At Pritchette Physical Therapy, we are always looking for ways to bring advanced, evidence-informed treatment options to our patients. We’re excited to announce the addition of the DuoLith® SD1 T-Top Ultra, an advanced Focused Extracorporeal Shockwave Therapy (ESWT) system from STORZ Medical/CuraMedix.
This addition is especially exciting because Pritchette Physical Therapy can now offer patients both focused shockwave therapy and radial pressure wave therapy.
Although the two treatments are often grouped together under the term “shockwave therapy,” they work differently. Having access to both technologies gives our physical therapists more options for targeting different tissues, treatment depths, and musculoskeletal conditions.
What Is the DuoLith SD1 T-Top Ultra?
The DuoLith SD1 T-Top Ultra delivers focused shockwaves, which concentrate acoustic energy into a small, precisely targeted treatment area.
Focused shockwaves can be directed to specific depths within the body, allowing a therapist to target structures that may be difficult to reach effectively with more superficial treatments.
STORZ Medical describes focused shockwaves as being concentrated into areas only a few millimeters in diameter, allowing treatment to be applied to a tightly localized area, including deeper tissue layers.
The DuoLith SD1 has also received FDA premarket approval for extracorporeal shockwave treatment of heel pain associated with chronic proximal plantar fasciitis in qualifying adults whose symptoms have persisted despite conservative treatment.
Focused Shockwave vs. Radial Shockwave: What’s the Difference?
Pritchette Physical Therapy already utilizes radial pressure wave therapy, and the DuoLith adds a different type of technology.
Focused Shockwave – ESWTRadial Pressure WaveEnergy deliveryConcentrates energy into a defined focal areaEnergy spreads outward from the applicatorTreatment depthCan precisely target deeper structuresPrimarily affects more superficial tissuesTreatment areaSmall, highly targeted areaLarger, broader treatment areaCommon clinical useLocalized tendon insertions, deeper tendons and persistent areas of pathologyMuscles, fascia, superficial tendons and broader areas of soft-tissue dysfunctionAt Pritchette PTDuoLith SD1 T-Top UltraExisting radial pressure wave technology
Radial pressure waves disperse acoustic energy over a relatively broad area and are particularly useful for superficial tissues, myofascial structures and diffuse areas of discomfort. Focused shockwaves concentrate energy at a controlled depth and can be used when greater precision is needed.
One isn't necessarily “better” than the other. They are different tools designed to accomplish different treatment goals.
And that is exactly why having both can be so valuable.
Why Use Focused and Radial Shockwave Therapy Together?
Musculoskeletal problems rarely involve only one isolated spot.
For example, someone experiencing chronic Achilles tendon pain may have a very specific area of tendon involvement while also having tightness and dysfunction throughout the calf and surrounding soft tissues.
A therapist may use radial pressure wave therapy across the larger muscle and soft-tissue area, then use focused shockwave therapy to precisely target the involved tendon or tendon attachment.
Similarly, with plantar fasciitis, radial treatment may be useful for treating broader areas of the plantar fascia and calf musculature, while focused shockwave can precisely address the painful area near the plantar fascia's attachment at the heel.
CuraMedix notes that focused and radial technologies are complementary rather than competing treatments and may be strategically combined to address different tissue depths and clinical objectives.
For our patients, this gives the physical therapist greater flexibility. Instead of attempting to treat every condition with the same device, we can select focused shockwave, radial pressure wave therapy, or a combination of both based on the patient's examination and treatment goals.
What Does Shockwave Therapy Do?
Shockwave therapy introduces controlled acoustic energy into targeted tissue.
Research into extracorporeal shockwave therapy suggests that this mechanical stimulus can influence biological responses within tissue associated with circulation, cellular activity, tissue remodeling and pain modulation.
It is important to understand that shockwave therapy isn't simply being used to temporarily “numb” a painful area.
Our goal is to incorporate shockwave therapy into a larger rehabilitation program that helps improve the patient's ability to move, exercise and progressively load the affected tissue.
That means shockwave therapy may be combined with strengthening, mobility work, manual therapy, movement retraining and a progressive home exercise program.
What Conditions May Benefit From Shockwave Therapy?
Depending on the patient's examination, diagnosis and medical history, focused and/or radial shockwave therapy may be considered for a variety of persistent musculoskeletal problems, including:
Plantar fasciitis and chronic heel pain
Achilles tendinopathy
Patellar tendon problems or jumper's knee
Tennis elbow and golfer's elbow
Rotator cuff and shoulder tendon problems
Calcific tendon conditions
Gluteal and lateral hip tendinopathy
Proximal hamstring tendon problems
Other chronic tendinopathies and tendon insertion problems
Myofascial pain and trigger points
Persistent muscle and soft-tissue restrictions
Not every condition or every patient is appropriate for shockwave therapy. Some clinical applications may also differ from the specific FDA-approved indication of a particular device, so your physical therapist will determine whether treatment is appropriate for you.
A Powerful Tool for Chronic Tendon Problems
One area where shockwave therapy can be particularly useful is with tendinopathy.
Tendon problems can become frustrating because they sometimes persist for months despite rest, stretching or changes in activity. Completely resting the tendon often isn't the answer either; tendons generally need an appropriate amount of progressive loading to regain strength and function.
Shockwave therapy can become another component of that process.
At Pritchette Physical Therapy, we can use the DuoLith's focused energy to precisely treat an involved tendon or tendon attachment and then use physical therapy to progressively restore the strength and capacity of that tissue.
That combination is important.
Our goal isn't simply to make an area feel better for a few hours. Our goal is to help the tissue tolerate the demands of walking, running, working, exercising, playing sports and everyday life again.
More Precise Treatment. More Options for Our Patients.
The addition of the DuoLith SD1 T-Top Ultra represents a significant expansion of our Shockwave Therapy program at Pritchette Physical Therapy.
We now have the ability to treat broader superficial tissues using radial pressure wave therapy while also precisely targeting deeper or highly localized structures using focused shockwave therapy.
For some patients, one technology may be appropriate.
For others, using both may provide a more comprehensive approach.
Most importantly, the technology is being incorporated into an individualized physical therapy program based on the patient's condition, goals and response to treatment.
Is Focused Shockwave Therapy Right for You?
If you've been dealing with persistent plantar fasciitis, tendon pain or another musculoskeletal condition that hasn't responded the way you expected to traditional conservative treatment, Shockwave Therapy may be worth discussing with your physical therapist.
Pritchette Physical Therapy now offers both Focused Shockwave Therapy and Radial Pressure Wave Therapy in Ahwatukee.
📞 480-785-5415
🌐 PritchettePT.com
Ask us whether Shockwave Therapy may be appropriate for your condition.