Many of you have asked me about potential treatments you’ve heard about about for chronic plantar fasciitis and other foot ailments. Two that continue to come up in conversation: GS surgery and ESWT.
In short, here is what my experience shows:
Gastrocnemius Slide (GS) surgery, also known as the Strayer Procedure
What It Is: Lengthening the triceps surae or Achilles tendon.
Pros: Potentially, you arrive quicker at your desired result and it requires less effort and diligence on your part. This surgery indeed does address the underlying cause.
Cons: First and foremost, money! Also, the risk involved – which is inherent to any surgery – should be considered (infection, nerve damage, scaring, etc.). But, there are also risks specific to GS, including over-lengthening of the muscle – potentially a real problem; permanent calf weakness; DVT, to name a few. All of these are low incidence, but as they say: you can’t win the lottery unless you play (lose in this case), or when you fall under that 2-3% chance of complication!
Recovery is not easy with the procedure, and 6 weeks immobilization and 2-6 weeks of no weight bearing is what you can expect.
Conclusion: I don’t support the surgery as a primary way of treating plantar fasciitis. For those who fail a bona fide six month course of stretching, and their problem remains recalcitrant, then I would consider this surgery.
Again, it comes down to the fact that stretching fixes the real problem in almost all cases. But it requires patience!
Extracorporeal Shock Wave Therapy (ESWT)
What It Is: Sound waves used to penetrate your heel; some doctors feel it may stimulate the healing of soft tissue and relieve pain.
Pros: Can be considered an alternative treatment to surgery, which has its risks, as mentioned.
Cons: Consistent medical research supporting the efficacy of the treatment is lacking. It’s felt to be legit, but really, only by docs — mostly podiatrists . Another generally unspoken aspect of this treatment is the immobilization, and often rest, required afterwards. It is my belief that if there any improvement with this form of treatment, the immobilization is likely responsible.
The use of ESWT is also used because these docs really have problems helping patients because they do not know or do not accept that the correct treatment is so simple. And they can’t make much jack doing it the right way. That really is the crux of the biscuit for a lot of docs, which guides their practice habits.
Conclusion: This is a classic example of a treatment that falls under the classification of “might help your pain reduction, but is expensive and won’t fix the real problem.”
Finally, show me doctors, orthopaedic surgeons or podiatrists who are doing a fair amount of gastroc lenthenings and/or ESWT and I will show you docs who need the ortho-bling, have alimony payments, or they just enjoy the high life.
When you foot tingles, heavy, and you do not feel anything when you
bump it, but if you are bard foot and step on a pebble, you hit the roof.
..what do you do to stop the pain?.
dear sir i have developed chronic regional pain syndrome after shokwave therapy to my sesamoditis
i do not recommend this violent therapy to anyone
I forgot I even wrote that blog. It is salty is it not. I must have been really angry. I could even be more emphatic now, but your comment does a bit of that for me. ESWT is not benign and makes no scientific sense. Chronic regional pain syndrome (CRPS) is a tough journey. Even though I have a lot of experience with CRPS I will not delve into it here. The one thing I will say is that the root cause is often the continued fuel on the fire. Make sure the sesamoiditis is in check in leu of going down the routine treatment path for CRPS.
Stay healthy my friends,
Hey Gilbert- I developed CRPS after having work done to repair a torn bicep tendon. It really sucked early on but got better over time. Be very careful about developing depression. People that experience this condition have a high rate of suicide. Keep doing the physical/ occupational therapy. The surgery was done on my left arm so of course it was my left hand that developed CRPS.
My hand blew up like a balloon and was VERY sensitive to hot and cold, in fact my whole arm is still.
I couldn’t get the swelling on my hand to go down so I used golfing gloves that were obviously too small for me but they acted as compression gloves and along with acupuncture, I got about 90% of my hand functionality back. It’s still sensitive to hot and cold, but it’s tolerable. Oh and try acupuncture too.
Also, a word of caution- they gave me a sling to rest my arm in and from the my shoulder locked up and I couldn’t raise my hand past my chest.
Now everything is working just fine it was a two year struggle