What scar tissue mobilization techniques and non-physical therapy related rehab can be done at home 6 weeks after a right open plantar fascial release with ostectomy of calcaneus?

Home-Based Scar Tissue Mobilization and Rehabilitation After Plantar Fascial Release with Calcaneal Ostectomy

At 6 weeks post-surgery from right open plantar fascial release with ostectomy of calcaneus, the patient should begin gentle scar tissue mobilization techniques and progressive weight-bearing exercises to optimize healing and prevent complications.

Scar Tissue Mobilization Techniques

• Begin gentle scar massage using circular motions with the thumb or fingers to prevent adhesions and improve tissue mobility. Start with light pressure and gradually increase as tolerated 1.
• Apply moisturizing lotion or vitamin E oil during massage to improve skin elasticity and reduce scar tightness 2.
• Perform cross-fiber friction massage perpendicular to the scar line for 3-5 minutes, 2-3 times daily to break down excessive scar tissue formation 3.
• Use silicone-based scar sheets or gel at night to help soften and flatten the surgical scar 1.

Non-Physical Therapy Home Rehabilitation

Progressive Weight-Bearing Activities

• Gradually increase weight-bearing activities as tolerated, being careful not to progress too quickly to avoid complications such as bony stress reactions of the calcaneus 1.
• Begin with short duration standing and walking activities, gradually increasing time and distance as pain allows 4.

Foot Strengthening Exercises

• Perform towel curls: place a towel on the floor and use toes to scrunch it toward you, 3 sets of 10 repetitions daily 5.
• Practice toe spreading and toe tapping exercises to improve intrinsic foot muscle strength 5.
• Roll a frozen water bottle or tennis ball under the arch of the foot for 3-5 minutes to help with desensitization and gentle stretching 5.

Range of Motion Exercises

• Perform gentle ankle circles in both directions, 10-15 repetitions, 3 times daily 5.
• Practice active ankle dorsiflexion and plantarflexion exercises within pain-free range 5.
• Gently stretch the plantar fascia by pulling the toes toward the shin while keeping the ankle in neutral position 5.

Important Considerations and Precautions

• Avoid aggressive stretching of the plantar fascia in the early post-operative period to prevent disruption of the surgical site 3.
• Monitor for signs of lateral column pain, which may indicate excessive stress on the lateral foot structures due to altered biomechanics after surgery 1, 2.
• Use supportive footwear with adequate arch support to maintain proper foot alignment during the rehabilitation process 4.
• Consider using a night splint to maintain ankle dorsiflexion and prevent morning pain and stiffness 5.

Progression Timeline

• Weeks 6-8: Focus on gentle scar mobilization and basic range of motion exercises 1.
• Weeks 8-10: Progress to more active strengthening exercises and increased weight-bearing activities 4.
• Weeks 10-12: Begin more functional activities including longer duration walking and balance exercises 4.
• After 12 weeks: Consider return to more demanding activities as tolerated, with continued attention to proper footwear and biomechanics 3.

When to Seek Additional Medical Attention

• Persistent or increasing pain despite following the rehabilitation protocol 1.
• Signs of infection including increased redness, warmth, swelling, or drainage from the surgical site 1.
• Development of new pain in the lateral column of the foot, which may indicate altered biomechanics 1, 2.
• Inability to progress with weight-bearing activities after 8-10 weeks post-surgery 4.