Shockwave Therapy: What to Expect at Your First Session

Shockwave therapy has a dramatic name, which makes patients understandably curious — and occasionally nervous — before a first session. Here's exactly how it goes.

Before the device comes out

Your first appointment starts like any good physiotherapy visit: a focused assessment to confirm shockwave is the right tool. It shines for chronic tendon and fascia problems — plantar fasciitis, tennis elbow, Achilles and rotator cuff tendinopathy — that have lingered past three months. If your condition will respond better to needling, loading, or manual therapy, we'll say so.

The treatment itself, step by step

1. Locating the target. Your clinician palpates to find the precise zone of maximal tenderness — shockwave works best delivered exactly there.
2. Gel application. A conductive gel goes on, the same as for an ultrasound.
3. Delivery. The applicator head rests on the area and delivers rapid acoustic pulses — typically about 2,000-3,000 of them over three to five minutes per area. It feels like a fast, firm tapping, deep in the tissue.
4. Intensity tuning. We start moderate and adjust. Effective treatment sits at "strong but tolerable" — you'll feel it, and you can absolutely breathe through it. You're in control the whole time.

The shockwave portion itself usually takes under ten minutes inside a normal treatment visit, which also includes the exercise and hands-on components of your plan.

Afterward

• Expect mild soreness or warmth over the area for a day or two — that's the intended biological stimulus at work
• Skip anti-inflammatories if you can; the controlled inflammation is part of how shockwave restarts healing
• Keep moving normally, but hold off on maximal loading of the area for about 48 hours
• Most plans run 3-6 sessions, one week apart, with improvement often continuing for weeks after the last one

Will it work?

For the right conditions, the research is encouraging — success rates around 70-80% for chronic tendinopathies, with some shoulder conditions higher still. Combined with progressive loading exercise, which we always pair it with, your odds are better again.

Curious whether your stubborn tendon qualifies? Call 587-355-3555 — Nolan Hill Physiotherapy & Massage, NW Calgary, direct billing available.