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March 2018

How To Wash Away Heel Pain With Water

San Antonio Podiatrist Washes Away Tough Cases of Heel Pain With Water


Heel pain is often caused by plantar fasciitis which is an inflammatory condition of the plantar fascia. The plantar fascia is a tough fibrous band of tissue that starts in the heel bone and goes forward across the arch to attach to the bases of the toes.  The fascia is a critical supporting structure of the foot but can become overused in sport and work.  The fascia is strong in certain respects but weaker in others.

The plantar fascia has tremendous tensile strength but is weaker when subjected to torsion or twisting. Torsional strain of the fascia may be due to unsupportive shoegear or faulty foot mechanics.  Overpronation is a rolling in of the foot and oversupination is a rolling out of the foot, both of which can lead to strain of the plantar fascia.

Symptomatic relief of plantar fasciitis may be obtained by massage, anti-inflammatories or perhaps use of cortisone but it is more important to identify and treat the underlying causes so that permanent relief can be achieved.

Plantar fasciitis, left untreated or treated symptomatically only, can eventually become plantar fasciosis which is more difficult to treat.  Fasciosis is a degenerative process of the fascia in which the fascia becomes thickened and scarred over time.  Only imaging via MRI or diagnostic ultrasound can determine the presence of plantar fasciosis.

New treatments have been developed over the years to treat fasciosis including use of ESWT or extracorporeal shockwave therapy, TenexTX which uses ultrsasound energy to removed the diseased tissue and more recently the HydoCision TenJet.  TenJet uses an ultrasound guided stream of water to remove the diseased tissue of plantar fasciosis in a minimally invasive fashion. 

TenJet technology uses a special wand that is placed through a small opening in the skin and, using ultrasound guidance,  delivers a controlled supersonic stream of saline (salt water) that essentially washes away the diseased tissue while leaving the good tissue undamaged.  The procedure is generally performed in an outpatient setting under local anesthesia and takes about 15 minutes.  Patients may walk immediately after the procedure and return to normal shoegear within 24 hours.   See

Dr. Ed Davis is a board certified podiatrist in San Antonio who has been an early adopter of advanced technologies to treat heel pain. He started using ESWT in 2002, the Topaz procedure in 2008 and can explain when and why to use the newer technologies.