Therapy Protocols
Treatment Recommendations
Radial and ulnar epicondylitis - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
1500-2000
Number of treatments
1-3
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarization 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , finally work over the area dynamically, preferably in the direction of lymphatic flow.
For treatment point on tendon attachment site :
energy level 60 mJ
For treatment point on tendon or muscle :
energy level 60 mJ (90mJ)
Indication
Tendinitis pf the shoulder/shoulder problems – Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-120 mJ
Shocks per treatment
2000
Number of treatments
1-4
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
Determine problem precisely – which tendon , which attachment point is affected ? First treat
statically with series up to 600 shocks per point and series , finally work over the area
dynamically , preferably in the direction of lymphatic flow .
For treatment point on tendon insertion site : energy level 60-90 mJ
For treatment point on tendon or muscle : energy level 120 mJ
Indication
Calcific tendinitis of the shoulder - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
90 mJ
Shocks per treatment
2000
Number of treatments
1-4
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode.
Indication
Status post muscular injury - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2000
Number of treatments
3
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode.
Indication
Patellar tendinitis - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2000
Number of treatments
3-4
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm
Notes
Determine problem precisely – is the tendon , the upper patellar attachment or the lower areas of
the quadriceps muscle affected ?
Treat tendon attachment ,existing trigger and pain points statically with series up to 600 shocks
per point and series , then work the area over dynamically.
For treatment point on tendon insertion site :
energy level 60-120 mJ
For treatment point on tendon or muscle :
energy level 120 mJ
Indication
Patellar tendinopathy - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2000
Number of treatments
1-4
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
Pay careful attention to definite acute signs of inflammation .Then either suspend the treatment or
reduce the dose as appropriate.
Generally static but from different directions towards the patella tip . Per application about 400
shocks , finishing on the front.
Indication
Achillodynia - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2000
Number of treatments
3
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
Differential diagnosis – is the tendon itself or the tendon attachment point on the heel bone
affected? Does the tendon move freely or with crepitation or are there detectable nodules in the
tendon?
Statically on the tendon insertion using energy level 60-90 mJ.
Dynamically on the tendon itself , work statically or semi-statically on nodules.
Do not work directly from a dorsal direction but rather from the side at a an angle of 45°.
Use energy level 60 mJ or 90 mJ in this case.
Indication
Plantar fasciitis - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2500
Number of treatments
3-4
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6 mm
Notes
Work with the patient in a prone position with supported or unsupported foot and work the entire
aponeurosis dynamically.
Indication
Heel spurs - Acute
Treatment recommendation
Frequency
10 Hz
Power level
90-120 mJ
Shocks per treatment
2000
Number of treatments
6
Frequency of treatment
1 per week
Recommended applicator head
15 mm, after familiarisation 6 mm
Notes
Apply directly to the pain point or to incipient or manifest calcification on the heel bone . Work
with the patient in a prone position with supported or unsupported foot.
Work statically or semi-statically.
Indication
Myofascial trigger point therapy e.g. Neck - Acute
Treatment recommendation
Frequency
Burst or 5-10 Hz
Power level
60 mJ
Shocks per treatment
1500-2000
Number of treatments
1-4
Frequency of treatment
1 per week
Recommended applicator head
15 mm / 6 mm
Notes
Determine trigger point and myofascial tone and prioritise.
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series. Begin with the point with the highest priority .Finally work over the whole area
dynamically.
Indication
Myofascial trigger point therap back pain - Acute
Treatment recommendation
Frequency
Butst or 5-10 Hz
Power level
60 mJ
Shocks per treatment
1500-2000
Number of treatments
1-4
Frequency of treatment
1 per week
Recommended applicator head
15 mm , after familiarisation 6 mm
Notes
Determine trigger point and myofascial tone and prioritise.
Frirst treat existing trigger and pain points statically with series up to 600 shocks per point and
series. Begin with the point with the highest priority .Finally work over the whole area
dynamically.
Indication
Trochanteric bursitis - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2000
Number of treatments
1-4
Frequency of treatment
1 per week
Recommended applicator head
15 mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode.
Approach treatment area rather from the side at an angle 45 and do not apply directly from the
lateral direction on the trochanter or iliotibial tract .
Indication
Periostitis / shin splints (Condition after overload ) - Acute
Treatment recommendation
Frequency
Burst or 5 Hz
Power level
60 mJ
Shocks per treatment
1000
Number of treatments
3
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm
Notes
Careful dynamic treatment over the entire affected tendon insertion site on the anterior tibial spine .
Follow the bone geometry and do not treat directly on the tibial spine.
If necessary , include the anterior tibial muscle in the treatment.
Indication
Dupuytren`s disease - Acute
Treatment recommendation
Frequency
10 Hz
Power level
90 mJ
Shocks per treatment
200-300*
Number of treatments
5
Frequency of treatment
1-2 per week
Recommended applicator head
6 mm
Notes
Static directly on the problem site , and in case of tolerance problems , apply the series
semi-statically from different directions . Support or fix the joint with two fingers from the left
and right sides during the treatment .
* Adhere to the rest periods ( after each 25 shocks ) and observe the reaction of the patient.
Indication
Thumb basal joint arthritis / rhizarthritis - Acute
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
1500*
Number of treatments
3
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm
Notes
Static directly on the problem site , and in case of tolerance problems , apply the series
semi-statically from different directions . Support or fix the joint with two fingers from the left
and right sides during the treatment .
* Adhere to the rest periods ( after every 200 shocks ) and observe the reaction of the patient.
Chronic
Indication
Radial and ulnar epicondylitis - Chronic
Frequency
10-16 Hz
Power level
120 mJ
Shocks per treatment
2000-3000
Number of treatments
4-8
Frequency of treatment
2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , finally work over the area dynamically , preferably in the direction of lymphatic flow .
For treatment point on tendon attachment site : energy level 60 mJ
For treatment point on tendon or muscle : energy level 60 mJ (90mJ)
Indication
Tendinitis pf the shoulder/shoulder problems - Chronic
Treatment recommendation
Frequency
10-16 Hz
Power level
120 mJ
Shocks per treatment
3000
Number of treatments
until 9
Frequency of treatment
2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
Determine problem precisely – which tendon , which attachment point is affected ? First treat
statically with series up to 600 shocks per point and series , finally work over the area
dynamically , preferably in the direction of lymphatic flow .
For treatment point on tendon insertion site : energy level 60-120 mJ
For treatment point on tendon or muscle : energy level 120 mJ
Indication
Calcific tendinitis of the shoulder - Chronic
Treatment recommendation
Frequency
10-16 Hz
Power level
120 mJ
Shocks per treatment
2000-2500
Number of treatments
until 9
Frequency of treatment
2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode
Indication
Status post muscular injury - Chronic
Treatment recommendation
Frequency
10-16 Hz
Power level
120 mJ
Shocks per treatment
2000-3000
Number of treatments
1-6
Frequency of treatment
2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode
Indication
Patellar tendinitis - Chronic
Treatment recommendation
Frequency
10-16 Hz
Power level
120 mJ
Shocks per treatment
2000-3000
Number of treatments
1-6
Frequency of treatment
2 per week
Recommended applicator head
15 mm
Notes
Determine problem precisely – is the tendon , the upper patellar attachment or the lower areas of
the quadriceps muscle affected ?
Treat tendon attachment , existing trigger and pain points statically with series up to 600 shocks
per point and series , then work the area over dynamically .
For treatment point on tendon insertion site : energy level 90-120 mJ
For treatment point on tendon or muscle : energy level 120 mJ
Indication
Patellar tendinopathy - Chronic
Treatment recommendation
Frequency
10-16 Hz
Power level
120 mJ
Shocks per treatment
2000-3000
Number of treatments
1-6
Frequency of treatment
2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode
Indication
Plantar fasciitis - Chronic
Treatment recommendation
Frequency
5-10 Hz
Power level
60-90 mJ
Shocks per treatment
1500-3000
Number of treatments
1-7
Frequency of treatment
2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
Work with the patient in a prone position with supported or unsupported foot and work the entire
aponeurosis dynamically .
Indication
Heel spurs - Chronic
Treatment recommendation
Frequency
10 Hz
Power level
90-120 mJ
Shocks per treatment
2000
Number of treatments
6
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm, after familiarisation 6mm
Notes
Apply directly to the pain point or to incipient or manifest calcification on the heel bone .
Work with the patient in a prone position with supported or unsupported foot .
Work statically or semi-statically .
Indication
Myofascial trigger point therapy e.g. Neck - Chronic
Treatment recommendation
Frequency
Burst or 5-10 Hz
Power level
60 mJ
Shocks per treatment
1500-3000
Number of treatments
6
Frequency of treatment
1 per week
Recommended applicator head
15 mm/6 mm
Notes
Determine trigger point and myofascial tone and prioritise .
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series .
Begin with the point with the highest priority .
Finally work over the whole area dynamically .
Indication
Myofascial trigger point therapy e.g back pain - Chronic
Treatment recommendation
Frequency
Burst or 5-10 Hz
Power level
60 mJ
Shocks per treatment
1500-2000
Number of treatments
6
Frequency of treatment
1 per week
Recommended applicator head
15 mm, after familiarisation 6 mm
Notes
Determine trigger point and myofascial tone and prioritise .
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series .
Begin with the point with the highest priority .
Finally work over the whole area dynamically .
Indication
Trochanteric bursitis - Chronic
Treatment recommendation
Frequency
Burst or 5-10 Hz
Power level
120 mJ
Shocks per treatment
2000
Number of treatments
6-8
Frequency of treatment
1 per week
Recommended applicator head
15 mm
Notes
First treat existing trigger and pain points statically with series up to 600 shocks per point and
series , then work the entire area over directly using slow dynamic mode .
Approach treatment area rather from the side at an angle 45 degree and do not apply directly from
the lateral direction on the trochanter or iliotibial tract .
Indication
Periostitis / shin splints ( Condition after overload ) - Chronic
Treatment recommendation
Frequency
Burst or 5-10 Hz
Power level
60-90 mJ
Shocks per treatment
2000
Number of treatments
4-8
Frequency of treatment
2 per week
Recommended applicator head
15 mm
Notes
Careful dynamic treatment over the entire affected tendon insertion site on the anterior tibial spine .
Follow the bone geometry and do not treat directly on the tibial spine .
If necessary , include the anterior tibial muscle in the treatment .
Indication
Dupuytren`s disease - Chronic
Treatment recommendation
Frequency
10 Hz
Power level
90 mJ
Shocks per treatment
200-300*
Number of treatments
3-4
Frequency of treatment
1-2 per week
Recommended applicator head
15 mm
Notes
Static directly on the problem site , and in case of tolerance problems , apply the series
semi-statically from different directions .
Support or fix the joint with two fingers from the left and right sides during the treatment .
* Adhere to the rest periods (after each 25 shocks) and observe the reaction of the patient .
Indication
Thumb basal joint arthritis / rhizarthritis - Chronic
Treatment recommendation
Frequency
5-10 Hz
Power level
90 mJ
Shocks per treatment
2000*
Number of treatments
4-8
Frequency of treatment
2 per week
Recommended applicator head
15 mm
Notes
Static directly on the problem site , and in case of tolerance problems , apply the series
semi-statically from different directions .
Support or fix the joint with two fingers from the left and right sides during the treatment .
* Adhere to the rest periods (after every 200 shocks) and observe the reaction of the patient .
