You wake up. You step out of bed. The first three steps feel like glass under your heel. By the time you’ve made co%ee, it’s calmed down. Then you sit at your desk for an hour and it’s back. Two years of this. Maybe more.
I see this patient four or five times a week. They’ve tried everything that costs less than two hundred dollars. Cortisone. Inserts. Night splints. The Strassburg sock. Eight weeks of PT. The Voodoo floss video on YouTube. Some of it helped a little. None of it solved it. They came here because the heel pain has officially started running their life.
Here’s the truth about plantar fasciitis that the first three providers probably didn’t tell you. You don’t have fasciitis. You have fasciosis. The “-itis” implies inflammation, and chronic plantar fascia pain — past about six weeks — is not primarily inflammatory. It’s a tissue degeneration problem. The fascia has tried to heal and gotten stuck in a partial-repair state, with disorganized collagen and an inadequate blood supply.
That’s why cortisone keeps disappointing you. Cortisone is an antiinflammatory. It does its job. But your problem isn’t inflammation anymore. Your problem is that the tissue itself has stopped repairing.
Why focused shockwave changes the equation?
Focused Extracorporeal Shockwave Therapy — focused ESWT — is the only non-invasive technology I know of that triggers actual tissue regeneration in chronic tendinopathy. It uses pressure waves at a much higher intensity than the radial shockwave devices used at most chiropractic and PT offices. The mechanism isn’t “breaking up scar tissue.” That’s the marketing version. The actual mechanism is mechanotransduction — the pressure wave triggers cells in the fascia to release growth factors, recruit new blood vessels, and restart the healing process that got stuck.
The data on this is strong. Multiple high-quality randomized trials have shown focused ESWT outperforms cortisone, PT, and placebo for chronic plantar fasciitis at the one-year mark. The FDA approved focused shockwave for plantar fasciitis years ago. It’s the standard of care in elite sports medicine in Europe and is becoming the standard here.
Why “shockwave” at most clinics in Boulder isn’t actually shockwave?
This is where you need to ask a hard question. Most clinics in Boulder and Denver advertising “shockwave” are running radial pressure wave devices. Radial is fine. It’s useful. It treats the surface and the muscle. But it does not penetrate deep enough to reliably treat the plantar fascia at its calcaneal attachment, which is where your pain is.
At Dynamic Athlete we run all three modalities — focused ESWT, radial pressure wave, and Extracorporeal Magnetotransduction Therapy, or EMTT. Almost no clinic in Colorado has all three. The protocol we use for chronic plantar fasciitis combines focused ESWT directly into the fascia at the heel attachment with EMTT to drive deeper cellular regeneration. The treatment takes about thirty minutes. You walk out. You walk back in for the next session three to seven days later.
“Cortisone treats yesterday’s plantar fasciitis. Focused shockwave treats the version you actually have.”
What treatment looks like for the patient ?
Most patients need three to five sessions. There’s no needle. There’s no anesthesia. There’s no downtime. You can run, hike, work the day of the treatment. Some patients notice improvement after one session. Most notice the meaningful drop in morning pain between sessions two and four. Full tissue remodeling continues for three to six months after the last session — meaning you keep getting better long after we stop seeing you.
If your case is severe or you have a heel spur with significant fat pad atrophy, I may add PRP into the protocol. PRP works on the plantar fascia when the fascia is genuinely torn or degenerative. We use our multi-spin PRP and Fibrin-Rich Plasma protocols here — not the single-spin kits most clinics use. The fascia is different from cartilage and we prep the biologic differently.
The cost of one more year of this!
Patients ask me about cost. I ask them how much they’ve already spent. The cortisone shot at the foot and ankle clinic was three hundred dollars after insurance. The custom orthotics were six hundred. The PT was twelve hundred over eight weeks. The two MRIs were eight hundred each. None of it solved it. They are usually three to five thousand dollars into a problem they still have.
Insurance does not cover focused shockwave or EMTT, and it doesn’t cover PRP. We have to be honest about that. What we can tell you is this: most plantar fasciitis patients are done in four to six visits, and they don’t come back six months later because the problem is gone. The investment is in the same range as what they’ve already spent on treatments that didn’t work — except this one ends.
Cherry financing handles the rest. Most patients use the 0% APR option to spread the cost over the months they would have been suffering anyway. The math is uncomplicated.
What about surgery?
Plantar fascia release surgery is a real option for patients who have failed everything. I am not against surgery — I work with the best foot and ankle surgeons in Boulder and Denver and I refer patients to them when surgery is the right answer. But surgical release weakens the fascia and lengthens recovery to six months or more. The data shows that focused shockwave should be tried before surgery, not after. The American Academy of Orthopaedic Surgeons updated its recommendations in this direction years ago.
If you’ve already had release surgery and you’re back here with pain, focused shockwave still works on the post-surgical version of this. We’ve done this protocol on a number of post-release patients. Different conversation, same machine.
90%+ OF PLANTAR FASCIITIS PATIENTS REPORT 75%+ IMPROVEMENT
3-5 SESSIONS TO RESOLUTION FOR MOST CASES
The questions we get on every plantar fasciitis call!
Does it hurt?
There’s a strong sensation during the focused ESWT — patients describe it as a deep tapping or pulsing — but no anesthesia is needed. The intensity is dialed to what you can tolerate. The treatment area is sore for a day or two after, then back to baseline.
Can I run between sessions?
Yes. We don’t tell plantar fasciitis patients to rest. The whole point of shockwave is that we’re restarting your healing process, not bypassing your activity. Most patients keep running and notice their morning pain dropping week over week.
How is this different from the shockwave at my chiropractor?
Penetration depth and energy density. Radial devices treat the superficial tissue well. Focused ESWT delivers therapeutic energy to the deep insertion of the fascia. For most chronic plantar fasciitis cases, focused is what changes the outcome.
If shockwave doesn’t fully resolve it, what’s the next step?
Multi-spin PRP injection into the plantar fascia under ultrasound guidance, often combined with continued shockwave. Resistant cases sometimes need stem cell-based treatment. We escalate methodically.
Will it come back?
If we address the root cause — and that means treating the tissue and also looking at the calf, ankle mobility, and footwear that contributed in the first place — recurrence is uncommon. We send you home with a maintenance plan.