Shockwave Therapy for Plantar Fasciitis
Do you have a case of stubborn heel pain that won’t go away?
Are you suffering from pain over the front of your heel and/or into the arch of your foot that came out of nowhere? Especially pain that feels worse first thing in the morning – and may even feel like you’re stepping onto glass? Then you may have plantar fasciitis.
For some people, plantar fasciitis can be resolved conservatively with a combination of activity modification, pain meds, arch supports, and stretching. Unfortunately, the foot is one of the most challenging areas of the body to rest (especially for those of us who like to stand, walk, or run on it). Approximately 10-20% of plantar fasciitis may develop into more chronic or stubborn cases (1).
Luckily, there’s exciting new research coming out demonstrating that Shockwave Therapy can help those with chronic plantar fasciitis (as well as tendinopathies and even breaking down calcium deposits in Calcific Tendinitis; 2,3,4)!
In conjunction with stretching the plantar fascia and calf, Shockwave Therapy is not only effective in decreasing pain, increasing weight bearing tolerance, and improving function (5, 6, 7, 8), but it can help treat chronic plantar fasciitis FASTER than conservative physiotherapy treatment alone (7).
Even more good news is that BOTH Thrive Now Physiotherapy Clinics have Shockwave Therapy machines.
What’s Shockwave Therapy & How does it work?
Technically, the term “shock” may be a little misleading… A Shockwave device does NOT actually give you electrical shocks. Instead it acts like a mini-jackhammer creating pressure waves (at approximately 5-10 times per second) that help stimulate healing in your tissues (9).
Initially after an injury, the body goes into an active “seek & repair” mode, resulting in inflammation (and all the uncomfortable symptoms that go with it including pain, redness, heat, and swelling) as well as thickening of the tissue.
However, if the tissue continues to get stressed (by doing too much, too soon) over a long period of time without allowing enough time to repair itself, it can go into a state of disrepair/degeneration or “limbo” (10, 11). This “limbo” state is where the tissue is not actively in a healing mode, but it’s not entirely healed either. The pressure waves from the Shockwave device help “re-boot” the system and restart the “seek & repair” mode. It improves blood flow to the region and increases local cellular activity (9).
What does it feel like?
Most patients report the sensation of light to moderate tapping with a numbing effect afterwards. Feel free to let your physiotherapist know if the tapping is too strong – as the intensity can be adjusted to make it more comfortable.
Contact us here at Thrive Now Physiotherapy (Duncan – 250-856-0531 Or Cobble Hill – 250-743-3833) if you would like to find out more about how Shockwave therapy can get you back up and running!
1) Schmitz C et al. (2013). Treatment of chronic plantar fasciopathy with extracorporeal shock waves (review). J Orthop Surg Res 8(1): 31. Accessed May 2/2021: https://josr-online.biomedcentral.com/articles/10.1186/1749-799X-8-31
2) Kolk A et al. (2013). Radial extracorporeal shock-wave therapy in patients with chronic rotator cuff tendinitis: a prospective randomised double-blind placebo-controlled multicentre trial. Bone Joint J 95-B(11): 1521-1526. Accessed May 2/2021: https://pubmed.ncbi.nlm.nih.gov/24151273/
3) Dedes V, Stergioulas A, Kipreos G, Dede AM, Mitseas A, & Panoutsopoulos GI (2018). Effectiveness and Safety of Shockwave Therapy in Tendinopathies. Materia socio-medica, 30(2), 131–146. Accessed May 2/2021: https://doi.org/10.5455/msm.2018.30.141-146.
4) Ioppolo F et al. (2012). Extracorporeal Shock-Wave Therapy for Supraspinatus Calcifying Tendinitis: A Randomized Clinical Trial Comparing Two Different Energy Levels. Phys Ther 92(11): 1376-1385. Accessed May 2/2021: https://academic.oup.com/ptj/article/92/11/1376/2735105
5) Aqil A et al. (2013). Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Clinical Orthopaedics and Related Research 471(11): 3645-3652. Accessed Apr 30/2021: https://journals.lww.com/clinorthop/Fulltext/2013/11000/Extracorporeal_Shock_Wave_Therapy_Is_Effective_In.40.aspx
6) Ibrahim MI et al. (2010). “Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy.” Foot Ankle Int 31(5): 391-397. Accessed May 2/2021: https://www.researchgate.net/publication/44589796_Chronic_Plantar_Fasciitis_Treated_with_Two_Sessions_of_Radial_Extracorporeal_Shock_Wave_Therapy
7) Grecco MV, Brech GC, & Greve JMD (2013). One-year treatment follow-up of plantar fasciitis: radial shockwaves vs. conventional physiotherapy. CLINICS;68(8):1089-1095. Accessed May 2/2021: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752632/pdf/cln-68-08-1089.pdf/?tool=EBI
8) Dizon JN et al. (2013). Effectiveness of extracorporeal shock wave therapy in chronic plantar fasciitis: a meta-analysis. Am J Phys Med Rehabil 92(7): 606-620. Accessed May 2/2021: https://www.researchgate.net/publication/236103374_Effectiveness_of_Extracorporeal_Shock_Wave_Therapy_in_Chronic_Plantar_Fasciitis_A_Meta-analysis
9) Watson, T. (2015) Shockwave Therapy. Accessed May 2/2021: http://www.electrotherapy.org/assets/Downloads/shockwave%20may%202015.pdf
10) Cook JL & Purdam CR (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med;43:409–416. doi:10.1136/bjsm.2008.051193
11) Lemont H, Ammirati KM, & Usen N (2003). Plantar Fasciitis: A Degenerative Process (Fasciosis) Without Inflammation. J Am Podiatr Med Assoc 93(3): 234–237. https://doi.org/10.7547/87507315-93-3-234. Accessed Apr 30/2021: https://meridian.allenpress.com/japma/article-abstract/93/3/234/205771/Plantar-FasciitisA-Degenerative-Process-Fasciosis?redirectedFrom=fulltext