Shockwave therapy delivers acoustic pressure waves into tissue, stimulating a healing response in tendons that have stopped progressing on their own. It's particularly suited to chronic, degenerative tendon problems — the ones that have been there for months rather than days.
Three upper-body applications where we use it most.
1. Calcific tendinitis of the shoulder
Calcium deposits form within the rotator cuff tendon, most often supraspinatus. The pain can be severe, and it frequently limits overhead movement significantly.
This is one of shockwave's stronger applications. The acoustic waves appear to help break down calcium deposits and stimulate reabsorption, and it's often used as an alternative to needling or surgical removal.
More on the condition: calcific tendinitis of the shoulder.
2. Lateral epicondylalgia — tennis elbow
Degenerative change at the common extensor origin on the outside of the elbow. Notoriously stubborn: many cases persist for a year or more, and rest alone rarely resolves them because the tendon needs stimulus, not absence of it.
Shockwave is typically used where symptoms have persisted beyond three months despite loading-based rehab. It works best alongside progressive eccentric loading rather than instead of it — the combination consistently outperforms either alone.
More on the condition: tennis elbow.
3. Rotator cuff tendinopathy
Chronic, non-calcific degenerative change in the cuff tendons — usually presenting as pain with overhead activity, difficulty sleeping on that side, and weakness that's hard to distinguish from pain inhibition.
Where a well-executed rehab program has plateaued, shockwave can help restart the healing response and reduce pain enough for loading to progress.
What to expect
- Typically three to six sessions, spaced about a week apart
- Each session takes roughly five to ten minutes of actual treatment
- It is uncomfortable during application — that's normal, and intensity is adjusted to what you can tolerate
- Some post-treatment soreness for a day or two is common
- Improvement is usually progressive over the course rather than immediate
Where it isn't appropriate
Acute injuries, over open growth plates, in areas of active infection or malignancy, over major nerves or blood vessels, and for people on anticoagulant medication or with clotting disorders. We screen for all of this first.
If you have a shoulder or elbow problem that's been going for months without progress, shockwave is worth a conversation.