We are the premiere provider of Shock Wave Therapy (ESWT or ECSWT) in Utah. Shockwave Therapy is a new treatment modality that has shown extraordinary efficacy with substantial clinical research evidence to support its use in a variety of conditions. Using visual ultrasound guidance with personalized settings, these treatments can be targeted to your specific injury or pathology. Radial and focused shockwave treatments have been shown to provide unique and significant improvements via biomechanical and biochemical mechanisms to injured tissues like tendon, ligament, muscle, and bone (see references below). This shock wave therapy accelerates healing and tissue repair by providing a regenerative stimulus to tendons, ligaments, fascia, and bone.
Shockwave therapy is a game changer in sports medicine, orthopedics, and many forms of acute and chronic injuries. An overwhelming amount of clinical evidence and scientific studies now show that shockwave therapy can safely be used to treat a multitude of musculoskeletal conditions in athletes, including rotator cuff tendinopathy, elbow epicondlyopathy, greater trochanteric pain syndrome, hamstring tendinopathy, patellar tendinopathy, achilles tendinopathy, plantar fasciopathy, bone stress injuries, and medial tibial stress syndrome. Athletes can use these therapies during their training seasons to rapidly overcome injuries since this requires no downtime and can provide rapid results. Additionally, shockwave and acoustic wave therapy can be used in conjunction with other therapeutic interventions to optimize tissue repair and achieve long-term improvements in function and outcomes.
"Mechanosensitivity is a pre-requirement for life, as we know it." --Kohl & Noble, Oxford (2008)
Shockwave therapy is a powerful biomechanical stimulus that strengthens and stimulates dense connective tissues like tendons and ligaments. Shockwaves generated by electromagnetic pulses tend to be more powerful while shockwaves generated by piezoelectric pulses can be more focused. In either case, shockwaves favorably disrupt pathologically misaligned "mushy" collagen depositions that result from degenerative processes and weak scarring in the tendon and ligament, thereby enabling proper collagen synthesis and crosslinking to renew. Shockwaves also perform a microscopic form of subcellular myofascial release, disrupting inappropriately bound crosslinked adhesions between myosin and actin fibers in muscles that have spasmed, cramped, or been energy depleted. Shockwaves help induce release of growth factors like VEGF, eNOS, and also helps relax tense areas and remodel neural firing patterns around an injury in addition to improving lymphatic flow. Shockwave treatment can also be coupled with PRF and peptides for amplified synergistic healing effects on injured tissues and joints.
Repetitive wear and tear or heavy unadapted strain on structural tissues of tendon, ligaments, fascia, cartilage, and bone have been shown to cause breakdown of the collagen fibers that reinforce these tissues. For example, the stress of running impacts puts significant strain on the tibia and connective fascia of the lower legs, which then can cause that tissue to break down, degrade, tear, and even microfracture. This is a condition known as medial tibial stress syndrome (MTSS or shin splints), and it has been shown to be caused by either tibial bone overload or degradative fasciopathy. It appears that the impact loads during plantar flexion can strain the fascia to the point where either the fascia itself breaks down or the fascia remains strong but pulls on the underlying bone where it causes edema of the bone cortex/marrow and in some cases even causes linear cracks or microfractures (which tend to run longitudinally rather than transversely). Interestingly, histological studies show that there is generally not an inflammatory component to this condition, but rather it appears primarily structural in nature. In fact, if bone remodeling and repair processes are present, this generally is a good prognostic indicator, meaning a faster time to recovery, than if there is no remodeling response seen. In about 50% of athletes with MTSS, tibial cracks or microfractures have been found, and strangely, there was frequently a complete absense of bone repair response around tibial microfractures, perhaps explaining why these injuries can be so chronic and likely to recur (and it seems this lack of bone repair is even more likely to occur in athletes!). Because shockwave therapy is a good stimulant of bone remodeling and increased bone deposition, this likely explains why shockwave therapy is effective for accelerating the recovery of shin splints. One randomized controlled trial showed that in patients with medial tibial stress syndome, a single shockwave therapy session resulted in 83% of patients being better just 4 weeks later as opposed to only 37% being better without it (PubMed). I also recommend a multivitamin with Vitamins D3, K2, & C, plus collagen or glycine supplementation, and possibly Cissus Quadrangularis supplement (still in research stages), in conjunction with shockwave therapy.
Clinical research at the top academic medical programs also shows definitive benefits for numerous other conditions, particularly tendonitis, tendinopathy, arthropathy, scoliosis, fractures, calcifications, muscle spasms, strains, and contractures in the following areas [references listed below]:
- Plantar fascia fasciitis
- Achilles tendon tendinopathy
- Elbow tendonitis (medial and lateral epicondyle epicondylopathy or tendinopathy)
- Rotator cuff pathologies
- Adhesive capsulitis
- Spine, facets, and paraspinal/iliopsoas muscle pathology
- Tricep and bicep tendon tendinopathies (proximal and distal)
- Labrum injuries of the shoulder and hip
- Greater trochanteric pain syndrome, bursitis, and hip injuries
- Gluteus maximus/medius/minimus and iliotibial (IT) band
- Pes anserine tendinopathy
- Hamstring tendinopathy (origin and insertion)
- Quadriceps/rectus femoris (proximal and distal)
- Adductor tendinopathy (origin and insertion)
- Calcific tendonosis
- Patellar tendon and plica
- Gastrocnemius/soleus injury
- Peroneus and tibialis anterior/posterior injury
- Myofascial pain and muscle strains without discontinuity
- Stress fractures, bone marrow edema, and bone stress syndromes
- Medial tibial stress syndrome (MTSS or shin splints)
- Osgood-Schlatter disease
- Coccygodynia (tailbone pain)
- Erectile dysfunction & Peyronie's disease
- Avascular necrosis and osteochondritis dissecans
- Delayed non-union or non-healing bone fractures
- Many other running, climbing, and athletic related injuries
Shockwave is not only therapeutic, but also helps in diagnosis because pathological injuries tend to be substantially more sensitive to shockwave, meaning that shockwave therapy along with dynamic ultrasound imaging helps to further target the exact muscles, tendons, ligaments, or joints that are injured. This is especially useful in multifactorial pathologies where it may not be clear which problem is the primary exacerbating problem versus a secondary downstream reaction or a more occult pathology triggering downward cycles of chronic inflammation, degeneration, and improper neural rewiring. Furthermore, a combined approach of shockwave, PRF, and peptide therapy can typically drive exponentionally more powerful tissue regeneration and healing.
At the University of Oxford, Dr. McMurtrey pioneered new tissue engineering techniques, studied new applications of ultrasonics in tissue healing and regeneration, and won top awards for his innovative design of novel medical devices. For those interested in the physics of ultrasonics, you can read his introductory engineering summary of ultrasonics and biomechanics in PDF form.
REFERENCES on SHOCKWAVE THERAPY:
Tendonitis and Tendinopathies: (1) (2) (3) (4) (5).
Myofascial Conditions & Musculoskeletal Pain: (6) (7) (8) (9) (10).
Spine Conditions and Spinal Cord Injury: (11) (12) (13) (14) (15) (16) (17) (18) (19).
Delayed or Non-Union Fractures: (20) (21) (22) (23) (24) (25) (26)
Plantar Fascia: (27) (28) (29).
Knee/Patella: (30) (31).
Shoulder and Rotator Cuff: (32) (33) (34) (35) (36).
Orthopedic injuries, tendon and cartilage defects, joint degeneration, stem cell activation, and wound healing: (37) (38) (39) (40) (41) (42) (43) (44) (45) (46).
Vascular Blood Flow: (47) (48) (49) (50) (51)
Neuropathy, Neural Injury, and Nerve Entrapments: (52) (53) (54) (55) (56) (57) (58) (59)
Sexual Health (Erectile Dysfunction, Peyronie's Disease): (60) (61) (62) (63) (64) (65) (66) (67).
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*Disclaimer: The information presented here is for informational use and cites the ongoing cutting-edge research and medical advancements on these relevant topics. There are many treatments, interventions, and protocols routinely practiced in medicine and surgery which the FDA has not studied nor formally approved yet which have demonstrated overwhelming evidence of efficacy and clinical benefit. The FDA does not regulate the practice of medicine but rather regulates medical marketing of devices and drugs. The FDA does not conduct clinical trials or attempt to discover new treatments, but rather requires companies or other entities to fund marketing approvals. Breakthrough technologies typically require years to decades of research work to optimize the technology and collect enough data to prove efficacy and superiority, which in some cases can optionally be submitted to the FDA if there is sufficient financial backing to market a specific product or drug. Thus the FDA has not yet studied, evaluated, or formally approved many regenerative therapies currently practiced by many of the top physicians and surgeons in the United States and around the world. Some therapies, products, or interventions may still be considered investigational or "off-label" even with substantial evidence of efficacy, and many different applications of regenerative therapies continue to be researched by our institute and other top institutions around the world. We seek to always provide the highest-quality evidence-based care to our patients, which may include FDA-approved therapies as well as additional investigational or alternative therapies. We always discuss potential risks and benefits of all these options. The rapid evolution and advancement of medicine demands that physicians continually update their knowledge and practice techniques to adapt to future improvements and advancing technologies. These statements have not been evaluated by the FDA, and the treatments and products presented here are for informational purposes and not intended or guaranteed to diagnose, treat, cure, or prevent any specific disease or condition. All injuries and conditions should be formally evaluated by a knowledgeable medical professional whereby standard treatments and/or additional therapeutic interventions may be considered with the diagnosis and treatment plan.