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SHOCKWAVE THERAPY

What is Shockwave Therapy?

Shockwave therapy or extracorporeal shockwave therapy (ESWT) is a tool used by sports medicine clinicians to treat musculoskeletal injuries in athletes. It has been shown to be effective at treating overuse conditions of tendons, fascia, ligaments, muscle, and can augment the healing of fractures [EPAT 5].

Shockwaves are a form of energy that can develop a peak pressure about 1000 times higher than that of ultrasound. They have mechanical and cellular effects that improve tissue healing and alter pain signaling mechanisms. These effects are a result of the mechanical stimulus caused by the shockwave vibrations of tissues, leading to regeneration and healing. The shockwaves produce a positive pressure causing absorption, reflection, refractions, and transmission of energy in tissues and cells. This transmission of energy has effects at the cellular level leading to downstream biochemical signals beings produced resulting in analgesic, angiogenic, and anti-inflammatory reactions.

Shockwave has been shown to be very effective in treating tendinopathies, such as tendinitis and tendinosis by increasing collagen synthesis and tenocyte proliferation [EPAT 5].

 

Shockwave is a non-invasive treatment that is also an excellent treatment option for patients who are needle-phobic, meaning having a fear of needles or treatments like acupuncture or dry needling.

How does Shockwave Therapy Work?

Shockwaves provide a strong biomechanical stimulus that strengthens and stimulates dense connective tissues like muscles, tendons, and ligaments by directly affecting collagen synthesis and integrity. Shockwaves favorably disrupt pathological collagen fibers that result from degenerative processes and weak scarring in the tendon and ligament, leading to proper collagen synthesis and correct crosslinking of fibers. Another result of shockwave therapy is the release of a myriad of growth factors that help relax tense areas, disrupt inappropriately bound muscle fibers, and remodel neural firing patterns around an injury.

 

Shockwave therapy also aids in diagnosis of injuries because pathological tissue tends to be more sensitive to shockwave, meaning that shockwave therapy helps to further target the exact muscle, tendons, ligaments, or joints that are injured.

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What does a Session of Shockwave Therapy Look Like?

First, the area of treatment will be located. Second, a gel is applied to the treatment area, typically ultrasound gel. The gel allows for better transmission of the sound waves to the injured area. After gel application, the shockwave therapy device is placed on the injured area and the sound waves are generated.

Treatment lasts between 5 and 10 minutes and the device can be a little noisy.

What are the Side Effects of Shockwave Therapy?

The side effects of shockwave therapy are very minimal and include soreness and redness in the area of treatment and mild discomfort during the therapy sessions.

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What Injuries Respond Well to Shockwave Therapy?

Shockwave therapy accelerates healing and tissue repair by providing a regenerative stimulus to tendons, ligaments, fascia, muscle, and bone. This stimulus has been shown to be safe and effective at treating a multitude of musculoskeletal conditions in athletes. Athletes can use this therapy in conjunction with a specialized strength and rehabilitation program to rapidly overcome injuries and minimize any downtime from activity. The following conditions have been shown to respond well to shockwave therapy:

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-Elbow tendonitis (medial and lateral)

-Rotator cuff pathologies

-Labrum injuries of the shoulder and hip

-Wrist injuries

-Hand and finger injuries

-Adhesive capsulitis

-Tricep and bicep tendinopathies

-Spinal pathologies

-Low back pain

-Plantar fascia fasciitis

-Achilles tendon tendinopathy

-Hamstring tendinopathy

-Adductor tendinopathy

-Quadriceps and patellar tendinopathy

-Calcific tendonosis

-Stress fractures

-Coccygodynia (tailbone pain)

-Osgood-Schlatter disease

-Peroneal and tibialis anterior/posterior injury

-And many more running, climbing, and athletic related injuries

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Shockwave Therapy and Rock Climbing Injuries

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