Many clinicians have focused on the plantar fascia when presented with complaints of pain under the heel. Still, sufficient evidence now exists to indicate that the plantar fascia is not the only culprit. The term “plantar heel pain” (PHP) is often used to describe the condition of pain under the heel where no differential diagnosis exists. The calcaneal (heel) bone is the largest bone in the foot and is specifically adapted to sustain high tensile, bending, and compressive forces, especially during weight-bearing.
Heel Pain is associated with a range of foot-level factors such as:
-pronated foot type
-limited ankle joint dorsiflexion
-first metatarsophalangeal joint (Big Toe) dorsiflexion
-reduced muscle strength in the foot and the ankle
There are two categories of patients with PHP: those who don’t know if they have heel spurs causing their plantar heel pain and those who know but haven’t found their solution YET.
As for the former, you should get a thorough examination by sports-based clinicians like us! We evaluate and treat foot and heel injuries all the time and can put your mind at ease about what's causing your plantar heel pain. It could be a heel spur or something else contributing to your plantar heel pain. We all know a friend or family member who claims they suffered from heel spurs for 10 years but has never gotten imaging or been properly examined (Youtube/TikTok doesn’t count lol). One of the benefits of seeing us is that we could refer you for an X-ray if needed to confirm which only costs about $50.
For many people who have foot pain due to heel spurs, it can be frustrating that it hasn’t resolved over time. Some have maybe even tried resting it, medication, or random exercises hoping it goes away. Shockwave therapy has been incredible for our patients in not only pain symptoms but also improving their day-to-day functionality and quality of life. Shockwave uses acoustic sound waves produced by the applicator that physically penetrate the tissue to help “break down” irritated tissue, scar tissue, and/or calcium deposits.
Although it sounds bad at first, the pro-inflammatory process essentially provides an opportunity for the body to re-boot the natural healing process by slightly breaking down the tissue from the trauma of the acoustic waves. To paint a better picture, imagine an explosion and the wave you see that follows afterward. This wave may break down the building, but a bigger and better building will soon follow. Also, the answer is yes. The shockwave does feel like a slight mini-explosion.
How We Incorporate Shockwave
In our office, following appropriate evaluation and diagnosis, the shockwave is used prior to starting the physical rehabilitation component to help with increasing the range of motion and decreasing pain so that the rehab that follows will not be as difficult.
There are a variety of intensity and speed settings depending on the condition, but after about 2-3 minutes, the results and relief will speak for themselves. Studies have shown that between 80 and 90 percent of patients report reduced pain and inflammation, while up to 30% of patients show a reduction in the protrusion of bone spurs after repeated treatments. Utilizing this in combination with our multi-modal approach, and spending 60 minutes with patients gives them the dedicated time they need to fully address the root cause of this injury. There is no better feeling than helping someone who doesn’t think their heel pain can get better and hearing how shocked they are by the results when they start working with our team.
If you're interested and want to know more about how we can help your plantar heel pain effectively, go to strengthchiro.com and schedule your FREE Discovery visit or your New Patient appointment!