Shockwave Therapy

Shockwave Therapy is a proven technology used to treat acute and chronic conditions of the musculoskeletal system. A shockwave is an intense, but very short energy wave traveling faster than the speed of sound.

This high-intensity sound wave interacts with the tissues of the body and this leads to a cascade of beneficial effects such as tissue ingrowth, reversal of chronic inflammation, stimulation of collagen and breakdown of calcium build-up. (In a nutshell,
shockwave therapy creates an optimal healing environment within your body).

The injured area begins to heal, functionality is restored, range of motion increases and pain is relieved. 

What Conditions Can You Treat With Shockwave Therapy?

Shock Wave Therapy can be used to treat a wide variety of musculoskeletal conditions--particularly those where major connective tissues attach to bone, such as the shoulder (such as the rotator cuff), elbow (epicondylitis or tennis/golfers elbow), hip, and knee (tendinitis), and the foot (Plantar Fasciitis, Strained Arch, Achilles Tendinitis or Tendinosis, Muscle Pain and Injuries, Joint Injuries). Shockwave Therapy also encourages bone healing and has been used to help treat stress fractures, Avascular Necrosis (A dead portion of bone), Slow-healing bone (Delayed unions), Non-healing bone (Non-unions)

 

What can I expect from a Shockwave Therapy treatment session?
  • An initial assessment must be conducted to determine if Shockwave Therapy is an appropriate treatment option for your condition. This can be done with our physician, physiotherapists, chiropractors or RMTs
  • Shockwave Therapy is a good treatment option when other types of therapys have been exhausted. It is most suitable for chronic conditions that have persisted more than 3 months.
  • It is most effective for conditions resulting from connective tissue attachments to bone. 
  • It is usually recommended to have 1 treatment per week for 3 - 5 weeks. Then we wait an additional 3 weeks without treatment to allow for healing to take place.
How does it work?

Simply put, shockwaves stimulate certain components within the body so the body is able to heal.  Shockwave Therapy is able to accomplish this even in chronic cases, when the body has demonstrated a previous unwillingness or inability to do so by itself.

In addition to stimulating the healing process, SWT has a direct effect on nerves, diminishing pain.  

**Many traditional therapies--such as anti-inflammatory medications, steroid injections, physiotherapy, massage, acupuncture, and so forth--can assist the body during the early, acute phase of an injury.  However, they are much less effective in assisting the body to heal when an injury becomes chronic.  As an example, many patients can relate to a history where a steroid injection (like cortisone) seemed to be effective in resolving pain early in their healing process, but subsequent injections were much less effective.  This isn't really surprising when you realize that a chronic-state, degenerative injury isn't likely to respond well to a medication designed to affect an acute-phase, inflammatory condition.**

What makes Shockwave Therapy unique is that it is one of the very few technologies in any field of medicine that seems to work best when an injury reaches the chronic, non-healing state.  Shockwave Therapy is able to jump start the healing process in chronic, non-healing injuries and move them back into the acute phase of healing. 

 

How do the physics of Shockwave Therapy Promote Tissue Healing?

SWT produces a very strong energy pulse (5-100 MPa) for a very short length of time, (approximately 10 milliseconds). The energy pulse quite literally breaks the sound barrier, and this is what creates the shockwave.

Our machine is able to produce a shockwave that is controlled, and focused precisely. In fact, we are able to control and focus the shockwaves to such an extent we are able to pass the shockwaves through the uninjured portions of the body without any effect, and deliver the energy to a focus point at the level of the injured tissue, where it has several known medicinal effects:

First, this shockwave exerts a mechanical pressure and tension force on the afflicted tissue.  This has been shown to create an increase in cell membrane permeability, thereby increasing microscopic circulation to the tissues and the metabolism within the treated tissues, both of which promote healing and subsequent dissolution of pathological calcific deposits.

Second, the SWT shock waves pressure front creates behind it what are known as "cavitation bubbles".   Cavitation bubbles are simply small empty cavities created behind an energy front.  They tend to expand to a maximum size, then collapse, much like a bubble popping.  

As these bubbles burst, a resultant force is created.  In the human body, this force is strong enough to help break down pathological deposits of calcification in soft tissues (scar tissue, etc). 

Third, as cavitation bubbles collapse, they create smaller, secondary energy waves known as microjets.  These microjets also create a lot of force that also breaks down pathological deposits of calcification in the soft tissues through direct, mechanical means.

In the application of a SWT treatment in a medical setting, it's not just one cavitation bubble or just a few cavitation bubbles being produced, but hundreds and thousands. 

Multiply this by several thousand shockwaves being administered to an injured tissue through a course of SWT treatment and you can imagine the forces that can be mustered to break down deposits of calcification that are found in joints, soft tissues and spurs.

Beyond breaking down pathological calcification deposits, SWT has been shown to stimulate cells in the body known as osteoblasts.  These bone cells are responsible for bone healing and new bone production, so stimulating them obviously enhances the healing process of bone.

SWT shockwaves have also been shown to stimulate fibroblasts.  Fibroblasts are the cells responsible for the healing of connective tissues such as tendon, ligaments, and fasica.

  • SWT also diminishes pain.  It does so in two ways.  First, as mentioned above, SWT initially diminishes pain through what is known as hyperstimulation anesthesia.  This is where the nerves sending signals of pain to the brain are stimulated so much that their activity diminishes, thereby decreasing or eliminating pain. This effect is usually, (but not always), short lived.  
     
  • SWT is also diminishes pain over longer periods of time through the stimulation of what is known as the "gate-control" mechanism, where nerves can be stimulated to "close the gate" to pain impulses sent to the brain.  It is sometimes thought of as activating a sort of "reset" button that recalibrates pain perception.

    Interestingly, it was demonstrated by research presented in 2005 that using anesthesia with SWT alters the sensor input - motor output balance of nerve fibres, inhibiting the pain-killing effect of SWT.  
     
    In other words, SWT appears to be most helpful for patients who are not anesthetized.   (This explains why some early studies where anesthesia was used before the administration of extracorporeal shockwave therapy did not get results as good as what is found in patients where no anesthesia is used.)

     

In summary, while SWT is used on a wide variety of body tissues and medical conditions, the effects of shockwaves are best documented in areas of changes in tissue density, such as where tendon attaches to bone and where bone attaches to ligaments.  For this reason, it is very effective for painful connective tissue pain in such locations as the foot, knee, hip, elbow, and shoulder.

What are the benefits of Shockwave Treatment?

This therapy works without the use of X-rays or drugs; it stimulates the body’s natural self-healing process. There is usually an immediate reduction of pain and improved ease of movement. Secondary effects are minor. Shockwave therapy may also eliminate your need for surgery. It is also especially effective for chronic conditions.

How long does each treatment last?

The Shockwave Therapy is approximately 5 minutes per point, or approximately 2000 shocks per session. Shockwave is used as an adjunct to Physiotherapy or Chiropractic Care. 

How many treatments will I need?

Typically 3 treatments sessions are necessary at weekly intervals. There is a possibility that 2 additional treatments may be necessary if your condition is very chronic.

Does the treatment itself, hurt?

Treatment can be uncomfortable, but it is usually well tolerated. It is an intense 5 minutes that most people are able to tolerate.

Will it hurt after the treatment?

As you leave the clinic, you will most likely be feeling no pain but you may experience throbbing pain 2-4 hours following the treatment. This throbbing pain may occur for up to 24 to 48 hours.

What should I do if I am in pain following the treatment?

The shockwave will trigger an inflammatory response, which is the body’s natural process of healing. For this reason, refrain from using anti-inflammatory medications or ice. Use Advil or Tylenol if necessary.

What if it feels good following the treatment?

Even if it feels good, we recommend decreased activity for 48 hrs following the treatment.

Is Shockwave Therapy covered by my insurance?

You will be invoiced under physiotherapy, or chiropractic care. If you have extended health benefits, this service is covered. 

What is the success rate for this kind of treatment?
  • Tennis elbow (Lateral Epicondylitis)- up to 91%
  • Calcifying tendonitis of the shoulder- up to 91%
  • Plantar Fasciitis- up to 88%
  • Patellar Tendonitis/tendonosis (Jumper’s knee)- up to 87%
  • Achilles Tendonitis/tendonosis- up to 87%
What if it doesn’t work for me?

Although the short-term effects alone are exceptional, the long-term benefits of this treatment may take up to 3 to 4 months.

Are there contraindications and/or precautions I should be aware of?

YES

  • Cortisone injections (within the last 6 weeks)
  • Hemophilia or any blood coagulation disorder
  • Blood thinning medications such as Heparin or Coumadin
  • Heart or circulatory problems
  • Cancer, Diabetes, Pregnancy
  • Growing children (Growth Plates)
  • Blood or nerve supplies too close to the affected area
  • Shockwaves are generally not applied to target areas located above air filled tissue (lungs), large nerves and blood vessels, the spinal column or the head

Ask your therapist if Shockwave Therapy can treat your condition and book your treatment sessions today!