How does Shockwave Therapy work?
Shockwave therapy (sometimes called extracorporeal shockwave therapy, or ESWT) is a non-invasive treatment that uses acoustic (sound) waves to stimulate healing in injured tissues.
Here’s how Shockwave Therapy works - step by step:
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Shockwave generation;
A handheld Shockwave device, produces high-energy acoustic waves. These are not electrical shocks, they are mechanical sound waves that penetrate the body non-invasively through ultrasound gel directly into the injured and damaged area.
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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.
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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.
Shockwave Therapy can be classed by two very different types of treatment. Radial and Focused shockwaves. They both produce acoustic waves, but they behave very differently in repairing the damaged tissue.
🔹 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.
At The Shockwave Therapy Clinic UK We are one of a limited number of clinics in the UK that has access to both Radial and Focused Shockwave. This is a complete game changer for our patients as we can offer treatment for a huge range of many different types of ailments by combining both types of Shockwaves together within the same sessions for most ailments, starting with Radial to relax superficial tissues, then using Focused Shockwave for the targeted specific point of pain.
This can be the most effective treatment to accelerate healing by promoting tissue regeneration and faster recovery. Together they are perfect to cover all angles of speeding up the body's natural healing process. The combination treatments and our first class training with many leading practitioners in the Shockwave world, is truly what sets us apart from many other Shockwave clinics and elevates us to the top.
The difference in penetration between Radial and Focused Shockwave Therapy.
Radial and Focused Shockwave treatment is clinically proven to be up to 90% effective for healing MSK conditions. This is true - even where other therapies such as massage or acupuncture have previously already failed to heal the pain or injury.
This is where we offer game changing results compared to other clinics that are limited to just Radial Shockwave therapy. Ideally the best possible Shockwave treatment for most conditions would generally involve both Radial and Focused in combination. In most cases, we also apply Myofascial release treatment as well. These three therapies together makes the world of difference for most ailments.
This diagram perfectly shows the difference between Radial and Focused Shockwave therapy and why Radial Shockwave therapy can be used for tendonitis shockwave treatment, as the tendons are more superficial and Radial doesn't have to penetrate as deeply.
What is very clear to see in the diagram demonstrates is how much deeper and focused the energy of Focused Shockwave is compared to Radial.
This is why Focused Shockwave is able to treat the deeper conditions, such as bone issues like Osteoarthritis (OA), Insertional tendinopathies, Deep seated tendons, Stress fractures and Facet joint pain.
1. Inflammatory Phase (First few days)
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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)
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What happens:
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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 may should start to decrease and body function gradually improves
Many patients feel some pain relief within the first 1–2 sessions, but the full benefit often takes 6–12 weeks as the healing cycle runs its natural course.
3. Remodelling/Maturation Phase (4–12 weeks)
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What happens:
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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.
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