What is shockwave therapy?

Shockwave therapy, also referred to as radial pressure shockwave therapy is an emerging treatment for the management of pain caused by various musculoskeletal disorders and injuries.

Shockwaves were initially used in the treatment of kidney stones. In the process of experimentation with the treatment, researchers noticed that shockwaves could have a substantial effect on bone. A series of experimental investigations later revealed that shockwaves have a healing effect on cartilage, bone and associated soft tissues.

How does Shockwave Therapy Work?

Today, the procedure is employed to deal with different types of soft tissue problems and other long-term problems in fascia, tendons, muscles and ligaments.

The Science:

A shock wave is an intense, short energy wave that moves faster than the speed of sound. They are typically characterized by:

• High positive pressures of more than 100 MPa
• Extremely short rise times (about 10 microseconds)
• Fast pressure rises (less than 10 nanoseconds)
• Narrow effective beams (2-8mm diameter)

When a pressure wave passes through the human tissue, it produces physiological and therapeutic effects. It is believed that four phases are involved in producing these therapeutic effects.

1. Phase one is the direct effect of the shock. Mechanical pressure causes extracellular cavitations which in turn ionizes the molecules increasing cell membrane permeability.
2. Phase two is the physical-chemical phase which involves the interaction of biomolecules with diffusible radicals. The waves may affect mitochondria and lysosomes and interfere with metabolism in the cell, increasing their activity to promote healing.
3. Phase three is the chemical phase which may be accompanied by molecular changes and intracellular reactions. When cavitation occurs, a high temperature is developed leading to the development of radicals.
4. The last phase, phase four, involves physiological responses to the first three phases.

These physiological responses lead to:

• Faster and long-term healing
• Regeneration of the tissue

Shockwave Therapy can help to:

• Reverse chronic inflammation that is very common in shoulder bursitis and rotator cuff injuries
• Stimulate collagen production, which is a vital substance in natural tissue repair
• Dissolution of calcium fibroblasts which are often part of the problem in chronic shoulder pain

What is it used to treat?

The following conditions are have shown positive responses to Shockwave Therapy:

• Plantar Fasciitis
• Hip and shoulder bursitis
• Achilles tendinopathy
• Carpal tunnel syndrome
• Coccydynia
• Hamstring tendinopathy
• Iliotibial band syndrome
• Lateral epicondylitis (tennis elbow)
• Medial tibial stress syndrome (shin splints)
• Myofascial trigger points
• Osgood-Schlatter disease
• Patellar tendinopathy
• Shoulder tendinitis & rotator cuff

Can Everyone Be Treated With Shockwave Therapy?

Shockwave Therapy isn’t suitable for everyone. If you have a condition on the following list you are not allowed to have this treatment:

• Haemophilia / Clotting disorder / Risk of haemorrhage
• Taking Anti-coagulant medication, eg. Warfarin or Rivaroxaban
• Cardiac pacemaker or other cardiac device
• Unstable heart condition
• Steroid injection to the treatment site in the last 6 weeks.
• Cancer
• Pregnant / trying to conceive
• Tumour at site of treatment
• Infection at site of treatment

Is Shockwave Therapy Painful?

Sometimes the treatment is a bit painful, but most people can normally tolerate this. If you cannot tolerate it, please let your practitioner know, as the dose can be amended to ensure you are comfortable.

It is also normal to feel a little tender on the area that has been treated during your session. Our team at iPhysio Australia will advise you how to keep this at a minimum and what activities to avoid directly after your treatment.