Shockwave Therapy
Educational purposes only. This content is not medical advice and does not establish a doctor-patient relationship. Every condition is different — please consult a qualified healthcare provider for guidance specific to your situation. Terms of Use
What it is
Extracorporeal shockwave therapy (ESWT) delivers acoustic pressure waves to injured tissue. These aren't electrical shocks. They're mechanical pulses that stimulate a biological healing response in tissue that's been stuck in a cycle of degeneration.
Think of it this way: chronic tendinopathy and fasciopathy often involve tissue that's stopped trying to heal. The normal inflammatory-repair sequence got interrupted, and the tissue is just sitting there in a degenerative state. Shockwave restarts that process by creating controlled micro-trauma that triggers the body's repair machinery.
What it treats
Shockwave has the strongest evidence for chronic tendinopathies and fasciopathies. The conditions I most commonly treat with shockwave include:
Plantar fasciitis (one of the best-studied indications). Achilles tendinopathy. Patellar tendinopathy. Gluteal tendinopathy (lateral hip pain). Lateral epicondylitis (tennis elbow). Calcific tendinitis of the shoulder. Chronic myofascial trigger points.
What a treatment feels like
I apply a coupling gel to the treatment area and deliver the shockwaves using a handheld applicator. Each session involves roughly 2,000 to 3,000 pulses over 5 to 10 minutes. It's not painless. Most patients describe it as a deep tapping sensation that ranges from mildly uncomfortable to moderately painful depending on the area and the severity of the condition.
I adjust the intensity based on your tolerance. The goal is to work at a therapeutic level without making the experience miserable.
Treatment protocol
A typical course is 3 to 6 sessions spaced one week apart. Improvement often begins after the second or third session and continues for several weeks after the last treatment as the tissue remodeling process unfolds.
After treatment
Some increased soreness in the treated area for 24 to 48 hours is normal. This is part of the healing response. Avoid anti-inflammatory medications (ibuprofen, naproxen) after shockwave treatment for the same reason we avoid them after PRP: they suppress the inflammatory cascade we just intentionally triggered.
Continue moving normally. There's no downtime. Activity modification is based on your condition, not the shockwave treatment itself.
What shockwave doesn't do
It's not a magic fix for everything. Shockwave works best for specific tissue pathologies where the mechanism of action (stimulating healing in degenerative tissue) matches the problem. It's not a substitute for addressing the biomechanical factors that caused the tissue to degenerate in the first place. That's why I pair it with OMM and a loading program.