Understanding Shockwave Therapy: What's the Difference Between Radial and Focused Shockwave?
Shockwave therapy has become an increasingly popular treatment option for chronic tendon pain, plantar fasciitis, calcific shoulder pain, and other musculoskeletal conditions. As more clinics begin offering shockwave therapy, patients often discover there isn't just one type.
The two most common forms are radial shockwave and focused shockwave.
While both use acoustic energy to stimulate the body's natural healing response, they deliver that energy differently, and each has situations where it may be appropriate.
What Is Shockwave Therapy?
Shockwave therapy uses high-energy acoustic waves that are delivered through the skin into injured tissue.
Unlike injections or surgery, shockwave therapy is non-invasive and requires little to no downtime. Research suggests it may help stimulate tissue healing, improve circulation, and reduce pain in appropriately selected patients.
Radial Shockwave
Radial shockwave generates pressure waves that spread outward from the applicator.
The highest energy is delivered near the treatment head, with the energy gradually dispersing into the surrounding tissues.
Because of this pattern, radial shockwave is particularly well suited for treating many common musculoskeletal conditions involving larger or more superficial structures.
Examples include:
Plantar fasciitis
Achilles tendinopathy
Patellar tendinopathy
Tennis elbow
Hamstring tendinopathy
Gluteal tendinopathy
Myofascial trigger points
Muscle tightness and chronic soft tissue restrictions
Radial shockwave also allows clinicians to treat a broader area, which can be beneficial when symptoms involve multiple tissues or larger regions.
Focused Shockwave
Focused shockwave delivers energy differently.
Instead of dispersing outward from the applicator, the device concentrates energy at a selected depth beneath the skin.
This allows higher energy to be delivered to a smaller target area while minimizing energy in the tissues above it.
Focused shockwave may be considered for certain conditions where precise targeting or deeper treatment is desired, depending on the patient's diagnosis and clinical presentation.
Is One Better Than the Other?
Not necessarily.
One of the biggest misconceptions is that focused shockwave is simply "stronger" or "better."
In reality, they are different technologies designed for different clinical purposes.
Many of the conditions commonly treated in outpatient orthopedic physical therapy have published research supporting radial shockwave.
For some diagnoses, focused shockwave may have advantages. For others, radial shockwave performs similarly or may even be preferred depending on the treatment goals.
The most important factor is not simply the machine being used, but selecting the right patient, establishing the correct diagnosis, and integrating shockwave into a comprehensive rehabilitation program.
How We Use Shockwave at SB Physio
At SB Physio, we use Chattanooga RPW2 radial shockwave therapy as part of a complete rehabilitation plan—not as a standalone treatment.
Shockwave is often combined with:
Progressive strengthening
Load management
Manual therapy, when appropriate
Mobility exercises
Functional movement retraining
Objective strength and performance testing
Our goal isn't simply to reduce pain during a treatment session. We aim to improve tissue capacity so patients can return to work, sport, and everyday activities with greater confidence.
Is Shockwave Right for You?
Shockwave therapy is not appropriate for every condition, and not every painful tendon requires it.
A thorough evaluation helps determine whether shockwave is likely to be beneficial or whether another treatment approach may be more appropriate.
If you're dealing with persistent tendon pain or have been told your injury is "chronic," shockwave therapy may be one option worth discussing with your physical therapist.
Want to Learn More?
This article explains the differences between radial and focused shockwave therapy. If you're interested in how we use radial shockwave as part of a comprehensive physical therapy program, read our related article:
→ How Shockwave Fits Into Real PT Care at SB Physio
Ready to Get Started?
If you're wondering whether shockwave therapy is right for your condition, we're happy to help.
Schedule an evaluation today to discuss your symptoms and treatment options.
Call or text: (805) 682-2536
Schedule online: https://www.sbphysio.com/
Disclaimer: This article is provided for educational and informational purposes only and is not intended as medical advice or a substitute for an evaluation by a qualified healthcare professional. Every individual, injury, and recovery process is unique. The information presented may not apply to your specific situation. Always consult with your physician or licensed physical therapist regarding any medical concerns, diagnosis, treatment decisions, or before beginning or modifying an exercise program. If you are experiencing severe pain, significant weakness, numbness, or have sustained an acute injury, seek appropriate medical evaluation promptly.
