Shockwave therapy is a non-invasive treatment that uses radial pressure waves which carry high energy to the painful area to initiate a healing response in chronic injuries. The energy promotes regeneration and reparative processes of the bones, tendons and other soft tissues. The treatment can occur in the office , patients can bear weight immediately, and there is no disruption of activities of daily life.
Shockwave therapy is actually treating the painful area directly by promoting healing response and not just improving the symptoms. It has been shown to produce great results in people suffering long term pain from conditions such as Achilles Tendonitis and Plantar Fasciopathy (Plantar Fasciitis).
At Brisbane Foot Clinic, our podiatrists often use it as an adjunct therapy with other treatments in order to provide the best possible outcome.
Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue structure. The application of acoustic waves creates capillary microruptures in tendon and bone. This stimulates new blood vessel growth to the treated area. The new blood vessels will then provide essential blood flow and oxygenation that support faster healing in bones, tendons and other soft tissues.
2. Reversal of Chronic Inflammation and Increase Cell Regeneration
Inflammation is not all evil and is a necessary process for healing. However, chronic inflammation can occur when the inflammatory response is not completely halted due to repetitive injury and thereby becoming a chronic pain. Shockwave therapy has the ability to reverse chronic inflammation back into an acute stage by increasing and inducing Mast cells to the area. Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds first enhance the inflammatory process and in the next step help restore normal healing and regenerative processes.
The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged myoskeletal and ligamentous structures. Shockwave therapy accelerates procollagen synthesis. The therapy forces the newly created collagen fibres into a longitudinal structure which makes the newly formed tendon fibres more dense and stiff and creates a firmer structure.
4. Reduce Calcification in Long Term Conditions (eg. Achilles Tendonitis)
Calcium build-up is most often a result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcifications. Shockwave therapy starts the biochemical decalcification of the calcium build-up of a toothpaste-like consistency and treats the tendon. The granular particles of calcium are then removed by the lymphatic system.
5. Release Trigger Points
Trigger points are the principal cause of pain and tightness in the calves. They are associated with palpable nodules in taut bands of muscle fibres and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the waste products to build up. Waste product build-up irritates the sensory nerve endings which then causes even more contraction. This vicious cycle is referred to as “metabolic crisis”. The assumed mechanism of action is that the delivered acoustic energy unblocks the calcium pump and thus reverses the metabolic crisis in the myofilaments and releases the trigger points.
- Tendinopathies – Hamstring Tendinopathy, Patella Tnedinoapthy, Achilles Tendinopathy
- Plantar Fasciopathy (Plantar Fasciitis, Heel Spur)
- Hip Pain
- Iliotibial Band Syndrome
- Osgood Schlatter Disease
- Tibial Stress Syndrome (Shin Splint)
- Myofascial Trigger Points
- During pregnancy.
- Haemophilia, or other coagulation disorders.
- Anticoagulant pharmaceuticals (blood thinners), especially Marcumar.
- Acute inflammations.
- Polyneuropathy area (lost of sensation).
- After cortisone therapy to the area. (will need to wait minimum of 6 weeks after local cortisone injection before treatment with radial pressure waves).
- Patient with haemorrhages or risk of haemorrhage.
- Patients with malignant tumours and undiagnosed tumours.
- Swellings that still feel warm.
- Implants, areas where implants have been removed, damaged implants, and medal inclusions.
- Severe arterial obstruction.
- Gynaecological disorders involving acute inflammation.
- Deep vein thrombosis, phlebitis, varices.
- Arterial disease, circulatory insufficiency.
Does the treatment hurt?
There could be some discomfort with the treatment, depending on the site and the level of pain that the patient is already experiencing. However, the treatment will normally last for few minutes with each session, and the intensity of the treatment can always be adjusted to suit patient’s pain tolerance.
How many treatment does it normally take and when will I feel better?
The number of treatments often varies on the indication, duration of injury, and patient’s response from the treatment. The effect of the treatment is cumulative, therefore multiple treatments are necessary in most cases. A minimum of 4 treatments will be perform on a weekly basis and our podiatrist will then decide whether further treatment will be required based on the improvement. Normally, the patient will have some sort of improvement during the course of treatment, however, it may take up to 12 weeks to see the maximum results as the main beneficial effect of the treatment is the development of new blood vessels, which takes time to happen.
What to expect with each treatment?
The consult will generally take about 20-30mins based on the site of injury. At first, the Podiatrist will need to locate and mark the painful areas. Conductor gel is then applied to the areas in order for the radial pressure wave to be transmitted to the site of injury.
Will I feel any pain after the treatment?
Pain is rarely reported after the treatment from our patients. However, some soreness may be expected to the treated area within the first 1 to 2 days. The soreness has been reported to be tolerable and not limiting.
Are there any restrictions after the treatment?
It is recommended to avoid performing heavy physical activities, especially to the treated area about 48hrs after each treatment.
Do I need to do anything after each treatment?
Our Podiatrist will often advise you to continue with other therapies that they have advised, such as stretching and strengthening exercises, continue with orthoses wearing, and other treatments that have been provided.