Skip to main content

Extracorporeal shock wave therapy in runners with a symptomatic heel spur

Abstract

The aim of this paper is to assess the benefit to treat plantar fasciitis with low-dose energy extracorporeal shock wave therapy (ESWT) and the efficacy of such treatment to abate the painful symptoms allowing a rapid return to the running activity. Our study included 54 running athletes treated for plantar fasciitis associated with a heel spur who received four sessions (once weekly) of low-dose ESWT, and followed prospectively on average 45 days, 6 and 24 months after their last session. The clinical results were excellent in 59% of cases, good in 12%, satisfactory in 21% and distinctly unsatisfactory in 8%. No patient was observed a significant modification of the heel spur at the follow-up X-ray. The ultrasound examination at 24 months showed a disappearance of the inflammation signs in 61% of cases. A strong correlation between ultrasound improvement and clinical results were found. Low-energy ESWT seems to be a good mean to treat plantar fasciitis in runners with a 71% of good or excellent results and a persistent improvement lasting 24 months. A randomized multicentric study seems to be necessary to define the type of energy that should be used in the future to treat plantar fasciitis, in particular in the athletic patients, to allow a faster return to sports activities.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Abt T, Hopfermuller W, Mellerowicz H (2002) Shock wave therapy for recalcitrant plantar fasciitis with heel spur: a prospective a randomized placebo-controlled double-blind study. Orthop Ihre Grenzgeb 140(5):548–554

    Article  CAS  Google Scholar 

  2. Amis J, Jennings L, Graham CE (1998) Painful heel syndrome: radiographic and treatment assessment. Foot Ankle 9:91–99

    Google Scholar 

  3. Barret SL, Day SV, Pignetti T, Egly BR (1995) Endoscopic heel anatomy: analysis of 200 fresh frozen specimens. J Foot Ankle Surg 34:51–56

    PubMed  Article  Google Scholar 

  4. Baxter DE, Yingas C (1995) The foot in running. J Am Acad Orthop Surg 3:136–145

    PubMed  Google Scholar 

  5. Buch M, Knor U, Fleming L, et al (2002) Extracorporeal shockwave therapy in symptomatic heel spurs—an overview. Orthopade 31(7):637–644

    Article  PubMed  CAS  Google Scholar 

  6. Delius M (1994) Medical applications and bioeffects of extracorporeal shock waves. Shock Waves 4:55–72

    Article  Google Scholar 

  7. Furey JP (1975) Plantar fasciitis: the painful heel syndrome. J Bone Joint Surg 57A:672–674

    Google Scholar 

  8. Gill LH (1997) Plantar fasciitis diagnosis and conservative management. J Am Acad Orthop Surg 5:109–115

    PubMed  Google Scholar 

  9. Graham CE (1983) Painful heel syndrome: rationale of diagnosis and treatment. Foot Ankle 3:261–267

    PubMed  CAS  Google Scholar 

  10. Grasel RP, Schweitzer ME, Kovalovich AM, et al (1999) MR imaging of plantar fasciitis: edema, tears, and occult marrow abnormalities correlated with outcome. Am J Roentgenol 173:699–701

    CAS  Google Scholar 

  11. Ham PS, Strayer S (2002) Shock wave therapy ineffective for plantar fasciitis. J Fam Pract 51(12):1017–1022

    PubMed  Google Scholar 

  12. Huang CK, Kitaoka HB, An KN et al (1993) Biomechanical evaluation of longitudinal arch stability. Foot Ankle 14:353–357

    PubMed  CAS  Google Scholar 

  13. Lee GP, Ogden JA, G Lee Cross (2003) Effect of extracorporeal shock waves on calcaneal bone spurs. Foot Ankle Int 23:301–308

    Google Scholar 

  14. Maier M, Steinborn M, Schmitz C, et al (2000) Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: prediction of outcome by magnetic resonance imaging. J Rheumatol 27:2455–2462

    PubMed  CAS  Google Scholar 

  15. McCarthy JJ, Goreecky GE (1979) Anatomical basis of inferior calcaneal lesions: a cryomicrotomy study. J Am Pediatr Assoc 69:527–536

    CAS  Google Scholar 

  16. Ogden JA, Alvarez R, Levitt R, Cross GL, Marlow M (2001) Shockwave therapy for chronic proximal plantar fasciitis. Clin Orthop 387:47–59

    PubMed  Google Scholar 

  17. Onwuanyo ON (2000) Calcaneal spurs and plantar heel pad pain. Foot 10:182–185

    Article  Google Scholar 

  18. Rompe JD, Hopf C, Nafe B, Burger R (1996) Low-energy extracorporeal shock wave therapy for painful heel: a prospective controlled single-bind study. J Orthop Trauma Surg 115:75–79

    Article  CAS  Google Scholar 

  19. Speed CA, Nichols D, Wies J, et al (2003) Extracoropreal shock wave therapy for plantar fasciitis. A double-blind randomised controlled trial. J Orthop Res 21:937–940

    Article  PubMed  CAS  Google Scholar 

  20. Steinborn M, Heuck A, Maier M, Schnarkowski P, Scheidler J, Reiser M (1999) MRI of plantar fasciitis. Rogo Fortschr Geb Roentgenstr 170:41–46

    CAS  Google Scholar 

  21. Tudor GR, Finlay D, Allen MJ, Belton J (1997) The role of bone scintigraphy and plain radiography in intractable plantar fasciitis. Nucl Med Commen 18:853–856

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elyazid Mouhsine.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Moretti, B., Garofalo, R., Patella, V. et al. Extracorporeal shock wave therapy in runners with a symptomatic heel spur. Knee Surg Sports Traumatol Arthrosc 14, 1029–1032 (2006). https://doi.org/10.1007/s00167-005-0025-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-005-0025-2

Keywords

  • Extracorporeal shock wave therapy
  • Heel spur
  • Plantar fasciitis
  • Shockwave