The Shocking Truth: Shockwave Therapy
What Is A Shock Wave?
When people first hear the term shockwave, they often think of electrical shock, but a shockwave is simply a SOUND wave that can be used to treat various medical conditions. So why can’t I just “yell” at my horse’s tendon injury or my dog’s broken bone & make it heal? Understanding a little physics will help us understand the difference between the sound you hear, the healing energy of a shockwave & how this therapy works. (For all you future vet students…..this is why you have to take that intensive summer physics class you have been dreading for you prerequisites!)
Let’s break it down:
Sound Waves
A sound wave is simply a mechanical vibration that travels through a medium (like air, water, or tissue) by compressing & expanding molecules in that medium. Sound waves are pressure waves that travel in a linear form— meaning the particles of the medium move back & forth in the same direction the wave travels. Sound waves carry energy, not matter. Waves propagation is the process by which a wave moves or travels through a medium or space, transferring energy without transferring matter.
Shock Waves
Shock waves are sound/pressure waves, but they are much more intense & sudden & they propagate differently . Examples of shock waves that occur in our atmosphere include explosive events, like detonations or lightning strikes, or when airplanes break through the sound barrier causing a sonic boom.
A shock wave consist of 2 phases (a biphasic wave form). The first phase, called the compression phase, is a rapid pulse of high-positive pressure traveling faster than the speed of sound, followed by a quick drop back to ambient pressure. The second phase, called the tensile phase, is a negative pressure drop of a few microseconds followed by a return to ambient pressure. Shock waves do not travel in a linear fashion, instead they are non-linear, they distorts & steepen into a discontinuity.
Below is a great video demonstrating what a shockwave looks like. You can see the balloons underwater rapidly expand & then compress due to the rapid high-positive pressure followed by the negative pressure drop. You can also visualize the non-linear propagation of the shock wave. This is great visual representation of what is happening to the cells in the tissue when shockwave therapy is applied to the tissue.
Wow, you’re talking about explosions & sonic booms, how does this help my pet heal? It’s important to remember we were only discussing the physics of shock waves & how they act on a much larger scale in-order to help you visualize what’s taking place on a smaller cellular level. In the clinical setting the device used to make the shock wave pulses both focuses the pulses & also allows us to select the perfect intensity, frequency, & amount of energy of the pulses delivered to an appropriate level that stimulates cells, but doesn’t “explode” them!
How Do Shockwaves Affect the Body?
Acoustic impedance describes how easily a material transmits or reflects the energy of a sound wave or shockwave. Because different tissues (like muscle, fat, & bone) have different acoustic impedances, a shockwave changes behavior as it travels through the body — reflecting, refracting, or dispersing energy at each boundary. These interactions trigger various biological effects, depending on the tissue type & the physical forces involved.
1) Mechanical Effects - As a shockwave passes through tissue creating a rapid pressure change, it generates compression, shear, & tensile stresses in & around cells. These microstresses deform cell membranes & the surrounding extracellular matrix.
This deformation activates mechanotransduction — the process by which cells convert mechanical forces into biochemical signals. The result is increased local blood flow & stimulation of tissue regeneration.
2) Cavitation Effects - During the negative pressure phase of a shockwave, microscopic bubbles form in the tissue fluids. These bubbles expand & collapse (a process called cavitation), producing localized microjets & mechanical forces. This enhances cell membrane permeability, stimulates the release of growth factors, & supports tissue repair processes.
In simple terms, high-energy sound waves enter the body & release their energy when they encounter areas of different tissue density. The cells in the treated area respond by releasing cytokines — small proteins that regulate inflammation, immune response, & healing.
These cytokines have:
Anti-inflammatory effects (reducing pain & swelling)
Angiogenic effects (promoting new blood vessel growth)
Osteogenic effects (stimulating new bone formation)
Together, these actions promote pain relief, improved circulation, & accelerated healing of bone, tendon, & soft tissue injuries.
These effects include:
Decreases inflammation
Speeds healing
Causes new blood vessel formation
Increases blood supply, which leads to tissue regeneration in tendons & ligaments
Improves fiber alignment in tendon repair so injuries heal more correctly & decreases the risk of re-injury
Increases cellular bone production for faster bone healing
Recruits stem cells to treated tissues
Shock Wave Generation & Technology
There are three basic types of shock wave generating technologies on the market including electrohydraulic, electromagnetic, & piezoelectric. Since we just did a deep dive into the physics of sound waves & shock waves, I’ll spare you all a discussion on these varying technologies for now.
Fauna Doc provides shockwave therapy via a Pulse Vet machine by Zomedica. Pulse Vet machines utilize electrohydraulic technology to produce the shock wave, which is by far the most clinically proven to provide results safely & effectively in veterinary medicine. In contrast, devices that use electromagnetic or piezoelectric technology generate a much smaller amount of total energy into a considerably smaller focal area.
Cutting-Edge, Sedation Free Shock Wave Technology
In 2021, PulseVet released the X-Trode, a new hand piece that deposits the energy into an even larger focal zone while reducing the intense central peak energy, taking the “sting” out of shock wave treatment. Horses, dogs, & even cats, (as well as a variety of other species) are now able to be treated without have to be sedated. With the new technology of the PulseVet X-Trode that allows for sedation free treatment, shock wave therapy is becoming a staple of small animal veterinary medicine..
What Types of Conditions Can Be Treated with PulseVet Shockwave?
A common question I get is, “Is this the same device they used to break up my kidney stone?” The answer is yes… & no.
While Extracorporeal Shockwave Therapy (ESWT) was originally developed for lithotripsy — a procedure used in human medicine to break up kidney stones — the technology has since evolved dramatically. Today, it’s used to successfully treat a wide range of orthopedic & soft tissue conditions in both people & animals.
Pet owners are increasingly looking for non-invasive, advanced therapies to improve their pets’ quality of life. We’re thrilled to offer this clinically proven, safe, & sedation-free treatment — a service that few veterinary practices in our area can currently provide.
Shockwave therapy is especially helpful in challenging cases such as shoulder injuries, non-healing fractures, lick granulomas, osteoarthritis, & chronic pain — helping pets recover more comfortably & get back to doing what they love. Equine tendon injuries are a considerably frustrating disease to manage & recover from. Shockwave has become a staple in treating these patients.
Tendon/Ligament Injuries: Shock wave therapy has been proven to decrease inflammation & increase fiber alignment in tendon & ligament injuries. Shockwave is commonly used in equine patients experiencing tendon tears.
Osteoarthritis & Non-Neurologic Back Pain: Shock wave therapy has been proven to be part of a multi-modal approach to osteoarthritis management. Inflammatory cytokine release is reduced in the joint & cartilage degradation is decreased due to the inhibition of chondrocyte apoptosis (cartilage death).
Chronic Wounds & Lick Granulomas: Shock wave therapy is now approved for treatment of diabetic ulcers in humans. In canine patients, shockwave has been used effectively to resolve lick granulomas after only 1-3 weekly treatments.
Bone Healing: Shock wave therapy has been shown to accelerate healing of fractures & osteotomies, such as post cranial cruciate ligament surgery. It is particularly effective for use in delayed union or nonunion fractures.
Equine Asthma: Shockwave therapy is emerging as a non-invasive, drug-free adjunct in the management of Equine Asthma Syndrome. Initial clinical data suggest that horses treated with shockwaves experience reduced respiratory effort, decreased cough frequency, & improved overall airway comfort. It is likely we will also see data become available in the further for treatment of cat’s, who commonly suffer from asthma.
What To Expect During My Pet’s Treatment
Shockwave is a non-invasive therapy that uses a small handheld applicator that is placed on your pets skin over the area requiring treatment . A generous amount of ultrasound gel is applied to help transmit the shockwaves. The hand held applicator, called the trode, delivers focused acoustic pulses to the targeted tissue, while the area is gently “painted,: moving the trode around. Your pet may feel a brief tapping sensation or mild pressure, but treatments are usually well tolerated & generally patients do not require sedation to complete. Treatments only take about 2-5 minuets to be completed. Most indications for shockwave only require 1-3 treatments 2-3 weeks apart for complete healing & there are long term lasting results. Most equine health insurance policies cover shockwave.
Contact us today to make a consult appointment to discuss how shockwave therapy can improve your pets healing & wellness.
