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EPF Surgery and Arch Problems

Posted by Ellen D on 4/05/04 at 12:53 (148422)

I had EPF surgery a year ago, after all conservative treatments had failed. My podiatrist said that the procedure was a complete success. He also said that my PF was very tight and also that I had a high arch. Since I had the procedure, the arch on that foot has been very tight and that part of my foot feels 'thick'. The first few steps in the morning and also when I have been sitting for a while are very uncomfortable - not really like the true pain of PF, but not pleasant nonethess. I saw the podiatrist 6 months after the procedure and he said that my arch might still be adjusting and that perhaps I was just too focused on it. I'm wondering if this is normal and if it's likely that it will go away or I'll just have to live with it. Truly, the pain is nothing at all like what I was experiencing pre-surgery (and I would do the surgery again), but I'm just curious if this is to be expected or if I should schedule an appointment with my podiatrist (or maybe another one for a second-opinion type discussion) for further treatment.

Re: EPF Surgery and Arch Problems

april l on 4/05/04 at 13:14 (148423)

Hmmmm, I seem to have a similar problem after having my second EPF (other foot). Do you feel a painful pulling when you put your weight leaning towards your big toe? That's where I feel it most, on the upper inside of my arch, under my big toe. I had surgery 7 months ago, and it's getting better slowly. I am getting a night splint in a few days to help stretch it. This is something I don't remember happening when I had EPF on my other foot 7 yrs ago. I will say that it took well over a year for that surgery to completely heal, I had pain for a long time and now have no pain in that foot. Initially, I believed that surgery was a failure, but now it is 100% better.

Re: EPF Surgery and Arch Problems

Ellen D on 4/05/04 at 17:58 (148441)

I would have to say that my arch problem is more in the middle - not really in the area of the big toe and, if anything, sort of extends outward to the outside of my foot. Many posts here seem to suggest that it takes 'up to a year' for things to completely work out, and, since I'm now at that point, I'm trying to figure out whether it's a done-deal as is, or whether I should be seeking further improvement.

I'm glad your experiences with this type of surgery have been utlimately good - hopefully that's where I'm headed too.

Re: EPF Surgery and Arch Problems

Juby on 4/06/04 at 15:34 (148486)

Sounds like maybe you have a scar tissue problem, if it feels thick where the fascia was cut. I just had surgery to remove mine two weeks ago. So far it feels pretty darn good. Hope this helps.

Re: EPF Surgery and Arch Problems

Ed Davis, DPM on 4/06/04 at 23:38 (148504)

I am surprised to see conservative treatments fail; what type of ESWT did you have?

Make sure that you have appropriate orthotics to wear since by cutting the plantar fascia an important supporting structure has been sacrificed and it must be compensated for somehow.

Re: EPF Surgery and Arch Problems

Ellen D on 4/07/04 at 17:34 (148550)

When I had this surgery, I had never even heard of ESWT, and it wasn't mentioned to me, so I went from resting and stretching and icing to wrapping to ultrasound to injections (the conservative treatments) over the course of a year. I guess I should have been more proactive in research, but I was in a LOT of pain (could hardly walk) and had an extended vacation planned for 12 weeks from the time I had surgery and was assured that everything would be fine by then. Truthfully, my foot is MUCH better and I don't regret the surgery - I was just wondering if I should pursue anything with this arch issue -or maybe it's just one of the possible outcomes. Unlike my prior pain, this is something I can live with.

I have worn othotics full time for 13 years (got a new pair a couple of years ago)and continue to do so at all times - so I think I'm getting the best support possible, and I wear 'sensible' shoes.

Thank you for taking the time to reply. Your perspective is appreciated.

Re: EPF Surgery and Arch Problems

Dr. Z on 4/07/04 at 17:37 (148551)

Sometimes after the pf is cut you change the function and shape of the foot. May have to have a new cast made and another pair of orthosis. Could help. Does taping help you arch pain?

Re: EPF Surgery and Arch Problems

Ellen D on 4/08/04 at 11:25 (148588)

Thank you for the suggestion about the possibility of new casts - that does make sense and I'll pursue that. As far as taping - I did tape the arch (just wrapping the tape around that part of the foot - I guess that is how it should be done) for about 2 or 3 months and seemed to think it might be helping. However, I haven't done it for about 3 weeks now and things really seem to be about the same with or without the tape. Maybe the taping just made it seem that the arch was getting some additional support.

Re: ? about casting process

Angela A. on 4/10/04 at 12:12 (148656)

Regarding casting for orthotics. Should your foot be in a neutral position or should you be standing when the casting process is done? I've heard different opinions about that.

Re: ? about casting process

Lisa H on 4/11/04 at 23:04 (148726)

The way they did mine was to have me sit on the chair/bed with my feet dangling off the edge and my toes spread. The nurse wrapped each foot in gauze that had some kind of plaster in it. After it dried, they slid off like slippers.

Re: EPF Surgery and Arch Problems

Joe B. on 4/13/04 at 11:54 (148807)


I have experienced the same problem. I had EPF in January of 2003, and while I have no more pain in my heel, I have nagging pain throughout my
arch when I walk. It feels like it is constantly being overstretched.
I wear a night splint, and it helps. The pain in the morning is less.
Some nights if I get up to go to the bathroom, take the splint off (walking is tough) and neglect to put it back on when I go back to bed, I feel the difference in the morning. So I know the splint is treating teh symptom, if not the problem.

It may never go away completely, but I feel like you do: What I have now is way better than it was before the surgery. I hope this helps.

Joe B.

Re: ? about casting process

john king on 4/13/04 at 15:59 (148820)

You know what I think? Some people have the surgery and get better, some worse and some remain the same. Surgeons are good at setting bones and taking out gall bladders. Other than that I am not so sure. Everyone seems to have residual problems after these PF or TTS surgeries. Why go through that misery if it is not 90% sure thing and you get major benefit? JMO since I have had shoulder and wrist surgery with little benefit.

Re: ? about casting process

Ed Davis, DPM on 4/14/04 at 16:04 (148887)

Most standing techniques involve a 'capture' of the position which causes the problem (with some exceptions). Generally, one is trying to capture an optimized position of the foot so a cast is made of a foot which is manipulated into a partially corrected position.

Re: EPF Surgery and Arch Problems

EKC on 4/19/04 at 08:08 (149123)

When I started walking again after my 2nd surgery, I felt like my arch wasnt stretching (or something). My feet/arches would fatigue very quickly when I walked. And I kept feeling something tightening up in there. Ive had a massage therapist working on it once/week for about 3 months. She found it, I could not. She has done a very good job loosenign up what I think is scar tissue. It was toward the outter side of the arch, not the inner. Im up to 25 min on my feet (yeah, 0 to 25 min in ~1.5 years, literally) and dont feel that tightening anymore.

Re: EPF Surgery and Arch Problems

Buck T. on 5/04/04 at 15:40 (150024)

Hi April. Had pf surgery little over a year ago and am doing okay but still having problems just getting over surgery. Area behind incision area still sore at times. Physical therapist thought by this time foot would not improve more (year after surgery).

So, I was interested that you said it took you well over a year to feel good.
Can you give me more insight into this? Maybe how long it took to feel really better, what you did to help recovery. Any advice appreciated.

Thanks, Buck

Re: EPF Surgery and Arch Problems

april l on 5/04/04 at 21:47 (150042)

Well, it's hard to say when I finally healed to 100% because it was so very gradual. I do remember that 15-16 mos. after surgery I was still feeling some pain and I resigned myself to the conclusion that it was a failed surgery. But it wasn't because I have no pain at all in that foot now. And I also had a lot of pain at the incision site as well as a lump of scar tissue. That also went away. The doctor who did my first surgery did not tell me how long it really takes to heal. I wish he had because I would've been more patient. A week after the surgery he said I shouldn't feel pain anymore and I was in severe pain.

Re: EPF Surgery and Arch Problems

Pauline on 5/05/04 at 14:47 (150089)

I guess that's the snip and go surgery that patients are promised. The only problem is, there isn't any snip and go surgeries unless perhaps you are piercing belly buttons.

Glad to see you had positive results after all you've been through.

Re: EPF Surgery and Arch Problems

Buck T. on 5/06/04 at 16:07 (150139)

Thanks April. Did you massage the scar site and the scar tissue? I keep massaging area but sometimes feel like maybe I shouldn't. Thanks,


Re: EPF Surgery and Arch Problems

april l on 5/06/04 at 23:47 (150168)

Yes I did a lot of massage to try to break up the scar tissue.

Re: EPF Surgery and Arch Problems

Buck T. on 5/07/04 at 13:50 (150197)

Thanks for answering, April. Think I need to be patient. Glad you are doing so great.