Shockwave Therapy vs. Physical Therapy for Plantar Fasciitis in Jacksonville

Physical therapy and shockwave therapy address different phases of the same problem. PT addresses the mechanical contributors that caused plantar fasciitis to develop. Shockwave addresses the tissue when it has stopped healing on its own. Both have a role. The question is which is appropriate at your current stage.

Early-Stage Plantar Fasciitis

If your heel pain has been present for less than three months and has not been treated, start with conservative care. Calf flexibility work, intrinsic foot strengthening, load management, gait assessment. Address the mechanical reasons the fascia is being overloaded. Many cases resolve at this stage without any procedural intervention.

When PT Has Plateaued

A loading program works because it stimulates the tissue to adapt. That mechanism requires the tissue to be in a responsive state. After months of chronic plantar fasciitis, the fascia at the calcaneal insertion often transitions into a tendinotic state where it is no longer responding to loading stimulus the way it did earlier. The collagen is disorganized. The tissue is poorly vascularized. Eccentric exercises that should produce adaptation stop producing results.

Shockwave changes the biology of the tissue directly. It stimulates fibroblast activity and collagen synthesis, promotes new blood vessel formation, and restarts the repair process that the tissue stopped running on its own. This is why patients who have completed proper PT programs and plateaued often respond well to shockwave when they would not have responded as well earlier in the process.

One Patient's Path

A runner came to us after completing a 12-week physical therapy program. She had done the calf raises, the towel scrunches, the progressive loading. The PT program was well-designed and she had followed it. Her heel pain had improved significantly and then stopped improving. She still had morning pain of about five out of ten. After five shockwave sessions combined with correction of her ankle mechanics, the morning step pain was gone. The PT had done its job building the mechanical foundation. The shockwave addressed what the PT could not reach.

Call (904) 539-3352 and describe where you are in your treatment history. We will tell you honestly whether shockwave makes sense at your current stage. 13770 Beach Blvd #4, Jacksonville FL 32224.

Written by

Dr. Cody Muren, DC

Doctor of Chiropractic · Certified Acupuncturist