Shockwave Therapy for Plantar Fasciitis in Lake County

We Have a Real and Proven Treatment. You Probably Wouldn't Be Reading This If You Didn't Have Plantar Fasciitis, so Don't Waste Your Time or Money on Orthotics or Injections (Which Probably Won't Work as Well).

Most people learn about non-surgical extracorporeal shockwave therapy after experiencing chronic and painful plantar fasciitis. Most of these people have tried orthotics, injections, or physical therapy in the past, and may have tried massage or some type of brace as well. If that sounds like you, then you're probably in the right place.



We purchased our first shockwave machine in 2020 and have been extremely impressed by the results we consistently get. Our typical patient is usually referred to us by frustrated local physical therapists, podiatrists, and medical doctors. When they can't get results with their methods, they send their tough cases to us for shockwave therapy. 

Shockwave therapy is a pretty confusing term. It kind of sounds like ultrasound, but it isn't. It is officially named Extracorporeal ShockWave Therapy (ESWT), also known as Extracorporeal Pressure Activation Technology (EPAT), or Acoustic Wave Therapy (AWT). To make things more confusing there are two types: Focused, and Radial.

Don't worry about the name. This non-surgical therapy essentially breaks up scar tissue and stimulates tendons to grow and heal. This is accomplished by pulsing a very short but very strong pressure wave into the tissue. This rapid increase and decrease in pressure causes a deep stretching which loosens tough tissue and causes tiny blood vessels to grow into the tissue. Essentially, shockwave therapy is a very advanced form of massage and regenerative medicine.



The basic idea is that a chronic tendon, ligament, or fascia injuries don't heal on their own. Traditionally, surgery would be used to cut out the damaged part and rejoin the undamaged parts.



Scockwave therapy is a treatment which causes the small tears in the plantar fascia to heal. This should relieve pain and improve your ability to walk. The image below shows how the therapy works. It is very simple and very tolerable.

The worse the better. This is important! Shockwave therapy works best for chronic foot or heel pain. The best course of action for the first episode of plantar fasciitis is simple rest and ice. Research suggests that plantar fasciitis which fails to resolve on it's own or continues to impair your activities will respond well to shockwave therapy.



Many of our patients are unsure if their pain is due to plantar fasciitis, a heel spur, some type of joint issue, or even a fracture. The good news is that shockwave can be used to treat all of these. Even though we do not treat fractures with shockwave, it has been shown to increase the healing rate of fractures.


An ideal shockwave therapy candidate has either struggled with ongoing plantar fasciitis or has failed to get improvement with other treatments. There are studies which show that shockwave therapy is more effective than cortisone/steroid injections, stretching and exercise, and even surgery. We work with patients who are frustrated that one of their prior doctors hadn't suggested shockwave therapy even though their $1,000+ treatments didn't work.



We believe that shockwave works best when it is paired with an active rehabilitation program to improve foot, ankle, and general leg strength and mobility. There are several excellent local physical therapists we can refer you to, if you are interested in maximizing your treatment.

 

• Shockwave therapy works best on chronic plantar fasciitis. 
• It works by accelerating the healing process and allowing chronic injuries to finally heal.
• Rehabilitation programs for improving foot and leg biomechanics can be done at the same time.

 

Shockwave therapy takes 5-10 minutes per session. Most patients require an average of six visits, which is what we recommend for plantar fasciitis. Treatment is performed once per week. The majority of patients experience a significant reduction in pain and they are able to return to sports or increased activity within 8 weeks of their first treatment. Some patients experience a significant improvement after their first session.



When being treated with shockwave therapy, a patient lies face down on a table. The symptomatic foot is raised slightly in the air and the shockwave applicator is placed over the damaged area of the plantar fascia. The unit is activated and begins to produce between 4 and 20 shockwaves per second, depending on the patient's tolerance. The intensity of the shockwaves can be adjusted from very light to extremely strong. The first session is generally spent familiarizing the patient with the treatment so they know what to expect during their second treatment.



Once a patient is comfortable with the pressure, the applicator is slowly moved around the area of pain. This part of treatment is very interesting. In most cases, a patient can identify the exact point which is responsible for their pain. It may be very painful at first. Once this point is located, the applicator is held there for 20-40 seconds. During this time the pain in this area will reduce to a very mild level. This is one of the potential benefits of radial shockwaves. Patients can help to identify the exact area of pain. This does not happen with the other type of shockwaves (focused) which require local anesthesia.

Shockwave therapy works by inducing "mechanotransduction" in the plantar fascia. The concept of mechanotransduction is simple; when a tissue experiences a particular type of physical stimulation, it responds by producing some sort of change. A familiar example is resistance exercise. When a muscle is subjected to a strong stretch microtears occur in the muscle and it responds by growing larger and stronger. Connective tissue like the plantar fascia, tendons, and ligaments are not the same as muscles and cannot be easily induced to grow though simple stretching, massage, or manual therapies.



The rapid pressure wave produced by a shockwave machine creates very short bursts (1/10,000th of a second) of very high pressure. This rapid increase in pressure creates a short negative pressure which essentially expands the tissue from the inside-out. The animation above demonstrates this. An ultra high-speed video shows the creation of tiny cavitation bubbles. These bubbles form in water when an extremely high and short pressure pulse moves through it.



The end result of this mechanotransduction is the generation of the healing response. Tiny blood vessels begin to grow into the tissue. Growth factors similar to growth hormone are released from the treated tissue. Tough scar tissue is physically loosened which reduces focused and repetitive tearing at the site of the injury.

According to a study published in Pain Medicine titled "Extra Corporeal Shock Wave Therapy Versus Local Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis, a Single Blinded Randomized Clinical Trial" shockwave therapy is safer, requires less rest, has less risk, and has better long-term results.



Corticosteroid injection requires a period of rest after administration, while radial ESWT has benefits of no immobilization and early return to work. Although pain occurs during the therapy session in both treatments, the pain during injection is greater than pain in radial ESWT.



Corticosteroid injection, and mainly multiple injections, may cause rare complications such as plantar fascia rupture, fat pad atrophy, medial plantar nerve injury secondary to injection, or calcaneal osteomyelitis.



There is a high frequency of relapse and recurrence following treatment with corticosteroid. In addition, some previous studies indicate better long-term efficacy for ESWT, but not for corticosteroid injection.



Browse some of the research articles listed at the bottom of this page if you are interested in the hard science behind shockwave therapy. It consistently proves to be more effective than standard treatments, especially in chronic cases.

Find Out If You Are A Candidate For Shockwave Therapy

The process for determining whether you might benefit from shockwave therapt starts with a short examination with Dr. Ryan Winslow. Luckily, plantar fasciitis is very easy to identify and complicated diagnostic procedures are generally not required. Therapy can be given on the same day as the exam. You can set an appointment through one of the following ways: 



 

• Call us at 224-656-5778 to schedule an appointment. 
• Email us at info@straightupspineandposture.com

 

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