Foot and ankle
- Plantar heel pain (plantar fasciitis)
- Achilles tendinopathy
- Shin splints (medial tibial stress syndrome)
Home / Shockwave
Kinetic Spine & Sport · estimated December 2026
Radial Shockwave Therapy
Short treatment courses for stubborn tendon problems, with musculoskeletal ultrasound to confirm the target before the first pulse.
STORZ MEDICAL MASTERPULS ultra
Ultrasound-confirmed target
First treatment included
Photos: STORZ MEDICAL
3 to 5
treatments in a typical course
~5 min
of shockwave per treatment
$185
evaluation, first treatment included
$210
for the four follow-up visits
What it is
Acoustic pulses, delivered where the problem is.
Radial shockwave therapy uses a handpiece that fires rapid acoustic pulses through the skin into a tendon, muscle, or area of connective tissue. Each treatment takes a few minutes. It is uncomfortable while the handpiece is on the sore spot, and the intensity is adjusted to what you can tolerate. No anesthetic, no needles, no downtime, and you walk out and go about your day.
Radial units are the type most of the published trials on heel pain, tennis elbow, and tendinopathy used. They treat from the skin surface down to a few centimeters, which covers most tendon and muscle targets. Deeper or calcified targets, and anything that is not improving after three sessions, get a different plan.
- A few minutes per treatment, no anesthetic, no downtime
- Most courses are 3 to 5 treatments about a week apart
- Combined with loading exercise and a home program, never used alone
Inside the handpiece: compressed air drives a projectile into the applicator, and each strike sends a pulse into the tissue. Photo: STORZ MEDICAL
The equipment
STORZ MEDICAL MASTERPULS ultra
The current-generation radial shockwave system from the Swiss manufacturer whose units appear throughout the published shockwave research. A clinic-grade unit, with applicators sized to the target and output set for each treatment rather than one fixed level.
Photo: STORZ MEDICAL
Matched to the tissue, set for the visit.
- Applicators. A small deep head for a tendon insertion, a larger head for a muscle belly, chosen after the depth is measured on ultrasound.
- Set per visit. Pressure, pulse rate, and pulse count are chosen for your tissue and your tolerance, and logged every session.
- Not a massage gun. A different class of equipment from the handheld devices sold online, which do not produce the same acoustic output.
Who it's for
The problems it is most often used for.
Shockwave is a tendon and soft-tissue tool. It is not a treatment for everything, and the evaluation is where we decide together whether it fits your problem.
Photos: STORZ MEDICAL
Knee and hip
- Patellar tendinopathy (jumper's knee)
- Lateral hip pain (gluteal tendinopathy)
- Hamstring and thigh tendon problems
Elbow and shoulder
- Tennis elbow (lateral epicondylalgia)
- Calcific shoulder tendinopathy
- Upper back and neck muscle trigger points
Results vary by person and by condition. The evidence is strongest for plantar heel pain and tennis elbow. I will tell you at the evaluation where your problem sits, and if shockwave is not the right tool for it you pay for the evaluation only.
How a course works
Evaluation first, then a short course.
1
Evaluate
60 minutes, one-on-one. History, hands-on exam, and musculoskeletal ultrasound to confirm the target and its depth. Baseline measures. If shockwave fits, your first treatment happens the same visit.
2
Treat
Four 20-minute follow-up visits, about a week apart. Each one is a recheck, the treatment, and an update to your loading program. Purchased at the evaluation, valid 26 weeks.
3
Retest
Progress is measured against your baseline at the end of the course and again at 6 and 12 weeks. If you are not improving after three sessions we change the plan rather than keep going.
Pricing
Two numbers. No surprises.
Start here
Shockwave Evaluation
$185
60 minutes, one-on-one. First treatment included.
- Ultrasound to confirm the target and its depth
- Baseline measures to track your progress
- First shockwave treatment the same visit
- Shockwave treatment begins December 2026 (estimated)
Follow-Up Course: 4 Treatments
$210 $52.50 per visit
Four 20-minute treatment visits after your evaluation.
- Recheck, treatment, and home program each visit
- Purchased at your evaluation, valid 26 weeks
- Unused visits refunded
- Single follow-ups are $130 if you prefer pay as you go
Unused course visits are refunded. Care is never extended just to use up a course.
Shockwave is offered at Kinetic Spine & Sport only, not at Mark 44 MMA. Payment at time of service. HSA/FSA accepted. No insurance billing.
Where
Tuesdays at Kinetic Spine & Sport.
Shockwave courses run out of Kinetic Spine & Sport at 1219 Caledonia St. in Mankato, where the unit lives. I am there Tuesdays, 8 a.m. to 1 p.m., by appointment.
If Kinetic or another clinic sent you here, you stay with them for the rest of your care. I handle the shockwave evaluation and the treatment course, send a summary back to your provider with your permission, and you go back to them when the course is done. No referral is needed to book.
Kinetic Spine & Sport
1219 Caledonia St., Mankato, MN 56001
Enigma is here Tuesdays, 8 a.m. to 1 p.m.
kinetic-chiro.com
Safety
Who should not have it, and who should tell me first.
Not suitable
Pregnancy. An implanted stimulator near the treatment area. Active infection or open skin at the site. A tumor at the site.
Tell me first
Blood thinners or a bleeding disorder. A steroid injection at the site in the last 6 weeks. Under 18. Cancer elsewhere.
Common after-effects are soreness, redness, or mild bruising at the site for a day or two. Treatment is paused if the area is unusually painful or swollen.
Evidence
What the trials actually show.
I read the research before buying this unit. The headline trials first, then the fuller picture by problem, with every paper listed below so you can check them yourself.
Heel pain
61% of patients a treatment success at 12 weeks versus 42% with sham, in a 245-patient placebo-controlled trial of radial shockwave for chronic plantar fasciitis [11].
Lateral hip
Radial shockwave beat a cortisone injection at 4 months (68% versus 51% success) and at 15 months (74% versus 48%) in a 229-patient randomized trial [12].
Calcific shoulder
Calcifications disappeared completely in 87% of treated patients and in none of the control group, with less pain and better function at 6 months [13].
Achilles
Adding radial shockwave to a loading program took the rate of patients completely recovered or much improved at 4 months from 56% to 82% [14].
Tennis elbow
Across 12 randomized trials, shockwave beat sham on pain and grip strength and radial outperformed focused, though the average effect was modest and strongest in people with symptoms over 6 months [15].
What that means here
These are the trials the course is modeled on: 3 to 5 radial treatments, no anesthetic, paired with loading exercise. The blocks below give the fuller, more mixed picture by condition.
Radial versus focused shockwave. A 2026 meta-analysis of 21 randomized trials found no significant difference between focused and radial devices for pain, function, or range of motion at any follow-up, with low certainty in the data [1]. A 2026 meta-analysis limited to tendinopathy also found no clear winner, and radial improved wrist extensor strength in tennis elbow [2]. Radial is the type most of the heel pain and tennis elbow trials used.
Plantar heel pain. This is where the radial evidence is deepest. Results against focused devices are mixed: one pooled analysis of placebo-controlled trials favored focused [3], a network meta-analysis ranked radial highest and called it an appropriate, lower-cost option [4], and a head-to-head randomized trial in calcaneal spur found radial better on the Foot Function Index [5].
Patellar tendinopathy. A randomized trial comparing the two device types found no difference in effectiveness [6].
Shoulder. For non-calcific rotator cuff tendinopathy, focused did better than radial at 24 and 48 weeks in one randomized trial [7]. Higher-energy focused treatment is also the better-supported choice for calcific deposits [10]. If your shoulder looks like one of those on ultrasound, I will say so at the evaluation rather than sell you a course.
Knee osteoarthritis. Focused outperformed radial in a randomized trial [8]. Arthritic knee pain is not a problem I promote radial shockwave for.
Myofascial trigger points. Both radial and focused beat sham treatment, with no difference between the two [9].
How it should be delivered. The current best-practice guidance is 3 to 5 treatments about a week apart, treating the most painful spot without anesthetic, and using imaging for structures that are hard to find by feel, such as calcific deposits [10]. That is how the course here is built.
References, 15 papers (tap to expand)
- Ismail Hassan M, Ibrahim Abdelhamed A, Emad T, et al. Focused shock wave versus radial pressure wave therapy for musculoskeletal disorders: A systematic review and meta-analysis. Journal of Back and Musculoskeletal Rehabilitation. 2026. doi:10.1177/10538127261477948
- Stania M, Pawłowski M, Benduch M, et al. Efficacy of radial and focused shockwave therapy for tendinopathy: a systematic review and meta-analysis. Scientific Reports. 2026;16(1). doi:10.1038/s41598-026-37160-3
- Wang YC, Chen SJ, Huang PJ, et al. Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials. Journal of Clinical Medicine. 2019;8(9):1497. doi:10.3390/jcm8091497
- Chang KV, Chen SY, Chen WS, Tu YK, Chien KL. Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: a systematic review and network meta-analysis. Archives of Physical Medicine and Rehabilitation. 2012;93(7):1259-1268. doi:10.1016/j.apmr.2012.02.023
- Şah V, Kaplan Ş, Özkan S, Adanaş C, Toprak M. Comparison between radial and focused types of extracorporeal shock-wave therapy in plantar calcaneal spur: A randomized sham-controlled trial. The Physician and Sportsmedicine. 2023;51(1):82-87. doi:10.1080/00913847.2022.2091413
- van der Worp H, Zwerver J, Hamstra M, van den Akker-Scheek I, Diercks RL. No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: a randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy. 2014;22(9):2026-2032. doi:10.1007/s00167-013-2522-z
- Li C, Li Z, Shi L, Wang P, Gao F, Sun W. Effectiveness of Focused Shockwave Therapy versus Radial Shockwave Therapy for Noncalcific Rotator Cuff Tendinopathies: A Randomized Clinical Trial. BioMed Research International. 2021;2021:6687094. doi:10.1155/2021/6687094
- Ko NY, Chang CN, Cheng CH, Yu HK, Hu GC. Comparative Effectiveness of Focused Extracorporeal versus Radial Extracorporeal Shockwave Therapy for Knee Osteoarthritis: Randomized Controlled Study. International Journal of Environmental Research and Public Health. 2022;19(15):9001. doi:10.3390/ijerph19159001
- Şenlikci HB, Yücealp Ö, Borman P, Ince Keskin Z, Gümüş Atalay S, Yaşar E. Comparison of the efficacy of radial and focused extracorporeal shock-wave therapy (ESWT) in myofascial pain syndrome: a randomized, sham-controlled study. Lasers in Medical Science. 2025;40(1):404. doi:10.1007/s10103-025-04676-5
- Tenforde AS, Borgstrom HE, DeLuca S, et al. Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration. PM&R. 2022;14(5):611-619. doi:10.1002/pmrj.12790
- Gerdesmeyer L, Frey C, Vester J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. The American Journal of Sports Medicine. 2008;36(11):2100-2109. doi:10.1177/0363546508324176
- Rompe JD, Segal NA, Cacchio A, Furia JP, Morral A, Maffulli N. Home training, local corticosteroid injection, or radial shock wave therapy for greater trochanter pain syndrome. The American Journal of Sports Medicine. 2009;37(10):1981-1990. doi:10.1177/0363546509334374
- Cacchio A, Paoloni M, Barile A, et al. Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study. Physical Therapy. 2006;86(5):672-682. PMID 16649891
- Rompe JD, Furia J, Maffulli N. Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial. The American Journal of Sports Medicine. 2009;37(3):463-470. doi:10.1177/0363546508326983
- Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. Does the Type of Extracorporeal Shock Therapy Influence Treatment Effectiveness in Lateral Epicondylitis? A Systematic Review and Meta-analysis. Clinical Orthopaedics and Related Research. 2020;478(10):2324-2339. doi:10.1097/CORR.0000000000001246
FAQ
Shockwave questions.
Does it hurt?
It is uncomfortable on the sore spot while the handpiece is running, usually a few minutes, and most people describe it as tolerable. The intensity starts low and is adjusted to you. Soreness for a day or two afterward is normal.
How many treatments will I need?
Most published protocols use 3 to 5 treatments about a week apart. The course here is the evaluation with the first treatment, then up to four follow-ups. If you are not improving after three sessions we change the plan rather than keep going.
Why do you use ultrasound with it?
To confirm that the structure we are treating is the structure that is sore, to measure how deep it is so the right applicator is used, and to find things like calcific deposits that are hard to locate by feel. Findings are documented descriptively within physical therapy practice and are not a medical diagnosis.
Is this the same as focused shockwave?
No. Radial units deliver energy that is strongest at the skin and spreads outward; focused units concentrate energy at a set depth. Head-to-head trials across tendon conditions have mostly found no meaningful difference between the two, with focused having an edge for some deep or calcified targets. The evidence section above has the papers.
Do I need a referral?
No. Minnesota is a direct-access state. Many patients come referred by their chiropractor or physical therapist, and they keep that provider for the rest of their care.
What does it cost, and what if I stop early?
The evaluation is $185 and includes the first treatment. The follow-up course of four 20-minute visits is $210, purchased at the evaluation. Unused course visits are refunded. HSA/FSA accepted, payment at time of service, no insurance billing.
Start with the evaluation.
Tuesdays at Kinetic Spine & Sport, 1219 Caledonia St., Mankato. Shockwave treatment begins December 2026 (estimated).