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Introducing Shockwave Therapy

Extracorporeal radial shockwave therapy (ERST), the new kid on the medical block that packs a small punch and is starting to gain a good reputation in the orthopaedic and physiotherapeutic world.

I had my reservations, it is a machine after all and I have prided myself in being a hands-on physiotherapist. But I have to give acknowledgement where it is due and so far this addition to my toolbox is proving successful.


Who would benefit?


Clinically in the practice I have seen it help with severe muscle spasm especially in the lower back, gluteal muscles and hamstrings. Some of the shoulder tendinopathies, tennis elbows and plantar fasciitis are also responding well, which was the main reason I first investigated this machine.


It can be used as an alternative to trigger point therapy resulting in reduced pain, muscle tension and muscle shortening.


Shockwave has been shown to be beneficial in treating:

  • Tennis elbow
  • Rotator cuff tendinopathy
  • Calcific tendinopathy in the shoulder
  • Plantar fasciitis
  • Shin splints
  • Jumpers knee
  • Trochanteric bursitis
  • Achilles tendinopathy
  • Myofascial pain
  • Cellulite (yes you read that correctly)


However, it is not the be all and end all. Research says that 60-90% of tendinopathies respond favourably. So some people don’t respond. The research also indicates that the best results are with a combination of exercise and shockwave rather than shockwave on its own.


Like I mentioned before, it is an addition to the toolbox not some miracle cure for all. Beware of those. But let’s take a closer look.


What is shockwave?

Let me start by dispelling the myth that the name ‘shockwave’ creates. It is not an electrical current that is sent through the body creating a ‘shock’. This is a purely mechanical machine. The tongue-in-cheek description I give my patients is that it is like a human jackhammer. The machine uses an electromagnetic current which causes a bullet to hit a metal plate on the end, creating a wave that feels like a sharp vibration.


Is it painful?

Yes it can be, it really depends on where and what needs to be treated. Shockwave therapy over tendons tends to be more painful than over muscle tissue. However, it is not unbearable and should not conjure up visions of torture.


How does it help?

The shockwave with its mechanical action induces tissue repair and regeneration. Many of the cells that are responsible for healing, respond to mechanical stimulation which the shockwaves provide. If you are interested in reading exactly how the body and cells respond to shockwaves, this LINK will take you to a very informative site with the biological effects.


What is contra-indicated?



Pregnancy – working over the fetus.

Malignant tumour – over the treatment area.


Relatively (depends on the energy of the wave)

Use of anti-coagulants

Severe coagulopathy

Lung fields

Brain or spine tissue

Growth plates


Are you currently struggling with any of the conditions mentioned above?

Maybe it is time to give shockwave a go. 

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