Extracorporeal Shockwave Therapy

Written by: Gabrielle Jackson, Edited by: Faye Appleby


Extracorporeal shockwave therapy (ECSWT) works as an acoustic wave, carrying energy to painful areas within the soft tissue. The machine has a bullet within a small barrel, compressed air is accelerated to hit the plate at the end of the barrel to generate the shockwave onto the skin. This style of treatment is a non-invasive, simple, fast and a safe approach to tendinopathies, calcification in tendons and chronic inflammation. Shockwave treatment is a relatively new therapeutic intervention, without the dangers of a surgical procedure and postoperative pain.

In 1980, extracorporeal shockwave therapy was first introduced as a modality within clinical practice. ECSWT was used in hospital settings for the treatment of kidney stones. Although in the last two decades extra corporeal shockwave therapy has been commonly used as a method for musculoskeletal disorders, as well as the stimulation of bone and tendon growth.


ECSWT holds an excellent place in physiotherapy practice and is extremely successful in assisting treatments of chronic tendon conditions. The shockwaves created have been shown to improve blood supply, and to increase cell growth. This benefits the tissue regeneration and repair of tendons and bones. Once the tendons architecture is improved, physiotherapy exercises and rehabilitation will be more efficient. ECSWT also helps to relieve pain from the tendons, which often enables our patients to continue playing sport and part taking in exercises during their rehabilitation.

Shockwave therapy is rarely used as a sole treatment modality, often it is only efficient when done as an adjunct and integrated modality to rehabilitation exercises.

At Elite, we recommend patients have 3-6 sessions, no longer than a week apart. Our physiotherapists also prescribe eccentric strengthening training or slow heavy resistance training alongside shockwave therapy in order to increase the tendons tolerance to load.

It is important that we address any underlying biomechanical issues (for example posture, alignment, gait, running style, muscle length and strength issues) that may have been contributing to your tendon issue.

Evidence-based practice

Numerous research studies have identified that ECSWT is very effective for treating tendon problems, when other forms of treatment have failed. It is an effective modality in relieving pain intensity and increase the functionality and quality of life for many patients. It has also been shown that if used early, ECSWT reduces recovery time, meaning patients prognosis may be shorter.

Our physiotherapists at Elite use ECSWT on a daily basis, this is due to the minimal significant side effects and patient restrictions. If you have been struggling with a chronic tendon ache or pain, this may just be the course of therapy for you.

Contact us on 01296 437717 to arrange an assessment.


  1. Dedes, V., et al., (2018) ‘Effectiveness and Safety of Shockwave Therapy in Tendinopathies.’ Materia socio-medica.30(2) pp. 131-146. doi: 10.5455/msm.2018.30.141-146
  2. Chung, B., (2002) ‘Extracorporeal shockwave therapy: a review.’Wiley JP Sports Med. 32(13) pp. 851-865. doi: 10.2165/00007256-200232130-00004
  3. Gerdesmeye, L., et al.,(2003) ‘Extracorporeal shockwave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial’.JD JAMA. 290(19) pp: 2573-80.