Schockwave therapy uses mechantransduction to convert cellular responses, meaning it uses mechenical energy to increase cell metabolism and activate repair cells. It is a intervention to help regenerate good tissue and break down bad tissue. Think of osteoarthritis- there is lots of adhesion and cartilage destruction, shockwave can help reverse this process and stimulate stem cells to repair. 

1.Angiogenesis and Tissue Repair: grow new blood vessels, activate stem cells = aid with repairing tissue

2. Pain reduction: the mechanical signal interrupts pain receptors in the nerves, with pain reduction being seen as early as the first treatment

3. Calcification Breakdown: the high energy waves from the shockwave machine break and dissolve the calcium deposition in the tendons. Conditions like Osteoarthritis, plantar fasciitis, frozen shoulder adhesive capsulitis), golfer/tennis elbow have seen good results with this treatment. 

ESWT activates chondrocytes, increases cellular metabolism, and promotes extracellular matrix production. It works by decreaseing chondrocyte apoptosis ("cell suicide"), that helps mitigate cartilage fissures that lead to osteoarthritis progression. It also stimulates mesenchymal stem cells which help repair subchondral bone (bone that gets damaged with arthritis). ESWT increases synovial fluid, which helps lubricate joints and allow more motion. 

Promoting cellular metabolism means increasing ATP production, which ACTIVATES P38 MAPK signaling, and that stimulates tissue repair. In inflammatory diseases, this P38 MAPK signal is dysregulated leading to inflammation and destruction of tissue.

Treatments are usually completed in 6-10 sessions depending on the area, level of tissue destruction, and chronicity of the complaint. Ultrasound gel is used as a conductor directly on the skin. Each treatment takes between 8-15 minutes per area. Treatments can feel uncomfortable, but we work with patients to their comfort level.