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Tendinopathy Adjunct

Shockwave Therapy in Soho, London

Focused extracorporeal shockwave therapy (ESWT) is a non-invasive option we use, alongside a progressive loading programme, for persistent tendon problems that have not settled with first-line rehabilitation.

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Physiotherapist delivering focused shockwave therapy to a patient's tendon at Physio and Performance

The short answer

What this treatment is

Extracorporeal shockwave therapy delivers acoustic pressure waves through the skin to a stubborn tendon using a hand-held applicator. The aim is to stimulate the body's own repair response in tissue that has stopped healing on its own. At Physio and Performance we reserve ESWT for recalcitrant tendinopathies — plantar fasciitis, calcific rotator-cuff tendinopathy, and Achilles or patellar tendinopathy — where a structured loading programme has not resolved symptoms. The evidence for shockwave is mixed and it works best as an adjunct, never in place of rehabilitation. NICE interventional procedures guidance supports its use in carefully selected cases, and we will tell you honestly if your presentation falls outside that group. Every course begins with a full assessment by an HCPC-registered, Chartered (CSP) physiotherapist and runs in parallel with the exercise plan that does the rebuilding.

Areas treated

What's included

  • Non-invasive, drug-free adjunct for persistent tendinopathies that have not settled with loading alone
  • Assessed and delivered by an HCPC-registered, Chartered (CSP) physiotherapist
  • Reserved for recalcitrant cases — plantar fasciitis, calcific rotator-cuff, Achilles and patellar tendinopathy — in line with NICE interventional procedures guidance
  • Always combined with a progressive loading programme, never delivered in isolation
  • Clear contraindication screen at every visit, so treatment is only offered when it is appropriate for you
  • Available across UNTIL Soho, Liverpool Street and Marylebone, with home visits and online review across London

Boundaries of practice

What's not treated

Good practice means saying no when indicated:

  • Pregnancy, or when actively trying to conceive
  • Not suitable for under-18s without specialist consultation
  • Active infection, open wound, or known tumour over the treatment area
  • Clotting disorders, or anticoagulant (blood-thinning) medication without prescriber clearance
  • Metal implants, plates, or a cardiac pacemaker near the treatment site
  • Recent corticosteroid injection to the area within the previous six weeks

Patient journey

What to expect

Consultation & preparation

Wear clothing that lets the affected area be examined, eat normally beforehand, and stay hydrated. Bring any prior scan reports, GP letters, or specialist correspondence. Tell us before the session about pregnancy, blood-thinning medication, clotting disorders, recent surgery, or any history of malignancy, as these are screened-for contraindications.

During treatment

Aftercare

Mild redness, warmth, or aching over the treated tendon for a day or two is normal and usually settles on its own. You can resume light activity the same day but should avoid heavy training of the treated tendon for 24 to 48 hours. Keep following your prescribed loading programme, as that is what rebuilds the tendon.

Transparent, all-in pricing

Initial Assessment
Price on enquiry
Follow-up Treatment
Price on enquiry

Written and medically reviewed by Sam Harvey , Physiotherapist & Clinical Lead · HCPC-registered · 15 Years’ Experience · National Institute for Health and Care Excellence (NICE) — Interventional Procedures; Chartered Society of Physiotherapy (CSP).

Common
questions

What conditions is shockwave therapy used for?

We use it for persistent tendinopathies that have not settled with loading rehabilitation — most commonly plantar fasciitis, calcific rotator-cuff tendinopathy, and Achilles or patellar tendinopathy. NICE interventional procedures guidance supports careful use in these recalcitrant cases. We do not offer it as a first-line treatment, and we will tell you if your problem is unsuitable.

Does shockwave therapy actually work?

The evidence is mixed. For some recalcitrant tendinopathies that have failed first-line loading, shockwave can be a useful adjunct, and that is the basis of NICE interventional procedures guidance. It is not a guaranteed cure and works best alongside a progressive loading programme rather than on its own. We reassess your response and stop if you are not improving.

Does the treatment hurt, and are there side effects?

Most people find it uncomfortable but tolerable; the sensation settles as soon as the applicator lifts. Temporary redness, mild swelling, or aching over the treated area for up to a day or two is common and usually self-limiting. We screen for contraindications at every visit, which is how we keep the treatment appropriate and safe for you.

How many sessions will I need?

Shockwave is usually given as a short course of weekly sessions, but the right number depends on your tendon, your response, and how rehabilitation is progressing. We review after each session and only continue while you are improving. We will not commit you to a fixed package or add sessions that the evidence does not support for your case.

Do I need a referral, and is shockwave suitable for everyone?

No GP referral is needed — you can self-refer and book a free 15-minute consultation call first. Shockwave is not suitable in pregnancy, over an active infection or tumour site, with certain clotting disorders or blood-thinning medication, or for under-18s without specialist input. We confirm suitability at your assessment before any treatment.

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Physio and Performance • 111 Charing Cross Road, Soho, London WC2H 0DT

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Appointments typically available within 1–2 weeks