How Shockwave Therapy (ESWT) Works
Get WISE - Get WELL - Get ON
Shockwave Therapy can be extremely effective — when it’s used for the right reason, at the right time, in the right person. That’s why I don’t offer it routinely or package it as a quick fix.
I use shockwave therapy when someone has a clearly defined tendon or soft-tissue problem that hasn’t responded to appropriate rehabilitation, loading, or time. In those situations, shockwave can help restart a healing process that has stalled. Used indiscriminately, it often disappoints.
A powerful, evidence-guided tool — only used when it truly makes sense
Condition Related Articles
Tendons
Ligaments
Tennis Elbow
If you’re reading this page, you’re probably dealing with a stubborn, lingering injury — and you want to know whether shockwave is genuinely worth considering, not just being sold to you.
Related Blog Posts
Subacromial Pain Syndrome
- should I get an injection in my shoulder or try shockwave therapy?
- My friend warned me shockwave therapy actually injures you, is this true?
- My injection into hip bursitis did not work, can I try Shockwave therapy?
- Can I get Shockwave Therapy on the NHS?
What Shockwave Therapy Actually Is
Shockwave Therapy (also known as Extracorporeal Shockwave Therapy or ESWT) uses controlled acoustic energy delivered through the skin to stimulate tissue healing. It’s not electrical stimulation, and it’s not ultrasound — it’s mechanical energy that penetrates deeper into tissue.
The technology was originally developed for kidney stones and later adapted for musculoskeletal conditions. I use radial shockwave therapy, which is specifically suited to tendons, ligaments, and chronic soft-tissue conditions.
How Shockwave Works — in Practical Terms
When I apply shockwave therapy, several things are happening:
-
Blood flow to poorly healing tissue is stimulated
-
Cellular activity involved in tissue repair is encouraged
-
Pain signalling can be temporarily disrupted, allowing movement and loading to resume
-
Chronic “stuck” tissue can become more responsive to rehabilitation
The aim is not to mask pain, but to change the biological environment so healing can progress again.
When I Will — and Won’t — Use Shockwave
I don’t use shockwave as a first-line treatment.
I consider it when:
-
symptoms have persisted for 12 weeks or more
-
the condition is clearly tendon- or soft-tissue related
-
appropriate rehab has already been attempted
-
imaging and examination support its use
I won’t use shockwave if:
-
the injury is very acute
-
there’s an untreated fracture, infection, or inflammatory condition
-
you’ve had a recent steroid injection into the same area
-
there are medical contraindications
If your problem doesn’t fit, I’ll tell you — and I’ll explain what will help instead.
What a Shockwave Appointment with Me Actually Looks Like
Shockwave is never delivered in isolation.
Each session lasts 60 minutes, and includes:
-
reassessment of symptoms and progress
-
hands-on treatment where appropriate
-
shockwave therapy if still indicated
-
adjustment of loading and exercise strategy
A typical course is 4–6 weekly sessions, but I reassess continuously.
If there’s no meaningful change after several treatments, we stop — I don’t persist for the sake of it.
What Shockwave Is Most Useful For
In my practice, shockwave is most useful for chronic, load-related soft-tissue problems, particularly where healing has plateaued.
It tends to work best when:
-
the diagnosis is clear
-
loading has been managed properly
-
expectations are realistic
-
it’s integrated into a broader rehab plan
Shockwave alone rarely solves the problem. Used properly, it can accelerate progress.
What Shockwave Does Not Do
Shockwave does not:
-
instantly “fix” tendons
-
reverse degeneration
-
replace proper rehabilitation
-
work for every condition
I’m upfront about this because unrealistic expectations are one of the main reasons people feel let down by shockwave therapy.
What Shockwave Feels Like
Shockwave feels like a series of firm, rhythmic pulses through the skin. Some discomfort is normal — but I control the intensity carefully. This is not about “pushing through pain”.
After treatment, you may feel:
-
temporary soreness
-
local sensitivity
-
a dull ache for 24–48 hours
These reactions are expected and usually short-lived.
Why I Don’t Sell Shockwave as a Standalone Service
Many clinics market shockwave as a miracle treatment.
I don’t.
In my view, shockwave should only be used when:
-
it makes clinical sense
-
it’s part of a clear plan
-
the person understands its role and limits
Used properly, it’s a powerful tool. Used indiscriminately, it’s just expensive noise.
Is There Evidence — and What Are the Limits?
There is good evidence supporting shockwave therapy for certain chronic tendon and soft-tissue conditions, particularly when other conservative treatments haven’t worked.
However:
-
outcomes vary
-
dosage and technique matter
-
not all conditions respond
That’s why clinical judgement matters more than the machine itself.
Key Takeaway
Shockwave therapy isn’t about doing more — it’s about doing the right thing at the right time.
I use it selectively, thoughtfully, and honestly.
If it’s right for you, I’ll explain why.
If it isn’t, I won’t recommend it.
Shockwave Therapy – Frequently Asked Questions
Does shockwave therapy actually work?
It can — when it’s used for the right condition, at the right stage.
Shockwave is most effective for chronic tendon and soft-tissue problems where healing has stalled. It does not work equally well for every injury, and it’s not something I recommend routinely. When it’s appropriate, it can meaningfully reduce pain and improve function. When it isn’t, it tends to disappoint — which is why I’m selective.
Is shockwave therapy painful?
It can be uncomfortable, but it should be tolerable and controlled.
You’ll feel firm, repetitive pulses through the skin. I adjust the intensity carefully — this is not about “pushing through pain”. Some discomfort during treatment and mild soreness for 24–48 hours afterwards is normal.
How many shockwave sessions will I need?
Typically 4–6 sessions, spaced about a week apart.
However, I reassess continually. If there’s no meaningful improvement after several sessions, we stop. I don’t continue shockwave simply because it’s been started — it needs to be earning its place.
Is shockwave therapy a quick fix?
No — and anyone selling it as one is being misleading.
Shockwave works best as part of a broader rehabilitation plan, alongside appropriate loading, exercise, and activity modification. It can help restart healing, but it doesn’t replace rehab or magically “repair” tissue overnight.
What conditions do you use shockwave therapy for?
In my practice, shockwave is most commonly used for chronic tendon and soft-tissue conditions, such as:
-
persistent Achilles or patellar tendinopathy
-
plantar heel pain (plantar fasciitis)
-
calcific shoulder tendinopathy
-
stubborn soft-tissue pain that hasn’t responded to standard care
I won’t recommend it if the condition doesn’t fit.
Are there any risks or side effects?
Shockwave is generally very safe when used appropriately.
Common short-term effects include:
-
local soreness
-
tenderness
-
mild bruising
Serious complications are rare. I screen carefully for contraindications, and if shockwave isn’t safe or suitable for you, I won’t use it.
Why wouldn’t you just try shockwave straight away?
Because timing matters.
In early or acute injuries, the body often heals perfectly well on its own with the right guidance. Introducing shockwave too early can be unnecessary or even counterproductive. I reserve it for situations where healing has clearly stalled.
Can shockwave therapy replace injections or surgery?
Sometimes it can help avoid them — but that’s not guaranteed.
Shockwave may reduce pain and improve function enough that injections or surgery are no longer needed. In other cases, it forms part of the decision-making process. I won’t present it as an alternative to everything — just as one option among several.
How do I know if shockwave is right for me?
You don’t decide that alone — we decide it together.
I assess:
-
your diagnosis
-
how long the problem has been present
-
what you’ve already tried
-
how your symptoms behave
-
whether the tissue involved is likely to respond
If shockwave makes sense, I’ll explain why.
If it doesn’t, I’ll explain that too.
Why You Should Choose Chris Heywood Physio
The most important thing when seeking help is finding a practitioner you trust—someone who is honest, responsible, and clear about your diagnosis, the treatment you really need, and whether any follow-up appointments are necessary.
I’m not here to poach you from another therapist, but if you’re looking for a new physiotherapist in Northamptonshire or simply want a second opinion, here’s why many people choose to work with me (read my reviews):
Over 25 Years of Experience & Proven Expertise
With 25+ years of hands-on physiotherapy experience, I’ve built a trusted reputation for clinical excellence and evidence-based care. My approach combines proven techniques with the latest research, so you can feel confident you’re in safe, skilled hands.
Longer Appointments for Better Results
No two people—or injuries—are the same. That’s why I offer 60-minute one-to-one sessions, giving us time to:
-
Thoroughly assess your condition
-
Provide focused, effective treatment
-
Explain what’s really going on in a clear, simple way
Your treatment plan is tailored specifically to you, aiming for long-term results, not just temporary relief.
Honest Advice & Support You Can Trust
I’ll always tell you what’s best for you—even if that means you need fewer sessions, not more. My goal is your recovery and wellbeing, not keeping you coming back unnecessarily. I have low overheads nowadays and I do not have pre-set management targets to maximise patient 'average session per condition' (yes it does happen commonly and I hate it with a passion - read my article here)
Helping You Take Control of Your Recovery
I believe the best outcomes happen when you understand your body. I’ll explain your condition clearly, give you practical tools for self-management, and step in with expert hands-on treatment when it’s genuinely needed.
Looking for a physiotherapist who values honesty, expertise, and your long-term health?
Book an appointment today and take the first step towards feeling better.
Contact Info
On a Monday and Tuesday I work as a advance musculoskeletal specialist in primary care but I can still be contacted for enquiries. You are welcome to call but it is often faster for me to reply via an email or watsapp message, simply as my phone will be on silent in clinic. Either way, I will reply as soon as possible, which in the week, is almost always on the same day at the latest.
Clinic Opening Hours
The Clinic is located at 2 Old Road, Scaldwell, Northants, NN6 9LA
Tel: 07576 473422 (Feel free to watapp)
** Please note that online sessions and Aquatic sessions be arranged outside of normal clinical hours on request.**
Sat -Sun
Closed (Family Time!)
0900 - 1330
Closed for Contract Work
Weds - Fri
Mon - Tues