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Endoscopic Plantar Fasciotomy

Posted by Leon S. on 9/18/02 at 18:35 (095649)

I saw an ad in my local paper for a couple of podiatrists who perform this procedure. I called one of them and had a long conversation about it and the whole treatment procedure for PF and it was very interesting. They are not quacks because they recommend this as a 3rd stage remedy if the traditional ones (rest, orthotics, etc) don't work. I asked about the Foot Trainer and he didn't think it was that useful a tool. I know that certain people are swearing by it and I guess what works for some doesn't necessarily work for others.
Anyway, I am curious if anyone has had this procedure. Basically, they make a tiny incision and cut a small part of the tendon (or whatever it is) to relieve the pressure. A more detailed description can be found at this web site: http://www.opma.on.ca/Miltchin%20Endoscopic%20Plantar%20Fasciotomy.htm
If you can't link to it, just type in Endoscopic Plantar Fasciotomy and you'll be surprised at how many links there are.

Re: Endoscopic Plantar Fasciotomy

Nancy N on 9/18/02 at 20:46 (095661)

Leon--

Do a search on EPF on this site and you'll find lots of horror stories. There are better surgeries, but even those are absolute last resorts. Try ESWT before surgery, even if you have to pay a lot more for it. Pay a visit to the foot surgery message board for info on surgery in general.

Re: Endoscopic Plantar Fasciotomy

BrianG on 9/18/02 at 21:09 (095668)

Hi Leon,

Did these fine doctors bother to tell you what would happen to your heel / foot after the surgery? Did they mention that the fascia pretty much holds up the whole body? Do you know what you should be doing for the rest of your life, if you have this surgery? Will you be able to talk with any patients they cured? And lastly, did they tell you it hurts like hell, you will have a hole cut through your heel!! Took me 2-3 months to heal, after my 'failed' EPF. So, I'm probably not a very good patient to give you a nice rosey report. Look into it carefully, it is falling out of favor with many Pods. Do some research, find out why!!

BrianG

Re: Endoscopic Plantar Fasciotomy

Julie on 9/19/02 at 01:11 (095689)

Leon

I agree with Nancy and Brian. And wouldn't you be suspicious of doctors who ADVERTISED surgery???!!! I would run a mile, even if I didn't know what I know about EPF from this website.

It really bugs me how doctors can mislead people about these 'painless', minimal-recovery-time endoscopic procedures - and not just for PF. When an instrument is inserted into your body and moved around inside, it disturbs tissues. Period. That is not painless.

Please do your research.

Re: Endoscopic Plantar Fasciotomy

Necee on 9/19/02 at 13:29 (095729)

Leon, my cousin had this type of surgery, and she is still in pain everyday. I would not recommend it at all.
Read all you can...and ask questions about various types of therapy, take the conservative approach....surgery should always be a last resort.

Happy trails....

Necee

Re: Endoscopic Plantar Fasciotomy

Leon S. on 9/19/02 at 18:19 (095765)

Wow! I appreciate the response. Just to set the record straight, I wasn't contemplating it but was interested to know more about it. I wasn't aware that many people had the precedure and that was why I put it out, to get more input. That's the value of these boards.

Re: Endoscopic Plantar Fasciotomy

Ed Davis, DPM on 9/21/02 at 10:19 (095900)

Julie:

I am sort of surprised that there are still docs advertising this surgery -- sort of a 1980's 'thing.'

By the way just as I finished an ESWT treatment (Ossatron) yesterday, one of the OR nurses came up to me complaining that her pod prohibited her from doing yoga due to PF. I told her that was nonesense and asked her to come to this website and ask for you. Unfortuneatly, I don't remember her name since things wer farily hectic yesterday.
Ed

Re: Yoga

Julie on 9/21/02 at 16:18 (095914)

Ed

I guess her pod was being cautious. Truthfully, I don't blame him. There are styles of yoga that would be altogether unsuitable for someone with PF - these tend to be the stronger, more aggressive styles that are popular now and they may be the only ones he is familiar with.

But there is much that would be suitable for her and I'll be glad to talk to her if she comes around.

Re: yoga shoe

Ed Davis, DPM on 9/21/02 at 21:18 (095928)

Julie:

The main reason her pod did not want her to do yoga was because he did not want her to do any barefoot exercises.

By the way, Nike has just come out with a 'yoga shoe' called the Nike Air Kyoto. I don't have any specifics on it. Nike usually does not have a good repoire with professionals as they are concerned about criticism.
Ed

Re: Barefoot yoga, and Nike shoe

Julie on 9/22/02 at 02:06 (095936)

Ed

He was right about that, and it's true that yoga is normally practised barefoot. But exceptions can be made. When I've had students with PF, I've insisted they wear their trainers while doing standing work, or Birkenstocks if they have them, as I did myself when my PF was active (and still do if I'm going to be standing for any length of time).

If she explains that she has to wear shoes because of PF, she should be able to judge by the teacher's response whether or not s/he is trustworthy and caring teacher, or just a demonstrator of postures.

Re 'yoga shoe' - sounds like Nike is just being Nike, and trying to get into yet another profit-reaping niche, doesn't it?

Re: Barefoot yoga, and Nike shoe

Leon S. on 9/22/02 at 12:51 (095957)

For some reason I am getting these latest threads as emails even though they don't refer to any of my messages. Could it be because my name is at the top of this grouping? Is there a way to prevent it? Nothing personal.
Leon

Re: Barefoot yoga, and Nike shoe

Julie on 9/22/02 at 15:18 (095968)

Leon, I think the way it works is that if you start a thread, and include your email address, you will then receive as an email every post that appears on that thread. If you want this to stop, you just remove your email address from the email box next time you post.

Re: Barefoot yoga, and Nike shoe

john h on 9/23/02 at 13:35 (096016)

I am of the opinion there is no one treatment that is going to work for all or even most of us. It is just trial and error until you hit upon some combinations that make your feet feel better. What may make one person better will make another person worse. I was in Florida when I read the brief article on ESWT studies conduted in Australia. I took note of the fact that the Doctor from Mass General who wrote the article said he would continue to use ESWT. As I have often commented my believe is that we all got to our PF condition in a different manner and if we are to improve or be cured we will take different paths.

Re: Endoscopic Plantar Fasciotomy

Nancy N on 9/18/02 at 20:46 (095661)

Leon--

Do a search on EPF on this site and you'll find lots of horror stories. There are better surgeries, but even those are absolute last resorts. Try ESWT before surgery, even if you have to pay a lot more for it. Pay a visit to the foot surgery message board for info on surgery in general.

Re: Endoscopic Plantar Fasciotomy

BrianG on 9/18/02 at 21:09 (095668)

Hi Leon,

Did these fine doctors bother to tell you what would happen to your heel / foot after the surgery? Did they mention that the fascia pretty much holds up the whole body? Do you know what you should be doing for the rest of your life, if you have this surgery? Will you be able to talk with any patients they cured? And lastly, did they tell you it hurts like hell, you will have a hole cut through your heel!! Took me 2-3 months to heal, after my 'failed' EPF. So, I'm probably not a very good patient to give you a nice rosey report. Look into it carefully, it is falling out of favor with many Pods. Do some research, find out why!!

BrianG

Re: Endoscopic Plantar Fasciotomy

Julie on 9/19/02 at 01:11 (095689)

Leon

I agree with Nancy and Brian. And wouldn't you be suspicious of doctors who ADVERTISED surgery???!!! I would run a mile, even if I didn't know what I know about EPF from this website.

It really bugs me how doctors can mislead people about these 'painless', minimal-recovery-time endoscopic procedures - and not just for PF. When an instrument is inserted into your body and moved around inside, it disturbs tissues. Period. That is not painless.

Please do your research.

Re: Endoscopic Plantar Fasciotomy

Necee on 9/19/02 at 13:29 (095729)

Leon, my cousin had this type of surgery, and she is still in pain everyday. I would not recommend it at all.
Read all you can...and ask questions about various types of therapy, take the conservative approach....surgery should always be a last resort.

Happy trails....

Necee

Re: Endoscopic Plantar Fasciotomy

Leon S. on 9/19/02 at 18:19 (095765)

Wow! I appreciate the response. Just to set the record straight, I wasn't contemplating it but was interested to know more about it. I wasn't aware that many people had the precedure and that was why I put it out, to get more input. That's the value of these boards.

Re: Endoscopic Plantar Fasciotomy

Ed Davis, DPM on 9/21/02 at 10:19 (095900)

Julie:

I am sort of surprised that there are still docs advertising this surgery -- sort of a 1980's 'thing.'

By the way just as I finished an ESWT treatment (Ossatron) yesterday, one of the OR nurses came up to me complaining that her pod prohibited her from doing yoga due to PF. I told her that was nonesense and asked her to come to this website and ask for you. Unfortuneatly, I don't remember her name since things wer farily hectic yesterday.
Ed

Re: Yoga

Julie on 9/21/02 at 16:18 (095914)

Ed

I guess her pod was being cautious. Truthfully, I don't blame him. There are styles of yoga that would be altogether unsuitable for someone with PF - these tend to be the stronger, more aggressive styles that are popular now and they may be the only ones he is familiar with.

But there is much that would be suitable for her and I'll be glad to talk to her if she comes around.

Re: yoga shoe

Ed Davis, DPM on 9/21/02 at 21:18 (095928)

Julie:

The main reason her pod did not want her to do yoga was because he did not want her to do any barefoot exercises.

By the way, Nike has just come out with a 'yoga shoe' called the Nike Air Kyoto. I don't have any specifics on it. Nike usually does not have a good repoire with professionals as they are concerned about criticism.
Ed

Re: Barefoot yoga, and Nike shoe

Julie on 9/22/02 at 02:06 (095936)

Ed

He was right about that, and it's true that yoga is normally practised barefoot. But exceptions can be made. When I've had students with PF, I've insisted they wear their trainers while doing standing work, or Birkenstocks if they have them, as I did myself when my PF was active (and still do if I'm going to be standing for any length of time).

If she explains that she has to wear shoes because of PF, she should be able to judge by the teacher's response whether or not s/he is trustworthy and caring teacher, or just a demonstrator of postures.

Re 'yoga shoe' - sounds like Nike is just being Nike, and trying to get into yet another profit-reaping niche, doesn't it?

Re: Barefoot yoga, and Nike shoe

Leon S. on 9/22/02 at 12:51 (095957)

For some reason I am getting these latest threads as emails even though they don't refer to any of my messages. Could it be because my name is at the top of this grouping? Is there a way to prevent it? Nothing personal.
Leon

Re: Barefoot yoga, and Nike shoe

Julie on 9/22/02 at 15:18 (095968)

Leon, I think the way it works is that if you start a thread, and include your email address, you will then receive as an email every post that appears on that thread. If you want this to stop, you just remove your email address from the email box next time you post.

Re: Barefoot yoga, and Nike shoe

john h on 9/23/02 at 13:35 (096016)

I am of the opinion there is no one treatment that is going to work for all or even most of us. It is just trial and error until you hit upon some combinations that make your feet feel better. What may make one person better will make another person worse. I was in Florida when I read the brief article on ESWT studies conduted in Australia. I took note of the fact that the Doctor from Mass General who wrote the article said he would continue to use ESWT. As I have often commented my believe is that we all got to our PF condition in a different manner and if we are to improve or be cured we will take different paths.