shockwave therapy

an effective natural treatment option

Shockwave Therapy (SWT) has been shown to be a highly effective treatment option for patients who have failed to respond to conservative manual therapies. The National Institute for Health and Clinical Excellence (NICE) has received numerous clinical studies and has endorsed its effectiveness. 

Shockwave was initially used in the 1970s and 80s as a non-invasive treatment for Kidney Stones and has since become the treatment of choice for such conditions.

Enquiring minds started to wonder what effects shockwaves could have on bone, cartilage and soft tissues (tendons, ligaments and fascia). This has led to a growing body of evidence of its efficiency? in aiding healing, especially in recurring? and chronic conditions.

The treatment goes by several different names, the most common being Shockwave therapy, Extracorporeal Shockwave Therapy (ECSW) or Radial Shockwave Therapy. The latter used to distinguish between the nature of the wave from the focused versions used elsewhere in medical practice.

SWT is a non-invasive, non-surgical evidence-based treatment which is quick, safe and affordable.

    Shockwave Therapy, in conjunction with an appropriately prescribed exercise programme by your health professional, has been shown to help with the following conditions

    • Achilles Tendinopathy
    • Biceps Tendinopathy
    • Plantar Fasciitis
    • Calcaneal heel spurs
    • Calcific tendonitis & bursitis of the shoulder
    • Supraspinatus tendinopathy
    • Patellar tendinopathy
    • Stress Fractures
    • Pseudoarthrosis (non-union)
    • Greater Trochanter pain at the hip
    • Trigger point treatment
    • Cellulite



    shockwaves are a physical wave that builds to a peak and affects the target tissues.

    The shockwave gets its name because the wave intensity peaks after a high rise in energy and then falls off just as quickly.  When you receive shockwave therapy you are getting between 4-21 of these shockwaves per second and the treatment lasts for about 4 minutes, this creating on average 2500 shockwaves into the tissues. The intensity of the shockwaves is governed by BAR pressure or Energy Flux Density (EFD) and is changed by the physician through feedback from the patient on the sensation they can feel.


    Professor Tim Kratson states, that one of the strongest arguments for the use of shockwave in therapy is that it effectively takes the affected issue from a chronic state to an acute one. In doing so, this provides a stimulant or trigger to a ‘stalled’ repair sequence.


    Tissue Regeneration
    Shockwave stimulates the cells that generate soft tissue and bone.Focused shockwave machines stimulate stem cell production and have shown amazing effects on reduced scarring, reducing healing times for a great many injuries and work on skin, soft tissues such as muscles, tendons or ligaments and also for regeneration of bone tissue for faster healing times.

    Pain Reduction
    The pulses delivered to the tissue help inhibit the transmission of the pain signal, initially via hypostimulation anaesthesia, then via the pain gate theory. This theory is based on Melzack and Wall’s work(1965).

    Shockwaves influence the tissue on a cellular level, promoting the release of pain inhibiting and inflammatory substances required for the healing process.

    Shockwaves influence blood flow deep into the tissues, promoting tissue healing and regeneration.



    If you would like more detailed information, please visit our SWT Evidence/Resource page for relevant papers, website and testimonies.

    If you have any further questions, or would like to discuss Shockwave Therapy as a treatment option and can be booked through Paul Hobroughs clinic in Northumberland via his online booking system here or to email Paul directly

    If you feel like shockwave is right for you click below to book an appointment

    what to expect


    We are guided by the current research which suggests 5-6 treatment sessions in conjunction with physiotherapy assessment and appropriate exercises.

    Ideally the session should be 5-7 days apart..


    The clinician will conduct a thorough subjective assessment of your injury. If they feel SWT is indicated. then they will proceed with the treatment.

    This process involves:

    Applying a contact gel to the skin

    The shockwave machines treatment head is then placed onto the affected area

    Shockwaves are delivered through the skin

    The shockwaves are felt as pulses which can feel uncomfortable.

    The clinician applying the treatment will start at a low intensity level and increase the level which is tolerable for you.


    Many patients report an improvement in symptoms after the first treatment, however this often can be temporary. This is the Pain Gate Theory coming into play as previously mentioned.

    Shockwave is working at a cellular level to influence the healing process and many patients see an improvement from the second week onwards. The healing process can take up to several weeks or even months to complete (dependent upon the diagnosis).


    There are no long-term side-effects from Shockwave.

    The treatment procedure can be uncomfortable, but it is very short term.

    Any potential side effects will be explained at your appointment, but you may experience some reddening, bruising and swelling as well as a potential brief increase in pain.

    These side effects usually subside over a few days.

    Shockwave is a ‘proinflammatory’ treatment, hence the above potential reactions to treatment.

    Remember we are trying to ‘kick start’ your healing process from a ‘stalled’ or chronic state.

    To this end, DO NOT take anti-inflammatory medication during your course of treatment as this will interfere with the natural healing process we are trying to reinstate.


    As a clinic we need to know if our treatments and patient care are effective. This is why you will receive a questionnaire at 3 and 6 months after your treatment, enquiring as to how your injury has progressed.

    Evidence also suggests that even after you have completed your SWT course, the effects are still on going many months later. That is why we audit all our SWT patient at 3 and 6 months.



    "Fantastic course by Paul today, Awesome!"

    "Delighted to be on the course today, even after 1 day I’m confident in integrating shockwave into the clinic"

    "The course was much more practical than expected, I learned much more than I thought I would!"

    ask the expert

    Paul Hobrough has treated some of the biggest names in British Sport, and trained some of the most successful practices in British Physiotherapy, if there's anything you need to know about Shockwave, he's the person to ask.

    Send a message using the form below.