FAQ Questions worth asking © United Physiotherapy Clinic 2011 / disclaimer How Does SWT Promote Healing? SWT tends to affect denser tissues more proficiently such as tendons and ligaments and especially where they attach to bones, known as the enthesis. A disease of the entheses (plural) is known as an enthesopathy. Enthesopathies are common at the shoulder, elbow, hip, knee and foot. These entheses tend to be the main target for shockwave therapy. Shockwave also affects bone and may assist in bone stimulation and healing. Research is currently offering a better understanding of the biological effects of shockwave therapy. SWT produces a sonic pulse for approximately 10 milliseconds which may: 1. Create pressure waves within the target tissue leading to greater cell permeability with a resultant increase localized circulation and metabolism which can promote healing. 2. Break down abnormal deposits of calcium in soft tissues such as tendons (calcific tendinitis). 3. Stimulation of osteoblasts (bone building cells) which are involved in promoting bone healing and growth. Stimulation of connective tissue potentially through simulation of fibroblasts. 4. May reduce pain by acting as a counter irritant through the pain gate mechanism as described by Melzack and Wall. 5. Affect sensory pain fibres that are involved in transmission of pain from musculoskeletal and soft tissues. Shockwave therapy may offer a unique ability to promote healing and these mechanisms may be very beneficial to persons suffering from chronic musculoskeletal pain.   Frequently Asked Questions 1: