Your symptoms, medical history, previous treatment and activity goals will be discussed.

The affected area will then be assessed to determine whether shockwave therapy is appropriate and whether further medical investigation or imaging may be required.

The findings and proposed treatment will be explained before beginning.

Shockwave intensity is adjusted according to the condition, treatment area and your tolerance.

Gel is applied to the skin, and the handheld device is positioned over the affected tissue.

A series of acoustic pulses is then delivered into the treatment area.

Treatment may feel uncomfortable, particularly over a sensitive tendon, but the intensity can be adjusted throughout the appointment.

You may be given exercises to improve strength, movement control and the tissue’s ability to tolerate load.

These exercises are an important part of treatment and help address the reasons symptoms may be persisting.

Your response will be reviewed at each appointment. Exercise, activity and treatment recommendations can then be adjusted as required.

A typical course consists of approximately 5 to 6 sessions, often completed at weekly intervals.

The precise number will depend on:

• The condition being treated
• How long symptoms have been present
• The severity of the problem
• Previous treatment
• Your response to each session
• Your consistency with rehabilitation
• Your work, exercise or sporting demands

Shockwave therapy can feel uncomfortable while the affected tissue is being treated.

The sensation is commonly described as repetitive tapping or pulsing. More sensitive areas may feel sharper, but the treatment intensity can be reduced or gradually increased according to your tolerance.

The aim is to deliver an appropriate therapeutic dose without making the treatment unnecessarily painful.

Shockwave therapy should not be viewed as a stand-alone cure.

Persistent tendon conditions are often influenced by several factors, including:

• Reduced strength or tissue capacity
• Sudden changes in training
• Repetitive occupational loading
• Inadequate recovery
• Movement or technique issues
• Previous injury
• Footwear or equipment
• Returning to activity too quickly

Your treatment may therefore be combined with:

• Progressive tendon-loading exercises
• Calf, hip, knee or upper-limb strengthening
• Mobility exercises where appropriate
• Balance and movement-control training
• Advice about exercise and training load
• Sports massage or manual therapy
• Therapeutic ultrasound where clinically appropriate
• Guidance for returning to work, running, gym training or sport
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This combined approach aims to reduce symptoms while improving the affected tissue’s ability to tolerate everyday and sporting demands.

Shockwave therapy is not suitable for everyone.

Treatment may be contraindicated or require medical approval if you:

• Are pregnant or could be pregnant
• Have a blood-clotting disorder
• Take certain anticoagulant or antiplatelet medications
• Have an active infection, wound or significant skin condition in the treatment area
• Have a tumour or suspected tumour in the area
• Have certain neurological or vascular conditions
• Have had a recent corticosteroid injection near the treatment site
• Have a recent fracture or significant acute tissue injury
• Have reduced sensation around the treatment area
• Have an implanted device close to the proposed treatment area
• Are under 18