The most frequent type of shockwave therapy is a radial pressure wave, which is employed in almost all physio clinics. However, because of the enhanced treatment options, treatment depth, treatment precision, and patient comfort in more acute instances, Focused are gaining favor.
Focused and radial shockwaves differ not only in physical features and manner of generation but also in the magnitude of the standard parameters utilized (pressure amplitude, pulse duration, impact) and the therapeutic tissue penetration depths reached.
Radial Pressure Waves / Shockwaves – Soft Shock
Larger treatment area for superficial indications. The radial shockwave is made up of ultrasonic pulses, audio acoustic pulses, and a relatively sluggish shear wave.
Radial pressure waves have the most energy at their source and diminish as they go further. A pneumatic system is used to generate radial waves. A projectile is propelled to a high-speed using compressed air and then abruptly decelerated by a transmitter attached to the treatment area.
The resultant kinetic energy is then passed to the tissue, where it propagates as a radial wave outwardly aspherically. The highest pressure and energy density are found on the transmitter surface.
The pressure waves lose strength as they go deeper into the body. Radial pressure waves are effective for therapies where the targeted tissue is superficial, such as plantar fasciitis, tennis elbow, or the Achilles tendon.
The Storz radial systems come with a variety of transmitters, including fascia and spine applicators, that can be used for both local and broad superficial treatments. In the course of a muscle chain, it is possible to treat it functionally.
Pressure waves break apart adhesions and trigger points by mobilizing the tissue layers. Myofascial release, which is required for fascia therapy, is caused by the shifting of tissue layers.
- Treatment depth of 3-4 cm on the surface
- Spreads out to cover a greater region
- Impulse that is slow
- Energy density is low.
Focused Shockwaves – Hard Shock
More precision and treatment depth are possible with a smaller focal point. Shockwaves that are focused can penetrate deeper into the tissues and deliver all of their energy at the depth that is specified. Focused shockwaves are generated electromagnetically through a cylindrical coil when electricity is delivered, creating opposing magnetic fields.
A submerged membrane moves as a result, creating a pressure wave in the surrounding fluid medium. With a narrow focal zone, they propagate through the medium without losing any energy. The amount of energy spread at the actual wave production site is small. This prevents injury to the skin and the sensitive tissues beneath it. Each shock is directed to a specific place within the body by the focusing device. The machine’s energy output or the focusing mechanism can be modified to change the place within the body. To adjust the depth of energy, a stand-off applicator can be employed. Focused shockwaves are beneficial in treatments that involve targeting tissue at a deeper level, such as tissue near to bone, calcifications, or delayed unions and non-unions. Patients who are unable to tolerate radial treatments for acute injuries will also be referred to this clinic.
- Depending on the attachments utilized, a deep reach of up to 12cm is possible.
- precise energy delivery to a specific location
- Immediate reaction
- Energy density is high.
Focused shockwave Indicators – Diagnostic imaging is occasionally utilized to pinpoint the exact location of the energy concentration point. Ultrasound diagnostic modules (black/white or color) are available for purchase with the STORZ equipment. Alternatively, constant patient feedback is used to find the ‘pain’ site during treatment.
It is used to treat a variety of conditions, including but not limited to:
- Male impotence or erectile dysfunction
- Chronic pelvic pain
- Peyronie’s disease are all urological indications.
- Elite athletes’ acute injuries
- Arthritis of the knees and joints
- Stress Fractures and Bone Fractures
- Splints on the shins
- Pubic Osteitis (Groin Pain)
- Achilles insertional pain
- Syndrome of the Tibialis Posterior Tendon
- Tibial Stress Syndrome (MTSS)
- Deformity of Haglunds
- Tendon of the Peroneal
- Ankle sprain in the tibialis posterior
- Enthesopathies and Tendinopathies
- Bone healing/non-unions delayed
- Other dermatological and aesthetic indications, including wound healing
Focused And Radial Shockwaves Combined
Many sophisticated shockwave providers have adopted the use of both modalities on a patient in recent years, treating the superficial and shallower structures with radial pressure waves and then targeting the source of the injury with targeted shockwaves. Physio Clinics that combine radial and targeted shockwave therapy are finding incredible outcomes.