Plantar Fasciitis / chronic patellar tendinopathy treatment

[yippikiyo]

In a study I found while searching for non-invasive treatments for some common over-use knee and foot problems I learned of this very hopeful treatment for plantar fasciitis and patellar tendonitis.

Below is an excerpt from the study summary on platar fasciitis.

yippikiyo

BACKGROUND: Extracorporeal shockwave treatment has shown mixed short-term results for plantar fasciitis. However, the long-term results are not available. HYPOTHESIS: Long-term results of shockwave treatment are comparable with short-term results. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. METHODS: This prospective study consisted of 149 patients (168 heels) with an established diagnosis of chronic plantar fasciitis, including 79 patients (85 heels) in the shockwave treatment group and 70 patients (83 heels) in the control group. In the shockwave group, patients received 1500 impulses of shockwaves at 16 kV to the affected heel in a single session. Patients in the control group received conservative treatment consisting of nonsteroidal anti-inflammatory drugs, orthotics, physical therapy, an exercise program, and/or a local cortisone injection. Patients were evaluated at 60 to 72 months (shockwave group) or 34 to 64 months (control group) with a 100-point scoring system including 70 points for pain and 30 points for function. The clinical outcomes were rated as excellent, good, fair, or poor. RESULTS: Before treatment, the groups showed no significant differences in the scores for pain and function. After treatment, the shockwave group showed significantly better pain and function scores as compared with the control group. The overall results were 69.1% excellent, 13.6% good, 6.2% fair, and 11.1% poor for the shockwave group; and 0% excellent, 55% good, 36% fair, and 9% poor for the control group (P < .001). The recurrence rate was 11% (9/81 heels) for the shockwave group versus 55% (43/78 heels) for the control group (P < .001). There were no systemic or local complications or device-related problems. CONCLUSION: Extracorporeal shockwave treatment is effective and safe for patients with plantar fasciitis, with good long-term results.

[AlanBaljeu]

Originally Posted by yippikiyo

In the shockwave group, patients received 1500 impulses of shockwaves at 16 kV to the affected heel in a single session. Patients in the control group received conservative treatment consisting of nonsteroidal anti-inflammatory drugs, orthotics, physical therapy, an exercise program, and/or a local cortisone injection.

What are shockwaves? Electrical pulses? Do they feel good when applied?

The and/or makes me wonder. Maybe some of these treatments are no good while others are very good. So the study proves that shock therapy is better than the mean effectiveness of good and bad treatments.

In my own case, I learned that PF is caused by excessive walking with insufficient arch support, and cured by SuperFeet insoles.

[Brotzie]

Alan

+1 to cause and remedy from my personal experience too.

I should imagine the shockwaves are more tingly than painful, although 1,500 in one go sounds like it could get quite irritating quite quickly.

For comparison, a typical stun gun is energised to 50kV @ 0.25A. Medical current for this treatment would likely be somewhat lower! Couldn't readily find the output specs for 'slim gym' type muscle toners but I guess they're in the sort of range cited.

[yippikiyo]

I believe the shockwaves are those electric ultrasound machines you may have seen at a physical therapist or chiropractic office. I've received that treatment many times over the years for things such as seized muscles due to car accident to treatment for Bell's Palsy. While it doesn't feel good, it doesn't hurt either. (As a pain tolerance standard, for me getting a tattoo hurts way more) I'm going to ask my chiropractor about this for my knee.

The long term positive effects are what really caught my eye.

For some people simply using SuperFeet or even custom orthotics is not enough. Notice that the control group did use custom orthotic inserts and other common methods of managing the pain. The and/or in this summary indicates that not all control group individuals had all the alternative treatment methods in the same way that you do not use all the alternative treatments for your PF (as using the inserts has worked for you. Note that the test group received only the shockwave therapy and were reporting excellent results even after 5 - 6 years.

In my personal experience with patellar tendonitis, using orthotics is not enough to prevent the pain though perhaps they have kept it at bay these last 7 years I've been wearing them.

For my 13 year old who has virtually no arch (her wet footprint looks like it could have been made by Fred Flintstone), walking more than 5-7 miles even with custom orthotics becomes very painful. My hope is that she will be able to continue enjoying the outdoors as she gets older with the help of this therapy.

yippikiyo

[mogle]

Plantar fasciitis has been a pain for me for almost a year now. Ibuprofin, stretching, and green superfeet haven't helped much. The only shoes I can wear that don't leave me sore at the end of a day are my chaco sandles.

[hoosierdaddy]

Originally Posted by mogle

Plantar fasciitis has been a pain for me for almost a year now. Ibuprofin, stretching, and green superfeet haven't helped much. The only shoes I can wear that don't leave me sore at the end of a day are my chaco sandles.

PF is really cramping my hiking style, too! While custom orthotics help somewhat in my boots and trail runners, I have found these Montrail sandals to be about the most comfortable and supportive sandals I have ever worn!

When I first tried them on at the shoe store, I was heard to exclaim, "Whoa!! That REALLY feels good!"

[OneTim]

After struggling with PF for a while I came across the Medi-Dyne Prostretch Unilateral Stretching System.

It worked better than anything else I tried.

(I have no interest in the company)

[Bluehaus]

I suffer from PF also. I'm currently having a rough go of it. I've tried orthotics and different styles of shoes to no avail. Ironicly, the one pair of shoes that I don't have problems with are my hiking boots with superfeet insoles. PF hasn't bothered my on the trails yet. Go figure!