Shockwave Therapy for a Patient Referred by a Podiatrist in Cronulla
A 62-year-old female came to the podiatry centre for shockwave therapy treatment after being referred by her Cronulla podiatrist. Her podiatrist had been taking calfe of her routine foot health problems for many years but more recently was unable to assist with this patients heel pain. The podiatrist in Cronulla had diagnosed plantar fasciitis and had been treating the patient conservatively with stretches and footwear recommendations. However the patient was not improving and therefore her podiatrist referred her to the podiatry centre here in Miranda for shockwave therapy. The Cronulla podiatrist was familiar with shockwave therapy and spoke highly of the treatment but did not possess a shockwave therapy unit in her practice. This patient had been experiencing the symptoms of plantar fasciitis for approximately 6 months and reported all of the typical signs and symptoms of the condition such as heel pain first thing in a morning when rising from bed. The podiatrist did not recommend any imaging such as x-rays or ultrasound but instead advised the patient to change from her day-to-day footwear into more functional running shoes. The patient was diligent and in addition to purchasing new Asics trainers she performed regular calf muscle stretches to improve the range of motion at the ankle joint. Her podiatrist in Cronulla had also advised the patient to apply cold packs to the base of the heel on a daily basis for approximately 20 minutes. The patient reported that this was fairly beneficial and did reduce the symptoms slightly. The patient advised the podiatrist that the calf stretches were beneficial and she was already beginning to feel the benefits however the symptoms of the plantar fasciitis persisted and did not seem to be improving. Interestingly, after this patient had performed her calf stretches she reported an increase in symptoms that would last for approximately 2 minutes. The previous podiatrist in Cronulla had recommended the use of anti-inflammatory medication if the symptoms were too great. The patient found that on some days she was required to take medication just to get through the day.
Follow Up Appointment with the Cronulla Podiatrist
After 8 weeks of rehabilitation with the Cronulla podiatrist , the patient returned to inform the practitioner she was not improving and at this point the Cronulla podiatrist advised the patient that she would refer her to the podiatrist in MIranda for shockwave therapy sessions. The podiatrist carried out a detailed physical and biomechanical assessment and confirmed that the patient did in fact have all the typical signs and symptoms of plantar fasciitis. The patient was given an outline treatment plan and it was explained that she would receive up to six sessions of shock wave therapy. This treatment would stimulate the turnover of new collagen and increase the number of small blood vessels in the heel. Research has shown that over time this promotes the growth of new healthy tissue and accelerates healing. There is also a significant reduction in pain levels with the use of shock wave therapy.
The podiatrist in Cronulla was kept up-to-date with the patient’s progress as the course of shockwave therapy unfolded. The patient reported that her heel pain was approximately 10 to 20% better each week. She explained to the podiatrist that the pain first thing in the morning had significantly reduced and that the recovery time each morning was quicker. She found that once she got moving and had her morning shower the pain in the heel had almost gone completely. However she explained to the podiatrist that late afternoon the dull ache and throbbing sensation would return. The practitioner, in accordance with the Cronulla podiatrist, recommended that the patient apply ice packs to the base of the heel in the afternoon to reduce the inflammatory change and associated discomfort.
After 3 weeks and 3 sessions of shock were therapy the patient reported that she was approximately 50% better. She was a diligent with the application of cold packs and was using her functional walking shoes on a day-to-day basis.
Her calf range had improved significantly and she was able to walk comfortably on a day to day basis. The sports podiatrist at the podiatry centre recommended that the treatment should continue. A further three sessions of shockwave therapy were applied to the patients heal over the course of the next three weeks.
6 Week Follow Up with the Podiatrist in Miranda
The patient returned to the podiatry centre in Miranda for her 6th and final session of shockwave therapy and informed the podiatrist that she had provided positive feedback to the Cronulla podiatrist. Her condition had improved significantly up to the point where she no longer needed to return to the Podiatry centre. The practitioner advised the patient that she could continue to exercise as long as she maintained the treatment program. She was also advised to return to her podiatrist in Cronulla for a brief follow-up in approximately 4 weeks time, so that her podiatrist could reassess the plantar fascia in case of any mild setbacks.
No further appointments were made for this patient and it was noted that her plantar fasciitis had completely resolved due to the use of the shockwave therapy and thorough treatment plan. A detailed report was sent back to the podiatrist in Cronulla.
Please note that the information contained in this case today is specific to one particular patient and should not be taken as general advice. If you think you have plantar fasciitis or would like to discuss shockwave therapy please contact a suitable qualified podiatrist in Cronulla or Miranda.
Written by Karl Lockett