9 Things you didn’t know about ESWT Shockwave Therapy

IT’S NON INVASIVE
Shockwave Therapy can be used to treat longstanding pain and discomfort. We use an EMS Swiss DolorClast shockwave machine. A hand-held device is moved over a conductive gel on the skin to send waves of energy to painful areas in the body. These mechanical pressure pulses – known as shockwaves - work by reinjuring tendons and tissues, which in turn stimulates blood flow helping problem areas to heal (neoangiogenesis).

IT’S RISK FREE
Shockwave Therapy requires no surgery which means there’s no chance of infection and there’s very littlerisk of tendon rupture, which may occasionally occur with steroid injections. There’s no need to take medication. It’s a wonderful technique to consider if all your other treatment options have failed.
The Shockwave Solution

IT’S NOT JUST FOR TENDON INJURIES
Yes Shockwave Therapy can be used to treat pain in areas such as the achilles tendon, but evidence shows it can help other conditions from Peyronie’s Disease (bent penis syndrome) to refractory plantar fasciitis (Policeman's Heel) and even help reduce the appearance of cellulite! It’s also great for chronic shoulder pain (calcific tendonitis of the shoulder), and hip bursitis inflammation around the outside of the hip joints, which can cause people discomfort on one side when they lie down or try to do certain exercises.

IT’S NOT TIME CONSUMING
A course of 3 sessions is generally needed but the sessions only last 15 minutes and after treatment you can go about your daily business. Exercises may be given at the end but it is inadvisable to participate in sport until your practitioner has given you the all clear.

THERE’S MORE THAN ONE OPTION:

FOCUSED SHOCKWAVE: This is generally used to treat targeted deep-rooted painful conditions and is particularly useful for joint related problems. The device uses piezoceramic crystals to generate a pressure wave through the tissue into the target area at a depth of 8cm. This creates cavitation bubbles which collapse, creating a secondary shockwave. This approach is less painful than the radial option.

RADIAL SHOCKWAVE: This is ideal for 90% of the problems we see in clinic. For example, soft tissue/ tendons which are more superficial. In fact some studies have shown this treatment can help with osteoarthritis and bone healing such as delayed non-union fractures. This process works in the same way as the Focused approach except the Radial shockwave does not penetrate as deep and therefore its use is considered for more superficial conditions. 

IT’S USED BY ATHLETES
Some of the best sports teams in the world including The AC Milan football club and its scientific research centre, the Milan Lab, have researched and used Shockwave Therapy as a way of keeping their athletes in peak condition.

IT’S APPROVED FOR USE IN THE UK
NICE (the National Institute for Health and Care Excellence) has reviewed Extracorporeal Shockwave Therapy (ESTW) and approved its use in the treatment of six conditions. The machine we use is on a number of databases around the world such as PEDro. 80% of randomised controlled studies featured on PEDro, have been undertaken using the Swiss DolorClast machine. 

IT’S NOT AS EXPENSIVE AS YOU MIGHT THINK
A full consultation will be given. If you are deemed suitable for a course of Shockwave Therapy, then the cost of three sessions including the consultation is £600. If you are not considered suitable for the treatment, then the consultation fee is £65. Would you put a price on becoming pain free? 

INSTANT ACCESS FROM AN EXPERT ON YOUR DOORSTEP

This treatment should only be performed by an expert practitioner with an understanding of the underlying adverse biomechanics of the body to ensure the results are the best they can be. Step in Paul Morrissey. Author of ‘The Shockwave Solution – The Non-Surgical Answer to Becoming Pain Free’. Paul has treated patients using Shockwave Therapy for the past 14 years. He’s also an ambassador and qualified trainer for EMS. And the best part is there’s no waiting list. Book an appointment today.

December's Early Blog

Shockwave enthusiasts may find some of the posts of interest. I recently spent time with the Guru of Shockwave, Professor Christoph Schmitz at Therapy Expo, assisting with In- house training, tutorials on Proximal Hamstring Tendinopathy and Tennis Elbow.

This week I was discussing a study published in the BMA Journal on failed A/C decompression shoulder impingement surgery and appropiate recommendations. This is a great opportunity for clinicians to push ESWT whether bias of Focused or Radial.

Here's a link to my post on Linkedin.

Here's another link to a post in favour of ESWT.

Another study of significance.

The message is clear, use Shockwave on your patients for shoulder impingements!

Shockwave at Therapy Expo

Well what another busy week, apologies for patients on my Thursday list as had to shoot up to the NEC to spend time with Professor Christoph Schmitz, clearly the most influential academic in Shockwave - MD Full Professor and Head, Extracorporeal Shock Wave Research Unit, Department of Neuroanatomy Ludwig-Maximilians-University of Munich, Germany. 

Christoph's talk was ‘Extracorporeal Shockwave Therapy on the musculoskeletal system in sports medicine and evidence based medicine’. This was well received and I personally got to spend  time with Christoph and managed to bend his ear on a few of his studies.

I have to say its one of the first exhibitions that I have been where other manufacturers of Shockwave machines were present and most certainly raised my eyebrows to some unusual experiences. One practitioner mistakenly believed that he could deliver shockwaves through clothing, whereas in fact castor oil is the necessary medium to allow the transmission of energy into the soft tissues. If the 'learned' practitioners are advocating this as standard practice then it's a worry because the general public will believe the same.

A further worry is that physiotherapists and sports physicians, the people buying these machines are being hoodwinked by price . 

There are other cheaper machines with very little evidence to support what they do but they don't produce consistent energy into the soft tissues.

For what we all charge professionally, we should all be using machines that have evidence to support their product and studies in abundance. The Swiss DolorClast has unrivalled evidence from around the world and one only needs to look at Pedro.org to confirm this.

For those who are following me on LinkedIn, there have been two interesting posts this week; one on subacromial impigement and another on Osteo Arthritis of the knee. Watch this space for more info and hopefully Christoph will shoot me details on his treatment for a 3D hamstring injury for a star he has worked in one of the main international football leagues. The results were amazing and he returned to competitive sport 31 days later. That's all I can say at this stage! 

Training in Camberley

I had a really great day yesterday (14th November) training the team at Camberley Chiropractics.

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Having recently expanded their services to include Shockwave, I was asked to deliver our QuickStart training to get them up to speed and familiar with the device, the latest research and delivery best practices. The day included a general introduction to Shockwave, a scientific overview of the technology, background information on who's using shockwave, the latest research, a in-depth look at the Swiss Dolorclast method and practical use as well as some things to look out for in further developments.

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They're a really keen team under Dr James Everett, and adding ESWT to their very modern clinic which has a strong interest in sports medicine is going to be a great benefit for their patients and their business.

As ever, the EMS device was purchased based on the wealth of evidence and the machines use in many of the clinical trials. This, along with the great support of the Swiss DolorClast Academy  (which all members will be invited to join), make it the perfect choice.

Anyone close to Camberley should check out this clinic for insertional tendinopathies, osteoarthritis and sporting injuries. They have the most up-to-date and internationally recognised radial shockwave equipment. 

If you've added or are considering adding shockwave to your practice, feel free to reach out to me at paul@osteopathclinic.co.uk with any questions or to find out more about the support and training we provide. 

New Video on Proximal Hamstring Tendinopathy (often called High Hamstring or Hamstring Syndrome)

Well again another busy week and fitting in another video was really challenging. I have to thank Rhea, my Pilates Teacher/ Ironman extraordinaire, my wife in the background and the ever supportive Artur who provides us with such good photos.

So what's so particular about this proximal hamstring video. Well the hamstring itself can be the cause of problems with the lower back, hip and indeed the knee. For this particular condition we see a number of athletes from the running world in particular and when not responding to treatment or even misdiagnosed, then Shockwave can be a valid solution. I've treated a number of these conditions with very successful results.

For the academics out there, check out our other Shockwave Practitioner videos and this very good paper to support this condition http://journals.sagepub.com/doi/abs/10.1177/0363546510379324.

For those of you who have or think you may have this condition, i.e pain in the lower buttock, worsened on sitting also whilst running during acceleration / deceleration phase, check out the Hamstring Tendinopathy page here. This may be your saving grace (as in Cacchio's study).

Have a good week everyone.

New Shockwave Video on Tennis Elbow

My word what week it has been, what with the launch of this new site! Thank you all for the nice comments; it's really appreciated. Incredibly 80 more copies of my book, The Shockwave Solution, have been downloaded which is amazing! Furthermore we shot another practitioner video on Tennis Elbow last Friday with Steve Avery Six times Professional Body Builder who has many other accolades and recently won the British title. 

I'm very proud of what Steve has achieved in his field of excellence, I have looked after Steve in excess of 25 years and treated a number of his injuries during this period. Steve is only too aware of the benefits of Shockwave despite his picture for the camera.

Watch this space for more Shocking news.

Focused Shockwave Arrival

Focused Shockwave Therapy now available at Osteopathic Clinic, Croydon

Yes, you read that right. 

We’re delighted to announce that the Osteopathic Clinic, Croydon has introduced a second Shockwave therapy treatment at the practice.

As our long time patients will know, for the past 13 years we’ve used the radial non-invasive form of treatment to help alleviate very painful conditions in patients including tennis elbow, policeman’s heel, also known as plantar fasciitis, osteoarthritis in the knee as well as shoulder tendonitis.

The clinically proven and NICE appraised technique sends shockwaves to problematic areas and works by reinjuring tendons and tissues, which stimulates blood flow and encourages them to heal (neoangioesthesis) It can also numb and anesthetise the nerve endings, thereby reducing pain.

And the best part about it is no medication or surgery is required and the results are both fast and effective.

So, now, excitingly we’ve introduced another form known as focused shockwave therapy to our suite of services.

Unlike the radial method, designed essentailly for superficial (diseases of tendon attachments) medical problems, this technique uses shockwaves that penetrate a depth of 8cm, which means we can get much deeper into the tissue or joint at demonstrated here.

It can also be less painful to deliver than the radial shockwave because it's aimed at deeper problems like bone fractures, middle of the hip however some studies have confirmed that it's had reasonable outcomes for some of the superficial problems also.

But don’t just take our word for it.

The benefits of this have been documented in a couple of clinical journals, principally in the USA gaining FDA approval.  Due to my experiences over the past 14 years and learned physicians asking me to participate in studies of my own, adding Focused Shockwave to the clinic seemed very prudent. 

Going forward, I will be involved in studies with some orthopaedic surgeons so watch this space. The Focused technology is considerably more expensive but for the moment we're charging the same as we would for the radial device. As before, between three and five sessions are needed. 

If you’d like to learn more about Shockwave Therapy, you can download my free book here, which explains everything you need to know.

If you’d like to book a consultation please call 020 8662 1155 or email contact@osteopathclinic.co.uk.

Principal Paul applying Shockwave to his knee

Never let it be said we’d recommend things we weren't willing to do ourselves…

Earlier this week Paul broadcast a Facebook Live session as he Shockwaved his knee. For those technically minded: lateral femoral condyle and soft tissues superiority and inferiority work 😉

If you’ve ever wondered about the procedure, this is a great watch.