Shockwave Therapy

EpicondylitisShockwave Therapy (also know as Extracorporeal Shockwave Therapy [ECST] or Rapid Pressure Wave [RPW] Therapy) is now in use at our Wollongong Clinic.

Shockwave treatment involves the application of short, frequent, and high intensity bursts of mechanical energy (in the form of a shockwave) into soft-tissue that is injured, scarred, or contains adhesions, is painful, or inflamed. This energy shock is a rapid high frequency mechanical vibration in the form of a Radial Pressure Wave (RPW). When appropriately applied, shockwave can increase local blood flow, improve healing response, break apart scar tissue and adhesions, reduce muscle spasm, and directly decrease pain. Most patients tolerate the treatments well, and report only mild discomfort.  It is one of the newest and most effective treatments in rehabilitating chronic pain, and one our patients have benefitted greatly from.

How does shockwave treatment work?

The effects of shockwave occur across several levels:

  • Cell Level Change – shockwave stimulus affects the chemical environment of tissues at a cellular level. This causes changes to free radicals which boost the release of the substances that help to prevent pain and inflammation.
  • Blood Flow Change – Normal blood flow is critical to the healing process, and shockwaves create a revascularization effect. This type of stimulus redirects new blood flow into the affected area which improves soft tissue healing and regeneration.
  • Muscle Tone Reduction – Shockwave treatment reduces the contractile activity of muscle and can also break patterns of neuro-cognitive pain that are associated with chronic conditions. This effectively decreases muscle tone and spasm, and has specific benefits with eliminating trigger points.
  • Pain Reduction – Shockwave pulses directly affect the nerve fibres that transmit pain signals to our brain. Through the Gate Control Mechanism, shockwaves impact the interneurons in the A-β fibres which prevent the communication of pain.

RPW Effects

What conditions can shockwave treat?

  • Plantar Fasciitis
  • Heel spurs/Heel pain
  • Calcific Tendonitis
  • Patellar Tendonitis (Jumper’s Knee)
  • Achilles Tendonitis
  • Rotator Cuff Tendonitis
  • Myofascial Trigger Points in muscle
  • Iliotibial Band Syndrome (IT Band Syndrome)
  • Tennis Elbow and Golfer’s Elbow
  • Bursitis
  • Heterotopic Ossification (Myositis Ossificans)

What should I expect with my shockwave appointment?

Once you are assessed to ensure Shockwave Therapy is both safe and appropriate for your specific problem the therapist will conduct the treatment. Our clinic uses the Storz Shockwave System to deliver treatment, which is the most widely used system for Radial Pressure Wave ECSW in practice. Aside from pre and post treatment prep and clean up, the actual application of shockwave lasts 3-5 minutes. The majority of our patients appreciate the faster rate of improvement when combining traditional physiotherapy with shockwave treatment. After the treatment, the rest of your visit will be spent with your physiotherapist, who may also use manual therapy, exercise prescription, or other modalities to facilitate rapid recovery. Many conditions require as little as three treatments; however, more chronic or complicated conditions may require more treatments to get the full benefit. Most patients will experience significant improvement while undergoing the first three treatments, and improvements often continue for several weeks.

Does shockwave therapy hurt?

plantar fasciitisMost patients experience mild discomfort during treatment, but it is generally well tolerated. The initial discomfort typically fades as the area becomes desensitized as it is being treated. Your physiotherapist will adjust the intensity of stimulus depending on your comfort level, and can gradually ramp it up to minimise discomfort. Shockwave Therapy purposefully creates an inflammatory response in injured soft tissue, so you may also experience mild discomfort following treatment. This is normal. Patients should not apply ice or take anti-inflammatories after shockwave treatment, as this will impact the inflammatory healing response and thus reduce the effectiveness of the Shockwave treatment.

How successful is Shockwave? Does it really work?

Shockwave Therapy is one of the most widely researched rehabilitation modalities used in physiotherapy clinics, with increasing numbers of scientific studies added each year. The majority of research validates the effectiveness of extracorporeal shockwave, and shows successful treatment rates of up to 90%! References to current research studies on Shockwave Therapy can be found below.

What does Shockwave Therapy cost?

RPW Shockwave Therapy is just one of the tools our physiotherapists have available in their treatment arsenal. You still pay your same treatment cost regardless of which modality the physiotherapist decides is best for your condition.

Patellar Tendonitis


Extracorporeal shock wave therapy as a treatment for heterotopic ossification. Physical Therapy Reviews. Aug2013, Vol. 18 Issue 4, p300-307.

Treatment for insertional Achilles tendinopathy: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy. Jun2013, Vol. 21 Issue 6, p1345-1355.

A single application of low-energy radial extracorporeal shock wave therapy is effective for the management of chronic patellar tendinopathy. Knee Surgery, Sports Traumatology, Arthroscopy. Feb2013, Vol. 21 Issue 2, p346-350.

Conservative Management of Midportion Achilles Tendinopathy. Sports Medicine. 2012, Vol. 42 Issue 11, p941-967.

Shockwave therapy for chronic Achilles tendinopathy: A double-blind, randomized clinical trial of efficacy. Acta Orthopaedica. Apr2008, Vol. 79 Issue 2, p249-256.

Extracorporeal shock wave therapy in runners with a symptomatic heel spur. Knee Surgery, Sports Traumatology, Arthroscopy. Oct2006, Vol. 14 Issue 10, p1029-1032.

Extracorporeal shock wave therapy promotes cell proliferation and collagen synthesis of primary cultured human tenocytes. Knee Surgery, Sports Traumatology, Arthroscopy. Dec2011, Vol. 19 Issue 12, p2159-2168.

The Efficacy of Extracorporeal Shock-Wave Treatment: A New Perspective. Athletic Therapy Today. Nov2005, Vol. 10 Issue 6, p50-51.