Radial Shockwave Therapy for Tendonitis & Tendinosis in Denver

A Savvy Physical Therapy guide to helping “stubborn tendons” calm down and rebuild

If you’ve been dealing with a nagging tendon issue like Achilles pain that won’t go away, plantar fascial heel pain that laughs at stretching, or “tennis elbow” that keeps flaring up - you’ve probably learned the hard truth: tendons don’t like quick fixes. They usually need the right kind of stimulus, repeated over time, to heal and get strong again.

At Savvy Physical Therapy in Denver, we use Radial Shockwave Therapy (also called radial extracorporeal shockwave therapy / rESWT) as a powerful add-on to a smart rehab plan for tendonitis and tendinosis—especially when progress has stalled.

First: tendonitis vs. tendinopathy

People say “tendonitis” for most tendon pain, but many long-lasting cases are actually tendinosis.

  • Tendonitis often implies a more acute, inflamed, irritated stage.

  • Tendinosis means the tendon has been cranky for a while and has developed degenerative/disorganized tissue changes (not just inflammation).

That matters because chronic tendon pain responds best to:

  • progressive strength loading, and

  • treatments that help the tendon “reset” and rebuild (shockwave can be one of those tools).

  • And doesn’t respond well to just resting, icing, or bracing.

What is Radial Shockwave Therapy?

Radial shockwave is a non-invasive treatment that delivers high-energy sound waves through a handheld applicator to the painful area. It’s commonly used for stubborn tendon problems and helps stimulate the cells to restart the healing process.

It’s performed in the clinic, takes just a few minutes, and doesn’t require surgery or injections.

Clinical guidelines and summaries from professional and research sources describe ESWT/rESWT as a commonly used, evidence-based option across multiple musculoskeletal conditions, including several tendinopathies. 

What tendon problems has shockwave therapy been shown to help?

Foot & ankle

  • Plantar fasciopathy (plantar fascia / heel pain)

  • Achilles tendinopathy (mid-portion and insertional in multiple studies)

Knee

  • Patellar tendinopathy (Jumper’s knee)

Elbow

  • Tennis Elbow (Lateral epicondylitis / lateral epicondylopathy)

  • Golfer’s Elbow (Medial epicondylitis)

Shoulder

  • Calcific tendinopathy of the shoulder (rotator cuff region)

  • Rotator cuff tendinopathy (non-calcific / “rotator cuff tendonitis”)

Hip

  • Greater trochanteric pain syndrome (often driven by gluteal tendinopathy—gluteus medius/minimus)

Upper hamstring

  • Proximal hamstring tendinopathy (high hamstring pain near the sit bone)

How shockwave helps tendon tissue heal.

Think of chronic tendinopathy like a rope that’s become frayed and sensitive. It’s not “broken,” but it’s not remodeling well.

Shockwave helps by delivering a controlled mechanical stimulus that helps:

  1. Turn down pain sensitivity
    Shockwave can reduce how “amped up” local pain nerves are, which often makes movement and rehab easier since pain relief can happen within minutes.

  2. Increase blood flow and local healing activity
    Studies and clinical guidelines describe effects like improved microcirculation and signaling that can support tissue repair.

  3. Stimulate tendon remodeling
    The goal isn’t just temporary relief—it’s to help the tendon respond better to the strengthening work you do afterward (the loading program is still the main event).

Bottom line: Shockwave doesn’t replace rehab. It often makes rehab work better by improving pain and tissue responsiveness so you can progressively load the tendon again.

What to expect at Savvy Physical Therapy In Denver

At Savvy PT, we use shockwave therapy as part of an overall plan—not a stand-alone

A typical tendon-focused plan includes:

  • A clear diagnosis (tendon vs joint vs nerve vs referred pain)

  • A progressive loading program

  • Mobility and movement work

  • Shockwave sessions layered in strategically (often weekly for a short block, depending on the condition and irritability)

We’ll also talk about what not to do—because tendon flare-ups are often caused by the wrong dose of activity, not “weakness” alone.

Is shockwave right for you?

Shockwave therapy is commonly considered when:

  • symptoms have lasted >6–12 weeks

  • you’ve tried rest/PT basics and keep relapsing

  • imaging or exam suggests tendinopathy (not a tear requiring different care)

  • you want a non-invasive option to support rehab

There are also situations where we modify or avoid it (example: certain clotting disorders, local infection, some nerve/vascular conditions, pregnancy considerations for some regions, etc.). We’ll screen you carefully.

Ryan Smith