Pulverize the Scar Tissue. Stimulate the Blood Flow. Restart Your Healing.
Are you stuck in a healing plateau? When basic stretches fail and chronic tendon pain sidelines your life, your body needs an aggressive reset. We use advanced Focused Extracorporeal Shockwave Therapy (ESWT) to drive high-energy acoustic soundwaves deep into damaged tissue.
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The Ultimate Biological Reboot
The name "Shockwave" sounds terrifying, but it is a massive misconception. There is absolutely zero electricity entering your body. Think of how an airplane breaking the sound barrier creates a physical "sonic boom" that can rattle windows. Focused Extracorporeal Shockwave Therapy uses a highly advanced machine to create miniature, targeted "sonic booms" (acoustic waves) and drives them deep into your injured tissue.
Why do we do this? Because chronic injuries like Plantar Fasciitis or Tennis Elbow have reached a "healing dead-end." Your body tried to fix the injury months ago, gave up, and left behind a mess of dense scar tissue, calcium deposits, and terrible blood flow. By driving these powerful acoustic waves into the exact site of your pain, we intentionally cause micro-trauma. This acts as a biological restart button, tricking your brain into sending fresh stem cells, new blood vessels, and powerful healing factors back to a forgotten injury.
Chronic Injuries We Pulverize
Is Shockwave Therapy Right for You?
Moving Past the Healing Plateau
We reserve this premium treatment for patients who possess a frustrated determination to get better. If you refuse to accept chronic pain but want to avoid the scalpel, you are in the right place.
You are an EXCELLENT candidate if:
- You have suffered from localized tendon or joint pain for more than 3 to 6 months.
- You have already tried rest, ice, specialized shoes, and standard physical therapy, but the nagging pain remains.
- You want an aggressive, non-invasive alternative to surgery or repetitive cortisone injections.
- You are willing to tolerate localized discomfort during the treatment to achieve long-term healing.
You may NOT be a candidate if:
- You are currently pregnant.
- You have an active blood clotting disorder or are taking heavy prescription blood thinners.
- You have a pacemaker or an active tumor directly over the treatment area.
The Realities of Acoustic Healing
Shockwave is not a relaxing spa massage. It is a highly effective, clinical medical intervention. We believe in setting clear expectations:
- The "Good Hurt": During the 10-to-15 minute session, you will feel a rapid, deep tapping sensation. It can be uncomfortable, but most patients describe it as a 'good hurt'—the feeling of the problem being fixed.
- The Post-Treatment Ache: Because we just restarted your healing process, your injury may feel slightly sore, achy, or throbbing for 24 to 48 hours after the session. This is a sign blood flow is rushing to the area.
- It Requires Commitment: Transforming chronic scar tissue requires cumulative energy. A standard protocol requires 3 to 5 sessions, spaced one week apart, to achieve the maximum regenerative effect.
Why Focused ESWT Matters
Uses a pneumatic piston to strike the skin, creating surface pressure wave. Essentially a massage gun. Energy scatters at the skin surface.
Uses electromagnetism to generate a true acoustic sonic boom. Energy converges into a pinpoint focal zone up to 4 inches deep.
Injects strong anti-inflammatory medicine to chemically mask pain. Does not heal scar tissue and can weaken the tendon over time.
The Timeline to a Rebuilt Tendon
The Activation Phase
You undergo weekly sessions. Your body is actively tearing down old scar tissue and rushing new blood to the area. Fluctuating soreness is normal.
The Rebuilding Phase
Sessions are complete. Inside, new blood vessels (angiogenesis) are feeding the tendon, and stem cells are laying down fresh, elastic collagen.
Peak Healing
The new tendon tissue strengthens and lasting relief sets in. Confidently return to high-impact sport safely.
Clinical Science & Technical Details
For our medical colleagues and highly analytical patients, we provide these transparent technical details on the pathophysiology and interventional protocols.
Explore the Clinical Science: Mechanotransduction and Neovascularization
Acoustic waves exert intense mechanical stress on the cellular membranes of the fibrotic tendon, triggering 'Mechanotransduction'. This upregulates eNOS and VEGF, initiating angiogenesis—the physical growth of new capillaries into the ischemic tendon.
ESWT transforms stagnant, chronic degenerative tendinosis back into an acute, highly active regenerative state by stimulating tenocyte proliferation and Type I collagen remodeling.
Detailed Diagnostic Pathways: Cavitation of Calcific Deposits
For Calcific Tendinitis, Focused ESWT utilizes high-peak acoustic waves to create massive pressure differentials, generating microscopic cavitation bubbles. When these bubbles collapse, they emit micro-jets that physically pulverize rigid calcium structures.
Once fractured into microscopic fragments, the body's macrophages resorb the calcium, relieving mechanical impingement without the need for surgical debridement.
Advanced Systemic Screening and Corticosteroid Washout Periods
Concurrent immune suppression neutralizes ESWT efficacy. If a patient recently received a Corticosteroid injection, Dr. Rabara mandates a strict 4-6 week 'washout period' before initiating shockwave.
Patients must also discontinue NSAIDs (Ibuprofen, Naproxen) throughout the duration of the shockwave protocol, ensuring the induced inflammatory healing response remains uninhibited.
Managing Substance P Depletion and Immediate Analgesia
ESWT hyper-stimulates unmyelinated C-fibers, forcing the rapid release and depletion of Substance P (a key pain neurotransmitter). This creates an immediate analgesic effect ('Gate Control Theory').
While patients feel pain-free immediately post-session, high-impact sports are cautioned against. The immediate relief is neurological; the structural collagen repair takes several weeks of biological remodeling.
Inside the Procedure: Adjusting Energy Flux Density (EFD)
Clinical mastery lies in manipulating Energy Flux Density (mJ/mm²). For Tennis Elbow, we utilize lower EFD (0.08 to 0.15 mJ/mm²). Deep pathologies like supraspinatus calcification require high EFD (0.28 to 0.60 mJ/mm²).
This kinetic force achieved via focused wave convergence is required to ACHIEVE cavitation, demonstrating why operator expertise and focused technology are critical for successful outcomes.
Synergistic Rehabilitation: Eccentric Loading Post-ESWT
Shockwave creates the raw materials (Type III collagen), but specialized PT is required for structure. Following the ESWT protocol, patients transition into a heavy-load eccentric training program.
Controlled mechanical loading provides the cellular signaling required to convert weak Type III collagen into highly organized, parallel Type I collagen, ensuring the regenerated tendon can withstand athletic performance.
What to Expect in the Treatment Room
Precision Targeting
Dr. Rabara uses diagnostic palpatory feedback and MSK Ultrasound to map the exact millimeter of the damaged tendon or bone spur before we begin.
The Acoustic Sonic Boom
After applying gel, Dr. Rabara activates the acoustic waves. You will hear a loud 'clicking' sound and feel a deep, pulsing thud as soundwaves penetrate the tissue.
Walk Out and Recover
There is no anesthesia, no needles, and no downtime. We wipe off the gel, and you walk out of the clinic to continue your daily activities immediately.
Common Questions
How many sessions of shockwave therapy will I need?
Clinical protocols dictate that transforming chronic tissue requires cumulative energy. Most patients require between 3 to 5 sessions, spaced approximately 5 to 7 days apart.
I had Radial shockwave at a physical therapy clinic and it didn't work. Why is yours different?
Radial machines (massage guns) scatter energy at the surface. Our Focused ESWT machine converges energy into a concentrated 'bullet' deep inside, reaching bone spurs and deep calcium that radial machines cannot touch.
Is Extracorporeal Shockwave Therapy covered by PhilHealth?
Focused ESWT is considered a premium regenerative medicine treatment. While some HMOs may offer partial coverage, it is predominantly a cash-pay medical investment in the Philippines.
Can I run or play sports while doing my weekly shockwave sessions?
We advise against high-impact sports during the 3-to-5 week treatment phase. We are breaking down scar tissue and initiating a raw healing response; your tendon is temporarily vulnerable.
Will this dissolve my painful bone spur?
For hard, established bone spurs (like heel spurs), the goal is not to 'dissolve' the bone, but to aggressively heal the inflamed, scarred plantar fascia tissue pulling on it.