Shockwave therapy for tendons and heels that won't heal
Radial shockwave therapy (ESWT) uses high-energy acoustic pulses to stimulate tendon healing when pain has lasted for weeks or months. At Fisiosmart we always combine it with therapeutic exercise, which remains the foundation of treatment.
When it can help
Shockwave therapy is mainly indicated for tendon problems that have lasted more than a few weeks and do not improve with rest alone. The strongest evidence is for plantar fasciitis and calcific tendinopathy of the shoulder.
- Plantar fasciitis Pain under the heel, worst with the first steps in the morning. Also with a heel spur (calcaneal spur). See also ankle and foot.
- Calcific shoulder Calcific tendinopathy of the rotator cuff, with pain when lifting the arm.
- Tennis elbow Pain on the outside of the elbow when gripping or lifting objects.
- Achilles tendon Pain and stiffness above the heel, typical in runners.
- Patellar tendon "Jumper's knee": pain below the kneecap when jumping and on stairs.
- Lateral hip pain Pain on the side of the hip, when you lie on that side or climb stairs.
How the treatment works
- 01 Assessment We listen to your story, examine the area and check that shockwave therapy is really right for you.
- 02 The sessions Usually 3 to 5 sessions, about a week apart. Each application takes just a few minutes.
- 03 Exercise A programme of progressive exercises to strengthen the tendon, which you can also do at home.
- 04 Review We reassess pain and function to decide together how to continue.
Does it hurt?
During the application you feel some discomfort, which we adjust with you by changing the intensity. In the hours afterwards the area may be a little sore: this is normal and passes quickly.
When it is not suitable
- Pregnancy
- Blood clotting disorders or anticoagulant treatment
- Tumours or infections in the area to be treated
- Growing children and teenagers, over the growth plates
We always check this at the first assessment.
Three myths to bust
Sources: Rompe, Furia, Maffulli, American Journal of Sports Medicine, 2009 · Schmitz et al., systematic review, British Medical Bulletin, 2015
Frequently asked questions about shockwave therapy
Content by Luca Barbisan, OMT physiotherapist · Updated October 2026
How many sessions will I need?
Usually 3 to 5, about a week apart. The exact number depends on the problem and how you respond to treatment.
Is shockwave therapy covered by health insurance?
Yes. Shockwave therapy is part of physiotherapy treatment: with a medical prescription it is covered by basic health insurance like the other sessions, minus the deductible (franchise) and co-payment.
Can I keep doing sport?
Often yes, by adjusting the load. During the assessment we tell you which activities you can keep doing and how to dose them.
What type of shockwave therapy do you use?
We use radial shockwaves, which are suited to tendons and tissues close to the surface, such as the heel, elbow, shoulder and knee.
Is shockwave therapy enough on its own?
No. It works better together with a targeted exercise programme, which strengthens the tendon and lowers the risk of the pain coming back.
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Pain that won't go away? Let's talk.
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