Cornerstone Physiotherapy provides Shockwave Therapy or ECST (Extracorporeal Shockwave Therapy) in downtown Toronto. Shockwave Therapy provides patients a non-surgical alternative for when conventional treatment has not fully resolved their conditions. It is one of the newest and most effective treatments in rehabilitating chronic pain, and one our patients have benefitted greatly from.
What is shockwave therapy?
Shockwave treatment involves the application of short, frequent, and high intensity bursts of mechanical energy (in the form of a shockwave) into soft-tissue that is injured, scarred, or contains adhesions, is painful, or inflamed. This energy shock is not electrical, but rather a rapid high frequency vibration in the form of a Radial Pressure Wave (RPW). When appropriately applied, shockwave can increase local blood flow, improve healing response, break apart scar tissue and adhesions, reduce muscle spasm, and directly decrease pain. Most patients tolerate the treatments well, and report only mild discomfort.
How does shockwave treatment work?
The effects of shockwave occur across several levels:
1. Cell Level Change – shockwave stimulus affects the chemical environment of tissues at a cellular level. This causes changes to free radicals which boost the release of the substances that help to prevent pain and inflammation.
2. Blood Flow Change – Normal blood flow is critical to the healing process, and shockwaves create a revascularization effect. This type of stimulus redirects new blood flow into the affected area which improves soft tissue healing and regeneration.
3. Muscle Tone Reduction – Shockwave treatment reduces the contractile activity of muscle and can also break patterns of neuro-cognitive pain that are associated with chronic conditions. This effectively decreases muscle tone and spasm, and has specific benefits with eliminating trigger points.
4. Pain Reduction – Shockwave pulses directly affect the nerve fibres that transmit pain signals to our brain. Through the Gate Control Mechanism, shockwaves impact the interneurons in the A-β fibers which prevent the communication of pain.
What conditions can shockwave treat?
- Plantar Fasciitis
- Heel spurs/Heel pain
- Calcific Tendonitis
- Patellar Tendonitis (Jumper’s Knee)
- Achilles Tendonitis
- Rotator Cuff Tendonitis
- Myofascial Trigger Points in muscle
- Iliotibial Band Syndrome (IT Band Syndrome)
- Tennis Elbow and Golfer’s Elbow
- Heterotopic Ossification (Myositis Ossificans)
What should I expect with my shockwave appointment?
Along with your treatment, your initial appointment will include an assessment to ensure Shockwave Therapy is both safe and appropriate for your specific problem. Our clinic uses the Storz Shockwave System to deliver treatment, which is the most widely used system for Radial Pressure Wave ECSW in practice. Aside from pre and post treatment prep and clean up, the actual application of shockwave lasts 3-5 minutes. The majority of our patients appreciate the faster rate of improvement when combining traditional physiotherapy with shockwave treatment. After the treatment, the rest of your visit will be spent with your physiotherapist, who may also use manual therapy, exercise prescription, or other modalities to facilitate rapid recovery.
Does shockwave therapy hurt?
Most patients experience mild discomfort during treatment, but it is generally well tolerated. The initial discomfort typically fades as the area becomes desensitized as it is being treated. Your physiotherapist will adjust the intensity of stimulus depending on your comfort level, and can gradually ramp it up to minimize discomfort. Shockwave Therapy purposefully creates an inflammatory response in injured soft tissue, so you may also experience mild discomfort following treatment. Patients should not apply ice or take anti-inflammatories after shockwave treatment, as this inflammatory healing response shouldn’t be reduced.
How many treatments will I need?
Most conditions require THREE treatments at one-week intervals. However, more chronic or complicated conditions may require up to five treatments. Most patients experience significant improvement while undergoing the first three treatments, and improvements often continue for several weeks. In some cases, improvements can be seen up to three to four months following therapy.
How successful is Shockwave? Does it really work?
Shockwave Therapy is one of the most widely researched rehabilitation modalities used in physiotherapy clinics, with increasing numbers of scientific studies added each year. The majority of research validates the effectiveness of extracorporeal shockwave, and shows successful treatment rates of up to 90%! References to current research studies on Shockwave Therapy can be found below.
Is Shockwave Therapy covered by insurance?
Registered physiotherapists administer our shockwave treatments, so if you have extended health benefits that include physiotherapy you may have a portion (or all) of your treatment covered. Cornerstone Physiotherapy can also bill directly to most health insurance companies. Please call us for further details.