My Experience with Radial Shockwave Therapy (The Final Chapter in my Plantar Fasciitis Story)

Someone recently asked me if I stopped writing about running on this space because I became more book focused. How I wish that was the case! I certainly wrote about books on the regular when I focused more on running and fitness, and had planned to still write race reports or anything running related that struck my fancy. Alas, other than discount codes, I've had nothing to share sincemy injury update in September. So, even though I feel like I talk about my plantar fasciitis ad nauseam, I suppose I haven't written about it for awhile. 

Now that I am healed (ahhhh!) I thought I would share the treatments I went through and what worked for ME. This is an important point because, as a teammate pointed out, the plantar club is HUGE and we could probably talk about the different things that worked for us until the end of time. And the causes and ways in which it manifests can vary greatly. For me, I'm pretty confident that training for a half marathon on completely worn out shoes caused my injury: I didn't want to search for a new shoe model when my tried and true model changed for the worse. (I understand the need for constant improvement and innovation, but WAH.) And the way my injury presented was a little unusual for plantar fasciitis: I didn't have the traditional tenderness first thing in the morning, nor any pain while running - my pain came in the evening after a day on my feet. 

All this to say that your mileage may vary, but I felt that sharing my experience with radial shockwave would be of some value to anyone who might not have heard of it, or is debating this treatment option. But first let's recap all the fun stuff I did in the months prior! From mid June to September:
  • 2 weeks off exercise completely, followed by...
  • 4 weeks of no running, only elliptical and cross training 
  • night splint
  • daily icing, rolling, stretching and neural flossing
  • prescription lidocaine cream on my heel
  • new shoe model (grumble) 
Good ol' night splint...

These things got me feeling much better after two to three months, but not great. Easy runs didn't make my foot hurt too bad at night, but incorporating speed or any distance beyond three miles made things hurt again. I was TIRED of boring easy and short runs. So I caved to...
  • orthotics
Yep, at the end of last year I shelled out quite a bit of flexible spending money for custom orthotics. Thankfully, they were easy to get used to and I ran with them for a good two months and yet... Nothing really changed. That's when I talked next steps with my podiatrist. I ruled out cortisone injections straightaway as it seems more a band-aid than a fix, and we did discuss PRP injection (where your blood is taken and the plasma is spun out and injected to the injured area). But that seemed too invasive for my level of injury and part of what might help PRP work is the injection actually hitting the heel bone to stimulate healing, which can also be accomplished with the radial shockwave therapy. Since it involved the least risk and was non invasive, I elected to shell out a bunch of this year's flexible spending on...
High level overview: the doc uses a wand like tool to massage the area with high frequency SOUND waves (not electrical shocks) that target the damaged tissue, breaking it down, and stimulate the bone in order to facilitate inflammation and healing. I was not permitted to take any NSAIDs for the duration of treatment and for six weeks afterward. For most practitioners, as with my doc, you schedule three 20 minute treatments one week apart.
In February, I scheduled three consecutive Tuesday evening appointments. Those 20 minutes consisted of taking off my shoes and one sock and then lying face down on the exam table while my doc massaged my heel to find 'hot spots.' Basically, when the shockwaves started to really hurt (for me it varied from an intense ache, to a burning feeling) he would leave it in the bad spot until the pain would dissipate or go a little numb and then he'd move on to the next spot until he covered all areas of my injured heel. Obviously, this wasn't pleasant and the machine is rather loud, but it only took 10-15 minutes to complete (at least for one foot). Then he did a couple minutes of calf massage on that leg, which felt LOVELY after the attack on my foot. 

After my first appointment, my foot felt a little numb that night and then I had some pretty intense DOMS the following day or two. Then things kind of settled into my normal pre-treatment state and it would be time for a second, and then the third treatment. With each consecutive visit, it took him longer, and increased sound wave speed, to find 'hot spots' and it hurt less. Yet I still felt the same after a day on my feet and wondered if I spent way too much money on nothing. However, he assured me that even though some people feel pain relief as early as the first treatment, the magic really happens in the 6-8 week window of healing. 

And, lo, almost EXACTLY 6 weeks after my last treatment, I started walking around at night and catching myself not feeling as much pain, and eventually ZERO pain. He encouraged me to continue running, as it would not affect the results. So I still took it easy, and was still stretching and rolling my foot regularly, along with wearing my orthotics - and I STILL do. At one point I was bemoaning the time and money that I thought I wasted on the orthotics, but I think that wearing them as my foot repaired itself might have been just the magical combination my body needed. 

I began to add some intervals to my runs, and all felt well. Then I added mileage, and all felt well. Then I ran a race (!) and ALL. FELT. WELL. I'm back up to long runs of six miles and doing some speed (a relative term) once a week, too. I was really pleased to keep my pace under an eleven minute mile for the Tenacious Ten given all the stopping to hug/chat up so many people along the course, and given how long I've been out of the game. Although, I have zero race plans for the rest of the year, other than to just build up my base and ENJOY. Not that I was in a slump, but this whole injury thing has really made me super happy about getting out for a run.
For anyone who read this far, thanks for following along and if you have an injury and any further questions about radial shockwave, ask away!