Quick answer (60 sec read) Extracorporeal shockwave therapy (ESWT) delivers focused or radial pressure waves to specific tendon and soft-tissue presentations. Evidence suggests it may be beneficial for chronic plantar fasciopathy in particular, where loading alone has not produced sufficient progress. It is always used alongside — never instead of — a progressive loading programme. Individual responses vary; an assessment comes first. AHPRA OST0004003860.
Shockwave therapy is one of three modalities Max uses alongside hands-on osteopathy and dry needling. It is considered for selected chronic tendon and soft-tissue presentations — typically after 6–8 weeks of progressive loading hasn't moved things along — and it is prescribed from an assessment, not offered as a default.
Shockwave therapy (ESWT) — Sydney
What shockwave therapy is
ESWT delivers pressure waves — focused or radial — into a specific tissue, most commonly the attachment points of tendons and fascia. The proposed mechanisms include stimulating local blood flow and tissue-repair processes and modulating pain signalling in the treated region.
Sessions are short (typically 5–10 minutes per area), require no anaesthesia, and can feel uncomfortable but are rarely painful. A typical course is 3–5 weekly sessions, run alongside a progressive loading programme.
What the evidence suggests
The evidence base differs by presentation, and it's worth being precise about that:
Plantar fasciopathy — the strongest case. Evidence suggests ESWT may be beneficial for chronic plantar fasciopathy that hasn't responded to loading alone (e.g., Sun et al., *Medicine*, 2017 — meta-analysis of ESWT for chronic plantar fasciitis).
Some patellar tendinopathy presentations — moderate evidence as an adjunct to loading in selected chronic patellar presentations.
Achilles tendinopathy — evidence is less consistent for ESWT as a standalone option; where used, it sits alongside a progressive loading programme rather than replacing it. See Achilles tendinopathy.
Individual responses vary. No modality works for everyone, and ESWT is no exception — which is why an assessment comes first, and why progress is reviewed against the plan rather than assumed.
How ESWT fits into a treatment plan
ESWT is an adjunct, not a foundation. The typical sequence Max follows:
Assessment — confirm the presentation, its stage, and its load tolerance
Loading first — a progressive loading programme is the backbone of tendon care
ESWT considered — if a chronic presentation hasn't progressed after 6–8 weeks of consistent loading and manual therapy, ESWT may be added as a course of 3–5 weekly sessions
Review — progress is measured against function (load tolerance, symptoms with activity), and the plan is adjusted or escalated (imaging, referral) if it isn't tracking
See how Max works for how the modalities combine.
What a session involves
The applicator is placed on the skin over the treatment area with contact gel. Pressure waves are delivered for a few minutes per site; intensity is adjusted to what you can comfortably tolerate. Mild redness or soreness afterwards is common and usually settles within a day or two. You can usually continue normal daily activity, and your loading programme continues through the course.
When ESWT is not used
Over areas with active infection, open wounds, or compromised skin
Near a known tendon rupture or suspected stress fracture — these need a different pathway
During pregnancy, over the trunk region
On patients with bleeding disorders or anticoagulant therapy, without prior GP discussion
Where the assessment doesn't support it — if loading alone is progressing well, adding ESWT adds cost without clear benefit
Book a Shockwave Therapy Consultation
Shockwave therapy is available at all three of our Sydney clinics. Book your initial consultation to discuss whether ESWT may be an appropriate component of your management plan.
• Bondi Junction — Harley Place Health, Oxford Street. Next to Westfield, short walk from Bondi Junction station.
• Sydney CBD — Sydney Osteopathic Medicine, Level 8, 109 Pitt Street. Near Wynyard and Martin Place stations.
• Leichhardt — Rozelle Osteopath, Tebbutt Street. Easy street parking, serving the Inner West.
Consultations are available in English and French. Pour prendre rendez-vous en français, veuillez nous contacter directement.