What it is

The plantar fascia is a thick band of tissue that runs along the bottom of the foot, from the heel to the toes, supporting the arch. It can become inflamed or develop small tears due to overuse, leading to plantar fasciitis.

Plantar fascia release is a surgical option for persistent plantar fasciitis that has not improved with long courses of rehabilitation. The procedure partially releases the fascia to reduce strain at its attachment to the heel, thereby reducing tension and pain.

This procedure can be performed via an open surgery with a larger incision or a minimally invasive keyhole (endoscopic) technique. While endoscopic release is more common, combining it with calf muscle lengthening can be more effective for persistent cases. The surgery is typically a day case, often followed by physiotherapy and the use of a CAM boot for weight-bearing.

Most people improve without surgery. Selection of a suitable candidate is essential to protect the arch function.

What happens when it occurs

A portion of the fascia is released. Early walking is protected while the foot adapts to the new position. Strength and gait training restore support from muscles and tendons.

Common causes and risk factors

  • Persistent heel pain despite sustained rehabilitation
  • Tight calves and reduced ankle dorsiflexion
  • High standing or walking workloads on hard surfaces

Who is most affected

Adults with recalcitrant plantar heel pain. Surgery is for people with severe or chronic plantar fasciitis who haven't responded to non-surgical treatments for at least 9-12 months.

Typical symptoms preop

  • Morning or start-up heel pain at the inside attachment of the fascia
  • Pain with prolonged standing or walking
  • Tenderness with palpation

When to seek care

After surgery, seek review for fever, wound change, calf pain, or increasing arch collapse.

How we diagnose

Clinical assessment with ultrasound when needed. Careful selection confirms the failure of non-surgical care and rules out nerve entrapment.

How is it performed?

  • Endoscopic (keyhole) release: A small incision is made on the side of the heel, and an endoscope (a small camera) and a special instrument are inserted to release the fascia under direct vision.
  • Open release: A small cut (around 3cm) is made on the inner side of the heel to release the fascia from the heel bone.

What happens during the procedure?

  • A local anaesthetic and/or general anaesthetic is administered.
  • The surgeon makes one or two small incisions to access the fascia.
  • Using an endoscope and specialised tools, the surgeon cuts a portion of the tight medial band of the plantar fascia.
  • Nerve release may also be performed if small nerves are trapped.

Post-operative care

  • Patients typically go home the same day.
  • A CAM boot may be used for 0-2 weeks to protect the foot.
  • Physiotherapy and rehabilitation are required for several weeks to months to ensure a full recovery.

Management

  • Early protected walking, swelling control, and a gentle range
  • Progressive calf and intrinsic foot strength
  • Gait and footwear review with gradual return to distance and hills
  • Orthoses trial during higher loads if comfort improves

Rehabilitation milestones

Phase 1 weeks 0 to 2: protected walking, pain control, gentle range.

Phase 2 weeks 2 to 6: strength basics for calves and intrinsics, balance.

Phase 3 weeks 6 to 12: walking distance goals, graded hills, light jog trials if suitable.

Phase 4 months 3 to 6: return to chosen activities.

Readiness to progress

  • Morning pain trend down
  • Strength and balance within 90 per cent
  • Walking and jogging trials without a next-day flare

Long-term care

  • Maintain calf and intrinsic strength
  • Match footwear to terrain and workload
  • Monitor training spikes in distance and hills

Australia snapshot

  • Surgery is uncommon and reserved for persistent cases
  • Rehabilitation and footwear changes are widely available and effective for most
  • Public and private pathways offer day surgery when required

Latest insights

Surgery reduces strain on the fascia. Muscles must take up the work. Train them well.

A strong calf and strong foot reduce recurrence and protect the arch.

Frequently Asked Questions

During plantar fascia release surgery, your orthopedic surgeon partially cuts the plantar fascia ligament to loosen tension in the tissue band. If a bone spur is contributing to your discomfort, the surgeon may also remove it. This outpatient surgery may be performed using an open incision on the bottom of the foot.

Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by prolonged periods of standing or when getting up from sitting.

A partial release aims to preserve arch function. Strength training supports the remaining structures.

The recurrence of plantar fasciitis after surgery is relatively low. Most patients do not experience the return of severe symptoms, provided they follow proper post-operative care and preventive measures.

Protected walking begins early, as advised. Distance and hills are built in steps.

Crocs can be a good choice for people with plantar fasciitis due to their thick, supportive soles and roomy toe box. However, they should be worn in moderation as they don’t provide sufficient arch support for long periods of standing or walking.

Plantar fasciitis is often caused by a lack of arch support, which puts stress on the plantar fascia—the tissue that connects your heel to your toes. Birkenstock’s arch support helps relieve this strain and reduce pain by protecting the plantar fascia from excess stress.

Use them if they clearly improve comfort during higher loads. Keep training your foot either way.

When it comes to your feet, being overweight is associated with a condition known as flat feet. Flat feet, in turn, put a strain on the plantar fascia, resulting in chronic plantar fasciitis. Unfortunately, when you’re overweight and have heel or foot pain, exercising and losing weight aren’t easy.

Yes, once walking is comfortable and strength and balance targets are met.

Review training spikes, footwear, and strength. Most recurrences can be settled with a clear plan.

Increasing numbness, swelling, or arch collapse needs review.