Extracorporeal shockwave therapy is excellent therapy. This 'Focused' type of this technology creates profound differences in therapy efficiency and the sensation during a session.

To be the leader in the market for extracorporeal shockwave therapy treatment. And more specifically, for plantar fasciitis, the shock wave system needs to be either of two types. We go through the pros and cons of both systems below:

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1) RADIAL Extracorporeal Shock Wave Therapy

Radial shock wave therapy is where the waves "radiate" from the handpiece tip like a ripple in a pond. The applicator utilises a bullet hitting a wall in a gun to make this fast sound wave.

The shock waves generated by the applicator can then be channelled from the gun-like apparatus through the skin and into the injury site (usually thickened tissue).

This drumming sound wave from radial devices creates a profound change in:

  1. The skin
  2. Directly underneath the skin
  3. 1-2 cm centimetre depth below the skin

However, this radial type, like the ripple-in-the-pond, loses power and productivity as it penetrates from 1 -3

That means that Radial Shock Wave Therapy (R-SWT) is effective for tendons and foot pain treatments with very little skin, fat or muscle in between them and the site of the lesion, for instance, heel pain like Achilles tendinitis or plantar fasciitis)

2) FOCUSED Extracorporeal Shock Wave Therapy

Focus shockwave therapy is usually otherwise known as 'painless shockwave therapy'. While focused shock wave therapy is not entirely sensitivity-free, the nature of the soundwave skipping the skin barrier creates a much better tolerance.

Skipping the skin means clients will often feel the vibration of the tissues fluttering rather than the repetitive string of waves drumming through the skin. Which is the sensation seen in the older Radial type (ballistic generator) handpiece.

In short, there are not many conditions where the focused type doesn't surpass the use of radial shock wave therapy and is the first choice for the client.

Focused shockwave therapy is:

  • More Efficient
    No Wasted Energy Into Skin
  • Less Painful
    Little Skin Irritation Creates Comfort
  • Shorter Treatment Times
    20% Quicker Due To Efficiencies
  • Penetrates Deep
    over 1 cm under the skin
focused shock wav etheapy shin splints stress fractures wimbledon london


At the London Foot Pain Clinic based in Wimbledon, we have access to both the Radial type (1) and the Focused type of shockwave therapy (2).

This therapy choice allows the practitioners treating you to choose either. But honestly, the treatment is a supporter/ stimulator to your body's healing, and it's ultimately up to the client which types they pick.

Focused Shock wave therapy could be summed up as the :

Most efficient kind of shock wave,
& Most comfortable type of shock wave therapy.


We often get this request to combine both types of Shock Wave Therapy and the two types of shockwave therapy to produce an overwhelming recovery that far surpasses the use of an individual choice alone.


Focused Shock Wave Therapy is highly successful and technologically Advanced; with these points in mind, the cost of treatment is reasonable. But some might be on the high side; due to this investment, you want to ensure your investment into your sore area is into the latest and greatest shockwave tech on the market.

The last five years have seen developments to produce focused shock wave therapy called piezoelectric in smaller clinical devices. The old focused devices used to take up a whole room but now are the size of a moped bike, so these smaller units were a revelation.

While size reduction created a swarm of simple machines, the technology, while miniaturized, stayed the same, and in fact, there were only three leading manufacturers of Piezoelectric devices.

This old tech situation Until BTL came to the market with their piezo-acoustic devices, which we use at the London Foot Pain clinic based in Wimbledon.

BTL re-invented the wheel with their new focused shock wave tech for many orthopaedic conditions.

While Focused Shock Wave Therapy was already an excellent therapy, BTL decided to make the area of treatment focus more significant. With the same power factor, slightly larger means you can double the size area stimulated each session. This larger treatment spot size means that you get more stimulation per square centimetre when using the therapy; this, in turn, implies that you are more likely to break up calcification or stimulate tendon repair.


We never like to talk badly about our competitors. Whilst we don't want to do this here, in this post we concede that there are other manufacturers of focus shockwave therapy devices.

While on the face of it, focused piezoelectric devices are all principally the same, BTL's focus on treatment is very different. We deem it to be much more efficient.

They also design technology from scratch using the latest innovation in orthopaedics and are well-known in the aesthetic medical world.


Indeed, cynics out there will often question the cost of therapies, so we felt it was important to indicate the cost of the device and how that filters down into the cost of treatment.

And whilst some insurers may pay for shock wave therapy, they sadly may not produce the premium for the focused type.
And unfortunately, this may come with a supplement should your insurance cover the slightly larger expenses.

It's important to note a focused shock wave unit cost about £24k and that the handpieces that generate the waves and target them into your tissue cost a further 6K.

There are also ongoing maintenance costs for the headpieces that channel the shockwaves into your tissue. These headpieces need to be replaced every 2 to 5,000,000 pulses depending on the manufacturer. The average session on a single foot (plantar fascia) area is about 2000 - 5000 pulses.

WHAT IS Piezoelectric

This is for the people who love the science of shock wave therapy tech but are a little dumbed down:
Essentially, unique crystals called piezoelectric materials can conduct an electric current. The crystals can be both human-made and natural.
The most well-known piezoelectric element used in electronic devices is the quartz crystal. Other naturally occurring piezoelectric materials include cane sugar, Rochelle salt, and bone.

If you attach the crystal to a circuit of two wires and bang the crystal, the electrical circuit shows a pulse of electricity.

This effect also works in reverse; a pulse of electricity to the crystals causes a throbbing of the crystal. This throbbing displaces the air around the crystal, and a shockwave is felt near the crystal.

The latest focused shock wave devices have thousands of crystals that converge the wave pressure to a single point. The concentrated energy point was tiny in the old focused piezoelectric shockwave devices. This small zone was helpful as they were used to break down tiny kidney stones.

Unfortunately, this pin size focus wasn't very helpful in sports injury care as the structures are typically 5 - 100 times the size of a classic kidney stone. BTL changed the focus point to be larger by arranging the crystals more effectively for orthopaedic conditions.

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