Shockwave - What is it and What does it do?
Up until earlier this year I (Colin) was using a borrowed shockwave machine on and off. I was getting some great results and felt it was a great addition to the treatments I have to offer. A quick side note - as therapists we need a variety of treatments to offer our patients as, unfortunately not all treatments work for everyone. So it is important to be able to offer different things. Now there is a lot of discussion still about how good shockwave can be, but I think the more important question to ask yourself is, what do I want / need from treatment and what do I have to do get that. So shockwave should be part of a treatment plan and it should be used at the right time to do the job that is required at that time. Does that make sense? Just firing 2000 shocks onto a painful insertion point is not necessary going to mean you are going to be healed the next week.
This is the machine I am using - BTL 6000 SWT
I have 9mm, 15mm and 20mm radial head and a 15mm focused head - will explain more later.
Shockwave works quite differently to many traditional treatments. We used to spend a lot of effort into reducing inflammation and now we are increasingly understanding that we need to stimulate the inflammatory response from the body to promote healing. Shockwave does just that. The shockwave machine generates an acoustic shockwave that is high in energy and stimulates the healing, regenerative and reparative process. The shockwave can penetrate up to 7cm into the tissues. You can hear the machine working and feel the wave go through the tissue.
The wave has a number of effects on the tissues:
A local analgesic effect - reduction in pain straight away
Decrease in muscle tension
Inhibition of muscle spasm
Inhibits transmission of the pain nerve fibres
Improved blood vessel circulation
Improved lymph vessel (fluid) circulation
Enhanced collagen (this is what body builds with) production
Stimulates osteoblast activity - these build bone
So basically there is reduction in pain sensation, promotion of local healing and overall improvement of surrounding tissue viability. Shockwave stimulates the bodies own healing systems to become more active. Your body thinks there has been more damage and so quick starts the healing process. This is why shockwave can be extremely useful when treating chronic (any injury that is over 3 months old) injuries when the body has stopped responding to conventional treatments.
What Happens During a Treatment?
After the assessment of what is happening and what we feel is the issue we discuss the best places to treat. This will involve treating the painful area but also the surrounding area as well. I can change the intensity and frequency of the shocks that are delivered and I start treatment at a level of intensity that is easy to endure. This gets you used to the feeling and starts to desensitise the tissues. I then build the intensity and frequency to a level that is just about manageable. You do not have to be in agony but it does need to feel like the treatment is doing something. Treatment over muscle does feel quite different to treatment close or over bony areas.
We need to treat both the acutely painful bit - like Achilles tendons or plantar fascia insertion (bottom of your heel) but we also need to treat the surrounding areas as well. This will have the desired effect of reducing the pain at the point where you feel it, improve the healing at this point, reduce local swelling around the area and reduce the tension in the surrounding tissues. It will all feel better straight away and put your body in a better position to start healing.
What Happens Afterwards
Although it may feel a lot better it won't be, so you do need to take it easy but you have to keep moving. Your body still has some healing to do and it will be better if you can keep up a certain level of activity. You should have an idea of what you can safely do and we shall discuss this at the time. Rehabilitation exercises are also going to be an important part of the repair and recovery process.
Shockwave works best as a series of treatments usually about a week apart and 3-6 is usual. Activity should be increasing as treatment progresses although the effects of treatment can take 2-3 weeks to start to be noticeable, especially with something like a long standing plantar fasciitis problem.
What can Shockwave Help With?
Chronic problems such as Plantar fasciitis
Achilles tendon issues
Muscle tears and spasm
Sciatic (muscle compression) / Piriformis entrapment
If you would like to know more then please get in touch.