Shockwave Therapy

Shockwave Treatment for Chronic Pain and Injuries 

‘Shock Waves’ are movements of high pressure caused by, for example, an explosion, a gun shot, or an airplane breaking the sound barrier.   

Extracorporeal Shock Wave Therapy (ESWT) is the application of shock waves in medicine.  The ESWT machine generates thousands of high-intensity shockwaves creating a significant amount of mechanical energy that is absorbed by the tissues being treated. This mechanical energy has a multitude of physiological effects on the area being treated. 

An abundance of research has shown that when shock waves are applied to injured tissues:

  • There is a reduction of pain felt by nerve fibers
  • The healing process is stimulated by activation of stem cells
  • New repair tissue can begin to ‘fill in’ the injured tendon or tissue
  • There is a decrease in neurogenic inflammation and inflammatory chemicals such as Substance P and CGRP
What conditions can be helped by Shockwave Therapy?

The most studied indications for ESWT are chronic tendon issues such as tendinitis and tendinopathies, plantar’s fasciitis, and chronic myofascial trigger points. Here is a brief list of the research-supported indications for ESWT:

  • Plantar Fasciitis
  • Achilles Tendonopathy or Achilles Tendonitis
  • Tennis Elbow (Lateral Epicondylalgia)
  • Golfer’s Elbow (Medial Epicondylalgia)
  • Subacromial Pain Syndrome or Rotator Cuff Tendonopathy
  • Calcifying Tendinitis of the Shoulder
  • Shin Splints (Medial Tibial Stress Syndrome)
  • Osgood Schlatter Disease
  • Trochanteric Hip Pain (Gluteal Tendinopathy, Bursitis)
  • Low Back Pain
  • Myofascial Trigger Points

Most of these conditions respond within 3-5 sessions of ESWT and are typically spaced about a week apart.

At Coeur Physiotherapy we are impressed with the abundance of research that backs ESWT and the results that it has achieved for our patients.

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How do I know if I should try shockwave therapy?

The best way to determine if ESWT will be beneficial is to have a consultation with your physiotherapist. Shockwave Therapy is effective if applied to the right injury, on the right person, at the right time, and our physiotherapists are specially trained to identify those who are most likely to respond to treatment.

Much of the research on ESWT shows that it works best when used in conjunction with a targeted exercise program. This makes sense – if you are trying to repair a tendon or tissue, it stands to reason that part of that process should be to make the tendon strong and resilient again. Your physiotherapist will provide you with a personalized exercise program that fits your lifestyle and goals to complement the effect the shockwaves are having.

Is Shockwave Therapy the same as Ultrasound Therapy?

No. Therapeutic Ultrasound works by generating low-frequency sound waves in order to affect the treated tissues.  While ultrasound can have several physiological effects, the mechanical impact and effect of shockwave therapy is significantly higher.  They are two very different technologies with very different indications.

Which Shock Wave device do you use?

At Coeur Physiotherapy we use the Swiss Dolorclast Radial Shockwave device.

Being the big nerds that we are at Coeur, we noticed that in the scientific literature that 80% of the studies showing effectiveness of ESWT used the Dolorclast devices and has been proven through over 26 randomized controlled trials. In comparison studies, the Dolorclast devices been shown to produce a consistently higher energy-output thanks to a robust 30-pound external oil compressor, compared to some of the smaller table-top units.

Radial Shockwave is a newer technology than the original Focused Shockwave technology, which was initially used for deeper applications such as to break up kidney stones in the bladder. Radial Shockwave was designed for the application of shock waves to more shallow areas such as tendons, muscles, and joints.