I am going to guide you through the essentials and what there is to know about Shockwave therapy here at SO Podiatry.
By the end of this blog about Shockwave Therapy, you’ll have a clear understanding of:
- Whether shockwave therapy is right for you.
- How shockwave therapy works its magic.
- What to expect during a session.
- Why it should be part of a comprehensive treatment plan.
- The potential risks and side effects.
So, fasten your seatbelt – this could be the key to finally breaking free from your chronic pain!


What is Shockwave Therapy?
Shockwave therapy is a safe and proven treatment for specific types of chronic pain that have persisted for more than six weeks, typically caused by overworked tendons and fascia.
The top three conditions that respond remarkably well to shockwave therapy are:
- Plantar Fasciitis or Plantar Fasciopathy that has been lingering for over six weeks.
- Achilles Tendonitis or Achilles Tendinopathy.
- Lateral Epicondylitis, commonly known as tennis elbow.
If your heel pain is relatively new or your diagnosis differs from the above, the chances of shockwave therapy being effective decrease. If you’re uncertain about the source of your heel pain, consult with us at SO Podiatry and we can help find out what it is that’s causing your pain. its important to remember that there are many causes of heel pain and not all heel pain is Plantar fasciitis
While there are other less common injuries that also respond well to shockwave therapy, these three conditions are the primary targets.
How Shockwave Therapy works
Understanding how shockwave therapy operates is crucial, and I can vouch for that. I wanted to be certain that the treatment deliver is firmly grounded in science and evidence.
At its core, shockwave therapy involves delivering sound waves to the injured area through a probe and ultrasound gel. These sound waves are non-invasive and lead to several benefits, including accelerated healing, reduced pain, and improved injury recovery.
Here’s a bit more detail on the changes that can occur:
- Stimulation of Collagen Production: Collagen is essential for building healthy tendons and fascia.
- Reversal of Chronic Inflammation: Shockwaves trigger the release of mast cells, crucial for healing.
- Formation of New Blood Vessels: This ensures more nutrients reach the injured tissue.
- Exhaustion of Substance P: This feels like a numbing sensation, as it depletes the neuropeptide.
- Breakup of Calcified Fibroblasts: Eliminating poorly repaired scar-like tissue to foster healthy tissue growth.
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Release of Myofascial Trigger Points: These are tight “knots” in the muscles surrounding an injury.
What Shockwave Therapy Feels Like
I remember feeling a mix of nerves and curiosity before my first shockwave session. What would it feel like, I wondered? Well, it turned out to be surprisingly good, albeit with a slight adjustment period.
In my case, as I had Achilles tendonitis, the session began with my calf and heel exposed to my podiatrist. They pinpointed the injury site and the tight trigger points in my calf. Next, they applied some cool ultrasound gel to those points, and the machine came to life.
It was a bit louder than I expected, emitting a rat-a-tat-tat sound that, while not loud in the clinic, still caught me off guard. As for the sensation, initially, the tapping on my tight trigger points and sore Achilles was uncomfortable. I knew my podiatrist started at a low intensity and would gradually increase it, which made me a bit nervous about the transition from discomfort to pain.
But then, as my substance P was depleted, I experienced a pleasant, numbing sensation. My podiatrist increased the shockwave machine’s intensity to deliver all six of its healing effects. After about 15 minutes, it was over. There were moments during the treatment that I was in some discomfort but it was short lasting.
I stood up, and cautiously loaded my Achilles, and it felt pretty good. These effects initially last a few hours, but as the healing process kicks in, they can endure much longer, leading to full injury resolution.
Part of Your Treatment Plan
Now, here’s an important point: Shockwave therapy is a valuable tool, but it’s rarely a standalone solution for chronic pain. To achieve your goals of pain relief and a return to optimal function, you’ll need a comprehensive treatment plan, developed in collaboration with your podiatrist or physiotherapist. This plan will encompass two key elements:
- Load Optimization: This involves reducing the strain on your injured tissue. For example, if you’re receiving shockwave treatment for plantar fasciitis, it may include:
- Choosing appropriate footwear to alleviate strain on your plantar fascia.
- Using strapping or orthotic therapy to reduce plantar fascia load.
- Making gait or activity modifications to limit overload.
- Capacity Building: This is about enhancing your tissue’s ability to tolerate load. It encompasses three aspects:
- Increasing the capacity at the site of the injury, facilitated by shockwave therapy.
- Enhancing the capacity of nearby tissues to assist, such as muscles supporting the injured area.
- Boosting your mental capacity to tolerate loading, an area of recent research related to brain training, resilience, and chronic pain.
With your treatment plan in place, it’s vital to be aware of the potential risks and side effects of shockwave therapy.

Shockwave Therapy Side Effects
As with any medical treatment, shockwave therapy comes with its share of potential side effects and unintended consequences. Here are some key considerations:
- Bleeding Risk: If you’re taking blood thinners (anti-coagulants), shockwave therapy can lead to bleeding around the application site. This might manifest as minor bruising or, in rare cases, a more significant hematoma.
- Not for Pregnant Individuals: Shockwave therapy is contraindicated during pregnancy.
- Potential Discomfort: While rare, some individuals may experience mild pain or discomfort during shockwave therapy. If this happens, inform your clinician immediately, and the session can be stopped.
Frequency of treatments
Now we have explained the essentials, let’s talk about how many sessions you may need. Shockwave therapy isn’t a one-and-done deal; it takes multiple sessions to yield results.
For chronic pain persisting for over six weeks, you’ll typically need at least three, and sometimes 4 sessions. Each session is performed once a week and you are asked to not do any explosive exercises within the 24 hours after it.
What are your thoughts?
Is it for you?
Feel free to get in touch and we can discuss if it’s suitable for you.
Remember your diagnosis is important and ‘Dr Google’ does not make up for what a Podiatrist can do and diagnose for you.