SHOCKWAVE THERAPY

Shockwave therapy is a non-invasive treatment using a therapeutic device that works by delivering acoustic waves to the site of an injury. The machine uses kinetic energy to reach the target area via a small applicator at the head of the shockwave therapy handle. This energy penetrates the skin sending a radial wave as deep as 7cm into the body with the highest pressure felt at the surface of the body.

The machine works based on three settings: frequency, bars and number of shocks. Frequency, measured in Hertz (Hz), is the number of pulses per second, ranging from 1 – 15 Hz. While Bars is the power each pulse sends into the body, ranging from 1.5 – 5 Bars, with a higher number of bars penetrating deeper into the body. This depth can vary based on internal and external factors, such as: body water content, transmitter head size, and quality of contact on skin.

Although it may have a very intimidating name, shockwave therapy is a modality that provides many benefits to clients suffering from injuries. Depending on the intensity of treatment, shockwave therapy can feel like a tapping on the skin to a slight discomfort in the area treated.  However, because the treatment typically lasts about five minutes, most clients are able to tolerate any discomfort.  The intensity of treatment can also be adjusted depending on the comfort level of the client.

Current research shows efficacy of shockwave therapy in both acute and chronic injuries (Zissler et al., 2018 & Astur et al., 2015), with most research surrounding musculoskeletal injuries affecting small, medium and large-sized tissues.  Shockwave therapy promotes regenerative and reparative process in the soft tissues of the body.

At Propel Physiotherapy, our physiotherapists, kinesiologists and exercise physiologists are trained to use shockwave therapy with multiple types of injuries, including:

• Shockwave Therapy for Medial Epicondylitis
• Shockwave Therapy for Lateral Epicondylitis
• Shockwave Therapy for Plantar Fasciitis
• Shockwave Therapy for Shoulder Tendinopathy
• Shockwave Therapy for Patellar Tendinopathy
• Shockwave Therapy for Achilles Tendinopathy
• Shockwave Therapy for Hamstring Tendinopathy
• Shockwave Therapy for Trigger Finger
• Shockwave Therapy for Frozen Shoulder
• Shockwave Therapy for Shin Splints
• Shockwave Therapy for Rotator Cuff Injuries

Shockwave therapy may not be for you if you:

• are pregnant
• are taking anti-coagulants or have blood clotting disorders
• have received steroidal treatment within 6 weeks of starting SWT
• are under 18 (certain injuries can still be treated, pending assessment)
• are under the influence of drugs or alcohol
• have a pacemaker

Shockwave therapy cannot be completed over the following areas:

• Tumours (benign or cancerous)
• Air-filled areas (i.e. lungs)
• Cartilage or small facet joints of the spinal column
• Metal implants
• Muscle tears
• Any area with vasomotor impairment or decreased neural sensitivity / pain reception

If you think shockwave therapy is the right course of action for you, contact Propel Physiotherapy for an assessment.

Treatment with shockwave therapy is measured based on total number of shocks received by the injured area. A typical session can last anywhere between 5 to 15 minutes, with total number of shocks ranging from 1000 – 8000 (broken into smaller doses).

Effects of shockwave therapy last about 2 – 4 hours after the session, if pain relief was felt during the session. Other potential side effects can include:

• Minor pain / discomfort during and/or after the session
• Transient redness of treated skin
• Local swelling
• Local tenderness
• Potentially, minor hematomas (bruising)
• Potentially, headaches, migraines and subsequent syncope

Always discuss previous reactions to shockwave therapy if you’ve experienced it before, or inform your therapist of any reactions during and following your treatment.

Injuries treated with shockwave therapy can require any number of sessions before pain relief is felt (if any). Treatments must be at least 5 days apart from each other, due to normal body healing processes. Upon completion of treatment, normal activities can resume almost immediately.

Shockwave therapy is performed under the direction of a registered physiotherapist.  You do not need a doctor’s note to attend a physiotherapy session, however some extended care plans require a physician’s note to have physiotherapy expenses reimbursed.

Your registered physiotherapy visits may be covered under an employment plan that you or a spouse has. Shockwave therapy is performed under the direction of a registered physiotherapist. You will be encouraged to check the details of that plan and submit your receipts for reimbursement.