I recently added Shockwave Therapy to my treatments at my Toronto practice. So far the results have been amazing. What exactly is shockwave therapy, it accelerates the healing process in the body by stimulating the metabolism and enhancing blood circulation to regenerate damaged tissue. Strong energy pulses (acoustic waves) are applied to the affected area. These pulses occur for short periods of time, creating micro-cavitation bubbles that expand and burst. The force created by these bubbles penetrates tissue and stimulates cells in the body that are responsible for bone and connective tissue healing.
When appropriately applied, shockwave can increase local blood flow, improve healing response, break apart scar tissue and adhesions, reduce muscle spasm, and directly decrease pain. Here’s a breakdown of the science.
Increase Local Blood Flow
Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue structure. The application of acoustic waves creates capillary microruptures in tendon and bone. As a result of these processes arterioles are remodeled, stimulated to grow and new ones are formed. The new blood vessels improve blood supply and oxygenation of the treated area and support faster healing of both the tendon and the bone.
Reversal of Chronic Inflammation
Chronic inflammation occurs when the inflammatory response is not completely halted. It can damage healthy tissue and results in chronic pain. Mast cells are one of the key components of the inflammatory process. Their activity may be increased by using pervasive acoustic waves.
Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds first enhance the inflammatory process and in the next step help restore normal healing and regenerative processes.
Stimulation of Collagen Production
The production of a sufficient amount of collagen is a necessary precondition for the repair processes of the damaged myoskeletal and ligamentous structures. Shockwave therapy accelerates procollagen synthesis. The therapy forces the newly created collagen fibers into a longitudinal structure which makes the newly formed tendon fibers more dense and stiff and creates a firmer structure.
Dissolution of Calcified Fibroblasts
Calcium build-up is most often a result of micro-tears or other trauma to a tendon. Acoustic waves break up the existing calcifications. Shockwave therapy starts the biochemical decalcification of the calcium build-up of a toothpaste-like consistency and treats the tendon. The granular particles of calcium are then removed by the lymphatic system.
Dispersion of Pain Mediator
“Substance P”
Substance P is a neurotransmitter that mediates pain information through C-fibers. This neuropeptide is generally associated with intense, persistent and chronic pain. It relays pain messages to the central nervous system. Lowering the concentration of Substance P reduces the stimulation of afferent nociceptive fibers and thus reduces the pain. Decreasing Substance P, histamines and other nociceptive metabolites also helps inhibit development of inflammatory oedema. Acoustic waves generated by Shockwave therapy lower the Substance P concentration and trigger pain relief.
Release of Trigger Points
Trigger points are the principal cause of pain in the back, neck, shoulder and limbs. They are associated with palpable nodules in taut bands of muscle fibers and have extremely contracted sarcomeres. The dysfunctional sarcomeres contract so tightly that they begin to cut off their own blood supply. This causes the waste products to build up. Waste product build-up irritates the sensory nerve endings which then causes even more contraction. This vicious cycle is referred to as “metabolic crisis”. The assumed mechanism of action is that the delivered acoustic energy unblocks the calcium pump and thus reverses the metabolic crisis in the myofilaments and releases the trigger points.
Treatable Conditions
Myofascial trigger points
Achilles tendinopathy
Bursitis
Hallux rigidus
Non-healing ulcers
Tendonitis
Scar tissue
Jumpers knee
Calcific rotator cuff tendinitis
Trigger point therapy
Shoulder pain
Tennis elbow
Patellar tendonitis
Plantar fasciitis/heel spur
Shin splints
Stress fractures
Enhancement of bone healing
Muscle and connective tissue
For more information on clinical studies please visit http://www.shockwavecanadainc.ca/scientific-evidence-and-case-studies
For more information or to book an appointment call 416-777-9355
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