September 2025

Why Walking Boots & Cortisone Injections Rarely Fix the Problem?

A Personal Note from Dr.Scott:

As we turn the calendar to September, I’m reminded of how this time of year always feels like a “second New Year.”

The kids are back in school, routines start to settle, and life begins to find a rhythm again after the busy summer months. It’s a natural moment to pause and ask yourself: How am I feeling? Am I moving the way I want to? Do I have the energy to do the things I love?

Here’s the truth: you don’t have to wait until January to hit the reset button on your health. September is the perfect time to recommit to your body—before the holiday season sneaks up and the year slips away.

I see so many people put their health on the back burner during the fall, only to arrive in December frustrated, tired, and wishing they had started sooner. Don’t let that be you. Whether you’ve been slowed down by pain, struggling with stiffness, or just feeling like your energy isn’t where it should be, there are small but powerful steps you can take today to change the trajectory of your year.

At Back In Motion, we believe it’s never too late to feel strong, confident, and pain-free again. Sometimes all it takes is the right plan, the right accountability, and the right support to get you moving in the right direction.

So as the leaves begin to change, think of September as your chance to change too—not out of guilt, but out of possibility. You deserve to finish this year feeling better than you started.

To your health,
 Dr. Scott Gray
 Back In Motion Physical Therapy & Performance

Article of the Month

The Great Plantar Fasciitis Debate: Why Walking Boots & Cortisone Injections Rarely Fix the Problem (And What Really Does)

If you’ve been struggling with plantar fasciitis, chances are you’ve already heard the typical recommendations: “Wear a walking boot for a few weeks.” Or maybe, “Let’s try a cortisone injection to calm the inflammation.”

At first, these options sound promising. They seem quick. They sound medical. And they may even give you some temporary relief.

But here’s the uncomfortable truth: neither a boot nor an injection addresses the real problem—and that’s exactly why plantar fasciitis so often lingers or comes roaring back.

So today, let’s debate it.
 We’ll compare the “quick-fix” approaches versus what actually works long-term—so you can make an informed decision about how you want to heal.

Side 1: The Case for Walking Boots & Cortisone Injections

Let’s be fair. Walking boots and cortisone injections are popular for a reason.

  • Walking Boots:
     The logic here is simple—if you immobilize the foot, you reduce stress on the fascia, giving it “time to heal.”
  • Cortisone Injections:
     These powerful anti-inflammatory shots reduce pain and swelling quickly. They can give short-term relief that feels like a miracle, especially if you’ve been hobbling out of bed in the morning for months.

So yes—they can help you feel better. But only in the short run.

The Problems With These “Solutions”

1. They Don’t Fix the Cause

Plantar fasciitis isn’t just “inflammation.” It’s usually caused by mechanical overload—too much stress on the plantar fascia due to tight calves, limited ankle mobility, weak stabilizing muscles, or faulty foot mechanics (like overpronation or oversupination).

  • A walking boot doesn’t fix mobility, strength, or foot mechanics.
  • A cortisone injection doesn’t change how your body moves.

So when you go back to walking, running, or exercising—the same forces that caused the problem are still there.

2. Risk of Making Things Worse

  • Walking boots can actually weaken muscles and create stiffness in the ankle. Many patients end up with more problems after weeks in a boot.
  • Cortisone injections can temporarily weaken the tissue, and in some cases, have been linked to plantar fascia rupture—a painful complication that can take months to recover from.

3. They Create Dependency

Because they only mask symptoms, you may find yourself repeating them: another injection, another period in the boot, another cycle of frustration.

That’s not healing—that’s management.

Side 2: The Case for Fixing the Root Cause

At our clinic, we take a completely different approach. Instead of masking symptoms, we restore function and heal the tissue so you can get back to activity without fear of the pain returning.

Our process involves three core elements:

  1. Dry Needling to Restore Muscle & Fascia Function
  2. Addressing Ankle & Foot Mechanics
  3. Re-training Strength & Movement Patterns

Let’s break it down.

Step 1: Dry Needling the True Pain Generators

Most people think plantar fasciitis is just about the plantar fascia itself. But what we see clinically is that certain muscles deep in the foot often drive the pain.

  • Medial Calcaneal Tubercle: This is where the plantar fascia attaches. By dry needling this area, we can release tension, increase blood flow, and stimulate a true healing response.
  • Flexor Digitorum Brevis (FDB): This muscle sits right under the plantar fascia and is frequently overloaded when the fascia is irritated. Needling here restores its function and reduces strain on the fascia itself.
  • Quadratus Plantae (QP): This small but powerful muscle helps align the pull of the flexor digitorum longus. When it’s tight or dysfunctional, it contributes to foot fatigue and chronic heel pain.

By targeting these overlooked muscles, dry needling helps break the pain cycle and restore normal mechanics at the source.

Why this works better than injections: Instead of suppressing inflammation, dry needling stimulates controlled healing. It tells the body: “Hey, repair this tissue properly.” That’s the opposite of masking the problem.

Step 2: Restoring Ankle Mobility

Plantar fasciitis rarely happens in isolation. One of the biggest contributors? Stiff ankles.

If your ankle can’t bend (limited dorsiflexion), every step puts more load on your plantar fascia. Over time, that irritation adds up to pain.

That’s why we:

  • Mobilize the ankle joint to restore normal motion
  • Stretch and release tight calf muscles
  • Re-train proper gait mechanics so the fascia isn’t overloaded

Why this matters: You can needle the fascia all day, but if the ankle is still locked up, the problem will just come back. Mobility is non-negotiable.

Step 3: Correcting Foot Mechanics (Pronation & Supination)

Another often-ignored factor is how your foot moves when it hits the ground.

  • Overpronation (rolling in too much) flattens the arch and overstretches the fascia.
  • Oversupination (not rolling in enough) creates a rigid, high-impact landing that strains the fascia.

We assess each patient’s foot mechanics and correct them with:

  • Targeted strengthening of the intrinsic foot muscles
  • Corrective exercises for the hips and knees (since they influence foot position)
  • In some cases, customized orthotics to provide support while we retrain the body

Why this works: Instead of blaming your fascia, we fix how the whole chain above it works. The result? Lasting change.

The Real Debate: Quick Fix vs. True Fix

So let’s put it head to head.

Walking Boot / Cortisone Injection
Masks pain temporarily
Doesn’t improve function
Risk of side effects / setbacks
Relies on rest
Problem often returns

Dry Needling + Mobility + Mechanics Approach
Treats the actual cause of pain
Restores muscle, fascia, and joint function
Stimulates natural healing
Gets you back to activity faster
Long-term relief and prevention

It’s not even close.

A Real-World Example

I once treated a patient who had been through two cortisone injections and six weeks in a boot. Each time, she felt a little better—until she started walking again. Then the stabbing heel pain returned.

When she came to us, we needled her medial calcaneal tubercle, FDB, and QP. We mobilized her ankle and corrected her excessive pronation with exercises. Within four weeks, she was walking pain-free. Within eight, she was back to running.

Her words: “I wish someone had told me this was possible before I wasted months in a boot.”

Why Most Clinics Don’t Treat It This Way

The unfortunate reality is that many clinics focus on symptom relief, not cause correction. Injections and boots are quick to prescribe, require little follow-up, and fit a traditional medical model.

But true healing takes more than a prescription—it takes a customized, hands-on approach. That’s exactly what makes our clinic different.

The Bottom Line

Walking boots and cortisone injections aren’t evil—they just aren’t the best solution. They may give you a few weeks of relief, but they rarely solve the problem.

If you’re tired of waking up with stabbing heel pain, skipping workouts, or planning your day around when your foot will hurt less, it’s time to stop debating short-term fixes.

Instead, focus on what actually heals:

  • Dry needling the true pain generators (medial calcaneal tubercle, FDB, QP)
  • Restoring ankle mobility
  • Correcting faulty foot mechanics

That’s how you get rid of plantar fasciitis once and for all—and that’s why this debate, for me, isn’t even close.

Oliver’s Healthy Recipe

Oliver’s Corner Recipe

Recipe of the Month: Game-Day Smoked (or Baked) Chicken Wings

Fall means football, and football means wings. But let’s face it — fried wings dunked in heavy sauces can weigh you down fast. That’s why this month we’re sharing a lighter, protein-packed version that doesn’t sacrifice flavor.

Ingredients (Serves 4–6):

  • 2–3 lbs chicken wings (drumettes and flats)
  • 2 tbsp olive oil (or avocado oil)
  • 2 tsp smoked paprika
  • 1 tsp garlic powder
  • 1 tsp onion powder
  • 1 tsp salt
  • ½ tsp black pepper
  • Optional: pinch of cayenne for heat

Ingredients

For dipping: Greek yogurt ranch or buffalo sauce

Instructions:

  1. Prep the wings: Pat wings dry with paper towels. This helps them crisp up without frying.
  2. Season: Toss wings in olive oil, then mix with paprika, garlic powder, onion powder, salt, and pepper.
  3. Choose your method:
    • Smoker/Grill: Smoke wings at 225°F for 1.5–2 hours, then finish with a quick sear over higher heat to crisp.
    • Oven-Baked: Place wings on a wire rack over a baking sheet. Bake at 400°F for 40–45 minutes, flipping halfway through.
  4. Serve: Enjoy with celery, carrots, and a lighter dipping sauce like Greek yogurt ranch.

Why They’re Better:

  • Lower in fat than fried wings
  • Packed with protein for energy and recovery
  • Smoky, flavorful, and guilt-free

Fitness Corner

Working Out for a Cause

This September, we’re combining fitness with giving back. From September 8th through September 13th, Back In Motion will be hosting a special fundraiser for Valerie’s House—and we’d love for you to join us.

Here’s how it works:

  • Come in for a workout during our fundraiser dates.
  • 100% of the proceeds will be donated directly to Valerie’s House.
  • The more people who participate, the more support we can provide!

So, what is Valerie’s House? It’s not a shelter or a traditional counseling center. It’s a non-profit organization that provides a safe, supportive space for children and families who have lost a loved one. They help kids process grief, connect with others who are walking the same path, and find hope for the future. Their mission is simple but powerful: no child should ever have to grieve alone.

By showing up, sweating it out, and moving your body with us, you’ll be helping local families heal during some of the hardest times of their lives.

Whether you’re already part of our Back In Motion family or just want to come try a workout for a great cause, this is your chance to do something meaningful—for yourself and for others.

Let’s move together, give together, and show Valerie’s House the strength of our community.

To attend a workout session, call our office at 239-223-0484.

Staff Spotlight

Anna is our lead office receptionist at our cape coral physical therapy clinic

Anna Bernier

Anna is originally from Cali, Colombia where she went to school for Fashion Design. She moved to the US many years ago. In the past years she worked in all aspects of a Natural & Organic Grocery Store where she grew into the Store Manager position. This is where she developed her passion for living a healthy lifestyle. She loves introducing others to the benefits of staying healthy by adding exercise and a healthy diet to their daily routine.

Outside the clinic Anna enjoys outdoor activities with her husband and her 2 playful schnauzers Midnight and Belleza. She is also passionate about cooking and trying new healthy recipes!

Place: The Beach
Food: Mediterranean
Vacation Spot: St. Augustine, FL & Pigeon Forge TN
TV Show: Master Chef
Film: Ben-hur
Song: Goodness of God
Celebrity: Liam Neeson
Book : The Bible
Sport: Soccer

Fitness Client Of The Month

Fitness Client of the Month —Shelly Wilson

Shelly has been working out with us at Back in Motion about 12 months ago. She came to us because she wanted to tone up, improve her energy, and take back control of her health.

Patient Case Study of the Month

How Steven Finally Kicked His Sciatica to the Curb With Dry Needling (And Why the Research Proves It Works)

Let me tell you about Steven.

Steven was like a lot of people who walk into my clinic. Mid-60s. Hard-working. Active. Proud that he still hit the golf course every weekend.

But then the pain started.First, it was a nagging ache in his lower back. Then it shot down into his buttock. Then into his thigh. Before long, he was wincing every time he stood up. Sitting was torture. Sleep? Forget it.

The diagnosis: sciatica.

Now, Steven was no wimp. He’d toughed out aches and pains before. But this was different. This was sharp, burning, relentless. 

By the time he saw me, Steven was skeptical. He’d been through the wringer of resting but no luck in resolving the issue.

The Problem With “Typical” Sciatica Treatment

Here’s the dirty little secret: most sciatica treatments are just Band-Aids.

  • Painkillers mask symptoms but don’t fix anything.
  • Injections (like epidurals) reduce inflammation but often wear off in weeks.
  • Rest actually makes the nerve more sensitive.
  • Stretching can even make things worse if you stretch the wrong tissue.

Steven had tried some of these. None worked.

That’s when I told him about something different: dry needling with the Gray Method™ evaluation.

Step One: Rule Out the Spine

Most people assume sciatica always comes from a herniated disc or spinal stenosis. That’s the story you hear again and again: “It’s your back, it’s compressing the nerve, nothing you can do except surgery.”

But the Gray Method™ is about fixing the cause, not chasing symptoms.

So before sticking a single needle, we tested him. We ruled out:

  • Radiculopathy from a herniated disc.
  • Spinal stenosis narrowing the canal.
  • Other red flags that might need a surgeon’s attention.

No signs of spinal cord compression. No disc herniation severe enough to cause his weakness. This wasn’t a case for surgery.

That meant his problem wasn’t at the spine. His problem was along the nerve pathway itself.

Step Two: Target the True Pain Generators

We started with the usual culprits:

  • Piriformis – the deep buttock muscle that can strangle the sciatic nerve like a vise grip.
  • Gluteus medius/minimus – when weak or tight, they mimic sciatic pain.
  • Hamstrings – the sciatic nerve runs through these muscles. When tight, they can compress the nerve.
  • Lumbar paraspinals – spastic back muscles feeding irritation into the nerve roots.

When I needled his piriformis, his whole buttock jumped. That was the twitch response we were looking for—the muscle letting go. Immediately, Steven felt looser.

But here’s where his case got more complicated.

Steven didn’t just have pain. He had weakness. In fact, his foot was starting to “slap” when he walked. Drop foot. That told me the nerve irritation had traveled further down.

Step Three: Follow the Sciatic Nerve Pathway

The sciatic nerve is like a highway. It starts in the spine, then splits in the leg into the tibial nerve and the common peroneal nerve.

Steven’s symptoms weren’t just in his buttock—they followed the path all the way down his hamstring into his calf and foot.

So we followed the nerve.

  • We needled his hamstring muscles, releasing taut bands that were choking the sciatic nerve as it ran down his leg.
  • At the fibular head (outside of the knee), we treated the common peroneal nerve entrapment site—a notorious spot where the nerve gets irritated.
  • We also needled along the deep peroneal and superficial peroneal pathways in his shin and foot, releasing tension where his nerve was most vulnerable.

Each session, he felt less burning. Less tingling. More strength returning to his foot.

Why Dry Needling Works Here

This isn’t magic. It’s physiology.

Dry needling at these entrapment sites does three things:

  1. Releases muscle tension around the nerve (taking pressure off).
  2. Improves blood flow to the nerve, bringing oxygen and nutrients.
  3. Resets abnormal nerve signaling that keeps pain and weakness going.¹

Compare that to cortisone injections that just “quiet the inflammation” or medications that numb your brain but do nothing for the nerve. This helps also reduce the muscles that are tight and compressing the nerve

The Research Backs It Up

You don’t have to take my word for it.

  • Gohil and colleagues ran a randomized controlled trial and found that dry needling reduced pain and improved function in patients with lumbar disc herniation and sciatica compared to sham treatment.²
  • Liu et al’s 2021 meta-analysis confirmed that dry needling improves pain and disability in patients with low back pain and sciatica by targeting trigger points along the chain.³
  • Domingo et al showed dry needling creates neuromuscular changes—normalizing electrical activity and reducing spasms in patients with low back pain—exactly what Steven needed.¹

This isn’t fringe. This is science.

The Transformation

Over the course of several weeks, Steven went from hobbling with drop foot to walking normally.

  • His hamstring pain was gone.
  • His calf tingling faded.
  • His foot began to lift with strength again.

And all without surgery. Without injections. Without another round of useless meds.

By retracing the nerve’s journey—and treating the muscles and entrapments along the way—we gave Steven his life back.

He went from fearing a permanent limp to playing golf again with zero pain.

Why the Gray Method™ Makes the Difference

Most clinicians would have stopped at “sciatica = back problem.” They would’ve thrown painkillers or injections at his spine, maybe even sent him to surgery.

But because we ruled out spinal causes, and then followed the nerve pathway step by step, we uncovered the true reason for his pain and weakness.

That’s the Gray Method™. We don’t chase symptoms. We find and fix the cause.

The Truth Bomb

Listen—if you’ve read this far, you might be where Steven was: stuck, in pain, wondering if life will ever feel normal again.

Most people bounce around the medical merry-go-round: meds, injections, failed stretches, bad advice. They lose months, sometimes years.

Steven was almost that guy.

But he didn’t give up. He tried something different. He got real answers. And now he’s pain-free.

If you’ve got sciatica, don’t settle for “band-aid care.” Find someone who will evaluate the whole chain. Find someone who can needle the right spots, restore your mobility, and give you back your strength.

Because like Steven, you deserve to get your life back.

References

  1. Domingo A, Mayoral O, Monterde S, Santafé M. Neuromuscular effects after the application of dry needling in patients with low back pain: A clinical trial. J Manipulative Physiol Ther. 2013;36(9):623-631. doi:10.1016/j.jmpt.2013.08.005
  2. Gohil P, Shetty N, Dabadghav R. Effect of trigger point dry needling on pain and function in patients with lumbar disc herniation and radiculopathy: A randomized controlled trial. Pain Med. 2019;20(7):1317-1323. doi:10.1093/pm/pny263
  3. Liu L, Huang QM, Liu QG, et al. Evidence for dry needling in the management of myofascial trigger points associated with low back pain: A systematic review and meta-analysis. Clin Rehabil. 2021;35(2):173-186. doi:10.1177/0269215520957572

Events of the Month

Events of the Month – September Highlights

We’ve got an exciting month ahead at Back In Motion! Mark your calendars and don’t miss your chance to learn, give back, and get rewarded:

Charity Workout – Valerie’s House

Dates: September 8th – September 15th
 Join us for a special week of workouts to raise funds for Valerie’s House, a nonprofit that helps children and families heal after the loss of a loved one. Every workout you attend during this week = a donation to Valerie’s House. Come sweat for a cause and make a difference in our community!

Plantar Fasciitis Workshop

Date: Wednesday, September 17th | 5:15 PM – 6:00 PM EST
 Heel pain shouldn’t hold you back. Discover the true root causes of plantar fasciitis and how to finally get lasting relief — naturally.
 👉 Save your spot now

Urinary Incontinence Workshop

Date: Tuesday, September 30th | 5:30 PM – 6:15 PM EST
 Topic: 3 Secrets to Overcoming Urinary Incontinence — Without Surgery, Pads, or Medications
 If bladder leaks are holding you back, this free workshop will give you the knowledge and tools to take control again. Led by Dr. Fernanda Paulsen.
 👉 Reserve your seat here

Fitness Workshop (October Sneak Peek!)

Date: Thursday, October 2nd | 5:15 PM – 6:00 PM EST
 Topic: How to Ignite Your Metabolism and Burn Fat After the Age of 50
 If you’re 50+ and tired of stubborn fat, low energy, and workouts that don’t seem to work anymore, this is your chance to learn how to safely and effectively rev up your metabolism.
 👉 Register today

Testimonials

“I’m a little apprehensive about driving from Naples to Fort Myers, just physical therapy several times a week, but I’m glad I did. The outcome has been absolutely spectacular!
“
- Barb Steinberg
“I really like that you were more focused on getting me back in the gym because you knew that was really important to me.”
- Emily

Get to the Root Cause of Your Pain Today!

Inquire About an Appointment Today and Someone From Our Team Will Be in Contact With You Shortly