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Comparing Radial vs Focused Shock Wave Therapy at Wimbledon Clinic

comparisons of the diffrent types of shock wave therapy in wimbledon London - offered by Wimbledon Chiro & Sports Injury Clinic

Shock Wave Therapy is a popular, non-invasive alternative to many surgical or steroid-related procedures.

There are now two common types of Extracorporeal Shock Wave Therapy (ESWT) available - 1) Radial ESWT and 2) Focused ESWT

- What are the comparisons between the shock wave types? And how are they to be used to treat different pain and limb function problems?

The article below gets right into the comparisons between the ESWT types, But if you are not aware of what Extracorporeal Shock Wave Therapy (ESWT) actually is there are some buttons to zap you to glossary content below:

What is Radial Shock Wave Therapy?

The Wave Characteristics:

Radial Shock Wave Therapy consists of three parts -

- Ultrasonic pulses - Audio acoustic pulses - Slow shear waves.

But their most important characteristic is all these waves have their greatest energy at the source (tip of applicator) which weakens the farther it travels away from the source i.e the deeper it penetrates into the skin.

The Radial Applicator:

Most Radial ESWT units have a gun-like applicator. Within the barrel of the applicator, the projectile is accelerated to a high speed. The projectile slams against the applicator tip, and the collision generates an energy pulse.

The kinetic energy created is then transmitted to the skin and pushed outwards as a ‘radial wave’ across the treated area.

The point of ‘impact’ constitutes the highest pressure and highest energy density (most effective for treatment). Sadly radial devices eventually lose power the more they enter the body (the critical difference for Focused-ESWT).

Radial shock wave therapy can give good results for patients with skin or close to skin conditions.

What is Focused Shock Wave Therapy?

Focused shock wave therapy - sometimes known as Focused Shockwaves - can provide more depth penetration for deeper tissue than radial waves, focusing its output into more localised, more profound areas.

Focused waves are made through a cone of crystals, and these cones focus the energy field when an electrical current is applied. The energy causes a pressure wave that can move through the skin without losing power in a concentrated zone.

Fortunately, the site of the applicator on the skin experiences a minimal impact, limiting the damage to surface skin and underlying soft tissues (safer & more comfortable).

While radial waves are applied all over a local area, FSWT treats at defined points within the body and is further adapted depending on the required depth.

This accuracy feature makes Focused Shock wave Therapy much better for treating issues affecting tissues deeper within the body (hips and lower limb conditions).


Not only is the effectiveness better with Focused-ESWT, but the skipping-the-skin part means you don't stimulate the skin sensory network; this leads to a more comfortable session. and due to the comfort levels being better higher doses can often be used

Comparing Radial vs Focused Shock Wave Therapy (Depth)

When comparing radial and focused shock wave therapy, the main considerations are penetration depth and localisation of the treatment.

As you’d imagine, the greater the depth penetration of the waves, the easier it is to treat deep issues in the tendons, muscles or bones. 

When it comes to a deep area like a hamstring or hip for instance there is little contest and focused shock wave therapy is the way to go.

What’s The Difference Between Radial & Focused Shock Waves (The Physics)?

While radial waves are good at providing relief over a wider area and can treat low-depth issues such as those on the Achilles or elbow, other conditions can require more focused treatments.

Radial waves are characterised by three key points 

- they have lower maximum intensity,

- they have a divergent wave

- they deliver their maximum intensity to a ‘superficial’ area i.e low depth. This depth is usually around 3 - 4cm.

Focused shock waves allow for ‘adjustable’ penetration depending on where needs to be treated and are ideal for treating deeper problem areas such as hamstring, pelvic or hip issues.

Focused waves are characterised as having a higher maximum intensity, delivered as a convergent wave with an adjustable depth of focal area. This can range between 2 and 30cm.

The reason the waves are different is down to how the therapy is applied. While

- RSWT follows a pneumatic principle, using compressed air and transmitters to determine the wave shape

- FSWT follows an electroacoustic principle, using electromagnetism and coupling pads to apply deeper, focused and adjustable waves.

Is There A Difference In Pain Levels Between The Two Types Of ESWT?

Radial therapy is typically more painful because of the way it is applied.

is radial shockwave more painful than focused shock wave therapy

With the vibrating nature of the Radial Shock Wave Treatment (SWT), the extra skin stimulation, and the fact that Radial SWT is delivered over a larger area, it is generally more uncomfortable.

With this additional discomfort, we now only use the Focused/ Painless SWT type, so our clients are comfortable. However, the sports injury department still uses the radial SWT type for price-conscious clients.

Focused Shock Wave Therapy, on the other hand, can be used in more acute cases, i.e. cases that are causing the patient more pain, as it's deemed as 'painless' compared to the Radial type.

Is there a difference in the number of sessions needed?

Here at Wimbledon Clinic's  Sports Injury Clinic Department, we can deliver Radial and Focused shock wave therapy through the BTL shock wave systems.

All treatments are given in our clinic based in Wimbledon, London. And initially, being one of only three clinics in London to offer ESWT, we have been doing Shock Wave Therapy Treatment here for over ten years.

Given this long history with both types, we have noticed Radial Shock Wave Therapy will commonly need more sessions than Focused Shock Wave Therapy.

On average, RSWT requires around 3 - 10 sessions, while FSWT typically needs less. This all depends on the individual's circumstances, but as standard, F-ESWT requires fewer sessions than R-ESWT.

You can book your consultation online today! If you're interested in finding out more about the application of Shock Wave Therapy for your condition at Wimbledon Clinic - click the contact us button at bottom of the page.

Glossary Of Shock Wave Therapy

What is Shock Wave Therapy?

Shock Wave Therapy is a non-invasive procedure often used to treat injured bones, joints, muscles, tendons and other soft tissues. With no need for painkillers, shock wave therapy can offer fast pain relief and aid recovery for a range of chronic conditions including:

  • Repetitive strain injury (RSI)
  • Achilles Tendonitis
  • Plantar Fasciitis
  • Tennis Elbow
  • Medial Tibial Stress Syndrome (otherwise known as shin splints)
  • Hamstring issues
  • Any other chronic soft-tissue
  • joint conditions causing long-term pain

Because of the conditions, it is used to treat, shock wave therapy is commonly used by athletes or those with ‘overuse’ injuries, although studies show it can benefit anyone currently undergoing physiotherapy for a range of complaints.

Shock wave therapy is a safe, effective treatment ​​provided it is delivered in a professional setting such as Wimbledon Chiropractic & Sports Injury Clinic and can be a great way of managing pain over the long term.

Because shock wave therapy is proven to stimulate metabolic ‘healing’ reactions, it has a very high rate of success in treating difficult-to-treat and painful injuries.

This is why it is often used as a safe alternative to surgery, steroids, or other treatment injections.

How Does Shock Wave Therapy work?

Shock wave therapy is delivered directly onto the affected area via the use of a ‘generator’ or device, using low-energy acoustic waves that penetrate the skin and treat the immediate area.

Most treatments are applied by a therapist using a hand-held device, which turns compressed air into low-energy sound waves. Light pressure is applied and the device is moved across the damaged areas that require treatment.

Shock wave therapy has two main ‘modes of action’ that can help with persistent pain.

Firstly, the shock waves work to ‘desensitise’ nerve endings which can immediately reduce pain in the local area. Secondly, the waves stimulate blood flow in the area, causing a small amount of localised inflammation.

In the days immediately following the treatment, the body naturally tries to heal the inflammation and in doing so, encourages the regeneration of cells, repairing damaged tissue and reducing pain.

Shock wave therapy can also help with issues relating to scar tissue. Because scar tissue is much denser - and much less elastic - than normal tissue, the sound waves can help break it down, improving mobility and reducing discomfort.

Similarly, the waves can be used to break down ‘disorganised’ tissue or any build-up. While these sound waves are radial, this should not be confused with the types of shock wave therapy that are typically available - ‘radial’ and ‘focused’.

Radial Wave Therapy is the most common type of shock wave therapy, although Focused Wave Therapy is growing in popularity due to the treatment options, depth and precision it can offer acute cases.

Below we explore some of the differences between Radial Shock Wave Therapy (RSWT) and Focused Shock Wave Therapy (FSWT), we must first understand what they are.

shock wave form for focused shock wave therapy at wimbledon clinic