Using shockwave on nerve conditions

Post 1 – Expanding Shockwave Beyond Heel PainWhen 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 entrapmentsKey adjustments for nerve applications: • Low energy settings (around 0.05 mJ/mm²) • Focused head for targeted treatment • Usually 3 sessions to startThis 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.⸻Post 2 – Why I Moved from 3 to 6 Shockwave SessionsEarly 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 cornerLesson: Sometimes small protocol changes can make a big impact — not just on results, but on patient trust and retention.⸻Post 3 – My “Sock Liner Test” for Nail & Toe PainMany 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.