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I see Phil at out of state marathons. He continues to tough out his heel pain. Others I’ve met gave up running or had surgery, and multiple cortisone shots. A new non-invasive “EPAT” ultrasound procedure is now available in the office.

Heel pain is one of the more common injuries we see. Many an everyday runner or weekend warrior at middle age can develop this nagging recurring pain. They don’t get the attention the elite or professional athletes receive. The pain typically comes when getting out of bed or a chair. The direct cause is usually a tight ligament in the arch, a tight Achilles cord or both causing a micro-tearing and inflammation. So we work at stretching the related calve and foot muscles and calming down the inflammation. The inflammation has to be reversed. Rest, ice, and stretching are used if the pain is recent, recent in terms of days or weeks.

More often, I see a patient like Phil, who has had the pain for several months. He blames it on a bruise, but runs anyhow and expects it to go away in couple of months. At this point, the scarring from the micro-tears thickens the ligament (plantar fasciitis) or tendon (Achilles tendinitis). The “tendinitis” digresses to a chronic “tendinosis”.

The thickness of the fascia or tendon is appreciated with an ultrasound exam.  Any spur or bone disease is also ruled out with an X-ray. Stretching and a night splint are used, depending on the degree of tightness. Ice therapy is recommended, along with gait analysis and training: “walking through the ball of the big toe”.  Shoes, orthotics taping and the use of kinetic tapes are reviewed. If these methods only bring limited relief, a EPAT therapy is recommended. This involves the application of a low frequency shock wave ultrasound treatment. No local anesthetic is required as it was in the recent past. Moreover, the advanced technology makes it possible to do in the office. The procedure takes four minutes and requires about four treatments. Less than 10 per cent of our patients require surgery. So no one has to give up running or like Phil, put up with the pain.


Dr. Landry is a foot doctor practicing podiatry in Overland Park, KS – which is near Shawnee Mission, Lenexa, and Olathe KS. Dr. Landry believes an ounce of prevention is better than a pound of cure. If you are suffering from foot heel pain, don’t wait until the symptoms get worse… call Dr. Landry today for a full foot & heel examination. Dr. Landry is also a board certified foot surgeon and marathon runner.

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