A special machine is used to deliver high-energy short pulses of sound waves (the “shockwaves”). These shockwaves radiate through the skin to the underlying injured tissue. The more you push onto the skin, the deeper the wave will penetrate, which lets it work on deep tissue injuries, whereas less pressure will be applied to bony injuries closer to the surface of the skin.
The mechanical energy and pressure from these waves trigger natural inter-related biological processes that heal the injury and reduce pain. It specifically does the following:
- Stimulates our body’s natural healing response
- Increases blood flow to the area
- Boosts Cellular Metabolism
- Myofascial Release
- Disperses Neurotransmitters that cause pain and reduces swelling
All these effects combined equip your body with what it needs to properly heal chronic foot and ankle injuries, and thereby decrease your pain.
A. Stimulates our Body’s Natural Healing Response
This is one of the main benefits of shockwave. To fully understand how shockwave therapy stimulates this healing response, we need to first explain our body’s immune system and its inflammatory response:
You can think of our immune system as our body’s defence force. It’s responsible for detecting and responding to anything that can harm it. When an injury is detected, it initiates your body’s inflammatory response. The inflammatory response signals and dispatches your body’s armies, peacekeeping forces and soldiers to the injured area to protect and fix the injury. It also boosts blood flow to the area, which provides a strong communication and supply line to continuously dispatch all the nutrients needed to heal the injury.
The inflammatory response is a good, healthy reaction to injury. However, in the case of chronic injuries, it stalls or goes into overdrive even after the injury is healed. That’s where shockwave therapy comes in:
Although it may sound a little counter-intuitive, the energy pulses from shockwave therapy causes controlled small microtears – or microtrauma – to the area. Don’t worry: this microtrauma is actually good for you. It literally “shocks” your body’s defence forces into action by stimulating the inflammatory response. This dispatches your body’s healing armies and peacekeeping forces to the area to fix it. Thanks also to the increased blood flow, your body’s army can now focus on repairing the affected area with everything it needs.
This process is similar to what happens when you work out: when you strengthen muscles it also causes microscopic microtears in those muscles, which activates the inflammatory response. The inflammatory response then increases blood flow to those muscles and transports white cells and nutrients to the area, which regenerates the muscles and makes them stronger. Shockwave works the same way.
Essentially, shockwave triggers your body’s initial natural response to an acute injury (a sudden, short-term injury). When we first get an injury, all your body’s defences and armies are activated and work to heal the area. However, when an injury becomes chronic, the body’s response changes, and the healing process stalls; shockwave brings it back to its prime.
B. Increases Blood Flow to the Area
Our blood vessels are our body’s transportation network. Oxygenated blood is the vehicle through which our organs, cells and tissues get what they need to function. Our body’s immune system also uses this transportation network to identify injured areas and reach them so your body can heal and protect itself. By boosting blood flow to the injured area, shockwave therapy facilitates the speedy delivery oxygenated blood and white cells to the area, which nourishes the injured tissues and gives them what they need to heal.
Not only does shockwave therapy increase blood flow, but it also stimulates the formation of new blood vessels in the treated area. This allows even more avenues for oxygenated blood and nutrients to reach and heal the injury.
C. Boosts Cellular Metabolism
By boosting the metabolism of the cells in the injured area, it allows smoother delivery of nutrients, and removal of damaged tissue.
D. Breaks Down Scar Tissue and Calcific Deposits
The pressure from the mechanical energy of the shockwaves physically breaks apart scar tissue and unwanted calcium deposits. This is very similar to the way sound waves are used to break apart kidney and gallstones (in fact, that’s the principle that led to the discovery of shockwave therapy’s therapeutic benefits for treating injuries). The breakdown of scar tissue also stimulates the immune system.
E. Myofascial Release
Although not the primary goal of shockwave therapy, myofascial release (the release of trigger points) is a beneficial byproduct. Trigger points are areas where muscles that become so tight, they form knots, cut off their own blood supply, and become tender. As explained before, shockwave therapy involves pulses of mechanical energy. In addition to breaking apart scar tissue, the pressure from this energy can physically release tension in trigger points. This is similar to the way dry needling, trigger point injections and deep tissue massage works. However, unlike these treatments, shockwave therapy is non-invasive and not as painful.
F. Reduces Pain and Swelling
The way we feel and interpret pain involves a complex neurological process. In a nutshell, neurotransmitters send “pain signals” from the injured area to our brain. Once this signal reaches the brain, we start to feel pain. The purpose of this is to let us know when something is wrong so we can fix it. However, with chronic injuries, the neurotransmitters keep firing, and sometimes misfire.
One of these neurotransmitters is called “Substance P”. In addition to sending pain signals to our brain, Substance P also causes swelling. The waves delivered by shockwave therapy disperse and reduces Substance P, which in turn reduces pain and swelling in the area.
