You’ve reduced your running kilometres, changed your gym routine or taken a few weeks off sport. Yet the pain in your Achilles tendon, heel or elbow keeps returning when you become active again.

Persistent tendon and soft-tissue injuries can be difficult to manage, particularly when symptoms interfere with training or everyday movement. Focused shockwave therapy is one treatment your physiotherapist may consider when an injury has not responded as expected to initial management.

What is focused shockwave therapy?

Focused shockwave therapy is a non-invasive treatment that delivers high-energy acoustic waves into a targeted area of tissue. These mechanical pulses are used to stimulate biological responses associated with tissue repair and pain modulation.

Unlike surgery or injections, shockwave therapy does not involve breaking the skin. Treatment takes place during a physiotherapy appointment, usually as one part of a broader rehabilitation program.

Which persistent injuries may benefit?

Shockwave therapy is most commonly considered for certain longstanding tendon conditions and other musculoskeletal complaints. Examples include:

Plantar heel pain: Persistent pain underneath the heel, often associated with plantar fasciitis.
Achilles tendinopathy: Pain or stiffness in the tendon connecting the calf muscles to the heel.
Patellar tendinopathy: Pain around the tendon below the kneecap, particularly during jumping, squatting or other activities that load the knee.
Lateral elbow tendinopathy: Commonly called tennis elbow, this can affect people who regularly grip weights, tools or sporting equipment.
Shoulder tendon complaints: Some rotator cuff conditions, particularly calcific tendinopathy, may be considered for shockwave treatment.

A physiotherapy assessment helps establish whether the symptoms are consistent with a condition for which shockwave therapy has an appropriate evidence base.

Who may be suitable for focused shockwave therapy?

Focused shockwave therapy may be considered for active adults whose tendon pain has persisted despite changes to activity and an appropriate rehabilitation program.

For a runner, that might mean Achilles pain that repeatedly returns as training distances increase. A gym-goer may notice ongoing elbow pain during gripping exercises, while a weekend athlete may struggle with persistent patellar tendon symptoms.

However, persistent pain does not automatically mean shockwave therapy is suitable. Your physiotherapist will consider how long symptoms have been present, which tissues appear to be involved and what treatment you have already tried.

Shockwave therapy may not be suitable if you’re pregnant (or could be), have certain bleeding disorders, or an acute injury. Your clinician will also review medications, relevant medical conditions and the proposed treatment site before recommending it.

What happens during a shockwave therapy appointment?

1. Initial assessment

Your physiotherapist will discuss your symptoms, medical history, sporting activities and previous treatment. They may assess joint movement, strength and how the affected tendon responds to loading.

This helps determine whether shockwave therapy is appropriate or whether another treatment approach should take priority.

2. The treatment session

If shockwave therapy is recommended, your physiotherapist will apply gel to the treatment area and position a handheld applicator against your skin. The device delivers a series of acoustic pulses to the targeted tissue.

You may feel repeated tapping or pressure at the treatment site. If your tissue is already sensitive, you may feel some discomfort. Please tell us if this happens, as we can adjust the treatment settings.

3. Rehabilitation and follow-up

You may experience temporary soreness, redness or bruising after your session.
For active patients, rehabilitation will often include reviewing training loads and gradually rebuilding the affected tissue’s capacity to tolerate activity.

Part of a bigger plan

Shockwave therapy is rarely a standalone treatment. It’s usually one part of a bigger treatment plan that may include:

Discuss your treatment options with The Brisbane Spine Clinic

If persistent tendon or soft-tissue pain is keeping you from running, training or enjoying your usual activities, our physiotherapists can help you understand what’s contributing to your symptoms and what treatment options may be appropriate.

At The Brisbane Spine Clinic, we combine detailed musculoskeletal assessments with hands-on treatment, exercise-based rehabilitation and additional therapies, including focused shockwave therapy, where clinically appropriate. We’ll consider your injury history, current activity levels and goals when developing a treatment plan.

Book a physiotherapy assessment in North Lakes, Eight Mile Plains or Daisy Hill to discuss your symptoms and find out whether focused shockwave therapy could form part of your treatment.

Frequently asked questions

Does focused shockwave therapy hurt?

You may experience discomfort or a tapping sensation during treatment. Your physiotherapist can adjust the settings and discuss how you are responding.

How many sessions will I need?

There is no single treatment schedule for every condition. Some protocols involve several sessions spaced over a number of weeks. Your physiotherapist will explain the proposed course after assessing your injury.

Who shouldn’t have shockwave therapy?

People with certain bleeding disorders, relevant acute injuries or other contraindications may not be suitable. Pregnancy and treatment near sensitive anatomical structures also require particular precautions. Your physiotherapist will screen for these before treatment.

How is focused shockwave different from radial shockwave or ultrasound?

Focused shockwave concentrates acoustic energy within a defined treatment area, while radial shockwave disperses pressure waves more broadly. Therapeutic ultrasound uses different acoustic frequencies and energy delivery. These treatments are not interchangeable.

Can shockwave therapy help you return to sport?

Hopefully, yes, but as part of a larger treatment and rehabilitation plan that includes easing pain, promoting healing, and ensuring your body can tolerate the movements and loads involved in your chosen activity.

Your physiotherapist can discuss whether you need to temporarily modify running distances, jumping exercises or heavy lifting while continuing suitable rehabilitation.

The aim is to establish a manageable progression towards your usual activities, rather than relying on shockwave therapy alone.

Can I keep training during treatment?

Often, some activity can continue, but this depends on your injury and symptoms. Your physiotherapist may recommend modifying the intensity, frequency or type of exercise while rehabilitation progresses.

Is shockwave therapy covered by private health insurance?

Cover depends on your insurer, extras policy and how the service is billed. Ask The Brisbane Spine Clinic for the relevant billing details and confirm your eligibility with your health fund before treatment.

Disclaimer

All information is general and not intended as a substitute for professional advice.

References

International Society for Medical Shockwave Treatment. (n.d.). ISMST recommendations. https://shockwavetherapy.org/ismst-recommendations/

Focused shockwave therapy for persistent musculoskeletal injuries: what to expect