Radial Shockwave (RSWT)
Mr Arjun Viswanath MCSP MPPA
Consultant Physiotherapist & Co-Founder
London Physiotherapy & Wellness
- February 2, 2026
- Mr Arjun Viswanath MCSP MPPA
- (3 min Read)
The Gold Standard for Chronic Tendon & Running Injuries
If you are a runner chasing a personal best, or simply someone struggling with persistent pain that hasn’t resolved with rest, standard massage, or basic rehabilitation, you need a solution that targets the root of the problem.
Radial Shockwave Therapy (RSWT) is a clinically proven, non-invasive medical treatment designed to reboot the healing process in chronic soft-tissue injuries. As a staple in high-level sports medicine and Consultant-led physiotherapy, it offers a powerful alternative to injections or surgery.
What Is Radial Shockwave Therapy?
Radial Shockwave Therapy (often referred to as Radial Pressure Wave Therapy) utilizes a ballistic mechanism to generate pressure waves. A projectile forms inside a hand-held applicator, accelerating at high speed to strike a transmitter tip.
Unlike Focused Shockwave, which targets a microscopic point deep within the body, Radial waves are divergent. This means the acoustic energy is highest at the skin’s surface and spreads outwards into the underlying tissue.
- Depth of Penetration: Approximately 3–4 cm.
- Target Tissue: Superficial tendons, fascia, ligaments, and muscle bellies.
This specific dispersion pattern makes RSWT the treatment of choice for extensive soft-tissue chains, such as the plantar fascia (foot arch) or the Achilles tendon complex.
The Science: How Does It Stimulate Healing?
Many patients ask, “How can sound waves fix my tendon?” The answer lies in the biological response your body has to the mechanical stress of the shockwave. This process is known as mechanotransduction.
When the acoustic waves enter the injured tissue, they create a pro-inflammatory response that jump-starts a stalled healing cycle. Key physiological benefits include:
- Neovascularisation: The formation of new blood vessels, significantly improving blood flow, oxygenation, and nutrient supply to the injured area.
- Collagen Synthesis: Stimulation of fibroblasts, which are the cells responsible for repairing connective tissue.
- Pain Relief (Analgesia): Through the “Gate Control Theory” and the depletion of Substance P (a neurotransmitter associated with pain), shockwave can reduce pain sensitivity immediately following treatment.
- Dissolution of Calcification: Helping to break down calcium deposits and chronic scar tissue (fibrosis) that restricts movement.
Who Is This Treatment For?
Radial Shockwave is most effective for chronic tendinopathies (pain lasting longer than 3 months) that have failed to respond to initial conservative management.
At our clinic, we frequently prescribe RSWT for:
- Foot & Ankle: Plantar Fasciitis (heel pain), Achilles Tendinopathy (insertional and mid-portion).
- Lower Leg: Medial Tibial Stress Syndrome (Shin Splints), chronic calf tightness.
- Knee: Patellar Tendinopathy (Jumper’s Knee).
- Hip: Greater Trochanteric Pain Syndrome (Lateral Hip Pain) and Gluteal Tendinopathy.
- Upper Limb: Lateral Epicondylalgia (Tennis Elbow) and Medial Epicondylalgia (Golfer’s Elbow).
These conditions are highly prevalent in runners and active professionals, making RSWT a vital component of a performance-focused recovery plan.
What to Expect During Your Session
We understand that medical procedures can be daunting. Here is what a typical session at our clinic involves:
- Assessment: We use palpation to locate the precise area of pain.
- Application: A contact gel is applied to the skin to ensure the acoustic waves penetrate efficiently without energy loss.
- Treatment: The applicator is moved over the area. You will hear a loud “tapping” sound. You will feel a strong vibration and some discomfort. This is necessary to stimulate the tissue, but it should remain within your tolerance levels. We communicate with you throughout to adjust the intensity.
- Duration: The active treatment takes only 5–10 minutes (delivering usually 2,000–3,000 shocks).
The Course of Treatment:
Clinical evidence suggests a standard protocol of 3 to 6 sessions, spaced one week apart. While some patients feel immediate relief, the cumulative healing benefits peak 6–12 weeks after the final session.
Is Radial Shockwave Safe?
RSWT is a safe, FDA-approved, and NICE-guideline-recognized treatment. However, it is not suitable for every clinical presentation.
Contraindications include:
- Acute inflammation (swollen, hot, red joints).
- Corticosteroid injection in the area within the last 6 weeks.
- Pregnancy.
- Blood clotting disorders or blood-thinning medication.
- Active cancer or bone infections.
- Open growth plates (in children).
Why Choose Our Clinic?
Shockwave therapy is not a “magic wand”—it is a catalyst. To achieve long-term resolution of pain, it must be combined with high-quality loading exercises and biomechanical correction.
We do not just treat the symptom; we treat the system. By combining Radial Shockwave Therapy with consultant-led rehabilitation, we ensure your return to running and daily life is robust and sustainable.
Summary
Radial Shockwave Therapy is a scientifically backed, low-risk intervention for stubborn musculoskeletal pain. By leveraging the body’s own repair mechanisms, it offers a path to recovery for injuries that have previously seemed untreatable.
Ready to resolve your chronic pain?
Contact our team today to schedule your comprehensive assessment and determine if Radial Shockwave Therapy is right for you.