Shockwave Therapy is a non-invasive treatment that involves the delivery of shock waves to injured soft tissue to reduce pain and promote healing. The bombarding of the affected tissue by pneumatically generated acoustic waves produces a number of biological responses resulting in new blood vessel growth which accelerates the healing process.
Shockwave Technology can be utilized to effectively treat a wide variety of conditions including but not limited to:
Pain in the bottom of the foot when standing or walking caused by thickening and irritation of the plantar fascia where it attaches onto the heel bone.
Pain and thickening of the tendon at either the insertion or mid portion of the tendon that attaches the calf muscle to the heel bone.
A painful condition of the tendon that attaches the patella to the tibia usually following increased jumping.
Pain and increased sensitivity with gripping at the outside of the elbow where the forearm extensor tendon attaches.
A very painful condition resulting from the presence of calcific deposits in the rotator cuff tendon or bursa in the shoulder.
Pain in the front of the shin which may involve the muscle, connective tissue and bone due to overuse usually in runners.
The mechanism and benefits of shockwave is not yet completely understood. Many of the following mechanisms have been described in explaining the effects:
Improved blood flow – Normal blood flow is necessary to start and maintain the repair processes of damaged tissues. The acoustic wave cause micro rupture that stimulates re-vascularization, improving blood supply and oxygenation to support faster healing in tendon and bone.
Stimulation of collagen – Collagen is an important building block and necessary in the repair process of the musculoskeletal system. Shockwave therapy accelerates pro-collagen synthesis creating a denser and stiffer structure.
Break down of calcium deposits – Calcifications in the rotator cuff tendon can be painful if they get inflamed. Shockwave therapy starts the biochemical decalcification of the calcium build-up and then the lymphatic system removes the particles.
Pain reduction – Substance P is a neurotransmitter that relays nociceptive messages to the central nervous system. Acoustic shockwaves lower the Substance P concentration and thus reduce pain.
Muscle tone reduction – An active trigger point is a hyper-irritable spot in skeletal muscle that is associated with a tender and palpable taut band of muscle. Shockwave treatment reduces the contractile activity in the muscle to effectively decrease muscle tone and spasm.
Shockwave therapy has been proven an effective and safe non-invasive treatment for relieving pain and improving the quality of life in patients with tendon pain.
Rigorous high quality research papers have shown it to have success in the treatment of many soft tissue disorders.
Shockwave therapy will be recommended only after a thorough orthopedic examination by your physiotherapist to determine that you are an appropriate candidate.
Our clinic uses the Storz Radial Shockwave system to deliver the treatment which uses the most successful technology used worldwide today. Shockwaves are released through the applicator as it is moved over the treatment area. You may feel a little pain or discomfort during the 3- 5 minute treatment time. Your therapist will adjust the settings if it is too painful to make it more comfortable.
No. Shockwave is not a stand-alone treatment. Tendon pain can be challenging to treat and requires the use of other modalities with loading the tendon through appropriate graded exercise as the most important.
In general, an average of 3 to 5 treatments are necessary at weekly intervals. Many patients patient’s report significant pain reduction after 1 – 2 sessions.
Many clients experience a decrease or complete absence of pain immediately after treatment. In some cases, patients may experience minor discomfort for a few days. Shockwave purposefully creates an inflammatory response in the injured tissue so pain can be normal and your body’s way of healing itself and regenerating the targeted tissue. Patients should therefore not interrupt this response by using ice or take anti-inflammatories after the treatment.
Wang, CJ, Chen, HS. Shock Wave Therapy for Patients with Lateral Epicondylitis of the Elbow. The American Journal of Sports Medicine, Vol. 30, No.8: 422-425, 2002
Kim YS, Lee HJ, Kim YV, Kong CG: Which method is more effective in treatment of calcific tendinitis in the shoulder? J Shoulder Elbow Surg. 2014 Nov;23(11):1640-6.
Rompe J, Furia J, Maffulli N. Eccentric loading vs eccentric loading plus shock wave treatment for mid-portion Achilles tendinopathy. A randomized controlled trial. American Journal of Sports Medicine. 2009;37(3):463-470.
Cacchio, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med. 2011 Jan;39(1):146-53.