| Condition | Right plantar fasciitis; chronic, progressive |
| Duration | 14 months |
| Activity Level | Recreational runner (30+ years) |
| Prior Treatment | Custom orthotics, Physical therapy (stretching, ultrasound), 2 cortisone injections |
| Prior Recommendation | Stop running permanently |
The Presenting Complaint
At 55 years old, this patient had been running for over 30 years. Running wasn’t just exercise for him—it was his identity, his stress relief, and his social life. Three to four times a week, he’d lace up and hit the pavement, a rhythm that had defined his adult life.
But 14 months of right-sided plantar fasciitis had slowly stolen that from him. The pain was progressively worsening. He’d tried everything his podiatrist recommended: custom orthotics, physical therapy with stretching and ultrasound, even two cortisone injections. Nothing worked.
Then came the recommendation that broke him: stop running permanently.
He came to City Integrative Rehabilitation looking for a different answer. Not “stop running.” But “how do I keep running?”
Treatment Approach
The Evaluation: A Gait Pattern Built Over Decades
When we analyzed his running gait, the picture became clear. Over 30 years, his running mechanics had adapted in ways that were slowly destroying his plantar fascia. He had developed an aggressive heel strike pattern that drove excessive loading directly into the plantar fascia with each footfall.
But it wasn’t just his foot. Age-related deactivation in his hip and glute muscles meant his lower kinetic chain wasn’t absorbing impact properly. The shock that should have been distributed up through his hips and core was instead cascading down to his foot, dumping excessive stress on the already-compromised fascia.
The Protocol
We deployed a three-pronged approach:
- F-ESWT (Focused Extracorporeal Shockwave Therapy) to stimulate tissue healing in the degenerated fascia. Learn more about shockwave therapy.
- AiM Gait Retraining to fundamentally modify his foot strike pattern, reducing plantar fascia load by correcting his heel strike mechanics. Read about Anatomy in Motion gait assessment.
- DNS (Dynamic Neuromuscular Stabilization) hip and glute reactivation to restore proper shock absorption up the kinetic chain. Discover DNS therapy.
Treatment Phases
| Phase | Focus | Duration |
| Phase 1 | Tissue Recovery | Weeks 1–3 |
| Phase 2 | Gait Retraining | Weeks 4–6 |
| Phase 3 | Return to Running | Weeks 7–10 |
Recovery Timeline
Week 1: F-ESWT begins. Patient reports initial soreness from treatment, typical for shockwave therapy. Begins gentle gait retraining exercises to introduce new motor patterns.
Week 3: 50% pain reduction achieved. Tissue is responding to shockwave stimulation. Gait retraining intensifies. Patient begins to feel confident that a different outcome is possible.
Week 5: Returns to light jogging. Heel strike pattern has been substantially modified. Hip and glute activation is improving, allowing better shock absorption. Pain continues to decrease.
Week 7: Running frequency and distance increase. Patient reports running pain-free for the first time in 14 months. Orthotics no longer needed during running.
Week 10: Completes a full 10K race. No pain during or after. Returns to his full running schedule (3–4 times per week) without limitations.
The Outcome
Ten weeks from his first appointment, this 55-year-old lifelong runner crossed the finish line of a 10K race—pain-free, without orthotics, and with his identity fully restored.
He’s back to his full running schedule. More importantly, he’s back to his life.
Key Insight
“After 30 years, his running gait had evolved in ways that were slowly destroying his plantar fascia. F-ESWT healed the tissue, but correcting the gait pattern is what made the result last.”
This case illustrates a critical principle: long-standing tissue damage often isn’t just about the tissue itself. It’s about the patterns that created the damage in the first place. You can heal the injury, but if the movement pattern that caused it persists, the injury will return.
By addressing both the tissue (with F-ESWT) and the movement pattern (with AiM gait retraining and DNS), we didn’t just reduce his pain. We changed his trajectory.
Ready to Get Back to Running?
If plantar fasciitis is limiting your running, we can help. Don’t accept the recommendation to stop doing what you love. Schedule your consultation or call/text us: Manhattan (646) 256-9513 · Great Neck (516) 418-3798 · West Hills (631) 659-2980.
Note: This case study is presented for educational purposes and is subject to HIPAA privacy regulations. Patient identifying information has been de-identified. Results vary based on individual circumstances, treatment compliance, and severity of condition.