Carolina Holistic Medicine | Functional & Alternative Medicine | Charleston, SC

Extracorporeal Shock Wave

Extracorporeal Shock Wave (Soft Wave) Therapy [ESWT] for Rotator Cuff tendonitis and other orthopedic disorders.

Extracorporeal Shock Wave (Soft Wave) Therapy [ESWT] for Rotator Cuff tendonitis and other orthopedic disorders.

JP Saleeby, MD


For the past two decades a noninvasive treatment modality referred to at ESWT for extracorporeal shock wave (sound wave) therapy has emerged as a safe and effective way to treat orthopedic disorders without the knife.  At the tip of the spear for the past thirty years is a German company with a device called the SoftWave.  Apollo-Wave is a company that emerged in 2022 treating patients in South Carolina with this device.  Me-too devices do emerge from time to time, but the effectiveness of this German made SoftWave device stands heads and shoulders (no pun intended) above the competitors in effective treatment for rotator cuff disease and other musculoskeletal disorders.  In 2003 JAMA published a peer reviewed paper on this emerging modality showing promise with shoulder pain.  It revealed the ESWT was effective in helping with painful rotator cuff disease.  ESWT involves the application of either high-energy or low-energy (Li-ESWT) to the rotator cuff area or other joints and tissues like the knee, lower back, plantar surface (plantar fasciitis) and other regions of the body.  The JAMA study showed how this type of ultrasound treatment addresses the root cause of the rotator cuff tendinitis which is the calcified tendons and calcium deposits near the muscles of the joint.  The therapy shows reduction in the calcified deposits and is a viable alternative to the more invasive surgery.


In their JAMA study, researchers treated patients with either high-energy or low-energy shock waves. For comparison, some patients received a placebo treatment during which the same procedure was performed but no shock waves were delivered. All 134 patients had shoulder pain caused by calcific tendinitis of the rotator cuff.  The participants received two treatments, each two weeks apart.  Three, six, and 12 months later, the high-energy and low-energy patients all had significant rotator cuff improvement in various areas with pain reduction, activities of daily living, range of motion, and power. When compared with the placebo group it was quite significant that this intervention had a positive impact on the patients.  Both high-energy and low-energy ESWT appeared to provide a beneficial effect on shoulder function, as well as on self-rated pain and diminished size of calcifications, compared with placebo. Furthermore, high-energy ESWT (Hi-ESWT) appeared to be superior to low-energy ESWT (Li-ESWT).


The group getting high-energy therapy to the rotator cuff got significantly better results than the low-energy group.  The researchers in 2003 suggested that if further studies duplicate the beneficial results seen in this study, treatment with shock wave therapy could one day replace surgery in some patients.  Other studies on shoulders were repeated in 2017 and again in 2020 showing similar very positive results.


The mechanisms of action for ESWT are an increase in blood flow to the region treated, reduction in inflammation following treatment (actually the device sparks some good inflammation in the short-term to attenuate the release of healing agents, and mediators that the body releases to rejuvenate and heal tissue).  As witnessed on the rotator cuff, the same effects are seen on other joints and body tissues.  For more visit


Dr. JP Saleeby is a Functional Medicine and Emergency Medicine physician.  He is the medical director for Apollo-Wave.



Chen, Kewei MMa; Yin, Shuai PhDb; Wang, Xiaodan MMb; Lin, Qianqian MMa; Duan, Huijie MMa; Zhang, Zhenhua MMa; Chang, Yiniu MMa; Gu, Yujing MMb; Wu, Mingli MMb; Wu, Nan PhDa,; Liu, Chengmeib, Effect of extracorporeal shock wave therapy for rotator cuff tendonitis, Medicine: November 25, 2020 – Volume 99 – Issue 48 – p e22661.

Li W, Zhang SX, Yang Q, Li BL, Meng QG, Guo ZG. Effect of extracorporeal shock-wave therapy for treating patients with chronic rotator cuff tendonitis. Medicine (Baltimore). 2017;96(35):e7940.

Gerdesmeyer L, Wagenpfeil S, Haake M, et al. Extracorporeal Shock Wave Therapy for the Treatment of Chronic Calcifying Tendonitis of the Rotator Cuff: A Randomized Controlled Trial. JAMA. 2003;290(19):2573–2580.


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