Post 1 – Expanding Shockwave Beyond Heel Pain

When I first started with shockwave therapy, I only used it for plantar fasciitis, Achilles tendinitis, and a few forefoot conditions.

Over time, I expanded:

• Fractures – especially stubborn metatarsal stress fractures

• Nerve pain – like neuromas and dorsal cutaneous nerve entrapments

Key adjustments for nerve applications:

• Low energy settings (around 0.05 mJ/mm²)

• Focused head for targeted treatment

• Usually 3 sessions to start

This evolution came from years of treating the “usual suspects” and then realizing the same technology could help more complex problems.

Sometimes the best innovation in practice isn’t buying a new device — it’s learning new ways to use the one you already have.

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Post 2 – Why I Moved from 3 to 6 Shockwave Sessions

Early in my shockwave career, my standard was 3 sessions, then a follow-up.

The problem?

• Most patients improved around week 5… when they were in physical therapy getting the credit!

Now, I run 6 sessions for most soft tissue cases.

• Improvement starts around session 5

• I’m still the one monitoring and guiding the progress

• Patients see me as the one who helped them turn the corner

Lesson: Sometimes small protocol changes can make a big impact — not just on results, but on patient trust and retention.

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Post 3 – My “Sock Liner Test” for Nail & Toe Pain

Many toenail problems aren’t caused by fungus or trauma — they’re caused by shoes that are too small.

Here’s my quick in-office test:

1️⃣ Remove the sock liner from the patient’s shoe.

2️⃣ Place their foot on it.

3️⃣ If the toes go to the very edge, the shoe is too small.

This visual is powerful — patients see how cramped their shoes are.

It’s simple, memorable, and doesn’t require any special equipment.

Sometimes the most effective patient education tool is already inside their shoe.