Published by PMR of NY & CT
Most sports injuries heal on a fairly predictable path. Some don't. The heel pain that greets your first steps each morning, the elbow that aches after every match or the Achilles that stiffens after every run can hang on for months, even when you rest and do your exercises.
That kind of chronic tendon pain is where shockwave therapy for sports injuries is most often used. It is a noninvasive treatment that may reduce pain and help restart healing in tissue that has stalled. Research supports it for a few conditions and is mixed for others, and it works best alongside a rehab program rather than in place of one.
How shockwave treatment works
Extracorporeal shockwave therapy (ESWT) delivers rapid pulses of acoustic energy through the skin to a painful tendon or other soft tissue. There are no needles, incisions or medicines involved.
Researchers think the pulses may trigger a fresh healing response and temporarily dull pain signals, though exactly how it works is still being studied. Clinics use focused shockwave, which concentrates energy at a set depth, or radial shockwave, which spreads it over a broader, shallower area.
Which tendon problems respond best
Shockwave therapy for sports injuries is mainly used for tendinopathy and similar soft tissue pain that has lasted at least a few months. Common examples include:
- Plantar fasciitis that hasn’t improved with stretching, footwear changes and time
- Calcific tendinitis in the shoulder, where calcium deposits form in a rotator cuff tendon
- Achilles tendon pain in runners and jumpers
- Tennis elbow and golfer's elbow
- Patellar tendon pain, often called jumper's knee
- Tendon pain on the outside of the hip
The evidence is strongest for chronic plantar fasciitis and calcific shoulder tendinitis, though results still vary. For Achilles, patellar, elbow and hip tendon pain, research is more mixed, and shockwave is usually paired with strengthening exercises rather than used alone. It is generally not a first choice for fresh sprains or muscle tears.
During and after a shockwave session
Your clinician finds the most tender spot, applies gel and moves a handheld applicator over the area as it delivers the pulses. Treatment usually takes only a few minutes, and you can carry on with your day afterward.
Expect some discomfort. Many people describe a strong tapping sensation over the sorest spot, and your clinician can adjust the intensity. Treatment usually involves a series of sessions spaced over several weeks. Afterward, the area may be red, tender or a little swollen for a day or two, and small bruises can occur.
Staying active during treatment
Tendons get stronger through gradual, progressive loading, so exercise remains the core of your recovery, and shockwave may make that loading more comfortable. Your physical therapy program might include slow, heavy calf raises for an Achilles problem or wrist strengthening for tennis elbow.
You may need to cut back on running, jumping or throwing for a while and swap in activities that don't aggravate the tendon. Many clinicians suggest avoiding hard training on the treated area for a day or two after each session.
Is shockwave therapy for sports injuries right for you?
You may be a good candidate if tendon or heel pain has lasted several months and hasn't responded to rest, activity changes and a consistent exercise program. It is also an option if you want to try a nonsurgical treatment before injections or surgery.
Tell your clinician if you have a bleeding disorder, take blood thinners, have a pacemaker or recently had a steroid injection in the area. Shockwave is generally not used during pregnancy or over an infection, open wound, tumor or open growth plates in children and teens.
Signs it may be more than tendon pain
Shockwave is meant for persistent pain, not for injuries that may involve a fracture or a complete tear. See a doctor promptly if:
- You felt a pop or a kick-like blow at the back of your ankle and can't rise onto the toes of that foot, a possible Achilles rupture
- You can't bear weight on the leg, or the area looks deformed
- A joint or tendon becomes hot, red and swollen, especially if you also have a fever
Calf pain with warmth and swelling in one leg can be a blood clot rather than a strain, so get same-day care. Call 911 if it comes with chest pain or sudden shortness of breath.
Frequently asked questions
Is shockwave therapy better than a cortisone shot?
They work differently. A cortisone injection often eases tendon pain quickly, but for tennis elbow that relief tends to fade, and results months later can be worse than with other approaches. Shockwave works more gradually. For chronic plantar fasciitis, some reviews suggest it relieves pain as well as or better than a steroid injection over a few months. Your physician can help you weigh the options.
When will I notice results from shockwave therapy?
Some people feel less pain within days of a session, but the main benefit tends to build gradually over several weeks to a few months after a course of treatment, as the tissue responds. Not everyone responds, so your clinician rechecks pain and function along the way rather than judging after one visit. Keeping up with your exercises during this period matters.
Can shockwave therapy help me avoid surgery?
For some people with long-standing plantar fasciitis or tendon pain, it is a reasonable nonsurgical option to try first, and some find they no longer need a procedure. It cannot repair a complete tendon rupture, a fracture or a joint problem that needs surgery. Your physician and therapist can help you weigh the options.
Ask about shockwave therapy at PMR
If tendon pain has held you back for months, Physical Medicine & Rehabilitation of NY & CT (PMR) can evaluate it and build a plan that pairs shockwave with rehab when it fits. Read about shockwave therapy in Danbury, CT and shockwave therapy in Brewster, NY, or request an appointment and we’ll be in touch to schedule.
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