We are proud to offer shockwave therapy at Harley Place Health. To book with one of our shockwave practitioners you can call us on 93896344 or use the online booking system for Marcus (https://www.harleyplacehealth.com.au/marcus-ng-osteopath/) or Max (https://www.harleyplacehealth.com.au/max-bellaiche-osteopath/)
Radial shockwave therapy (RSWT), also called radial extracorporeal shockwave therapy (rESWT), is a non-invasive treatment that uses high‑energy acoustic waves delivered through the skin to underlying tissues. Unlike focused shockwave devices, radial systems disperse energy over a broader, more superficial area, making them particularly useful for treating conditions in muscles, tendons, and soft tissue near the surface. RSWT is now widely used in sports medicine, orthopedics, physiotherapy, and rehabilitation clinics because it can help reduce pain, improve function, and in some cases accelerate tissue healing without the need for injections or surgery.
One of the most common and best‑supported uses of radial shockwave therapy is for chronic tendinopathies and enthesopathies (conditions where tendons attach to bone). Examples include plantar fasciitis, Achilles tendinopathy, patellar tendinopathy (jumper’s knee), and lateral epicondylitis (tennis elbow). In these conditions, pain often persists for months despite rest, exercise therapy, orthotics, or anti‑inflammatory medications. RSWT is thought to work by stimulating neovascularization (new blood vessel formation), modulating pain pathways, and promoting a controlled “microtrauma” that triggers a more effective healing response. Radial devices are particularly suited to these problems because the affected tissues are relatively superficial and spread over a larger area rather than being a tiny, deep target.
Plantar fasciitis and heel pain syndromes are arguably the flagship indications for radial shockwave therapy. Patients typically present with sharp heel pain, especially during the first steps in the morning or after rest. RSWT can be applied over the plantar fascia insertion and surrounding soft tissue, often in a series of 3–6 weekly sessions. Multiple randomized or controlled studies have shown improvements in pain and function compared with sham or conventional care, especially in chronic cases that have not responded to stretching, orthotics, or NSAIDs. For plantar fasciitis, radial devices are well suited because the plantar fascia lies close to the skin surface, making energy delivery efficient without the need for deeply focused waves.
Another major area where radial shockwave therapy is frequently used is for lateral epicondylitis (tennis elbow) and other upper‑limb tendinopathies, such as calcific and non‑calcific rotator cuff disease and medial epicondylitis (golfer’s elbow). These conditions commonly affect manual workers and athletes who perform repetitive gripping or overhead movements. RSWT can be targeted over the tender tendon origin and surrounding muscle tissue, helping reduce pain and improving grip strength and range of motion. For calcific shoulder tendinopathy in particular, shockwaves may help fragment calcium deposits and stimulate resorption, although focused devices are sometimes preferred for very dense, well‑localized calcifications. Nevertheless, radial systems remain a practical, widely available option in many physiotherapy clinics.
Beyond classic tendon problems, radial shockwave therapy is increasingly used for myofascial trigger points and chronic soft‑tissue pain syndromes. Conditions such as chronic neck and back myofascial pain, piriformis syndrome, iliotibial band friction syndrome, and muscle tightness around the hip and shoulder girdle can respond to RSWT aimed at trigger points or tight fascia. Here, the broad, superficial energy distribution of radial devices is an advantage, as it can treat a larger area of dysfunctional muscle or fascia rather than a single pinpoint. RSWT is also used in scar tissue management, some forms of chronic hamstring or adductor pain, and in post‑surgical rehabilitation to help mobilize adhesions and improve tissue quality, always as part of a broader rehab program including exercise and manual therapy.
Some clinics also employ radial shockwave therapy for less conventional indications such as cellulite, non‑healing wounds, and erectile dysfunction, though the evidence base is stronger for focused shockwave in some of these applications. In musculoskeletal practice, the conditions to which RSWT is best suited share several features: they are typically chronic (lasting more than three months), involve relatively superficial soft tissue or tendon insertions, have not responded adequately to standard conservative care, and do not show signs of complete tendon rupture or acute inflammatory pathology where shockwave would be inappropriate. Patient selection, correct diagnosis, and combining RSWT with active rehabilitation (such as progressive loading exercises) are key to maximizing outcomes and avoiding disappointment.
Evidence for the effectiveness of radial shockwave therapy comes from a growing body of trials and systematic reviews, although results vary by condition and study quality. For example, Gerdesmeyer et al. (2008, American Journal of Sports Medicine) conducted a randomized controlled trial showing that extracorporeal shockwave therapy significantly improved pain and function in chronic plantar fasciitis compared with placebo. In a systematic review and meta‑analysis, Ioppolo et al. (2014, Muscles, Ligaments and Tendons Journal) reported beneficial effects of shockwave therapy for various tendinopathies, particularly plantar fasciitis and lateral epicondylitis, though they noted heterogeneity in protocols and device types. More recently, Mani‑Babu et al. (2015, British Medical Bulletin) reviewed shockwave therapy in lower‑limb tendinopathy, concluding that it can be an effective adjunct for chronic cases, especially when integrated with exercise‑based rehabilitation programs. Collectively, these and other studies support the use of radial shockwave therapy as a valuable tool in managing chronic, superficial musculoskeletal conditions, while also underscoring the need for standardized protocols and proper clinical judgment.
