Shockwave Therapy
Radial Shockwave Therapy (RSWT) consists of a series of high energy percussions to the area being treated. The shockwave spreads outwards (radially) from the applicator head into the tissue to a depth of about 3.5cm. The shockwave is physical in nature, not electrical.
What is shockwave therapy?
It is hypothesized that RSWT creates a controlled local tissue injury. The micro-trauma created by RSWT creates an inflammatory response, leading to neovascularization (new blood flow), speeding up the healing process.
What does shockwave treat?
RSWT is primarily used to treat chronic connective tissue injuries such as:
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Plantar Fasciitis
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Jumpers Knee
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Achilles Tendinosis
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Calcific Tendonopathy
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Rotator Cuff Tendinosis
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Tennis/Golfer’s Elbow
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Trigger Points
However, any chronic tendon or fascia injury may be a candidate for shockwave treatment.
How many treatments are needed?
The typical number of RSWT treatments for an injury is 3. These treatments are performed every 7 to 10 days. On occasion, 1 or 2 additional treatments are indicated.
How long does the treatment last and what does it feel like?
RSWT treatments will take only a few minutes to complete in most cases. Shockwave often is accompanied with a moderate amount of discomfort during treatment. Shockwave discomfort should not be unbearable. If the treatments are not within clients’ comfort tolerance they should inform their treating clinician.
Are there precautions or contraindications?
RSWT is not recommended for clients with bleeding disorders, suspected neuropathic lesions, malignancies or other neoplastic lesions. Shockwave is not used if a cortisone injection has been received in the previous 6 weeks. Shockwave is not recommended during pregnancy. Precautions or contraindications should always be discussed with your treating clinician prior to receiving RSWT to ensure that it is safe to proceed with shockwave treatments.
After Treatment
Following a treatment, the area that is shockwaved should not be treated with antiflammatory agents, such as ice, as this may alter the desired cascade of healing that is expected to occur. Interestingly, even though RSWT can be somewhat painful to receive, many patients report an immediate decrease in pain in the days following initial treatment. However, it is also not uncommon to have some increase in discomfort for a few days after treatment.
What does the research tell us?
Calcification disappeared completely in 86% of shoulder calcific tendinitis and only partially in 8.8% in the control (non-RSWT) group. Physical Therapy, 8(5), 2006
Shockwave patients showed superior results to eccentric loading exercises for the treatment of insertion Achilles tendinosis. Journal of Bone & Joint Surgery, 90(1), 2008
Radial shock wave therapy significantly decreases pain and improves function and quality of life compared to placebo group in study of 245 patients with chronic plantar fasciitis. Am. J Sports Med., 36(110), 2008