We had an opportunity to interview Dr. Nicholas Romansky of Health Mark Foot and Ankle Associates about using EPAT Shockwave for treating the causes instead of the symptoms of foot, ankle, and heel pain. He’s a renowned Podiatrist as well as a contributing editor to Podiatry Today magazine.
Dr. Romansky is a Board-Certified Diplomate of the American Board of Podiatric Surgery, with a graduate degree in Exercise Physiology/Cardiac Rehabilitation as well as a Podiatric Medicine Degree.
He’s also the team Podiatrist for the U.S. World Cup National Men and Women’s Soccer teams and is a medical consultant to many of Philadelphia’s professional sports teams.
Doctor Romansky, how would you describe your practice?
Dr. Romansky: We have three offices in the Philadelphia area. It’s a well-rounded practice offering cutting edge treatment. We have a diverse scope of practice, and we see a very good variety that involves sports medicine, reconstruction, limb salvage, wound care and more.
It’s our goal to keep people walking. One of the things about our practice is that it’s not just about sports medicine.
How did you get into the sports medicine side?
I played sports in high school and college at a high level, NCAA Division One. I then went on to graduate school in exercise theology, biomechanics, and cardiac rehab and that really presented the whole sports medicine world to me.
I was working in biomechanics, athletic shoe design, soccer injuries and basically injury reporting that’s now part of the NFL injury reporting system. That was part of my thesis and it’s just grown over time.
In your practice, even though you specialize in foot and ankles, you really look at the whole person and take kind of a whole-body approach with the patients. Why?
I think you must take that approach in the sense that many things start in the foot. There are many diseases that really start in the foot.
Some of the first signs of diabetes are in the foot, some of the first signs of rheumatoid arthritis start in the foot, the first sign of AIDS starts in the foot.
We also have hypothyroidism that starts in the foot, as well as circulation issues and low back problems that start in the foot.
Some of the first signs of systemic issues, or more proximal involvement, in the body or the back also start in the foot. A lot of people don’t realize that.
Recently you added something called EPAT also known as Shockwave to your practice. Why did you choose to add this type of technology to your private practice?
In our practice we like to think outside the box. We have this mentality that the patient is number one. They are our priority and they are personal to us, so we make it like family.
When EPAT therapy treatment came around we wanted to get this to help our patients. I had been very fortunate over the years with U.S. Soccer and in Europe to use this technology. We can use it for acute and chronic conditions and we want to offer patients more conservative care, more conservative modalities in an attempt to avoid surgery.
EPAT helps us do that. We can just use it for so many abnormalities in the foot and ankle and lower extremity.
What role can EPAT technology play when it comes to addressing foot, ankle, and heel pain?
In Pennsylvania we’re allowed to treat higher than the ankle, so we don’t just limit this to foot and ankle. We can use it on a calf muscle, on a hamstring, and shin splints.
It works for both acute and chronic conditions, which means a lot of times we’re trying to reverse chronic conditions to potentially make them heal.
Our big focus is really to make something that’s chronic, or has been around for a long time, and reverse the process through a non-invasive, aggressive way when using EPAT.
What are some conditions that you most frequently find patients need help with that can be successfully addressed by EPAT technology where other methods may not have had the same results?
EPAT is incredible at treating Plantar Fasciitis, Achilles Tendonitis, Shin Splints another thing we call Tibialis Posterior Tendonitis, which is a flattening of the foot and the tendon that holds up the foot, and many other conditions.
What is the impact of using EPAT technology when it comes to sports injuries?
Our goal for the regular population is that we want to keep you walking, and the goal for the athlete is to keep you playing at whatever level it may be.
EPAT technology basically will get the athlete back quicker. Athletes don’t want to take a lot of medications, and they don’t want to go through a very long process of physical therapy. They want something that gets directly into their pinpoint area. So EPAT is an adjunct to get them back to play quicker.
We have had very good results with a speedy 3 to 4 treatments at 7 to 15 minutes of therapy once every five to ten days. It really makes a big difference, especially after the second treatment. EPAT really gets the athlete back to playing faster.
Why do you feel EPAT is so effective?
The big word is called “neovascularization.” “Neo” means new and “vascular” means blood. So basically, it increases blood flow.
By sending a series of 3,000 hits or shockwaves into a particular area, it increases blood flow.
The blood flow then affects the platelets, the protein that affects the growth factor, and that basically increases recovery from injury or ailments.
Who is an ideal candidate for EPAT treatment?
Really anyone. There really are no limitations at all with this. It works for any age and most ailments.
What is the treatment protocol like for the patient?
The treatment protocol is three to five treatments, typically on a weekly basis depending on the condition.
A conductor, like an ultra sound gel, is put on a specific body part and then the EPAT device handpiece transmits sound waves into the area of treatment.
Typically, in our experience, we see a really big difference after the second treatment 5 to 10 days later. We see significant improvement of multiple aliments at about 80% to 85% after the second treatment.
What would you say to people regarding why they should consider using EPAT, also known as Shockwave, as a treatment option?
There are a few things I would say. I think you need to look at it from a cost perspective with the health care crisis that we are having now with more that’s coming out of the patient’s pocket. Plus nobody has time now. So, this cuts down on the copays, co-insurance, and deductible.
Typically it’s a cash payment and there’s no co-pay. This is something that takes 7 to 15 minutes, so there is no co-pay, no deductible.
This makes a big difference when you consider going to physical therapy two or three times a week at $35 to $70 per visit. You’re talking about hundreds of dollars a week for 3 treatments that can each take 45 minutes to an hour or longer.
Plus, you have to drive to and from physical therapy multiple times a week. With EPAT you can come to the office for 7 to 15 minutes at typically a third of the price.
Between the time commitment, payment point, and the effectiveness of EPAT, it is just a win, win, win on all three points.
How you would summarize the results your patients have realized from you treating them with EPAT Therapy?
The thing that EPAT does is it treats the cause and not the symptom, and you may have symptom as pain but really what is the cause? Inflammation? Scar tissue? Lack of blood supply?
This is a long lasting, not a short-term thing. This is actually treating a problem or the cause of the problem and not the symptom. We see a range of 85% to 93% success rate.
How would someone get in touch with your practice to get some information about EPAT or make an appointment to come in and talk to you about it?
They can go to our website at HealthmarkFootAndAnkle.com or simply call the Health Mark Foot and Ankle Associates office at 610-269-4610.