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Shockwave Therapy at Sammy Margo Physiotherapy

We are now offering Shockwave Therapy at our in Hampstead and Highgate included in your treatment if referred by a GP or consultant.

Dimitrious has had extensive experience with Shock Wave therapy which he uses in his professional football settings at Barnet (he is now at Tottenham)

We're getting great results for some of those stubborn pathologies and have decided to not charge any extras for this service aside form our usual fees.

The treatment goes by several names, the most popular being SHOCK WAVE THERAPY or EXTRACORPORAL SHOCKWAVE THERAPY (ESWT). It has been suggested that the therapy version of shockwave therapy might be usefully called RADIAL SHOCKWAVE THERAPY (RSWT) to distinguish the nature of the wave from the high energy, focused versions, employed elsewhere in medical practice.

Radial shockwaves are also referred to as Radial Pressure Waves. They are pulses generated by compressed air which converts into acoustic energy. The acoustic pulses are then transmitted via a dispersive wave into the tissue of the affected area.

Principles of production

There are basically four different way to produce the ‘shock wave’, which in simple terms are: spark discharge; piezoelectric; electromagnetic and pneumatic (or electrohydraulic). The wave that is generated will vary in its energy content and also will have different penetration characteristics in human tissue. In therapy the most commonly employed generation method is based on the pneumatic system, and the key reason for this is that a radial (dispersive) wave results. The focused waves are essential for ‘surgical’ interventions, but given their destructive nature, they are less appropriate for therapeutic uses. Focused waves are sometimes also referred to as ‘hard’ shockwaves, and the radial or dispersive wave termed a ‘soft’ shockwave.

RPW Hypotheses of mode of action

Pain reduction: the intensive pulses transmitted from the hand piece to the tissue help inhibit the transmission of the pain signal (Gate Control theory)

Increased metabolism: shock waves influence the tissue on a cellular level, promoting the release of pain inhibiting and inflammatory inhibiting substances

Revascularisation: repeated shock waves influence the blood flow, promoting tissue healing and regeneration

Reduced muscle tone: shock waves help restore a normalized muscular tone by reducing the impact of pain on muscle tone


The basic technology involved in extracorporeal shockwave therapy has been used for decades to treat millions of people. The technology has been used most extensively in Europe and during all this time, ESWT of the musculoskeletal system has been found to have virtually no serious side-effects when used by trained physicians. In fact, even mild side-effects such as tingling, aching, redness, or bruising are relatively rare, mild, and transient.

Evidence for Shockwave technology

There is good clinical research into the effectiveness of shockwave therapy.

NICE (National Institute for Health and Clinical Excellence) has reviewed ESWT and has approved guidelines for its application.


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