Shockwave therapy is a non-invasive treatment that delivers acoustic pressure waves through the skin to a targeted area of the body. It is commonly used in physiotherapy for certain persistent tendon and soft-tissue problems or injuries.
Despite its name, shockwave therapy does not give you an electrical shock. A handheld applicator sends a series of mechanical pulses into the treatment area. There are no needles, incisions or medications involved.
At The LiveWell Centre in Kingston, our physiotherapists Jennifer Kates and DK (Dakshan Krishnapalan) use shockwave therapy when it is clinically appropriate as part of an individualized treatment plan. It is usually combined with education, activity modification and progressive exercise to help our patients return to the activities that matter to them.
How does shockwave therapy work?
Shockwave therapy is also known as extracorporeal shockwave therapy, or ESWT. “Extracorporeal” simply means that the energy is produced outside the body.
During treatment, acoustic pressure waves deliver mechanical stimulation to a carefully selected area. Studying how this affects pain and tissue recovery, results show changes in local pain sensitivity and biological responses within the treated tissue.
You may hear claims that shockwave therapy “breaks up scar tissue” or “restarts healing.” We even say that here at The LiveWell in Kingston, but we are just trying to simplify the complex process during healing. It is more accurate to say that shockwave therapy can reduce pain and improve function in many conditions, but the response can vary.
The great thing is that our physiotherapists will know very quickly, within a couple of treatments, of whether your condition is a good candidate for shockwave therapy.
Jennifer or DK will always explain the type of shockwave treatment available at The LiveWell Centre, and whether it is suitable for the tissue and condition being treated.
What conditions may shockwave therapy help?
Shockwave therapy is most often considered for persistent musculoskeletal problems, particularly when symptoms have not improved as expected with time and an appropriate rehabilitation plan. A very common case would be a tendinopathy (injuries involving tendons and /or their attachment to bone and muscle). So whether you are a student at Queen’s University here in Kingston, an active soccer or hockey player, a casual runner, golfer or even an active Kingston office worker, shockwave therapy should be considered for your injury and pain.
Conditions for which it may be considered include:
Plantar heel pain, often called plantar fasciitis or plantar fasciopathy
Achilles tendinopathy
Patellar tendinopathy, sometimes called jumper’s knee
Lateral elbow tendinopathy, commonly called tennis elbow
Some rotator-cuff-related shoulder problems, including calcific tendinopathy
Greater trochanteric pain syndrome at the outside of the hip
This list does not mean that shockwave therapy is appropriate for every person with pain in these areas. Heel, shoulder, hip and tendon pain can have different causes, and some require a different form of treatment or further medical investigation.
Does shockwave therapy work?
Research suggests that shockwave therapy can improve pain or function for some musculoskeletal conditions, but the strength of the evidence varies by diagnosis, device and treatment protocol. For example, evidence is encouraging for persistent plantar heel pain, but less consistent for Achilles tendinopathy.
Shockwave therapy has not been shown to work for every condition or every patient.
For that reason, Jennifer and DK do not recommend it solely because an area is painful. They first assess the likely source of the problem, how long it has been present, what treatments have already been tried and how your symptoms affect your daily activities.
What happens during a shockwave-therapy appointment?
Your LiveWell physiotherapist will begin by reviewing your symptoms, health history and goals. They will examine the area and discuss whether shockwave therapy is a reasonable option. The expected benefits, possible risks, alternatives and cost should be explained before you consent to treatment.
If you decide to proceed, a small amount of gel is applied to the skin. The handheld applicator is then positioned over the selected area and delivers a controlled series of pulses. You may hear a repetitive tapping sound and feel pressure or tapping beneath the applicator.
The intensity can usually be adjusted based on the treatment plan and your comfort. The shockwave portion of the appointment often takes only several minutes, although the full physiotherapy visit may also include reassessment, exercise, education or other care.
Is shockwave therapy painful?
Shockwave therapy can be uncomfortable, particularly when the applicator passes over a sensitive area. People often describe it as rapid tapping, pressure or a sharp aching sensation.
More intensity is not automatically better. Tell your physiotherapist what you are feeling so the treatment can be adjusted when appropriate. You remain in control and can ask to pause or stop at any time.
What should I expect after treatment?
Some people notice a change in symptoms soon after treatment, but improvement may also be gradual over several weeks. It is common to experience short-term tenderness, aching, redness or mild bruising in the treated area.
Your LiveWell physiotherapist will advise you about activity after the appointment. Recommendations depend on the tissue being treated, your symptoms and the rest of your rehabilitation plan. Unless instructed otherwise, do not assume that feeling temporarily better means the area is ready for a sudden return to heavy training or competition.
Is shockwave therapy safe?
Shockwave therapy is generally considered a low-risk, non-surgical treatment when it is used appropriately by a trained healthcare professional. Tissue irritation or injury is uncommon but possible. Your physiotherapist should choose the treatment area and settings carefully and reassess your response.
Who may not be a good candidate for shockwave therapy?
Shockwave therapy may need to be avoided or modified depending on the treatment area, device and your medical history.
Before treatment, tell your physiotherapist if you:
Are pregnant or may be pregnant
Have cancer or a tumour in or near the proposed treatment area
Have a pacemaker, defibrillator or other implanted electronic device
Have a significant bleeding or clotting disorder
Take blood-thinning medication
Have an infection, open wound or impaired skin in the area
Have reduced sensation or circulation in the area
Have recently received an injection or undergone surgery near the area
May have a fracture, tendon rupture or another condition that has not been assessed
This is not a complete list. Suitability should always be determined through an individual assessment and by following the precautions for the specific shockwave device.
How many shockwave treatments will I need?
There is no single schedule that is right for everyone. Many treatment plans involve a short series of appointments spaced over several weeks, but the number and timing depend on the diagnosis, device, response and overall rehabilitation plan.
Your progress should be measured rather than continuing treatment automatically. Jennifer or DK may reassess pain, strength, movement and your ability to perform a meaningful activity. If shockwave therapy is not helping, the plan should be reconsidered.
Why is shockwave therapy usually combined with exercise?
Shockwave therapy may help reduce pain or improve tolerance for movement, but it does not replace the need to restore strength and gradually rebuild the tissue’s capacity for work, sport and daily life.
For a runner with persistent heel pain, a gym-goer with patellar tendon pain or someone with an irritated elbow from work or sport, a complete plan may include load modification, progressive strengthening, mobility work and a gradual return to activity.
Our goal at The LiveWell Centre is not to make patients dependent on a machine. It is to use the right tools at the right time while helping people become more confident and capable in their own recovery.
Who provides shockwave therapy at The LiveWell Centre?
Jennifer Kates and DK are physiotherapists at The LiveWell Centre in Kingston, Ontario. Both use shockwave therapy as one of the treatment options available in the care of their patients.
Shockwave therapy is not automatically included in every physiotherapy visit. Jennifer or DK will first assess your symptoms, movement, health history and goals. If shockwave therapy may be helpful, they will explain why they are recommending it and how it fits into your overall plan.
Is shockwave therapy right for you?
The best way to find out is through an individual assessment. At The LiveWell Centre, Jennifer and DK consider your diagnosis, symptom history, previous care, activity goals and treatment preferences before making a recommendation.
If shockwave therapy is not a good fit, they can discuss other physiotherapy options with you.
To ask about shockwave therapy in Kingston, Ontario, contact The LiveWell Centre or book a physiotherapy assessment with Jennifer or DK.
Frequently asked questions about shockwave therapy
Is shockwave therapy electrical?
No. The applicator delivers acoustic pressure waves, not electrical current. The word “shockwave” describes the mechanical energy produced by the device.
Is shockwave therapy the same as therapeutic ultrasound?
No. Both treatments use handheld applicators and gel, but they produce different forms of acoustic energy and are used with different settings and treatment goals.
What is the difference between shockwave therapy and dry needling?
Shockwave therapy is non-invasive and delivers pressure waves through the skin. Dry needling uses a thin, sterile needle that passes through the skin into a selected muscle or soft-tissue area. Jennifer and DK may consider either treatment—or neither—depending on their assessment and your preferences.
Can shockwave therapy remove a heel spur?
The goal of treatment is generally to improve pain and function, not necessarily to remove a heel spur. Heel spurs are not always the source of heel pain, so an accurate assessment matters.
Can I exercise after shockwave therapy?
That depends on the condition, area treated and your rehabilitation plan. Your physiotherapist will tell you whether to continue, reduce or temporarily avoid specific activities.
Is shockwave therapy covered by insurance?
Yes, shockwave is covered as being part of your physiotherapy treatment. In fact, the Live Well Centre can usually direct bill for your treatment, so there is little or no out of pocket cost. Physiotherapy coverage does vary, so make sure you check with your coverage.