Shockwave Therapy: What Does the Research Say?

Shockwave Therapy: What Does the Research Say?

Have you been battling an injury that just doesn’t want to go away? Shockwave Therapy may just be the missing piece to kick start the recovery process. It’s non-invasive, evidence-based, and often used when injuries stop responding.


What is Shockwave Therapy?

Shockwave Therapy is a non-invasive treatment used to stimulate healing. A handheld device sends high-pressure sound waves through the skin. It’s used for chronic injuries and provides a safe addition to manual therapy and exercise-based rehab.


How Does It Work?

Shockwave therapy is believed to support healing through different mechanisms:

    • It increases blood flow to the injured tissue by encouraging the formation of new blood vessels. More blood flow means more oxygen and nutrients, essentials for healing. 1, 2
    • It stimulates collagen production and activates tenocytes, which are key cells that help repair tendon. This promoting tissue remodelling. 3, 4
    • Shockwave therapy may help break down scar tissue and calcium, especially in the shoulder, so the body can reabsorb the deposits naturally over time. 2, 5
    • It may reduce pain in the short-term by desensitising hypersensitive nerves in the area, however the exact mechanism is not fully confirmed.6, 7
    • Shockwave therapy is thought to restart the healing process, through dosed microtrauma. It may trigger the body to treat an old injury, like a new injury and trigger a fresh healing response.3, 4


What Injuries Can It Help?

    • Plantar fascitis
    • Achilles tendinopathy
    • Patella tendinopathy
    • Gluteal tendinopathy
    • Tennis and Golfer’s elbow
    • Calcific Tendinopathy of the shoulder
    • Proximal hamstring tendinopathy
    • Shin splits

These are all well researched and have good outcomes using shockwave therapy, especially when combined with exercise-based intervention.


How Many Sessions Will You Need?

Most people respond well to 3 to 6 sessions, depending on how irritated the tissue is and how long the injury has been lingering for. Sessions are ideally spaced one week apart.


Each session is tailored to the specific injury and how your body responds. The physio adjusts three key things during treatment:

    • Pressure: how strong the shockwaves are.
    • Pulses: the total number of pulses applied in the session.
    • Frequency: how fast the pulses are applied.


Your physio will adjust these setting’s based on your injury, your individual pain levels, and how you respond after each session.


What Does It Feel Like?

You’ll feel a constant tapping over the area. And, yes it may feel tender and uncomfortable, especially in the more irritated areas, however people are able to tolerate the feeling well. Sessions are quite short lasting 10 to 15 minutes, followed by other adjunctive therapy. 

Post treatment, you may feel an ache in the area or possibly some bruising. This is normal and will settle within a day or so.

Final Thoughts

If you’re dealing with a stubborn injury that is just not budging, shockwave therapy might be the adjunct required. It can be used to help accelerate healing when things have began to plateua and give the injury a new burst of healing. Feel free to chat with one of our physios for more information regarding shockwave therapy.



References:

1. Gligor, Ș., Vutan, A. M., Sîrbu, E., & Lupu, A. (2024). Current evidence of extracorporeal shock wave therapy (ESWT) in soft tissue disorders. Balneo and PRM Research Journal, 15(1), 54–59. https://bioclima.ro/Balneo684.pdf


2. Dedes, V., Stergioulas, A., Mitrogiorgou, M., Mitrogiannis, C., Mikalef, P., & Panoutsopoulos, G. I. (2018). Effectiveness and safety of shockwave therapy in tendinopathies. Materia Socio-Medica, 30(2), 141–146. https://doi.org/10.5455/msm.2018.30.141-146


3. Sampson, S., Semaan, A., Galido, P. V. G., & Brenchley, B. (2023). Extracorporeal Shockwave Therapy as an Orthobiologic Tool for Musculoskeletal Injuries: A Narrative. OrthoHealing Institute. https://www.orthohealing.com/wp-content/uploads/2025/03/Shockwave-as-an-orthobiologic-tool-2.24.pdf


4. De la Corte-Rodríguez, H., Román-Belmonte, J. M., Soriano-Maldonado, A., Ibáñez-Vera, A. J., Carrillo-Pérez, F., & Ortiz-Rubio, A. (2023). Extracorporeal Shock Wave Therapy for the Treatment of Musculoskeletal Pain: A Narrative Review. Healthcare, 11(21), 2830. https://doi.org/10.3390/healthcare11212830


5. Rhim, H. C., Shin, J., Kang, J., Park, S., Kim, D. H., & Kim, Y. (2024). Use of extracorporeal shockwave therapies for athletes and physically active individuals: A systematic review. British Journal of Sports Medicine, 58(3), 154–162. https://bjsm.bmj.com/content/58/3/154


6. Majidi, L., Khateri, S., Nikbakht, N., & Moradi, Y. (2024). The effect of extracorporeal shock-wave therapy on pain in patients with various tendinopathies: A systematic review and meta-analysis of randomized control trials. BMC Sports Science, Medicine and Rehabilitation, 16(1), 28. https://doi.org/10.1186/s13102-024-00884-8


7. Schmitz, C., Császár, N. B. M., Rompe, J. D., Chaves, H., & Furia, J. P. (2015). Treatment of chronic plantar fasciopathy with extracorporeal shock waves: Therapy recommendations. International Journal of Surgery, 24(Pt B), 179–183. https://doi.org/10.1016/j.ijsu.2015.10.037

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