Shockwave Therapy
Treatment with Mechanical Pulses
Shockwave Therapy is a form of physical therapy used to treat certain orthopedic and trauma-related conditions. Similar to ultrasound, the shockwave works through mechanical waves that pass through body tissue. The effect on the tissue comes from a powerful pressure wave, followed by a slower vacuum phase, during which the tissue is exposed to tensile forces.
Radial and Focused
There are two types of shockwave generators: radial and focused. Radial shockwave therapy is the most common in the Czech Republic, with its greatest effect at the point of application and penetrating 3-5 cm deep. Its advantage lies in its strength and ease of application. Focused shockwaves, on the other hand, are directed deeper into the tissue and are typically used to treat deeper structures or areas requiring precise targeting without affecting surrounding tissue (e.g., acute conditions or localized problems). At *Fyzio svět*, we use the radial shockwave generator SwissDolorClast Smart 20, manufactured by the Swiss company EMS. It is excellent for relieving muscle tension, overloaded tendons and joints, and is one of the most widely used generators worldwide.
What are the effects?
Shockwave therapy has several effects on tissue. Calcifications in muscle tendons are broken down during the pressure phase of the wave and then absorbed by the vascular and lymphatic systems. The therapy changes blood circulation in the area, creating local hyperemia and initiating the process of neovascularization (formation of new blood vessels). The mechanical energy acting perpendicular to the muscle fibers results in muscle relaxation by releasing actin-myosin bonds. There is a proven positive effect on the quality of bone and connective tissues, and it supports stem cell differentiation. One of the most important effects is pain relief, achieved by reducing the sensitivity of pain-transmitting fibers, affecting inhibitory interneurons, and through other neurophysiological and biochemical processes (e.g., reducing the release of substance P for up to 6 weeks after treatment), providing long-lasting pain relief.
Best results are achieved after 3-5 sessions
The effectiveness of shockwave therapy has been demonstrated in numerous clinical studies and falls under Evidence-Based Medicine. Shockwave therapy is effective, safe, and typically involves 3-5 sessions at weekly intervals, with a single dose of 2000-5000 impulses per session. The first visit includes a detailed diagnosis of the musculoskeletal system, treatment, and recommendations for compensatory exercises or lifestyle changes. Therefore, the initial session typically lasts an hour. Properly indicated shockwave therapy has minimal side effects, including the possibility of bruising at the treatment site and pain during the procedure. In the first two days after treatment, there may be a temporary increase in pain—this is known as the healing inflammation activation phase, during which the body’s healing immune responses are triggered. For this reason, it is not advisable to suppress this inflammation with anti-inflammatory medications.
Common conditions treated with shockwave therapy
- Tennis elbow (lateral epicondylitis)
- Heel spurs and plantar fasciitis
- Painful shoulder conditions
- Achilles tendon tendinopathy
- Tendon pain, such as jumper’s knee
Contraindications
Shockwave therapy should NOT be applied if you suffer from hemophilia or blood clotting disorders, have skin defects, acute inflammation, fever, have received a corticosteroid injection in the area within the past 6 weeks, have metal in the target area, deep vein thrombosis, phlebitis, varicose veins, or if you are pregnant. If you fall into any of these categories or have any doubts, please consult your doctor before undergoing shockwave therapy.
