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Question please, on EPF 9-1999

Posted by Bria G on 3/19/01 at hrmin (041891)

Hi Everyone,

Back in Spetember, 1999, I had Endoscopic Plantar Fasciotomy on the sorest of my heels. The doc was kind of young and cocky, using Dr. Barrett's method. Of course he felt he could help me. Unfortunatly it didn't happen. I ended up with about the same amount of pain, including a little more in my arch. It's gotten worse since.

My question concerns the instructions I was given post surgery. The 1st day I was supposed to walk in the sugical shoe for 5 miutes every 1.5 to 2 hours. On days 2-7 walk no more than 10 minutes in an hour, in 2-3 minute sputs.

I was on crutches and so far, so good. I must mention I was still in alot of pain, even up to 3 weeks. No infection, just pain. On the 8-14th day, 5-7 minutes at a time, not exceeding 15-20 minutes an hour. On days 15-21, 'if you are now experiencing no discomfort' walk 10 minutes at a time, not to exceed 20-30 minutes per hour.

By now I'm way behind. I call the doc, and he sys to keep on, doing as much as I can. Days 22-28 I should be feeling no pain, YA RIGHT. 30-60 days is 15 to 20 minutes at a time. After 2 months, 'you will be able to resume normal activity' I WISH

Does anyone think this therapy was too agressive, or was I just a tough case? I'm thinking I may have healed better if I had really taken it easy. I must say I really pushed it trying to keep up with this schedule. There was much more pain than I was expecting, yet the Pod told me everything went normally during the scope.

Any thoughts?
BG

PS I wish I had known about this site back then :*(

Re: Question please, on EPF 9-1999

Dr. Zuckerman on 3/19/01 at 19:31 (041895)

I have seen plantar fascia releases hurt alot off and on for six months or more and then start to get better. You are near or at the six month post-op period. So relief could start to happen. Physical therapy could help you and maybe even a walking cast.

The problem with any type of plantar fascia surgery is that in some cases could take six months or more to heal and in a very small amount of cases could take even longer.

Now the most important question I need to know is this. Did you have heel spur syndrome or what we call pain when you first get up in the morning or after being on your foot for any length of time. This is a very important question in order for me to help determine a course of help for you.

Re: Question please, on EPF 9-1999

Brian G on 3/20/01 at 06:20 (041912)

Actually it's been a year and a half since the scope release. And yes, my heel hurts first thing in the morning. I stretch before I get out of bed, but it's not enough. My PF is sort of OK during the morning, but continually gets worse as the day goes on. The pain is really bad at night, and gets that way whether I've rested, or walked a bit.

Thanks
Brian

PS I'm just trying to save someone else the pain if indeed I did push it too hard.

Re: Question please, on EPF 9-1999

Susan U on 3/20/01 at 07:24 (041915)

Hey, Brian. I'm certainly no expert, but everything I've read or been told by Drs. is to rest, rest, rest! I've been told I'll be TOATLLY NON-WEIGHT BEARING for at least 2 weeks, then slight, etc. I was also told it may be as many as 4 weeks before weight bearing. Sounds to me like your Dr. really rushed you. Hopefully you can do something for your pain. I am SO sorry for you! Hang in there and let us know how you are doing.

Re: Question please, on EPF 9-1999

Dr. Zuckerman on 3/20/01 at 16:10 (041976)

Hi,

Actually the amount of time post EPF isn't that much and alot of doctors have you on your feet alot more. The problem you are having is the procedure itself can cause exactly what you are experiencing. This is why I do ESWT first. I don't care if you rest, non-weight bearing, etc. The cutting of the plantar fascia can and does cause this kind of problem . So I appreciate you telling people on this board your post- EPF complicaton from the cutting of the plantar fascia. I wish there was something I could tell you that would help you.

I know that there are people on this board that feel that my endorsement of ESWT is only self serving but trust me I have seen enough post pf releases that have ruined the human foot . So I speak because I know. Glad that you had the courage to tell us your story

Re: Question please, on EPF 9-1999

john h on 3/27/01 at 11:25 (042644)

dr z: i see so many post where the surgery patient has no idea how much of the fasica was release. there are some doctors who still totally release all the fascia. this it seems to me should be an important question the patient should ask even if the doctor is not sure how much he release. this should be a question going into and before the surgery. if the doctor was going to release all or 70% i would run or hobble out as quick as i could.

Re: Question please, on EPF 9-1999

Dr. Zuckerman on 3/19/01 at 19:31 (041895)

I have seen plantar fascia releases hurt alot off and on for six months or more and then start to get better. You are near or at the six month post-op period. So relief could start to happen. Physical therapy could help you and maybe even a walking cast.

The problem with any type of plantar fascia surgery is that in some cases could take six months or more to heal and in a very small amount of cases could take even longer.

Now the most important question I need to know is this. Did you have heel spur syndrome or what we call pain when you first get up in the morning or after being on your foot for any length of time. This is a very important question in order for me to help determine a course of help for you.

Re: Question please, on EPF 9-1999

Brian G on 3/20/01 at 06:20 (041912)

Actually it's been a year and a half since the scope release. And yes, my heel hurts first thing in the morning. I stretch before I get out of bed, but it's not enough. My PF is sort of OK during the morning, but continually gets worse as the day goes on. The pain is really bad at night, and gets that way whether I've rested, or walked a bit.

Thanks
Brian

PS I'm just trying to save someone else the pain if indeed I did push it too hard.

Re: Question please, on EPF 9-1999

Susan U on 3/20/01 at 07:24 (041915)

Hey, Brian. I'm certainly no expert, but everything I've read or been told by Drs. is to rest, rest, rest! I've been told I'll be TOATLLY NON-WEIGHT BEARING for at least 2 weeks, then slight, etc. I was also told it may be as many as 4 weeks before weight bearing. Sounds to me like your Dr. really rushed you. Hopefully you can do something for your pain. I am SO sorry for you! Hang in there and let us know how you are doing.

Re: Question please, on EPF 9-1999

Dr. Zuckerman on 3/20/01 at 16:10 (041976)

Hi,

Actually the amount of time post EPF isn't that much and alot of doctors have you on your feet alot more. The problem you are having is the procedure itself can cause exactly what you are experiencing. This is why I do ESWT first. I don't care if you rest, non-weight bearing, etc. The cutting of the plantar fascia can and does cause this kind of problem . So I appreciate you telling people on this board your post- EPF complicaton from the cutting of the plantar fascia. I wish there was something I could tell you that would help you.

I know that there are people on this board that feel that my endorsement of ESWT is only self serving but trust me I have seen enough post pf releases that have ruined the human foot . So I speak because I know. Glad that you had the courage to tell us your story

Re: Question please, on EPF 9-1999

john h on 3/27/01 at 11:25 (042644)

dr z: i see so many post where the surgery patient has no idea how much of the fasica was release. there are some doctors who still totally release all the fascia. this it seems to me should be an important question the patient should ask even if the doctor is not sure how much he release. this should be a question going into and before the surgery. if the doctor was going to release all or 70% i would run or hobble out as quick as i could.