Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Need Advice - 4 weeks post surgery

Posted by Andrea B. on 11/24/01 at 11:24 (065144)

Help, I am four weeks post endoscopic plantar fasciotomy and do not feel any better. I have had problems with swelling and when I called the doctor's office and talked to the nurse this week her advice was to quit drinking so much pop. My doctor is out of the office again and will not be back until my appointment next Tuesday. It was my understand from the doctor and the information I found on-line that by four weeks after surgery I would be back to my normal activities with out pain. I just got off the cruthes this week, the doctor wanted me to use them longer because of the swelling, and am not any where near back to my normal activites. I am so frustrated and don't know that to do. Any advice?

Re: Need Advice - 4 weeks post surgery

Anthony P on 11/24/01 at 21:06 (065165)

Hi Andrea,I'm not a doctor but :
Returning to normal activity after only 4 weeks is not realistic.
Healing can take 6 monthes to a year, I know it is a long time its true,
reading this board and my doc said 6 mo to a year. but everyone heals diffent so It
maybe sooner . I know the feeling,
I'm over 2 weeks post op with swelling feeling better, So do this
Keep your foot elevated ,always use crutches until you see your doctor.
Well good luck to you. keep us posted.
Antony P :)

Re: Need Advice - 4 weeks post surgery

Paula on 11/25/01 at 18:55 (065238)

Sorry,but you will NOT be back to your old self in 4 weeks. I had my surgery 2 months ago, almost 3. I still use crutches when my foot gets really painful. I still have swelling, which is a normal thing, depending upon how much.
Please, elevate that foot. Above your heart if possible. That will help with swelling. That and ice it periodically.
Be kind to yourself. Time is what it takes. My surgery was different than yours, but the outcome is still the same. Commitment to healing. Everyone is different. I thought by now I would be much better too. Hang in there. The nurse was talking the salt content of pop is what causes you to retain water. That is not your problem though.

Re: Need Advice - 4 weeks post surgery

BrianG on 11/25/01 at 21:02 (065256)

I don't know how many people have ever gone to the home page of Stephen Barrett, DPM, who designed the EPF, Endoscopic Plantar Fasciotmy. He states that most patients will be back in their regular shoes in 3-5 days. But the really big kicker is that he also states that patients will return to normal activities by the 3rd week. Sounds pretty good doesn't it!!!! I don't believe it. I also don't believe that we only see the few failures here. I urge people to check this procedure out before falling for it. Do your research, there are many foot specialists out there that will tell you this method is not all it's cracked up to be.

BCG

Re: Need Advice - 4 weeks post surgery

Sue D on 11/26/01 at 13:47 (065308)

Brian, I agree with you about EPF. My surgeon felt the old way was best. My incision was only slightly longer than an inch. It's now been five weeks since my surgery and I'm doing more each day-can go for three to four hours straight on uneven ground. I'll have an occassional day where I'm more sore. And I rest my foot when it's sore. Connective tissue takes a long time to heal and we all must be patient as Paula says...Sue

Re: Need Advice - 4 weeks post surgery

Ed Davis, DPM on 11/26/01 at 16:35 (065316)

Do you have his web site address? 'Back to regular activities' 3 weeks after EPF is highly unlikely.
Ed

Re: Need Advice - 4 weeks post surgery

Andrea B. on 11/26/01 at 18:15 (065333)

Paula - You mention that you still use your crutches when your foots gets really painful - have you ever used a cane and do you think that would help. I have considered using one but would like to know if anyone else has tried one.

Re: Need Advice - 4 weeks post surgery

Ami P. on 11/26/01 at 21:28 (065352)

I am five weeks out of heel spur removal and pf release. I also had a portion of a nerve removed. I walk in the 'boot' with my insert and with a cane if its a long walk. I'm not back in shoes yet, but a cane is certainly a welcome relief if I am on my feet too long. You just have to get use to letting the cane do some of the work. I highly recommend one. They seem a lot less cumbersome than crutches. Hope all goes well!

Re: Dr Barrett (EPF) information

BrianG on 11/27/01 at 16:35 (065431)

Hi Ed,

Dr. Barretts web address is http://www.footspecialists.com
I'll try to cut and paste the section I quoted.
From his home page, click on 'Breakthroughs in Technology', then go to 'Surgical Treatment for chronic heel spur / PF'
This is as close to false advertising that I've ever seen!

BCG

New Treatment for Heel Spur Syndrome
Endoscopic Plantar Fasciotomy
What is Heel Spur Syndrome?
It is often described as a 'stone bruise' by the patient. Pain is usually worse in the morning, especially the first several steps, or after periods of rest when first standing. As the pain worsens, the heel can hurt even while not weight-bearing.

What causes it?
Heel Spur Syndrome, or heel pain, is usually caused by a mechanical problem involving the structural alignment of the foot. There is a dense fibrous band of tissue in the bottom of the foot known as the plantar fascia. The plantar fascia inserts into the heel bone and spreads out into the foot. (See diagram below.) Because of mechanical misalignment of the foot, excessive tension is placed on this band of tissue, causing inflammation and pain. The size or presence of a heel spur does not always correlate with the amount of pain.

What is Endoscopic Plantar Fasciotomy?
Endoscopic Plantar Fasciotomy is a recent advancement in foot surgery for the correction of Heel Spur Syndrome and Plantar Fasciitis. The procedure was developed by Dr. Stephen L. Barrett and Dr. Stephen V. Day to permanently correct chronic heel pain in a less traumatic manner. The new technique allows for a quicker recovery and a faster return to normal activity. The procedure involves an outpatient surgical visit and utilizes specially designed instruments that allow the surgeon to directly visualize the foot structures on a video screen while only making two small incisions on the foot.

How is this procedure different?
In classic heel spur surgery, a large open incision is made to sever the tight ligament in the arch known as the plantar fascia and to remove the bone spur which has formed within this fascia attaches to the heel bone. The heel spur is formed over a long period of time because of constant pulling. The injury produces inflammation, pain and inability to bear weight on the heel comfortably. The inflammation stimulates spur formation. The spur is a symptom of the inflammation and not the cause of the heel pain. In Endoscopic Plantar Fasciotomy it is not necessary to remove the heel spur in order to cure the pain.
Am I a candidate for this surgical procedure?
If you have failed to obtain complete relief of heel pain symptoms with the use of conservative treatment such as: taping, orthotics, cortisone injections, oral medication or physical therapy, then you may benefit from Endoscopic Plantar Fasciotomy. A complete evaluation and discussion with Dr. Barrett will help determine your best options.

What then?
If all of your symptoms go away with conservative care then surgery will not be necessary. If, however, pain and discomfort are still present after conservative care has been tried, then surgery is recommended.

What are the expected results of this procedure?
Most patients return to their regular shoes in 3-5 days. Most return to work after the first week, and return to their normal activities by the end of the third week. Everyone heals slightly differently. Other factors such as age, weight, and occupation can contribute to healing times.

Why us?
Dr. Barrett is a Board Certified Foot Surgeon, extensively trained in techniques of plastic, orthopedic, micro vascular, Arthroscopic, and reconstructive surgery of the foot and ankle. As a co-developer of the Endoscopic Plantar Fasciotomy technique, Dr. Barrett has trained over 2,000 surgeons throughout the nation in this technique.
Endoscopic Foot Specialists Home Page
Treatment for Neuromas
 

[ About Podiatry ] [ About the Physicians ] [ Practice Philosophy ]
[ Office Information ] [ Services ] [ Breakthroughs in Technology ]
[ Referrals for Endoscopic Surgery ] [ email ] [ Home Page ]
 Thomas T. Pignetti, DPM, FACFAS
Stephen L. Barrett, DPM, FACFAS, FACFO
25227 Borough Park Drive - Spring, TX 77380
Phone: (281) 292-7000  Fax: (281) 292-5222  
c2000 Advanced Foot Care - Designed by The Texas Network
 
Please scroll to the top for Dr. Barrett info.
BCG 

Re: Wrong web site - sorry

BrianG on 11/27/01 at 21:52 (065464)

This is the wrong web address. I'm not sure what happened. The right one can be found at most search engines: Google, Yahoo, etc. Just type in 'Barrett dpm' and hit search. I tried to modify my last entry, but couldn't figure out how to do it.

BCG

Re: Wrong web site - sorry

Ed Davis, DPM on 11/28/01 at 16:36 (065527)

EPF is one of many ways to accomplish a plantar fascial release. There has been a tendency for this procedure to be 'sold' by its high tech attributes (use of an endoscope) and perhaps by understating the recovery time. The recovery time is not necessarily different from any other type of plantar fascial release. The amount of trauma to tissues is perhaps a little bit less than with a traditional open release and a bit more than with a minimal incision type release.
Ed

Re: Need Advice - 4 weeks post surgery

denise j on 12/01/01 at 18:45 (065852)

hi, my name is denise and i have had chronic foot pain for 3 years, just recently diagnosed with tarsal tunnel syndrome and i am scheduled for surgery on dec. 12. do you have any advice for me concerning this surgery? if so please let me know. how long of a recovery is it and do you lose feeling in your foot forever? thanks denise
(email removed)

Re: Dr Barrett (EPF) information

denise j on 12/01/01 at 18:52 (065854)

hi, i went to dr. barrett a few weeks ago i have had severe pf for 3 years or so i thought it seemed to just get worse the last 6 months i have been in constant pain, severe most of the time. he seemed to think i had something else wrong with my foot so he sent me for a test and it confirmed that i have tarsal tunnel syndrome, so since i live in lake charles i didnt want to have surgery in houston so my ortho looked at my test results and concluded i did need surgery and i am scheduled for it 12-12.

Re: Need Advice - 4 weeks post surgery

Paula on 12/03/01 at 13:33 (065987)

Hi I hope you read this. I just now saw your message. Yes, I have used a cane. I still do when I can. It just does not distribute the weight control like crutches do. With crutches I can walk real lightly on my foot and the crutches handle the weight. With a cane, you are bearing FULL weight and the cane only assists with walking. Make sense? I hope you are doing better..

Re: Need Advice - 4 weeks post surgery

BarbaraTX on 12/03/01 at 20:16 (066023)

I agree that crutches are better than a cane - worth getting used to and the hastle of the big things. They take at least part of the weight off and spare the hips of an uneven gait that you have with a cane. With crutches, both underarms and hands bear the burden of the weight, not just one arm. I have been using them for a year. GOOD LORD! B.

Re: Need Advice - 3 weeks post surgery

Patrick on 12/14/01 at 18:53 (066992)

This is my 3rd weeks after my surgery on my torn achilles. I am still feeling painful. How long does it take to have no pain? Please advise.

Re: Need Advice - 4 weeks post surgery

Anthony P on 11/24/01 at 21:06 (065165)

Hi Andrea,I'm not a doctor but :
Returning to normal activity after only 4 weeks is not realistic.
Healing can take 6 monthes to a year, I know it is a long time its true,
reading this board and my doc said 6 mo to a year. but everyone heals diffent so It
maybe sooner . I know the feeling,
I'm over 2 weeks post op with swelling feeling better, So do this
Keep your foot elevated ,always use crutches until you see your doctor.
Well good luck to you. keep us posted.
Antony P :)

Re: Need Advice - 4 weeks post surgery

Paula on 11/25/01 at 18:55 (065238)

Sorry,but you will NOT be back to your old self in 4 weeks. I had my surgery 2 months ago, almost 3. I still use crutches when my foot gets really painful. I still have swelling, which is a normal thing, depending upon how much.
Please, elevate that foot. Above your heart if possible. That will help with swelling. That and ice it periodically.
Be kind to yourself. Time is what it takes. My surgery was different than yours, but the outcome is still the same. Commitment to healing. Everyone is different. I thought by now I would be much better too. Hang in there. The nurse was talking the salt content of pop is what causes you to retain water. That is not your problem though.

Re: Need Advice - 4 weeks post surgery

BrianG on 11/25/01 at 21:02 (065256)

I don't know how many people have ever gone to the home page of Stephen Barrett, DPM, who designed the EPF, Endoscopic Plantar Fasciotmy. He states that most patients will be back in their regular shoes in 3-5 days. But the really big kicker is that he also states that patients will return to normal activities by the 3rd week. Sounds pretty good doesn't it!!!! I don't believe it. I also don't believe that we only see the few failures here. I urge people to check this procedure out before falling for it. Do your research, there are many foot specialists out there that will tell you this method is not all it's cracked up to be.

BCG

Re: Need Advice - 4 weeks post surgery

Sue D on 11/26/01 at 13:47 (065308)

Brian, I agree with you about EPF. My surgeon felt the old way was best. My incision was only slightly longer than an inch. It's now been five weeks since my surgery and I'm doing more each day-can go for three to four hours straight on uneven ground. I'll have an occassional day where I'm more sore. And I rest my foot when it's sore. Connective tissue takes a long time to heal and we all must be patient as Paula says...Sue

Re: Need Advice - 4 weeks post surgery

Ed Davis, DPM on 11/26/01 at 16:35 (065316)

Do you have his web site address? 'Back to regular activities' 3 weeks after EPF is highly unlikely.
Ed

Re: Need Advice - 4 weeks post surgery

Andrea B. on 11/26/01 at 18:15 (065333)

Paula - You mention that you still use your crutches when your foots gets really painful - have you ever used a cane and do you think that would help. I have considered using one but would like to know if anyone else has tried one.

Re: Need Advice - 4 weeks post surgery

Ami P. on 11/26/01 at 21:28 (065352)

I am five weeks out of heel spur removal and pf release. I also had a portion of a nerve removed. I walk in the 'boot' with my insert and with a cane if its a long walk. I'm not back in shoes yet, but a cane is certainly a welcome relief if I am on my feet too long. You just have to get use to letting the cane do some of the work. I highly recommend one. They seem a lot less cumbersome than crutches. Hope all goes well!

Re: Dr Barrett (EPF) information

BrianG on 11/27/01 at 16:35 (065431)

Hi Ed,

Dr. Barretts web address is http://www.footspecialists.com
I'll try to cut and paste the section I quoted.
From his home page, click on 'Breakthroughs in Technology', then go to 'Surgical Treatment for chronic heel spur / PF'
This is as close to false advertising that I've ever seen!

BCG

New Treatment for Heel Spur Syndrome
Endoscopic Plantar Fasciotomy
What is Heel Spur Syndrome?
It is often described as a 'stone bruise' by the patient. Pain is usually worse in the morning, especially the first several steps, or after periods of rest when first standing. As the pain worsens, the heel can hurt even while not weight-bearing.

What causes it?
Heel Spur Syndrome, or heel pain, is usually caused by a mechanical problem involving the structural alignment of the foot. There is a dense fibrous band of tissue in the bottom of the foot known as the plantar fascia. The plantar fascia inserts into the heel bone and spreads out into the foot. (See diagram below.) Because of mechanical misalignment of the foot, excessive tension is placed on this band of tissue, causing inflammation and pain. The size or presence of a heel spur does not always correlate with the amount of pain.

What is Endoscopic Plantar Fasciotomy?
Endoscopic Plantar Fasciotomy is a recent advancement in foot surgery for the correction of Heel Spur Syndrome and Plantar Fasciitis. The procedure was developed by Dr. Stephen L. Barrett and Dr. Stephen V. Day to permanently correct chronic heel pain in a less traumatic manner. The new technique allows for a quicker recovery and a faster return to normal activity. The procedure involves an outpatient surgical visit and utilizes specially designed instruments that allow the surgeon to directly visualize the foot structures on a video screen while only making two small incisions on the foot.

How is this procedure different?
In classic heel spur surgery, a large open incision is made to sever the tight ligament in the arch known as the plantar fascia and to remove the bone spur which has formed within this fascia attaches to the heel bone. The heel spur is formed over a long period of time because of constant pulling. The injury produces inflammation, pain and inability to bear weight on the heel comfortably. The inflammation stimulates spur formation. The spur is a symptom of the inflammation and not the cause of the heel pain. In Endoscopic Plantar Fasciotomy it is not necessary to remove the heel spur in order to cure the pain.
Am I a candidate for this surgical procedure?
If you have failed to obtain complete relief of heel pain symptoms with the use of conservative treatment such as: taping, orthotics, cortisone injections, oral medication or physical therapy, then you may benefit from Endoscopic Plantar Fasciotomy. A complete evaluation and discussion with Dr. Barrett will help determine your best options.

What then?
If all of your symptoms go away with conservative care then surgery will not be necessary. If, however, pain and discomfort are still present after conservative care has been tried, then surgery is recommended.

What are the expected results of this procedure?
Most patients return to their regular shoes in 3-5 days. Most return to work after the first week, and return to their normal activities by the end of the third week. Everyone heals slightly differently. Other factors such as age, weight, and occupation can contribute to healing times.

Why us?
Dr. Barrett is a Board Certified Foot Surgeon, extensively trained in techniques of plastic, orthopedic, micro vascular, Arthroscopic, and reconstructive surgery of the foot and ankle. As a co-developer of the Endoscopic Plantar Fasciotomy technique, Dr. Barrett has trained over 2,000 surgeons throughout the nation in this technique.
Endoscopic Foot Specialists Home Page
Treatment for Neuromas
 

[ About Podiatry ] [ About the Physicians ] [ Practice Philosophy ]
[ Office Information ] [ Services ] [ Breakthroughs in Technology ]
[ Referrals for Endoscopic Surgery ] [ email ] [ Home Page ]
 Thomas T. Pignetti, DPM, FACFAS
Stephen L. Barrett, DPM, FACFAS, FACFO
25227 Borough Park Drive - Spring, TX 77380
Phone: (281) 292-7000  Fax: (281) 292-5222  
c2000 Advanced Foot Care - Designed by The Texas Network
 
Please scroll to the top for Dr. Barrett info.
BCG 

Re: Wrong web site - sorry

BrianG on 11/27/01 at 21:52 (065464)

This is the wrong web address. I'm not sure what happened. The right one can be found at most search engines: Google, Yahoo, etc. Just type in 'Barrett dpm' and hit search. I tried to modify my last entry, but couldn't figure out how to do it.

BCG

Re: Wrong web site - sorry

Ed Davis, DPM on 11/28/01 at 16:36 (065527)

EPF is one of many ways to accomplish a plantar fascial release. There has been a tendency for this procedure to be 'sold' by its high tech attributes (use of an endoscope) and perhaps by understating the recovery time. The recovery time is not necessarily different from any other type of plantar fascial release. The amount of trauma to tissues is perhaps a little bit less than with a traditional open release and a bit more than with a minimal incision type release.
Ed

Re: Need Advice - 4 weeks post surgery

denise j on 12/01/01 at 18:45 (065852)

hi, my name is denise and i have had chronic foot pain for 3 years, just recently diagnosed with tarsal tunnel syndrome and i am scheduled for surgery on dec. 12. do you have any advice for me concerning this surgery? if so please let me know. how long of a recovery is it and do you lose feeling in your foot forever? thanks denise
(email removed)

Re: Dr Barrett (EPF) information

denise j on 12/01/01 at 18:52 (065854)

hi, i went to dr. barrett a few weeks ago i have had severe pf for 3 years or so i thought it seemed to just get worse the last 6 months i have been in constant pain, severe most of the time. he seemed to think i had something else wrong with my foot so he sent me for a test and it confirmed that i have tarsal tunnel syndrome, so since i live in lake charles i didnt want to have surgery in houston so my ortho looked at my test results and concluded i did need surgery and i am scheduled for it 12-12.

Re: Need Advice - 4 weeks post surgery

Paula on 12/03/01 at 13:33 (065987)

Hi I hope you read this. I just now saw your message. Yes, I have used a cane. I still do when I can. It just does not distribute the weight control like crutches do. With crutches I can walk real lightly on my foot and the crutches handle the weight. With a cane, you are bearing FULL weight and the cane only assists with walking. Make sense? I hope you are doing better..

Re: Need Advice - 4 weeks post surgery

BarbaraTX on 12/03/01 at 20:16 (066023)

I agree that crutches are better than a cane - worth getting used to and the hastle of the big things. They take at least part of the weight off and spare the hips of an uneven gait that you have with a cane. With crutches, both underarms and hands bear the burden of the weight, not just one arm. I have been using them for a year. GOOD LORD! B.

Re: Need Advice - 3 weeks post surgery

Patrick on 12/14/01 at 18:53 (066992)

This is my 3rd weeks after my surgery on my torn achilles. I am still feeling painful. How long does it take to have no pain? Please advise.