What is it?

Shockwave therapy in physiotherapy is a non-invasive treatment that uses acoustic sound waves to stimulate healing in injured tissues. It’s particularly useful for treating chronic musculoskeletal conditions that haven’t responded to other forms of treatment.

Key Points:

How it works: High-energy sound waves are directed into the affected area to promote blood flow, cell regeneration, and collagen production, while also helping to break down calcified tissue or scar tissue.
Common conditions treated:
- Plantar fasciitis
- Achilles tendinopathy
- Patellar tendinopathy (jumper’s knee)
- Tennis or golfer’s elbow
- Shoulder tendinopathy (e.g. calcific)
- Chronic hamstring issues
What to expect: It’s usually delivered in short sessions (5–10 minutes), and a course of 3–6 treatments is typical. It can feel uncomfortable but is generally well-tolerated.
Benefits: Can reduce pain, improve function, and speed up recovery—especially when used alongside a rehab programme.

What the research says?

Frozen Shoulder

Groin Injuries in Athlete

Rotator Cuff Calcific Tendinitis

Plantar Fasciitis

Osteonecrosis of Femoral Head

Tendinopathies (General)

Achilles Tendinopathy

Lateral Epicondylitis

Type of Shockwave Therapy (if specified)

Extracorporeal (ESWT)

Shock wave therapy

Focused (F-SWT), Radial (R-SWT)

Radial, Focused

Focused (F-SWT)

Shockwave therapy

Extracorporeal (ESWT)

Shockwave therapy

Protocol Details/Comparisons Mentioned

New option, mechanism may involve increased blood flow, collagen flexibility, reduced inflammation.

Used in football players.

High-energy SWT may lead to greater total resorption of calcifications compared to low-energy SWT. One study using radial SWT reported high resorption rate with specific parameters not detailed in the excerpt.

Greater reduction in plantar fascia thickness with radiological guidance.

Dosage parameters did not appear to have a significant influence on imaging outcomes.

Moderate effectiveness compared to sham treatments and other modalities.

Presented as an alternative to eccentric exercises.

Compared to corticosteroid injection with at least 12-week follow-up.

Reported Effectiveness

Showed potential benefits for pain relief and functional improvement. Currently available data shows satisfactory improvement from multiple aspects.

Effective in reducing pain and returning athletes to sports within 3 months. Football players experienced earlier pain relief and returned to football significantly earlier compared to those without this therapy.

Overall reduction in calcium deposit size. Favoured over placebo but less effective than ultrasound-guided needling. High-energy may be superior to low-energy for total resorption. One review suggested it could be an alternative to surgery.

Overall reduction in plantar fascia thickness. More effective than placebo. Less effective than low-level laser therapy and therapeutic ultrasound in one comparison.

Modest reduction in the size of the lesion with marginal statistical significance. Generally favoured over other interventions like core decompression.

Demonstrated moderate effectiveness for tendinopathies regardless of type or location.

Can decrease pain similarly to eccentric exercises.

Relieved pain and improved function, with better improvements in pain and grip strength in the shockwave group compared to corticosteroid injections.

Source(s)

Zhang et al., "Nonsurgical Options for Frozen Shoulder: A Network Meta-analysis of Randomized Controlled Trials"

Fernandes et al., "Comparative analysis of treatment strategies for groin injuries in athletes: Effects on successful recovery and recurrence of sports conditions – A systematic review"

Al-Abbad et al., "The effects of shockwave therapy on musculoskeletal conditions based on changes in imaging: a systematic review and meta-analysis with meta-regression" ; Rosen et al., "Clinical Management of Tendinopathy: A Systematic Review of Systematic Reviews Evaluating the Effectiveness of Tendinopathy Treatments"

Al-Abbad et al., "The effects of shockwave therapy on musculoskeletal conditions based on changes in imaging: a systematic review and meta-analysis with meta-regression"

Rosen et al., "Clinical Management of Tendinopathy: A Systematic Review of Systematic Reviews Evaluating the Effectiveness of Tendinopathy Treatments"