If you’ve been dealing with elbow pain for months, you already know how stubborn these injuries can be. You’ve rested, iced it, worn a brace, maybe tried cortisone shots. And yet you still can’t grip a coffee mug, shake someone’s hand, or open a jar without wincing. Tennis elbow and golfer’s elbow are maddening because they seem like minor injuries—until they refuse to heal. Shockwave therapy offers a way forward when conservative treatment stalls out.
What Tennis Elbow and Golfer’s Elbow Actually Are
Despite the names, you don’t need to play tennis or golf to develop these conditions. Tennis elbow (lateral epicondylitis) is tendon damage on the outside of your elbow, where the muscles that extend your wrist attach to the bone. Golfer’s elbow (medial epicondylitis) affects the inside of the elbow, where the flexor muscles connect.
Both are overuse injuries. Repetitive gripping, twisting motions, or forceful wrist movements create tiny tears in the tendon fibers. Over time, those microtears accumulate faster than your body can repair them. The tendon becomes inflamed, weakened, and painful.
What makes these injuries so persistent is poor blood supply. Tendons don’t get much circulation compared to muscles, so healing happens slowly—if it happens at all. Add in the fact that you use your hands constantly throughout the day, and it’s nearly impossible to truly rest the injured area.
Why Rest and Braces Don’t Always Fix the Problem
The standard advice for tennis elbow and golfer’s elbow is rest, ice, and anti-inflammatory medication. If that doesn’t work, you might get a brace or strap to offload tension from the tendon. Physical therapy comes next, followed by cortisone injections if symptoms persist.
For some people, that’s enough. But plenty of others get stuck in a cycle where the pain improves slightly, then comes roaring back the moment they return to normal activities. The tendon never fully heals because it’s not getting the blood flow and regenerative signals it needs.
Cortisone shots can provide temporary relief, but they don’t promote healing. In fact, repeated cortisone injections may weaken the tendon over time. They reduce inflammation, which helps with pain, but they don’t address the underlying tissue damage.
That’s where shockwave therapy comes in. Instead of just managing symptoms, shockwave stimulates the body’s natural healing response in tissue that’s stuck in a chronic, low-grade inflammatory state.
How Shockwave Therapy Works on Tendon Injuries
Shockwave therapy delivers high-energy acoustic waves directly to the injured tendon. Those waves create controlled microtrauma in the tissue, which sounds counterintuitive—why would you want to cause more damage?
Here’s the thing: chronic tendon injuries like tennis elbow and golfer’s elbow aren’t actively healing anymore. The tissue is in a stalled state, where inflammation persists but repair processes have shut down. Shockwave essentially reboots the healing cycle.
The acoustic waves stimulate increased blood flow to the area, which brings oxygen, nutrients, and growth factors that promote tissue regeneration. They also break down scar tissue and calcifications that have built up in the tendon. On top of that, shockwave has a pain-relieving effect by overstimulating nerve endings, which disrupts the pain signals being sent to your brain.
At Indian Trail Chiropractic & Rehab, Dr. Gentile uses shockwave therapy for patients who’ve been dealing with elbow pain for months without improvement. The treatment is non-invasive, takes about 10 to 15 minutes per session, and doesn’t require any downtime afterward.
What to Expect During Treatment
Shockwave therapy isn’t painless, but most patients describe it as tolerable discomfort rather than actual pain. You’ll feel a rapid tapping or pulsing sensation at the treatment site. The intensity can be adjusted based on your tolerance, and it usually becomes easier to handle as the sessions progress.
A typical treatment plan involves 3 to 5 sessions, spaced about a week apart. Some patients notice improvement after the first or second session, but the real healing happens over the weeks following treatment as new tissue forms and blood flow improves.
You might feel sore for a day or two after a session—similar to post-workout muscle soreness. That’s normal and actually a sign that the tissue is responding. You can continue most of your regular activities, though Dr. Gentile may recommend avoiding heavy gripping or repetitive wrist movements during the treatment phase to give the tendon the best chance to heal.
Why Shockwave Works When Other Treatments Don’t
The beauty of shockwave therapy is that it works at the tissue level. You’re not masking pain or reducing inflammation temporarily—you’re actually changing the biology of the tendon.
Research has shown that shockwave increases the production of collagen, the main structural protein in tendons. It also stimulates the release of growth factors like VEGF (vascular endothelial growth factor), which promotes new blood vessel formation. More blood vessels mean better circulation, which is exactly what these poorly vascularized tendons need.
For people who’ve tried everything else without success, shockwave offers a legitimate non-surgical option. It’s not a miracle cure—some cases are severe enough that surgery becomes necessary—but the success rate is high for chronic tendon injuries that haven’t responded to conservative care.
Dr. Gentile’s background as a Certified Strength and Conditioning Specialist gives him a solid understanding of how tendons respond to load and stress. He’s treated countless athletes and active adults dealing with overuse injuries, and he knows the difference between tissue that just needs time to heal versus tissue that’s stuck and needs intervention.
Combining Shockwave With Other Treatments
Shockwave works well on its own, but it’s often most effective when combined with other therapies. Graston Technique or Active Release Technique can break up adhesions and scar tissue in the surrounding muscles and fascia, which reduces strain on the injured tendon.
Corrective exercises are also critical. If your tennis elbow or golfer’s elbow developed because of poor wrist mechanics, weak forearm muscles, or compensatory movement patterns, you’ll need to address those issues or the injury will likely return. Strengthening the tendon through controlled, progressive loading helps rebuild its capacity to handle stress without breaking down again.
At our practice, treatment isn’t just about getting you out of pain—it’s about figuring out why the injury happened in the first place and making sure it doesn’t keep coming back.
Is Shockwave Right for Your Elbow Pain?
If you’ve been dealing with tennis elbow or golfer’s elbow for more than a few months, and rest, bracing, or physical therapy haven’t brought lasting relief, shockwave is worth considering. It’s particularly effective for cases where the pain has become chronic and other treatments have plateaued.
You’re not a good candidate if you’re pregnant, have a pacemaker, or are taking blood-thinning medications. There are also a few localized conditions—like infections or tumors near the treatment site—that would rule out shockwave. Dr. Gentile will review your medical history and evaluate your elbow before recommending treatment.
The other factor is readiness to commit to the full treatment plan. Shockwave isn’t a one-and-done fix. You’ll need multiple sessions, and you’ll need to follow through with any recommended exercises or activity modifications. Half-hearted effort gets half-hearted results.
FAQs
Does shockwave therapy hurt?
It’s uncomfortable during the session, but not unbearable. Most people rate it as a 4 to 6 out of 10 on the pain scale. The discomfort only lasts while the device is active—usually 5 to 10 minutes—and eases immediately once the session ends.
How long do results last?
Many patients experience long-term relief after a full course of treatment. The tendon healing that shockwave stimulates is real tissue regeneration, not just temporary symptom relief. That said, if you go back to the same repetitive activities that caused the injury without addressing movement patterns, you could re-injure the tendon.
Can shockwave therapy help with other conditions?
Yes. Shockwave is also effective for plantar fasciitis, Achilles tendonitis, rotator cuff tendinopathy, and other chronic soft tissue injuries. It works best on conditions where poor blood flow is limiting healing.
Will insurance cover shockwave therapy?
Coverage varies. Some plans cover it under physical therapy or chiropractic care, while others consider it experimental. We can help verify your benefits and discuss payment options during your consultation.
Ready to find out if shockwave therapy can finally get rid of your elbow pain? Schedule an appointment with Dr. Gentile or call (704) 821-3222.