Shockwave Clinical Research & Applications of Focused Shockwave Therapy

Focused shockwave therapy is an evidence-backed, non-invasive treatment for chronic musculoskeletal conditions. This page summarizes the clinical research, mechanisms of action, and practical use cases most relevant to orthopedic specialists, physical therapists, and sports medicine providers.

Clinically Proven Indications

Common conditions supported by strong clinical evidence:

Plantar fasciitis
Achilles tendinopathy
Patellar tendinopathy (jumper’s knee)
Lateral and medial epicondylitis (tennis/golfer’s elbow)
Gluteal tendinopathy and high hamstring strains
Calcific tendinitis of the shoulder
Non-union fractures and delayed bone healing
Chronic muscle tension and myofascial trigger points
Scar tissue and fascial adhesions

Mechanism of Action – How It Works

Delivers precise acoustic waves deep into tissue
Increases blood flow and angiogenesis
Breaks up scar tissue and calcifications
Stimulates fibroblast and tenocyte activity
Enhances collagen production and tissue remodeling
Desensitizes pain pathways via neuromodulation

Key Research Findings

🔹 Plantar Fasciitis

🔹 Achilles Tendinopathy

🔹 Lateral Epicondylitis (Tennis Elbow)

🔹 Calcific Shoulder Tendinitis

🔹 Myofascial Pain / Scar Tissue

🔗 Full-text references and PDFs available upon request

Why Refer for Focused Shockwave Therapy?

Non-invasive with minimal risk and no downtime
Excellent for “failed rehab” or “not quite surgical” cases
Complements PT and orthopedic care
Ideal for chronic overuse injuries and delayed recovery
Delivered by sports-focused DCs with rehab integration

Dr. Laura performing focused shockwave therapy on Coach Chris’s chronic high hamstring strain in a clinical rehab setting.

Dr. Tyler performing focused shockwave therapy with the PiezoWave2 on a physician’s foot to treat plantar fasciitis.

Emerging & Adjunctive Applications of Focused Shockwave Therapy

Post-Surgical Scar Tissue Remodeling

Cesarean section scars (abdominal wall adhesions & fascial restrictions)
Abdominal or pelvic surgery adhesions
Post-arthroscopy (shoulder, hip, knee) scar management
Spinal surgery fascial restriction and pain

Studies show shockwave improves tissue pliability, pain, and vascularity in post-surgical scars

📚 Yoon Soo Cho et al., 2016: ESWT significantly reduced scar pain in burn patients after wound recovery.

📚 Vetrano et al., 2011: Enhanced Collagen Synthesis

📚 Mittermayr et al., 2012: Improved Wound Healing

📚 Pirri et al., 2022: Extracellular Matrix Remodeling

Clinical Observations: Clinics specializing in women's health have reported positive outcomes using focused ESWT for C-section scars.

Peripheral Nerve Entrapments

Carpal tunnel syndrome
Tarsal tunnel syndrome
Radial tunnel syndrome

Shockwave may reduce perineural fibrosis and promote local vascular healing

📚 Vahdatpour et al., 2014: Improved pain and nerve conduction velocity in CTS

📚 Shen et al., 2018: Decreased VAS and Quick DASH scores, cubital tunnel syndrome

Pelvic Floor Dysfunction & Chronic Pelvic Pain

Interstitial cystitis
Dyspareunia and pelvic myofascial pain
Hypertonic pelvic floor dysfunction

📚 Zimmermann et al., 2009: Significant pain relief in CPPS

📚 Huang et al., 2023: study protocol for a randomized controlled trial comparing the effectiveness of ESWT and myofascial release therapy in CPPS patients

📚Legacy Therapy STL: Clinical observations suggest that ESWT can help reduce muscle tension and spasms in the pelvic floor

Delayed Healing & Non-Union

Chronic post-op sites
Bone-tendon junction injuries

📚 Wang et al., 2011: Enhanced healing in non-union and delayed wound models

📚 Kuo et al., 2009: Angiogenic benefits in soft tissue repair

🔸 Note to Referring Providers:

These indications are not experimental, but adjunctive. They are most effective in cases of failed conservative care, fascial adhesions, or when patients are not candidates for further surgical or pharmaceutical interventions.