Active Release Technique
Active Release Technique (ART) is a non-invasive, movement-based soft tissue technique designed to locate and treat soft tissue problems. Your physical therapist applies pressure to a tight area while you move it.
Service
Shockwave Therapy
Shockwave therapy (SWT) uses focused acoustic sound waves, delivered through the skin with a handheld device, to address pain in muscles, tendons and joints. It is offered at our Irvine clinic.
What is shockwave therapy?
Shockwave therapy, also called extracorporeal shockwave therapy (ESWT), was first introduced in 1980 as a non-invasive way to break up kidney stones and gallstones. Today it is commonly used in physical therapy clinics for pain in the muscles, tendons and joints, including acute and chronic sports and overuse injuries, and it offers a non-invasive option for people hoping to avoid surgery or long-term pain medication.
We offer focused shockwave therapy using a PiezoWave² unit at our Irvine clinic. Focused shockwaves concentrate energy on specific points and reach deeper tissues. Radial shockwaves, a different type, spread more widely and mainly reach tissue near the surface.
During treatment, a conducting gel is applied to the skin and a handheld applicator sends acoustic waves to the target tissue. Tendons, ligaments, bone and blood vessel cells respond to this kind of mechanical energy, which may increase local blood flow and support the body's repair process.
Many professional sports teams use shockwave therapy for their athletes, including NBA teams such as the Los Angeles Lakers and LA Clippers, NFL teams such as the Los Angeles Rams and Los Angeles Chargers, and teams in the NHL.
“We’re thrilled to be the first physical therapy clinic in Orange County to offer Shockwave Therapy to our patients.”
Where it is offered: Offered at our Irvine clinic only. Long Beach clients who need this treatment are referred to Irvine.
In your plan of care
How can shockwave therapy help?
Shockwave is not a stand-alone treatment at KOH Physical Therapy Lab. Your physical therapist uses it within a plan of care, usually alongside hands-on treatment and a progressive exercise program, so the treated tissue is loaded and strengthened as it recovers.
It may be considered when tendon or soft tissue pain has lingered, or when earlier care has not been enough. Your therapist decides during your evaluation whether it fits your condition, and screens for reasons it should not be used.
Sessions take place at our Irvine clinic at 9080 Irvine Center Dr. Long Beach clients who may benefit are referred to the Irvine clinic for shockwave sessions.
Benefits
Benefits of shockwave therapy
- Fast and effective: sessions are quick, and research shows it is effective for conditions such as plantar fasciitis.
- May reduce pain in tendons, muscles and joints affected by overuse or older injuries.
- Can increase local blood flow to the treated area.
- May help release trigger points and tight areas in muscle.
- May stimulate collagen production, which the body uses to repair tendons and other tissue.
- May support muscle repair and regeneration.
- May help break up calcium deposits that can form in a tendon after injury.
- Non-invasive and extremely safe, with few side effects and a relatively easy recovery, and it combines with hands-on care and exercise in the same plan.
Conditions
Conditions shockwave therapy may help address
- Tennis elbow and golfer's elbow
- Calcific tendonitis of the shoulder
- Achilles tendinopathy
- Pain on the outside of the hip (greater trochanteric pain syndrome)
- Knee pain around the kneecap (patellofemoral syndrome)
- Shin pain from medial tibial stress syndrome
- Plantar fasciitis, heel pain and foot pain (plantar tarsalgia)
- Arthritis
- Trigger points and myofascial dysfunction
- Repetitive stress injuries and soft tissue strains in athletes and active people
The technique
How does shockwave therapy work?
Shockwave therapy uses high-energy acoustic sound waves to reach tissue at different depths. The waves compress and work the tissue, much like a focused, precise deep tissue massage, which can increase circulation and ease pain.
The PiezoWave² delivers mechanical energy as sound waves to the target tissue. Cells in tendons, ligaments, skin, bone, cartilage and blood vessels all respond to this kind of mechanical energy. Your therapist can locate trigger points and deliver focused pulses to the right depth, between about 0.5 millimeters and 3 centimeters depending on the applicator, to support cellular repair by increasing blood flow and reducing pain.
Research
What does the research show?
Shockwave therapy is scientifically proven for several conditions, with a high success rate for plantar fasciitis. A 2023 systematic review and meta-analysis found high-quality evidence that shockwave therapy has a large effect on pain and function in plantar fasciitis.
A 2024 systematic review found shockwave therapy to be a safe treatment for plantar fasciitis and more effective than corticosteroid injections at reducing pain and improving foot function at six months. The most common side effects were brief local pain and mild skin redness.
It is also widely used for other tendon conditions, such as tennis elbow and calcific tendonitis of the shoulder. Your physical therapist evaluates your condition to decide whether shockwave is a good fit.
Sources
- Charles et al. (2023). The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis. Frontiers in Immunology (PubMed) (opens in a new tab)
- Cortés-Pérez et al. (2024). Efficacy of extracorporeal shockwave therapy, compared to corticosteroid injections, on pain, plantar fascia thickness and foot function in patients with plantar fasciitis: a systematic review and meta-analysis. Clinical Rehabilitation (PubMed) (opens in a new tab)
Safety
What are the risks of shockwave therapy?
Shockwave therapy is an extremely safe procedure with few side effects. Some swelling, bruising or tenderness can appear shortly after a session and usually settles within a few days; serious reactions are highly unlikely.
Soreness after treatment is thought to come from the tiny areas of controlled stress the shockwaves create in tissue such as tendon, muscle and bone, which prompt blood flow and cell regeneration. Sensitive areas can feel uncomfortable for a short time afterward.
Your therapist screens you before treatment. If you have neuropathy or hypersensitivity in the area, your therapist decides with you whether shockwave is appropriate.
Shockwave therapy is not used for people who:
- Are pregnant
- Have certain heart conditions or a pacemaker
- Take medication that affects blood clotting
Men's pelvic health
Shockwave therapy for erectile dysfunction (ED)
Low-intensity shockwave therapy (Li-ESWT) is also studied as a treatment for erectile dysfunction. A small handheld applicator delivers low-energy sound waves to penile tissue, with the aim of improving blood flow.
A 2022 review in American Family Physician found mild to moderate improvement with no significant side effects. The American Urological Association considers it investigational, the European Association of Urology says it may be used for mild ED caused by reduced blood flow, and it is not FDA approved specifically for ED. At KOH Physical Therapy Lab it is offered at our Irvine clinic as part of men's pelvic health care.
Read more: shockwave therapy for erectile dysfunction →
Sources
- American Academy of Family Physicians, American Family Physician (2022): shockwave therapy for erectile dysfunction (opens in a new tab)
- American Urological Association: Erectile Dysfunction Guideline (opens in a new tab)
- European Association of Urology: Guidelines on Sexual and Reproductive Health, management of erectile dysfunction (opens in a new tab)
FAQ
Shockwave Therapy questions
Is shockwave therapy painful?
It feels different for everyone, but most people describe it as mild discomfort rather than pain. Bony areas such as the hip tend to be more sensitive than well-cushioned areas such as the calf. Some soreness, minor swelling, bruising or tenderness in the treated area for a few days afterward is common.
Do you offer focused or radial shockwave therapy?
Focused. We use a PiezoWave² focused shockwave unit, which concentrates energy on specific points and reaches deeper tissue, and is often used for chronic pain, tendonitis and conditions such as plantar fasciitis. Radial shockwave spreads more widely and mainly reaches tissue near the surface. Because focused shockwave is more concentrated, it typically needs fewer sessions than radial.
How many sessions will I need?
It depends on the area treated and your medical history. A course is typically two to three treatments over six to twelve weeks. If shockwave suits your condition, many people notice a change soon after the first session; if you are not responding, your therapist looks at other possible causes of your symptoms.
Who should not have shockwave therapy?
Shockwave is not used during pregnancy, for people with certain heart conditions or a pacemaker, or for people taking medication that affects blood clotting. Your therapist may also avoid it if you have neuropathy or hypersensitivity in the area. You are screened before treatment.
Is shockwave therapy used on its own?
No. At KOH Physical Therapy Lab it is one part of a physical therapy plan, usually combined with hands-on care and exercise that you continue at home.
Can shockwave therapy help erectile dysfunction?
Low-intensity shockwave therapy is studied for ED. A 2022 American Family Physician review found mild to moderate improvement with no significant side effects, but the American Urological Association considers it investigational, and it is not FDA approved specifically for ED. We consider it as part of men's pelvic health care and recommend you also see your physician or a urologist.
Where is shockwave therapy offered?
At our Irvine clinic, 9080 Irvine Center Dr., Irvine, CA 92618. Long Beach clients who may benefit are referred to Irvine for shockwave sessions.
How do I get started?
Text or call (949) 540-5641, or send a request through our contact page. Your first visit is an evaluation, where your therapist decides whether shockwave fits your condition.
Related
Related services
Cold Laser Therapy
Cold laser therapy, also called red light therapy or low-level laser therapy, is used for muscle and nerve pain from sprains, bursitis, tendonitis, and more. A handheld device delivers non-heating light to the injured area.
Fascial Stretching
Fascia stretching therapy is therapist-assisted stretching and mobility work for plantar fasciitis, neck pain, and other musculoskeletal conditions. It works on the whole connective tissue system, not just single muscles.
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