Details: Written by: Heather Jeffcoat, DPT; Published: 16 March 2023; Last Updated: 23 April 2024; 2644 Views

Utilizing Shockwave Therapy in Rehabilitation

We are excited to offer shockwave therapy at our Sherman Oaks and Beverly Hills offices

Shockwave has been increasingly utilized in rehabilitation environments. Shockwave therapy has well-researched applications not only for conditions like wound healing, but is also useful for general orthopedic conditions including joint inflammation, sprains and strains. It can also help create angiogenesis and activate healing in the body.

There are two primary types of shockwave therapy, low intensity and high intensity. High intensity focused shockwave would be the type used in lithotripsy for kidney stones, for example. This type of energy wave can break up tissue and be very precise. Low intensity shockwave has a therapeutic effect and is the one we utilize in rehabilitation. Focused, low intensity shockwave is believed to create microtrauma to then stimulate healing. Unfocused shockwave does not cause microtrauma and is believed to stimulate healing through mechanotransduction.

There are three types of low intensity shockwave therapy: electrohydraulic, electromagnetic, and piezoelectric. Applicators can deliver focused or unfocused energy. The electrohydraulic technology comes in both focused (microtrauma) and unfocused. The unfocused electrohydraulic shockwave penetrates the deepest, and with the patented unfocused applicator created by Softwave Technologies, covers the most surface area in the least amount of time or shocks. Electromagnetic shockwave only has a focused version and has moderate penetration. Piezoelectric shock wave has the lowest energy with minimal to moderate penetration of tissues.

The SoftWave patented unfocused applicator design makes it possible to spread energy to a large area of both superficial and deep tissue soliciting a biological response to the target area to initiate the body’s natural healing process.

The Softwave Technologies OrthoGold100 unit is designed in Germany. It delivers an unfocused shockwave by an electrohydraulic process. The body of the unit has an attached applicator through which the shocks are applied to the body.

Frequency of treatment is typically one time per week, up to two times a week for very acute conditions, and treatment is usually provided 3-7 days apart. Some patients benefit from as little as 1- 3 sessions, but more typically are seen for 6-9 sessions, with some patients returning for care once per month.

Extracorporeal Shockwave Therapy (ESWT): Research supports that ESWT promotes healing by promoting an anti-inflammatory environment and by angiogenesis or the forming of new blood vessels. More details on the research and technology of the device we are using can be accessed at the company website.

How does Shockwave Therapy work?

An electrode inside a dome full of water sends short, frequent sparks of mechanical energy (shockwaves) which when contacting the skin penetrate and create soundwaves traveling through the affected tissue. The soundwaves travel faster than the speed of sound and result in an increased blood flow and decreased inflammation.

Click here for more information on how the Softwave shockwave machine works.

What does it feel like?

Over an area without inflammation, it feels like a rubber band gently snapping on your skin. Over a "hot spot" or sensitive area patients report a deeper discomfort, often replicating the discomfort for which they are being treated.

How long does it take?/ How many sessions?

A treatment lasts 5–15 minutes depending on the number of shocks used. Some patients notice a dramatic improvement after 3 to 4 sessions, while more chronic issues may require 6 to 10 sessions of shockwave to note significant changes.

Is it covered by insurance?

Shockwave is currently not covered under insurance. Physicians have a CPT code in some cases for billing high intensity shockwave, but there is not a code for rehabilitation at this time.

Common pelvic health conditions treated:

Erectile Dysfunction Pelvic Pain
Penile Pain
Persistant Genital Arousal Disorder (PGAD)
Rectal Pain
Sacroiliac/SIJ Pain
Tailbone Pain
Testicular Pain
Vulvodynia/Vestibulodynia

Other conditions treated:

Arthritis/Joint Pain
Low Back Pain
Musculoskeletal Pain
Neck Pain
Non-healing Wounds
Plantar fasciitis
Scars
Sciatica Tendonitis

For more information on our use of shockwave therapy, call us or use our contact form here.

Go here if you are ready to schedule an appointment with one our licensed physical therapists.

What Our Patients Have to Say

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.
Read more: Testimonial by T.H.

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.
It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.
Read more: Testimonial by R.D., age 38

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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Now Offering Orthopedic and Therapeutic Treatments Using Shockwave Therapy