Aims: To assess the efþcacy of repeated low-energy extracorporeal shock wave application (ESWA) for chronic plantar fasciitis in runners. Methods: 45 running athletes with intractable plantar heel pain were enrolled in a randomized single-blind trial with a parallel-group design and blinded independent observer, to evaluate the efþcacy of three applications of 2100 impulses of ESWA (Group I) compared with sham treatment (Group II). Follow-up examinations were done at six months, and at one year after ESWA. The primary efþcacy endpoint was reduction of subjectsñ self-assessment of pain on þrst walking in the morning on a visual analog scale (range, 0 Ð 10 points) at six months after shock wave application. Results: After six months self-assessment of pain on þrst walking in the morning as primary efþcacy endpoint showed a signiþcant reduction from an average 6.9 to 2.1 points in Group I, and from an average 6.9 to 4.7 points in Group II on the visual analog scale. The mean difference between both groups was 2.6 points (p= 0.0004; 95% CI: 1.3 Ð 3.9; power = 0.9). After twelve months pain on þrst walking in the morning showed a further reduction in both groups, to an average 1.5 points in Group I, and to 4.4 points in Group II (p < 0.0001). Conclusion: The current study showed that three treatments with 2100 impulses of low-energy ESWA were a safe and effective non-surgical method for treating chronic plantar fasciitis compared with sham therapy.