EPAT Strategies for Midfoot Arthritis and Heel Pain

Back from a shockwave certification weekend and a full Monday of patient careEPAT sessions, neuroma post-op management, midfoot arthritis consults, nail procedures, and several ultrasound/X-ray workups, I’m sharing what worked, what didn’t, and how I’m turning new education (plus joining the American Society for Shockwave Therapy) into better outcomes. You’ll also hear the real-world frustrations when patients decline self-pay options, and the simple workflow tweaks I’m using to protect time, reduce low-value follow-ups, and keep care moving.What You’ll Learn in This EpisodeApplying focused shockwave for arthritis and tendon painTriage rules to avoid low-value repeat visitsWhen to use ultrasound, X-ray, and nail samplingOrthotic/boot timing after surgery to streamline billingHow to set expectations for self-pay servicesFollow-up cadence for EPAT to maximize resultsWhy You Should ListenIf you’re scaling a modern podiatry practice, this episode gives you practical scripts, scheduling tweaks, and shockwave pearls you can use today—especially when insurance hurdles or patient hesitancy threaten momentum.Key Topics Covered[0:01] Shockwave course takeaways and joining the new society[0:56] A candid look at a frustrating clinic day[1:14] Midfoot arthritis case: explaining EPAT value[1:49] Handling “insurance-only” expectations[2:14] Post-op neuroma: when to transition to CAM boot[2:41] Orthotic dispensing and 6-week follow-up rhythm[3:15] Second opinions: nail sampling first, X-rays next visit[3:58] Callus vs fissure: coding ulcer debridement correctly[4:47] Peroneal tendon pain: imaging, plan, and EPAT pathway[5:07] Achilles follow-up: Pelto Special vs night splint pushback[6:06] Kids and warts: why cantharidin before Swift[6:41] Neuroma workup: X-ray, ultrasound, injection, PRN follow-up[7:18] Hallux/first MPJ arthritis: EPAT as surgery-sparing attempt[8:18] Same-day cyst drainage and porokeratoma care[8:33] Bilateral Achilles EPAT after prior soft-wave failure👉 Tune in to hear the exact language, timing, and treatment sequencing I use to convert education into outcomes, even on the tough days, and bring your practice closer to the million-dollar mark!Shockwave notes - https://dr-pelto.notion.site/Shockwave-Seminar-2024-15005263c99180f9ad53fcfc84f9bc1a?pvs=4American Shockwave Society - www.asmst.com