recent employment I damaged my feet to the point of constant discomfort. My doctor is away at seminars so my curiosity led me to the internet to see what I should prepare myself for. So far I think I have a pretty good idea of what to expect. The problem is that I now notice that a doctor said there are several operations you can do for PF. I would like to know what they are, and are they covered by insurance companies? What is the estimated time for recovery for the procedure I described? How soon after doing the first foot would they want to do the other?

I know this is multiple questions but I am very nervous and haven't slept all week. I worry what my doctor will tell me and will I be able to be apart of the living again. I am a young lady thats tired of bed rest off and on and barely going out the house because of the discomfort of walking short distances. Any and all information will be greatly appreciated!!!!

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Julie on 2/05/01 at 01:47 (038211)

Shawn, while you're waiting for everyone in the U.S. to wake up, go to the Home Page of the heelspurs.com website and click on 'Surgery'. There you will find a detailed description of the different types of surgery you are asking about. You can also use the search facility to learn more about each type.

Your post re ESWT: the 'surgery' link I mentioned above gives a little info, but if you click on 'ESWT' on the Home Page you'll find lots more. You can also search the site for members' experiences. Most of them have been positive about this non-invasive treatment which you should certainly investigate before agreeing to surgery. You may be a candidate for it.

I don't think there are single answers to your queries about recovery time and insurance. Different people have had different experiences, but the doctors can probably give you some guidance. May I suggest that you post your questions on a new thread, on the Ask the Doctors message board, in case they don't see your first one, which is now fairly far down the thread you've put it on.

Also: please read the PF Book, where you will find a great deal of useful information about PF and related foot problems.

All the best

Julie

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Julie on 2/05/01 at 01:50 (038213)

PS

Apologies for duplication. I re-posted my message because I couldn't find it on the board when I checked and thought it hadn't gone through. In fact it was on the 'next set' page - the thread was started in December! So, Shawn, do please re-post your questions on the 'Ask the Drs' board so they'll be sure to see them.

Re: Difference between EPF and Endoscopic Plantar Fascia Release

Shawn on 2/06/01 at 20:20 (038317)

Thanks Julie for responding. I will go and try those references right now. Thanks for taking the time to help me. I will keep my progress posted.