How does Shockwave Therapy work?
The science behind the mechanics of Shockwave Therapy explained.
Here’s how Shockwave Therapy works - step by step:
1. Shockwaves penetrated into targeted area;
A handheld Shockwave device, produces high-energy acoustic waves. These are not electrical shocks, they are sound waves that penetrate the body non-invasively through ultrasound gel directly into the injured and damaged tissue that needs regenerating.
2. Tissue response;
*Increased blood flow: The waves stimulate new blood vessel growth (neovascularization), bringing oxygen and nutrients to speed up repair.
*Cell activation: Shockwaves activate fibroblasts and stem cells, which are key players in repairing tendons, ligaments, and bone.
*Pain modulation: The soundwaves positively interfere with nerve signals that transmit chronic pain, leading to reduced sensitivity.
*Breakdown of calcifications/scar tissue: In some conditions (like calcific tendinitis), the waves help break down calcium deposits or fibrotic tissue, making it easier for the body to reabsorb or remodel them.
3. Healing process;
Over the following weeks, the body uses these micro-stimuli to enhance tissue regeneration and reduce inflammation, often leading to pain relief and improved function.
The difference in penetration between Radial and Focused Shockwave Therapy.
🔹 Focused Shockwave Therapy (FSWT)
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How it works: Generates high-energy shockwaves that converge at a specific depth (like focusing sunlight through a magnifying glass).
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Penetration: Can reach deeper tissues - up to around 12 cm.
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Energy: Higher intensity, more targeted.
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Uses: Best for deep structures (e.g. non-healing bone fractures, deeper tendinopathies, calcific shoulder tendinitis).
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Sessions: Fewer are usually needed, but each session can be more intense.
🔹 Radial Shockwave Therapy (RSWT)
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How it works: Produces pressure waves that spread radially (like ripples when you throw a stone into water).
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Penetration: More superficial—effective up to about 3–4 cm depth.
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Energy: Lower intensity, more dispersed.
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Uses: Often for muscle pain, myofascial trigger points, and superficial tendon issues (like plantar fasciitis or tennis elbow).
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Sessions: Usually requires more treatments compared to focused.
The phases of healing after Shockwave treatment.
1. Inflammatory Phase - (First few days immediately after treatment)
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The shockwaves create tiny microtraumas in the tissue. This isn’t harmful, it’s absolutely intentional.
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Produces an increased blood flow, release of growth factors, and activation of immune cells
2. Regeneration/Proliferation Phase - (1–4 weeks post treatment)
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Fibroblasts (cells that build connective tissue) become more active.
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New blood vessels form (neovascularization).
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Collagen production ramps up to repair and strengthen tissue.
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Pain should start to decrease and body function gradually improves
3. Remodelling/Maturation Phase -
(4–12 weeks post treatment)
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New collagen fibres organize and align properly.
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Tissue structure becomes stronger and more resilient.
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Calcifications or scar tissue may break down further.