What is Shockwave, & Why Should You Consider It as a Treatment Option?
Your secret tool to recovering faster
Do you have pain with your first couple of steps out of bed in the morning? Do you have an old rotator cuff tear? Suppose you have seen a Chiropractor, Physiotherapist, or Athletic Therapist for treatment. In that case, the chances are you have been offered shockwave as an adjunct (i.e., addition) to your therapy. So why is this tool so popular, and what does shockwave therapy treat?
Shockwave or Extracorporeal shockwave therapy (ESWT) is a non-invasive vibration therapy solution that can quickly help you recover from soft tissue injuries. Shockwave has been around for more than 50 years[1], initially, shockwave was developed to treat kidney and urinary stones. Recently, bodies of literature have found that shockwave can be a beneficial treatment for soft tissue injuries.
How does shockwave work?
Have you ever been to an air show and heard a thunderous clap? Well, that sound is associated with the shockwaves from the sonic boom of an aircraft travelling faster than the speed of sound! Shockwave therapy applies similar physical principles, which cause sonic pulses to pass through a specific region of the human body[2,3]. For medical purposes, the sonic pulses or changes in pressure generally occur in a fluid then travels through a medium, such as ultrasound gel, before reaching tissue. The sonic pulses travel through fluid because the energy loss travelling through air is approximately 1000 greater than fluid. Once the sonic pulses reach the tissue, they act directly and indirectly (i.e., the fluid surrounding the area) on the tissue. The scientific community cannot identify the exact mechanism of pain relief; however, it is theorized that increased blood flow to the treated site causes an inflammatory-healing cascade[3] to occur, allowing the tissue to heal in the long-term.
Not only for tendon injuries…shockwave can be used for trigger point therapy, activating or decreased tension in muscles
Conditions Shockwave Therapy Can Treat
· Plantar fasciitis
· Achilles tendinopathy
· Myofascial trigger points
· Jumper’s knee
· Stress fractures
· Bursitis
· Hallux rigidus
· Shin splints
· Tennis elbow
· Non-healing ulcers
· Calcific rotator cuff tendonitis
· Scar tissue
· Hamstring tendinopathy
· Osgood Schlatter
· Stress fractures
· Enhancement of bone healing
· Hallux rigidus
91% success rate for calcific rotator cuff tendonitis
Benefits of Shockwave Therapy
· Non-surgical treatment
· No significant side effects
· Accelerates healing
· Covered by most insurance companies
· Quick mobility and strength benefits in treated areas
The foot & ankle international, in 2012 found a 90% success rate for plantar fasciitis
Backed by Research
Gordon et al., from the American Orthopaedics Foot & Ankle Society[4], conducted a study to determine if there was a change in pain and plantar fascia thickness after shockwave therapy. Bilateral (i.e., both feet) ultrasound was used as an objective measurement of the plantar fascia. The study found that with shockwave treatment, the patient’s pain at rest and activity significantly decreased. Concurrently, the average plantar fascia thickness significantly decreased by approximately 1.3mm or 17.7%.
Gerdesmeyer et al. from the American Journal of Sports Medicine[5] conducted an international randomized control trial comparing patients with chronic plantar fasciitis who received shockwave therapy to those who received placebo treatment. They found that three shockwave therapy sessions significantly reduced pain, increased function and quality of life when measured at follow-up (12-weeks).
Overuse injuries, including but not limited to chronic hamstring tendinopathies, are typically managed by conservative care, like chiropractic, athletic therapy, and physiotherapy. Cacchio and colleagues from the Journal of Sports Medicine[6] identified that shockwave therapy significantly reduced the pain of hamstring tendinopathies in professional athletes. After three months of care, the group that underwent shockwave therapy had approximately a 70% reduction in pain. The control group, which underwent non-steroidal anti-inflammatory drugs, physiotherapy, and an exercise program for hamstring specific exercises, had approximately a 2% reduction in pain at three months.
Shockwave is a safe and successful treatment for chronic hamstring tendinopathy with 80% success rates.
Contraindications
General contraindications for shockwave include:
· Pregnancy
· History of Cancer
· Blood clotting disorders
· Use of blood thinners
Ask your health care provider if you think shockwave would be a good fit for you.
Kristy Blair is an Athletic Therapist with Integra Health Centre. She would be thrilled to work with you to reach your athletic and lifestyle goals. To book your initial Athletic Therapy assessment with Kristy, click the link or visit her bio at https://www.integrahealthcentre.com.
1. Thiel M. Application of shock waves in medicine. Clin Orthop Relat Res. 2001;(387):18–21. doi:10.1097/00003086–200106000–00004
2. Ogden JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy. Clin Orthop Relat Res. 2001;(387):8–17. doi:10.1097/00003086–200106000–00003
3. Chung B, Wiley JP. Extracorporeal shockwave therapy: A review. Sport Med. 2002;32(13):851–865. doi:10.2165/00007256–200232130–00004
4. Gordon R, Wong C, Crawford EJ. Ultrasonographic evaluation of low energy extracorporeal pulse activated therapy (EPAT) for chronic plantar fasciitis. Foot Ankle Int. 2012;33(3):202–207. doi:10.3113/FAI.2012.0202
5. Gerdesmeyer L, Frey C, Vester J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis. Am J Sports Med. 2008;36(11):2100–2109. doi:10.1177/0363546508324176
6. Cacchio A, Rompe JD, Furia JP, Susi P, Santilli V, De Paulis F. Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. Am J Sports Med. 2011;39(1):146–153. doi:10.1177/0363546510379324
