For the stubborn
tendon stuff.
Focused-shockwave therapy delivers high-energy acoustic pulses into pathological tendon tissue, triggering the healing cascade that has stalled out. The standard of care in elite sports medicine for plantar fasciitis, Achilles tendinopathy, and lateral elbow that hasn't budged in months.
The cases
that haven't moved.
Shockwave is the right answer when conservative care has plateaued: twelve or more weeks of pain, imaging showing tendon thickening, and a tissue that needs a fresh inflammatory cascade to actually heal. We screen for it; we don't sell it.
Foot & ankle
- Plantar fasciitis12+ wks of heel pain, worse on first steps.
- Achilles tendinopathyMid-portion or insertional. Hill-runners, masters.
- Peroneal tendinopathyLateral ankle pain in cutting sports.
Elbow & arm
- Lateral epicondylitisTennis elbow that's lasted past PT and a brace.
- Medial epicondylitisGolfer's elbow, grip-strength deficit cases.
- Triceps tendinopathyPost-pressing or rope-pull volume issues.
Hip, knee, shoulder
- Patellar tendinopathyJumper's knee, basketball and plyometric load.
- Greater trochanteric painLateral hip pain in runners and cyclists.
- Calcific shoulderCalcific deposits in the rotator cuff.
Five sessions.
One real outcome.
Consult & screen.
Twenty minutes. Confirm it's actually a tendinopathy. Check that conservative care has been tried. Set the protocol. Focused shockwave isn't the right call for every tendon.
First session.
Ten to fifteen minutes of focused pulses targeted at the tendon. Some discomfort during. You'll feel it. Walking out, no restrictions on activity for most cases.
Weekly cadence.
Three to five sessions, one week apart. Loading dose builds, with pulse count, energy density, and depth dialed to response. You'll know by session three whether it's working.
Loaded rehab.
Alongside the protocol, a tendon-loading program: eccentrics, isometrics, and sport-specific work. The healing cascade needs load to organize the new tissue properly.
Recheck at 12 wks.
Tendons remodel slowly. Pain improvement front-loads; structural change keeps coming for three months. We recheck at twelve weeks and decide if a booster session is warranted.
What changes
and what doesn't.
Outcomes vary case-to-case, but for the right candidate the pattern is consistent. We track pain scale, function, and time-to-activity at every session, not vibes.
Twelve weeks of pain. Conservative care plateaued.
- Pain 6–8 / 10 with sport-specific loading
- Morning stiffness or first-step pain > 5 minutes
- Tendon thickening on imaging or palpation
- Already tried: PT, NSAIDs, rest, bracing
- Avoiding the sport you actually do
Loaded tendon. Back to training. No injection.
- Pain 0–2 / 10 with the same loading
- Morning symptoms resolved or near-resolved
- Returning to full sport-specific volume
- Tendon-loading program ongoing, sustainably
- No cortisone. No surgical consult required.
Outcomes are typical for appropriately screened cases. Shockwave is not indicated for every tendon presentation, and is not appropriate for acute tears, infections, or patients on certain anti-coagulants. Dr. Mike screens at the consult.
Twelve weeks of plantar fasciitis. Three weeks of shockwave. Ran the Big Sur Half barefoot on the grass on weekend four, for the first time in two years.
About shockwave, specifically.
Does it hurt?
+How is this different from "radial" shockwave at the chain spa?
+Will I need to stop training?
+How quickly does it work?
+What does it cost?
+Twelve weeks is enough.
Book a shockwave consult.
Twenty-minute consult. Dr. Mike screens whether shockwave is the right tool for your case before scheduling a single session. If it isn't, we'll tell you.