Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Considerations

Review Article | Volume 1 | Issue 1 | JRS December 2021 | Page 39-43 | Osvaldo Valle Toledo. DOI: 10.13107/jrs.2021.v01.i01.021

Author: Osvaldo Valle Toledo [1]

[1] Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.


Address of Correspondence
Dr. Osvaldo Valle Toledo, MD,
Department of Orthopedics and Traumatology, Ankle Foot Subspecialist, Ankle-Foot Team, MEDS Clinic, Santiago de Chile.


Plantar fasciopathy is the most common cause of heel pain. It is a primarily degenerative and mechanical overuse pathology. The plantar fascia fulfills important biomechanical functions in the foot, being its “windlass” mechanism, the most important function in this regard, allowing the foot to act as a single and efficient motor unit during gait. Its clinical and imaging diagnosis is fully defined, being Baxter’s nerve entrapment neuropathy, its most significant differential diagnosis. The elongation exercises constitute the basic treatment, being the extracorporeal shock wave therapy of significant utility, amplified in its effects by the association with the referred therapeutic exercises.

Keywords: Plantar fasciitis, shock waves, fasciopathy.


1. Rodríguez. Qué es la Fascia Plantar? 2015. Available from: [Last accessed on 2021 Dec 12].
2. Buchanan BK, Kushner D. Plantar Fasciitis. Treasure Island, FL: StatPearls Publishing; 2021.
3. Monteagudo M, de Albornoz PM, Gutierrez B, Tabuenca J, Álvarez I. Plantar fasciopathy: A current concepts review. EFORT Open Rev 2018;3:485-93.
4. Pasapula C, Kiliyanpilakkil B, Khan DZ, Di Marco Barros R, Kim S, Ali AM, et al. Plantar fasciitis: Talonavicular instability/spring ligament failure as the driving force behind its histological pathogenesis. Foot (Edinb) 2021;46:101703.
5. Harutaichun P, Boonyong S, Pensri P. Differences in lower-extremity kinematics between the male military personnel with and without plantar fasciitis. Phys Ther Sport 2021;50:130-7.
6. Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: A review of anatomy, histology, etiology and key associations. J Anat 2017;230:743-51.
7. Li J, Muehleman C. Anatomic relationship of heel spur to surrounding soft tissues: Greater variability than previously reported. Clin Anat 2007;20:950-5.
8. Díaz-Llopis IV. Despejando dudas sobre la fascitis plantar. XXIX Congreso de la Sociedad Valenciana de Medicina Física y Rehabilitación. Slides Presentation. Available from: [Last accessed on 2021 Dec 12].
9. Forman WM, Green MA. The role of intrinsic musculature in the formation of inferior calcaneal exostoses. Clin Podiatr Med Surg 1990;7:217-23.
10. Acosta TB, Pérez YM, Tápanes SH, Cordero JE, Lottie AG, Aliaga B, et al. Bibliographic review. Rev Iberoamericana Fisiot Kinesiol 2008;11:26-31.

11. Finkenstaedt T, Siriwanarangsun P, Statum S, Biswas R, Anderson KE, Bae WC, et al. The calcaneal crescent in patients with and without plantar fasciitis: An ankle MRI study. AJR Am J Roentgenol 2018;211:1075-82.
12. Arnold MJ, Moody AL. Common running injuries: Evaluation and management. Am Fam Physician 2018;97:510-6.
13. Cotchett M, Lennecke A, Medica VG, Whittaker GA, Bonanno DR. The association between pain catastrophising and kinesiophobia with pain and function in people with plantar heel pain. Foot (Edinb) 2017;32:8-14.
14. Tschopp M, Brunner F. Diseases and overuse injuries of the lower extremities in long distance runners. Z Rheumatol 2017;76:443-50.
15. Baur D, Schwabl C, Kremser C, Taljanovic MS, Widmann G, Sconfienza LM, et al. Shear wave elastography of the plantar fascia: Comparison between patients with plantar fasciitis and healthy control subjects. J Clin Med 2021;10:2351.
16. Schillizzi G, Alviti F, D’Ercole C, Elia D, Agostini F, Mangone M, et al. Evaluation of plantar fasciopathy shear wave elastography: A comparison between patients and healthy subjects. J Ultrasound 2021;24:417-22..
17. Yucel I, Ozturan KE, Demiraran Y, Degirmenci E, Kaynak G. Comparison of high-dose extracorporeal shockwave therapy and intralesional corticosteroid injection in the treatment of plantar fasciitis. J Am Podiatr Med Assoc 2010;100:105-10.
18. Puttaswamaiah R, Chandran P. Degenerative plantar fasciitis: A review of current concepts. Foot 2007;17:3-9.
19. Buchbinder R, Ptasznik R, Gordon J, Buchanan J, Prabaharan V, Forbes A. Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: A randomized controlled trial. JAMA 2002;288:1364-72.
20. Aqil A, Siddiqui MR, Solan M, Redfern DJ, Gulati V, Cobb JP. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Clin Orthop Relat Res 2013;471:3645-52..

21. Moya D, Ramón S, Schaden W, Wang CJ, Guiloff L, Cheng JH. The role of extracorporeal shockwave treatment in musculoskeletal disorders. J Bone Joint Surg Am 2018;100:251-63.
22. Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: A meta-analysis of RCTs. Medicine (Baltimore) 2017;96:e6621.
23. Chang KV, Chen SY, Chen WS, Tu YK, Chien KL. Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: A systematic review and network meta-analysis. Arch Phys Med Rehabil 2012;93:1259-68.
24. Greve JM, Grecco MV, Santos-Silva PR. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis. Clinics (Sao Paulo) 2009;64:97-103.
25. Rompe JD, Meurer A, Nafe B, Hofmann A, Gerdesmeyer L. Repetitive low-energy shock wave application without local anesthesia is more efficient than repetitive low-energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis. J Orthop Res 2005;23:931-41.
26. Haddad S, Yavari P, Mozafari S, Farzinnia S, Mohammadsharifi G. Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis. Int J Burns Trauma 2021;11:1-8.
27. Llurda-Almuzara L, Labata-Lezaun N, Meca-Rivera T, Navarro-Santana MJ, Cleland JA, Fernández-de-Las-Peñas C, et al. Is dry needling effective for the management of plantar heel pain or plantar fasciitis? An updated systematic review and meta-analysis. Pain Med 2021;22:1630-41.
28. DiGiovanni BF, Nawoczenski DA, Lintal ME, Moore EA, Murray JC, Wilding GE, et al. Tissue-specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 2003;85:1270-7.
29. Avilés SG. Efectividad de las Ondas de Choque en la Fascitis Plantar. Revisión Sistemática. España: Alcalá la Real; 2017.
30. Schuitema D, Greve C, Postema K, Dekker R, Hijmans JM. Effectiveness of mechanical treatment for plantar fasciitis: A systematic review. J Sport Rehabil 2019;29:657-74.

31. Weil LS Jr., Roukis TS, Weil LS, Borrelli AH. Extracorporeal shock wave therapy for the treatment of chronic plantar fasciitis: Indications, protocol, intermediate results, and a comparison of results to fasciotomy. J Foot Ankle Surg 2002;41:166-72.
32. Maier M, Steinborn M, Schmitz C, Stäbler A, Köhler S, Pfahler M, et al. Extracorporeal shock wave application for chronic plantar fasciitis associated with heel spurs: Prediction of outcome by magnetic resonance imaging. J Rheumatol 2000;27:2455-62.


How to Cite this article: Toledo OV | Plantar Fasciopathy, General Concepts, Shock Wave Treatment and Other Additional Therapeutic Consideration. | Journal of Regenerative Science | Dec 2021; 1(1): 39-43.

[Full Text HTML] [Full Text PDF] [XML]