This option offers a full Physiotherapy Initial assessment plus Shockwave Therapy, and two further follow-up shockwave sessions.

Please give a short description of your symptoms when booking your appointment.

During your initial assessment, your physiotherapist will ask a series of questions about your condition and about your general health. This will be followed by a detailed examination involving some movements and tests that highlight the problem and potential causes of your condition. These findings will then be discussed with you to formulate a personalised treatment plan.

There will be time for you to ask any questions you may have or give them the information you feel is relevant to your condition.

During the session, Shockwave treatment will be given. Further destails regarding this are found below. Other treatment may also be offered during your appointment and an explanation of any findings will be discussed.  If further sessions are required your next appointment can be arranged by our reception team or you can book online.

You are likely to leave with some ‘homework’ exercises that can be emailed directly to you so you don't need to rely on your memory alone.

During the Follow-up sessions your response to treatment will be assessed and any adjustments required will be made to your Shockwave Therapy and home exercises. Other manual techniques may also be utilised.

These sessions last 45 minutes for the Initial Assessment and 30 minutes for the Follow-up sessions.

What is Shockwave?

Focused shockwave (f-ESWT) harnesses high energy sound waves which are delivered precisely to your injury to activate tissue repair mechanisms at a cellular level.

Are all shockwave technologies the same? Focused versus Radial

Focused

Focused Shockwaves generates the energy outside the body and is then delivered to a focal target area deep inside the body. Piezowave2 is the only technology that can create a shockwave which forms direct at the focus of treatment to ensure the delivered energy is maintained.

Radial

Radial Shockwaves are actually pressure waves and differ considerably from focused shockwaves. The energy spreads radially on contact with tissues and the density of energy dissipates rapidly through the top layers of the skin reducing penetration depth. This makes Radial systems unsuitable for targeted deeper areas classically associated with ESWT applications.

Radial shockwave is not as accurate, powerful or as comfortable as focused shockwave.

In a bit more detail of how it works…..

The Piezowave2 focused shockwaves reach their peak pressure precisely on the target tissue. This mechanical stimulus, known as Mechanotransduction, induces biochemical changes in living tissue which, on a molecular level affects gene expression and can promote cell growth, protein synthesis, release of growth factors, stimulation of stem cells and lubricin production.

This treatment can provide an an anti-inflammatory, antibacterial effect whilst promoting microcirculation and metabolic activity. It is also proven to reduce the chemical substance in the tissues that induces pain, as well as reverse the growth of pain nerve receptors, meaning we can get rid of your pain, not mask it.

It is one of the few technologies that has been shown to effectively treat pain syndromes of the musculoskeletal system.

The shockwave focal zone

The focal zone is the point we deliver the treatment. This is where the sound waves produced by the therapy source, converge into one point to produce the shockwave at a selected depth.

An important aspect to consider is how precise shockwaves can be delivered to the injured tissue which is why we chose Piezowave2.

This system has the highest level of output energy in the focal volume and has the smallest focal volume. This means:

• The more precise the shockwaves can be delivered.
• The therapeutic energy is delivered to the injured tissue.
• And therefore, less trauma to the surrounding, uninjured, tissue.

Piezoelectric technology has the narrowest focal point (or focal volume) of any comparable technology.

Range of Indications

Musculoskeletal diseases are among the most common disorders of the human body. Considerable research has been conducted into the efficacy of focused shockwave and its use in the management of these conditions. The success rates are high ranging from 65% to 91% and complication rates are low.

Focused Shockwave treats:

• Plantar Fascitis
• Medial Tibial Stress Syndrome
• Ligament injury
• Knee Meniscal Tears 
• Knee Osteo-Arthritis 
• Stress Fractures and Non-Unions 
• Tendon Pathologies (Achilles / Patella / Gluteal / Hamstring / Adductor)
• Rotator Cuff Calcific Tendonitis
• Golf & Tennis Elbow 
• Carpal Tunnel Syndrome
• Myofascial Pain Syndrome 

Why focused shockwave?

• Targeted treatments
• Stimulate new blood vessel growth (Angiogenesis)
• Stimulate biological, chemical and physical responses to promote tissue regeneration
• Induce calcific reabsorption in tendinopathies
• Promote new bone growth
• More tolerable treatments for your patient

Why we use the PiezoWave2?

• Only DIRECT focused system in the world
• Linear focused shockwave – perfect bridge between radial and focused shockwave
• Most powerful system available on the market
• Lowest noise level
• Precise and adjustable penetration depths between 0-100mm
• Smallest, most accurate focal zone
• Most comfortable treatment

How effective is focused shockwave?

Patients report an initial improvement almost immediately following treatment. Pain scores drop on average by 50% with many patients reporting pain disappearing completely in 1 session. This DOESN’T mean that you are fixed though!

This reduction of pain is usually (but not always) temporary and is part of the process of helping your tissues heal without compromising other structures.  

The reduction of pain is often associated with the analgesic effect resulting from hyperstimulation of the tissue. However, focused shockwave, has been shown to reduce pain physiologically.

Our overall aim is to improve the efficiency of tissue regeneration and reproduction and manage pain throughout the healing process.

Often, positive results (chronic injuries) are felt within 3 sessions (average).

What to expect from a treatment

You will be positioned in a comfortable way which gives the therapist access to the injured structures. The therapist then selects the appropriate gel pad to control the depth of the treatment. They will then apply a water based gel to your skin to help transmit the energy into your tissue.

What will you feel?

This is the part where we may need your help and guidance. The therapist will explain the below you can help by guiding them to your pain points as the Piezowave2 REPLICATES YOUR PAIN.

On healthy tissue;

• Very often - not painful.
• Slight ‘toothache’/pinching sensation.

On problematic tissue;

• Replication of pain being experienced.
• Heightened ‘toothache’ sensation.
• Pain should settle within 20-40 seconds.

If the discomfort doesn’t settle in that time, your therapist will move away and come back. The sensation can ebb and flow… this is often when we know we are on the right spot.

On healthy bone;

• Gradual amplification of pain.
• Significant difference in sensation.

On problematic bone

• Is the same experience as the soft tissue sensations outlined above.

How much, how long and how often?

This very much depends on what you need. There are many variables which include:

• Tissue type being treated.
• Tendon, muscle, ligament
• Stage of healing.
• Tissue tolerance.
• Clinical outcome desired.

Your therapist will guide you through this and ensure you know what your treatment plan is with shockwave to maximise your time with us.