Plantar Fasciotomy Plantar Fasciitis is the most common cause of localized heel pain. It is an inflammation of the plantar fascia, a ligament structure that supports the long arch of the foot. The plantar fascia is a tough, fibrous band of connective tissue that runs from the heel bone to the ball of the foot. Plantar fasciitis starts as dull, intermittent pain in the heel or arch and progresses to a sharp, persistent pain. The pain usually occurs in the morning or after resting and gradually disappears with walking. Symptoms may also include tightness in the calf muscle. Although it may occur spontaneously, plantar fasciitis is generally caused by repetitive strain, increased activity, athletic activity, running on uneven surfaces, running on heels or balls of feet, flat feet, high arched rigid feet, poor supporting shoes, large sudden weight gain, aging, and/or family history. When conservative management does not work, a surgical procedure called plantar fasciotomy can correct this problem. The physician makes an incision across the long axis of the heel. The affected area is removed or freed from any inflammation inside the tissues. The incision is sutured, dressed and a walking boot is applied. Most plantar fasciotomy surgery is performed under ankle block anesthesia in which the patient is awake but their foot is numb. Occasionally, general or spinal anesthesia is used. Patients should consult their surgeon for a complete explanation of the procedure and its associated risks and complications.