Shockwave therapy in functional rehabilitation

Shockwaves are a non-invasive therapy that has been widely tested and successfully applied in the rehabilitation field since the 1990s.

Shockwave therapy sessions can be included in the Isokinetic personalised treatment protocols after a careful preliminary clinical analysis performed by a specialist Sports Medicine Doctor.

Let’s try to understand what shockwaves are, what they are for and what advantages they can offer in a functional rehabilitation programme.

What are shock waves?

The term shockwaves indicates acoustic waves, that is mechanical impulses of high intensity and short duration, capable of crossing the human body causing “micro-massages" capable of accelerating the regeneration of damaged or suffering tissue.

They were experimented for the first time in the 1970s for painless crushing of kidney stones but for over 20 years they have been used in motor rehabilitation therapies with evidenced benefits.

Shockwaves are emitted by electromagnetic generators and can be focused with extreme precision on the area to be treated. In consideration of their physical nature, shockwaves do not present a risk of radioactivity.

What are shock waves used for?

Through mechanical stimulation, shockwave therapy is able to obtain significant biological effects both on the symptoms and on the causes of numerous pathologies and traumas of the locomotor system. They can reduce pain and promote tissue regeneration, with a rapid return to functional normality.

The shockwaves are included in the Isokinetic personalised rehabilitation programs only at the request of the doctor dedicated to following the patient throughout the treatment path. They can be indicated in the case of:

Tendinopathies (shoulder, elbow, knee, Achilles tendon), and even in the absence of calcifications
Plantar fasciitis
Non-union
Wear and stress fractures
Calcifications and ossifications of soft tissues
Joint stiffness of shoulder, elbow, hip or knee

They are also indicated for many other musculoskeletal problems.

In some cases, both for bone consolidation disorders and for some pathologies of the tendons, the non-invasive treatment with shockwaves can avoid the patient having to undergo surgery, solving the problem with conservative therapies.

How do shockwaves act on skeletal muscle diseases?

Shockwave treatments produce beneficial mechanical effects both direct and indirect:

the direct effects are due to the transformation of sound waves into kinetic energy when they come into contact with the different densities of the musculoskeletal tissues: these tiny movements trigger a series of biochemical reactions which have an anti – pain and anti – inflammatory effect. It is possible that these reactions lead, gradually and over time, to the dissolution of the calcifications and the re-absorption of the disintegrated matter. The shock waves that are used in the musculoskeletal field do not have a traumatizing effect so intense as to “break the calcifications" but can achieve the same result gradually.

the indirect effects are linked to the passage of the wave through the tissues and are known as “cavitations": inside the “target area" there is the formation of microscopic gas bubbles which, hit by the subsequent shock waves, implode favouring a more profuse vascularisation.

In addition, shock wave treatments stimulate the release of substances (neuropeptides) that reduce the sensation of pain, stimulate tissue re-growth and inhibit the COX II enzyme, producing a beneficial anti-inflammatory effect and preventing the onset of new pathologies.

Is shockwave therapy painful?

Shockwave therapy sessions are generally well tolerated: especially in the case of treatments addressed to bone tissue, in which waves of greater intensity are used. It is though possible to feel a slight discomfort during the session, which tends to disappear quickly.

What happens during a shockwave session?

The methods of administration of shockwave therapy and the type of waves themselves change according to the type of pathology (bone, tendon, muscle, etc.).

The average duration of a session is 10/15 minutes in the case of treatments targeting soft tissues and can even reach 60 minutes when the “target area" is made up of bone tissue.

The patient is made to sit or lie on his back on the bed: after careful analysis and determination of the target area, the operator applies the probe in contact with the affected part for a variable time, from a few seconds to a minute.

Depending on the clinical indication and the patient’s reaction and sensitivity, the doctor can vary the point of application, the energy density, the frequency and the total number of shots to be administered.

How long can I have the first benefits?

The Isokinetic personalised rehabilitation protocols usually include 3 to 5 applications, lasting 5-6 minutes each and spaced 2-7 days, always depending on the pathology.

The beneficial action of the shock waves is linked to complex biological reactions which sometimes mean there are no immediate effects but which are perceived by the patient gradually and progressively session after session.

Occasional exacerbations, between one session and another, of the pain already present must not alarm: it could be a simple reaction to stimulation that reactivates healing and regeneration processes.

Are there any contraindications for shockwaves?

In Isokinetic rehabilitation centres, shockwave sessions are carried out by expert professionals with the most modern equipment, and therefore they do not present any health risk at a local or general level.

It is a non-invasive, repeatable, safe and effective outpatient therapy, with no clinical side effects.