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Shockwave Therapy

Shockwave therapy is a modality that has be offered at Be in Motion for the past 8 years that creates a microtrauma by repeated shockwave to the affected area and creates neo-vasculation (new blood flow) to the area. It is this new blood flow that promotes tissue healing. A second theory is that with chronic pain, the brain has "forgotten" about the pain and is doing nothing to heal the area. Shockwave therapy creates a new inflammatory process is created and the brain can react to it by sending the necessary body nutrients to the area to promote healing.

Extra Corporal Shock Wave Therapy (ESWT) uses 2500 targeted shock wave pulses (11 pulses per second) to treat the affected area per treatment. ESWT causes a controlled micro-trauma at the lesion site. A mild inflammation ensues and inefficient scar tissue is broken down.

Re-Modeling

Post treatment, the tissue undergoes a process of remodeling and maturation, which allows manual therapy and rehabilitation techniques will be more effective.

Protocol

The current research recommends a course of 3-4 treatments separated by 7 days. Each treatment is non-invasive, causes minimal discomfort and lasts approximately 15 minutes followed by eccentric loading of the tissue to promote healing. You can return to normal activity immediately after treatment. The Physiotherapist must add eccentric loading (tendon lengthening) after the treatment to help the tissue realign.


Common Conditions treated with Shockwave Therapy

  1. Plantar Fasciitis
  2. Achilles Tendonopathy
  3. Tennis and Golfers Elbow
  4. Jumpers Knee
  5. Stress Fractures
  6. Calcific Rotator Cuff Tendonitis
  7. Bursitis
  8. Trigger Point Therapy
  9. Non Healing Ulcers
  10. Non Unions
  11. Morton's Neuroma
  12. Scar Tissue Treatment
  13. Hallux Rigidus

Applications

  • Therapy of myofascial pain
  • Activation and loosening of muscle and connective tissue
  • Disorders of tendon insertions and ligaments
  • Acupuncture shock wave therapy
  • Success Rates
  • 91% improved for Calcific Tendinitis
  • 81% improvement for Tennis Elbow
  • 90% improvement for Plantar Fasciitis

Research/Scientific Evidence

A list of scientific articles showing the evidence behind Shockwave therapy is being updated regularly.

Plantar Fasciitis

Radial Extracorporeal Shockwave Therapy Is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis. The American Journal of Sports Medicine, Vol 36 No.11, 2100-06.
Shockwave Therapy
Chronic Plantar Fasciitis Treated with two sessions of Radial Extracorporeal Shockwave Therapy, Foot & Ankle International, 2010, p391-96.

Gerdesmeyer L et al, Radio extracorporeal shockwave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis, The American Journal of Sports Medicine, 2008, Vol 10(10), 1-10.

Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med. 2008 Nov;36(11):2100-9. doi: 10.1177/0363546508324176. Epub 2008 Oct 1.

Achilles Tendonits

Treatment for insertional Achilles tendinopathy: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2013 Jun;21(6):1345-55. doi: 10.1007/s00167-012-2219-8. Epub 2012 Oct 6.

Rompe J et al, Eccentric loading, shockwave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo achillis: A randomized control trial, American Orthopaedic Society for Sports Medicine, 2007, Vol 35(3), 374-83.
Common Conditions treated with Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) for refractory Achilles tendinopathy: A prospective audit with 2-year follow up. Foot (Edinb). 2016 Mar;26:23-9. doi: 2015 Aug 31.

Rotator Cuff Tendonitis

The Effectiveness of High-Energy Extracorporeal Shockwave Therapy Versus Ultrasound-Guided Needling Versus Arthroscopic Surgery in the Management of Chronic Calcific Rotator Cuff Tendinopathy: A Systematic Review. Arthroscopy. 2016 Jan;32(1):165-75. doi: 10.1016/j.Arthro.2015.06.049. Epub 2015 Sep 15.

Current knowledge on evidence-based shockwave treatments for shoulder pathology. Int J Surg. 2015 Dec;24(Pt B):171-8. doi: 10.1016/j.ijsu.2015.08.079. Epub 2015 Sep 9

A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014 Nov;48(21):1538-42. doi: 10.1136/bjsports-2012-091961. Epub 2013 Aug 5.

Extracorporeal shockwave therapy in calcifying tendinitis of the shoulder. Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2085-9. doi: 10.1007/s00167-011-1479-z. Epub 2011 Mar 23

Cacchio A et al, Effectiveness of radial shockwave therapy for calcific tendinitis of the shoulder: single blinded, randomized clinical study, Physical therapy, 2006, Vol 86(5), 672-82.

Patellar Tendonitis

Wang CJ et al, Extracorporeal shockwave for chronic patellar tendinopathy, American Journal of Sports Medicine, 2007, Vol 35(6), 972-79.

The TOPSHOCK study: effectiveness of radial shockwave therapy compared to focused shockwave therapy for treating patellar tendinopath - design of a randomised controlled trial. BMC Musculoskelet Disord. 2011 Oct 11;12:229. doi: 10.1186/1471-2474-12-229

Morton's Neuroma

Extracorporeal Shockwave Therapy in Patients with Morton's Neuroma A Randomized, Placebo-Controlled Trial. J Am Podiatr Med Assoc. 2016 Mar;106(2):93-9. doi: 10.7547/14-131.

Extracorporeal shockwave therapy for interdigital neuroma: a randomized, placebo-controlled, double-blind trial. J Am Podiatr Med Assoc. 2009 May-Jun;99(3):191-3.

Tennis Elbow (Tendonitis)

Lateral epicondylitis: This is still a main indication for extracorporeal shockwave therapy. Int J Surg. 2015 Dec;24(Pt B):165-70. doi: 10.1016/j.ijsu.2015.09.034. Epub 2015 Oct 9.

Radial shock wave therapy in patients with lateral epicondylitis. Folia Med (Plovdiv). 2012 Jul-Sep;54(3):35-41.

Be in Motion Physiotherapy in Oakville Offers Therapists Specializing in Orthopedics for
Oakville, Burlington, Mississauga, Milton and Surrounding Communities