Shockwave – 10 Things To Know
Physiotherapists use shockwave therapy to help stimulate healing in stubborn or chronic musculoskeletal conditions.
Shockwave reduces pain by de-sensitising local nerve endings. It is used alongside a progressive loading and strengthening program, helping patients recover faster and return to activity with less pain and better tissue resilience.
1. Shockwave is not “electrical shock” therapy.
Despite the name, shockwave therapy doesn’t use electricity. It uses acoustic sound waves that travel through the skin to stimulate tissue healing.
2. Shockwave is evidence-based treatment for chronic tendon pain.
Clinical research supports shockwave therapy for tendinopathies such as plantar fasciopathy, achilles tendinopathy, tennis elbow & calcific shoulder tendinopathy — especially when symptoms have lingered for more than 3 months.
3. Shockwave works by kickstarting the body’s healing response.
Shockwaves cause controlled microtrauma that increases blood flow, stimulates cell regeneration & triggers the release of growth factors to help tissue repair itself.
4. Shockwave helps break down stubborn scar or calcific tissue.
The mechanical waves can disrupt adhesions and calcifications, improving tissue mobility and reducing local stiffness or “grittiness.”
5. Shockwave decreases pain by altering nerve sensitivity.
Shockwave therapy can desensitise local pain receptors and reduce substance P — one of the body’s pain-signalling chemicals — giving both short & long-term pain relief.
6. Shockwave can improve tendon strength and structure.
Studies using ultrasound and MRI show that tendons treated with shockwave demonstrate better collagen alignment and structural integrity over time.
7. Shockwave is quick — sessions take about 10–15 minutes.
Most treatment courses involve 3–6 sessions spaced a week apart, often combined with a progressive loading or rehab program.
8. Never Shockwave alone – you’ll still need exercise rehab.
Shockwave isn’t a magic fix. It’s most effective when combined with graded strengthening, load management & movement retraining — that’s where your physio comes in.
9. Shockwave can be mildly uncomfortable — but it’s brief.
The sensation is a firm tapping or pulsing over the treatment area. Discomfort usually settles within minutes and rarely causes post-treatment soreness.
10. Shockwave is drug-free, non-invasive & safe.
There’s no downtime, no injections & no surgery. Most people can resume normal activity straight after treatment.
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Korakakis V, Whiteley R, Tzavara A, Malliaropoulos N. The effectiveness of extracorporeal shockwave therapy in common lower limb conditions. Br J Sports Med. 2018;52(6):387-406.
van der Vlist AC, Coombes BK, et al. (via “The Efficacy of Extracorporeal Shock Wave Therapy as a Monotherapy for Achilles Tendinopathy”) – systematic review & meta-analysis.
Xue X, Song Q, Yang X, et al. Effect of extracorporeal shockwave therapy for rotator cuff tendinopathy: systematic review and meta-analysis. BMC Musculoskelet Disord. 2024;25:357.
Efficacy of Extracorporeal Shock Wave Therapy for Achilles Tendinopathy. Am J Sports Med. (systematic review)
Rhim HC, Singh M, Maffulli N, et al. Recommendations for use of extracorporeal shockwave therapy in sports medicine: an international modified Delphi study. Br J Sports Med. 2025;59(18):1287-1295.
Xiong Y, Wen T, Jin S, Lin L, Shao Q, Peng Y, Zheng Q, Li W. Efficacy and safety of extracorporeal shock wave therapy for upper limb tendonitis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2024 Jul 30;11:1394268. doi: 10.3389/fmed.2024.1394268. PMID: 39139789; PMCID: PMC11319137.
