Shockwave Therapy for Plantar Fasciitis: Does It Work?
If you have plantar fasciitis that has been going on for more than three months — or you’ve tried stretching, orthotics, cortisone injections, and rest with limited results — this post is written for you.
Shockwave therapy is one of the most evidence-supported treatments for chronic plantar fasciitis, and it’s one of the most underutilized in the St. Louis area. We’ll explain exactly how it works, what the research shows, and what you can expect at St. Louis Sports Clinic.
What Is Shockwave Therapy?
Shockwave therapy uses high-energy acoustic waves — delivered through a handheld device pressed against the skin — to stimulate healing in damaged tissue. The waves penetrate into the affected area, creating mechanical stress that triggers a cascade of biological responses: increased blood flow, activation of growth factors, breakdown of calcific deposits, and stimulation of the body’s own repair mechanisms.
There are two types of shockwave relevant to plantar fasciitis:
Radial shockwave (RSWT): Pressure waves that radiate outward from the point of contact. Best for treating broader areas and superficial structures.
Focused shockwave (FSWT): Energy concentrated at a precise focal point within the tissue. More targeted, able to penetrate deeper, and typically used for focal chronic tendinopathy.
St. Louis Sports Clinic is one of the only clinics in the St. Louis area to offer both. We use the Storz Medical MASTERPULS® ULTRA+ for radial shockwave and the Storz Medical DUOLITH® SD1 ULTRA for focused shockwave — both considered among the gold-standard devices in the field.
Why Plantar Fasciitis Becomes Chronic
Acute plantar fasciitis — the heel pain that wakes you up in the morning after ramping up your mileage — often resolves with rest, stretching, and time. But when pain persists beyond 3–6 months, something different is happening in the tissue.
Chronic plantar fasciitis is not primarily an inflammatory condition. It’s a degenerative one — called plantar fasciosis. The collagen fibers within the plantar fascia break down and fail to remodel properly. The tissue becomes disorganized, blood vessel in-growth increases abnormally, and the normal healing process stalls.
This is why anti-inflammatories, cortisone injections, and rest often fail to resolve chronic cases. They target inflammation — which isn’t the main problem.
Shockwave therapy works differently. It mechanically stimulates the tissue to restart the healing process that has stalled. It breaks down disorganized collagen, increases vascularity in ways that support healing (rather than the pathological in-growth of chronic disease), and triggers growth factor release that initiates true tissue repair.
What the Research Says
Shockwave therapy for plantar fasciitis has one of the stronger evidence bases in musculoskeletal care. Multiple randomized controlled trials and systematic reviews support its use for chronic plantar fasciitis, with success rates typically ranging from 60–80% in patients who have failed conservative treatment.
The American College of Foot and Ankle Surgeons includes shockwave therapy as a recommended treatment option for chronic plantar fasciitis, and it is approved by the FDA for this indication.
For patients considering surgery — plantar fascia release or other procedures — shockwave therapy is considered a first-line option that should be attempted before surgical intervention.
What to Expect at St. Louis Sports Clinic
Assessment first: We don’t apply shockwave without understanding the full picture. Your provider will assess your foot mechanics, calf and Achilles function, hip mobility and strength, and overall loading patterns — because plantar fasciitis almost never exists in isolation.
Shockwave treatment: Each session lasts 10–20 minutes. The device is pressed against the heel and plantar fascia. The sensation varies — most patients describe it as a moderate pressure or pounding feeling at the treatment site. It is uncomfortable but tolerable. Some areas are more sensitive than others.
During treatment: You may experience temporary pain during the procedure, particularly at the most affected areas of the fascia. This is normal and expected.
After treatment: Some temporary worsening of symptoms is normal in the first 24–72 hours after shockwave, as the tissue responds to the mechanical stimulus. Most patients see meaningful improvement after 3–5 sessions.
Protocol: A typical shockwave protocol for plantar fasciitis is 4–6 sessions over 4–6 weeks. We combine shockwave with dry needling to address the muscular and trigger point components, manual therapy, and a progressive loading program for the calf, intrinsic foot muscles, and hip.
Conditions We Treat with Shockwave at St. Louis Sports Clinic
Shockwave therapy isn’t just for plantar fasciitis. Our team uses it effectively for:
- Achilles tendinopathy — insertional and mid-portion
- Calcific tendinitis of the shoulder — calcium deposits in the rotator cuff that cause severe pain
- Patellar tendinopathy — “jumper’s knee” in athletes
- Tennis elbow (lateral epicondylitis) — chronic cases that haven’t responded to other care
- Proximal hamstring tendinopathy — high hamstring pain with sitting and loading
- Greater trochanteric pain syndrome — lateral hip pain in runners
- Medial tibial stress syndrome — shin splints with chronic bony involvement
Why Most St. Louis Clinics Don’t Offer Shockwave
Shockwave therapy devices — particularly the focused DUOLITH® SD1 ULTRA — are expensive capital investments. Most chiropractic and physical therapy clinics in the St. Louis area have never offered shockwave, or offer only a single radial device.
St. Louis Sports Clinic invested in both radial and focused shockwave because we want to offer the full spectrum of treatment options our patients need — not just what’s economical for the clinic.
If you’ve been told shockwave isn’t available in St. Louis, or that you’d need to travel to get it — you don’t.
Book a Shockwave Consultation
If you have chronic plantar fasciitis, Achilles tendinopathy, calcific tendinitis, or another chronic tendon condition, call or book online. No referral needed.
Book an Appointment → stlsportsclinic.com/book
📞 (314) 200-5032
📍 645 Spirit Valley Central Dr, Chesterfield, MO 63005
Serving Chesterfield, Clayton, Ladue, Frontenac, Town and Country, and the greater St. Louis area.
