If you’ve looked into shockwave therapy for a stubborn tendon or chronic joint problem, you’ve probably found that most clinics offer it – but very few explain what kind they’re using or why it matters. At Durango Chiropractic Associates, we use both radial and focused shockwave devices, and the difference between them isn’t a minor technical detail. It’s the reason patients who haven’t responded elsewhere finally start getting results.
Not All Shockwave Therapy Is the Same
Shockwave therapy has become a popular treatment option for chronic musculoskeletal pain, and for good reason – the research behind it is solid. But the term gets applied loosely to devices that work in fundamentally different ways. Walking into a clinic that offers “shockwave therapy” without knowing which type they’re using is a bit like asking for a trail recommendation in Durango without knowing if you want a flow trail or a technical descent. The category is the same. The experience is not.
There are two distinct types: radial shockwave and focused shockwave. Each generates energy differently, penetrates tissue at different depths, and is suited to different types of injuries. Using one when you need the other produces mediocre results. Using both, when the condition calls for it, produces something meaningfully better than either alone.
How Radial Shockwave Works
Radial shockwave uses compressed air to accelerate a projectile inside the applicator, which strikes a transmitter tip and generates a mechanical pressure wave that spreads outward from the point of contact. The energy is highest at the surface and diminishes as it travels deeper into tissue.
That sounds like a limitation, but for the right conditions it’s exactly what you want. Radial shockwave covers a broader treatment area, making it highly effective for superficial tendon and soft tissue problems – the kind of injuries that are common in Durango’s hiking, running, and cycling community. Achilles tendinopathy, plantar fasciitis, tennis elbow, and IT band syndrome all tend to respond well because the injured tissue sits close enough to the surface for radial waves to reach it effectively.
Radial shockwave also works well for myofascial trigger points and muscle chains – spreading the mechanical energy across a wider area to release tension and improve circulation in ways that feel similar to a deep, targeted soft tissue treatment.
How Focused Shockwave Works
Focused shockwave generates acoustic energy that converges at a precise focal point deep within the tissue – reaching up to 12 centimeters below the skin surface without losing power along the way. Unlike radial waves, focused shockwave doesn’t disperse. It concentrates its energy exactly where it’s aimed.
This makes it the right tool for injuries that sit deeper – at the bone-tendon interface, within calcified structures, or in joint tissues that radial waves simply can’t reach with enough intensity to produce a therapeutic effect. Calcific shoulder tendinopathy, deep hip tendon issues, and chronic conditions involving the bone-tendon junction are where focused shockwave tends to outperform radial significantly.
Focused shockwave is also generally more comfortable during treatment despite its deeper penetration, because the energy at the skin surface is relatively low. Patients who found radial shockwave too intense at other clinics are often surprised by how well they tolerate focused treatment.
Why Using Both Changes the Outcome
Here’s what most shockwave pages won’t tell you: many chronic injuries involve both superficial and deep tissue components at the same time. A calcific rotator cuff condition, for example, involves deep calcification at the tendon insertion point and surrounding soft tissue inflammation closer to the surface. Treating only one layer leaves the other untouched.
At Durango Chiropractic Associates, Dr. Ridgway uses both devices in the same session when the condition calls for it – addressing the surface tissue with radial shockwave and the deeper pathology with focused shockwave in a single visit. The result is a more complete treatment than either device can deliver on its own.
This dual-device approach isn’t common. Most clinics invest in one system and use it for everything. Having both – and knowing when and how to combine them – is what separates a genuinely comprehensive shockwave protocol from a one-size-fits-all application.
What Conditions Respond Best
Shockwave therapy works by stimulating the body’s natural healing response – increasing blood flow, promoting collagen production, breaking down calcifications and scar tissue, and disrupting the chronic pain cycles that keep injuries from resolving on their own. It’s particularly effective for conditions that have become stuck in a chronic state where the normal healing process has essentially stalled.
Conditions that tend to respond well to our dual-device protocol include:
- Achilles tendinopathy – one of the most common complaints among Durango’s trail running and hiking community
- Plantar fasciitis and heel spurs
- Tennis elbow and golfer’s elbow
- Calcific shoulder tendinopathy and rotator cuff issues
- Patellar tendinopathy (jumper’s knee)
- Hip bursitis and gluteal tendinopathy
- IT band syndrome
- Myofascial trigger points and chronic muscle tension
If you’ve been dealing with any of these for months – or longer – and rest, physical therapy, and anti-inflammatories haven’t produced lasting relief, shockwave is often the next logical step before considering more invasive options.
How It Fits Into Your Overall Care
Shockwave therapy at Durango Chiropractic Associates doesn’t exist in a silo. Depending on your condition, Dr. Ridgway may combine it with laser therapy to support tissue regeneration after treatment, or with dry needling to address the muscular tension patterns that often develop around a chronic tendon injury. For patients with both extremity pain and spinal involvement, shockwave for the joint and spinal decompression for the disc can run concurrently.
The point is that treatment should match the full picture of what’s going on – not just the loudest symptom. That’s how most people who’ve struggled with chronic pain for a long time finally start making real progress.
What to Expect During a Session
Sessions are straightforward. Dr. Ridgway or a team member will assess the treatment area, identify the specific zones to target, and apply the appropriate device – or both – based on your condition. Treatment takes around 15-20 minutes for most presentations. There’s no anesthesia, no needles, and no downtime. Most patients return to normal activity the same day.
Some mild soreness in the treated area is normal for 24-48 hours after a session – this is the inflammatory response the treatment intentionally triggers, and it’s part of how shockwave works. Avoiding anti-inflammatory medications in that window helps rather than hinders your recovery.
Most patients go through a series of sessions spaced about a week apart. The number depends on the condition and how your tissue responds, but meaningful improvement is typically noticeable within the first three to four treatments.
Frequently Asked Questions
Is shockwave therapy painful?
Radial shockwave can cause some discomfort over sensitive tendons, particularly in the first session. Focused shockwave is generally more comfortable. Most patients adjust quickly and tolerate treatment well by the second or third visit.
How is it decided which device to use?
Dr. Ridgway determines this based on the location of your injury, the depth of the affected tissue, and your overall presentation. In many cases both are used in the same session to cover the full injury from surface to deep tissue.
Can shockwave help if I’ve had the same injury for years?
Yes – and chronic injuries are actually where shockwave tends to shine. Long-standing tendon and joint problems often involve calcifications and scar tissue that have built up over time. Shockwave is specifically designed to break those down and restart the healing process.
Ready to Stop Managing the Pain and Start Resolving It?
If a tendon or joint issue has been limiting what you can do in Durango – on the trails, on the slopes, or just in daily life – we’d be glad to take a look and put together a plan. Call us at 970-247-5519 or request an appointment online to get started.
