Shockwave Therapy Since 2018
Trusted physician-directed treatment for chronic tendon, ligament, and bone injuries.
Advanced Treatment for Chronic Foot & Ankle Tendon and Ligament Injuries
If you are struggling with chronic heel pain, Achilles tendonitis, or lingering ligament injuries, extracorporeal shockwave therapy (ESWT) may help you heal without surgery.
Shockwave therapy is part of Dr. Hoy’s musculoskeletal foot and ankle treatment program for chronic tendon, ligament, and bone injuries. Musculoskeletal conditions of the foot and ankle have long been part of comprehensive podiatric medicine. Podiatrists diagnose and treat these conditions using both conservative and surgical approaches. A foot and ankle physician can first evaluate the problem, establish the diagnosis, and determine the appropriate course of care. When additional expertise is needed, that care can be coordinated as part of the treatment plan.
In pain? Don’t wait. Early treatment leads to faster recovery. Urgent appointments available. Schedule now or call: 206-682-8741.
At Seattle Foot and Ankle Center, Dr. J. John Hoy provides advanced extracorporeal shockwave therapy in Seattle for a wide range of foot and ankle injuries and conditions, particularly bone, tendon and ligament injuries that have not improved with traditional treatments. This non-invasive therapy stimulates your body’s natural healing response so damaged tissue can repair and regenerate.
Many patients experience significant pain relief after only a few treatments and can return to normal activities much faster than with surgical procedures.
Why Diagnosis Matters Before Shockwave Therapy
Shockwave therapy is not simply a procedure applied to an area of pain. Successful treatment depends on identifying the specific tissue involved and understanding why the injury has failed to heal.
Chronic foot and ankle pain may involve:
- Tendon degeneration
- Ligament injury
- Bone stress
- Joint instability
- Biomechanical overload
- Structural abnormalities
Treating symptoms without identifying the underlying cause may lead to incomplete recovery or recurring injury.
Before recommending ESWT, Dr. Hoy evaluates the diagnosis, biomechanics, and contributing factors to determine whether shockwave therapy is appropriate — or whether another treatment approach is needed.
The right treatment starts with the right diagnosis.
Why Patients Seek Dr. Hoy for Shockwave Therapy
“I found his “bedside manner’ very compatible with my expectations: professional, succinct, thorough, and cordial. He explained diagnostics, treatment options, and home care very clearly, and frequently checked in with me to ask if I had questions or concerns. I was thrilled to find a podiatrist who uses extracorporeal shockwave therapy and am hopeful the results will be beneficial. I would highly recommend Dr Hoy for treatment of recalcitrant plantar fasciitis.” -Susan F.
Dr. Hoy has been performing extracorporeal shockwave therapy for chronic foot and ankle injuries since 2018 and has treated hundreds of patients with this technology as part of his daily practice.
Dr. Hoy has advanced training in extracorporeal shockwave therapy (ESWT) through ongoing sports medicine and foot and ankle education, including lectures from internationally recognized leaders in shockwave and running medicine such as Adam Tenforde, Ludger Gerdesmeyer, and Amol Saxena. This training reflects a modern, evidence-based approach to treating chronic heel pain, plantar fasciitis, Achilles tendinopathy, and other overuse injuries.
Shockwave therapy is not an experimental or trendy treatment in this practice. It’s one of the best-studied regenerative treatments for chronic plantar fasciitis and has been used extensively in Germany for years before becoming widely adopted here. It has become a trusted and established part of treating chronic tendon, ligament, and bone injuries when the body’s healing process has stalled and traditional treatments have not been enough.
At Seattle Foot and Ankle Center, Dr. Hoy has incorporated shockwave therapy into comprehensive treatment plans for athletes, workers, and active adults looking to heal stubborn foot and ankle injuries, recover faster, and return to walking, running, work, and sport—often helping them avoid repeated injections or surgery.
Many patients seek treatment after months—or even years—of persistent pain despite stretching, physical therapy, orthotics, injections, or immobilization. Shockwave therapy is often used to help restart the healing process when tissue has become chronically overloaded, degenerative, or slow to heal.
Success with shockwave therapy depends on more than the machine itself. Accurate diagnosis, understanding biomechanics, and identifying the exact injured structure are critical for achieving good outcomes.
What Is Extracorporeal Shockwave Therapy (ESWT)?
Extracorporeal Shockwave Therapy (ESWT) is a non-invasive treatment that uses acoustic pressure waves to stimulate healing in injured tissue.
“Extracorporeal” simply means the therapy is delivered from outside the body, meaning no incisions, no anesthesia, and minimal downtime.
At Seattle Foot and Ankle Center, Dr. Hoy uses the OrthoPulse® radial shockwave system by Storz Medical, a proven and widely used technology for chronic musculoskeletal injuries. This is the same technology he has used since 2018 as part of his treatment protocols for tendon, ligament, and bone healing.
The therapy works by:
• Stimulating cellular metabolism
• Increasing blood circulation to damaged tissue
• Triggering tissue regeneration
• Reducing chronic inflammation
• Breaking up scar tissue and calcifications
These biological effects help restart the healing process in tissues that have become chronically injured.
ESWT has been widely used in Europe for decades and is supported by extensive scientific literature. ESWT is considered a gold- or platinum-standard non-surgical treatment in many clinical guidelines, and in countries such as Germany it is often required before surgical intervention is considered.
Why Shockwave Therapy Is a Mainstay of Treatment
Chronic tendon and ligament injuries often fail because the tissue has stopped progressing through normal healing. Shockwave therapy helps restart that process.
For many chronic foot and ankle injuries, shockwave therapy has become one of Dr. Hoy’s primary non-surgical treatment options—not because it is new, but because it consistently helps patients heal.
Foot and Ankle Conditions Treated with Shockwave Therapy
Shockwave therapy is especially effective for ligament and tendon conditions such as plantar fasciitis, Achilles tendonitis, peroneal tendonitis, posterior and anterior tibial tendonitis, flexor and extensor tendon injuries, ankle sprains, Lisfranc injuries, sinus tarsi syndrome, capsulitis, plantar plate injuries, and partial tears or ruptures.
Dr. Hoy commonly uses ESWT to treat chronic tendon, ligament, bone and soft-tissue injuries of the foot and ankle, including:
Heel Pain
• Plantar fasciitis
• Heel spur syndrome
Tendon Injuries
• Achilles tendonitis
• Posterior tibial tendonitis
• Peroneal tendonitis
• Anterior tibial tendonitis
• Flexor and extensor tendonitis
Ligament Injuries
• Chronic ankle sprains
• Partial ligament tears
• Capsulitis
• Plantar plate injuries
Sports and Overuse Injuries
• Lisfranc injuries
• Sinus tarsi syndrome
• Chronic inflammation or degeneration of connective tissue
Bone Healing Problems
• Delayed fracture healing
• Bone malunions
• Slow healing after osteotomy or reconstructive surgery
In select cases, shockwave therapy may help stimulate bone healing when fractures or surgical bone cuts are healing slowly or incompletely.
Shockwave therapy is especially effective for conditions that have persisted for months despite stretching, orthotics, injections, or physical therapy.
Why Physician-Directed Shockwave Therapy Matters
Many providers offer shockwave therapy as a standalone service. However, the effectiveness of ESWT depends on more than delivering energy waves to painful tissue.
A physician evaluation helps determine:
- Whether the diagnosis is correct
- Which structure is actually injured
- Whether biomechanics are contributing
- Whether immobilization, bracing, orthotics, rehabilitation, or other treatment is needed
Shockwave therapy is most effective when it is part of a comprehensive medical treatment plan rather than an isolated procedure.
Having a board-certified podiatric physician perform the treatment can significantly improve accuracy and outcomes. The foot and ankle are an anatomic region, and podiatry is the specialty dedicated to that region. Since 2018, Dr. Hoy has integrated shockwave therapy into the diagnosis and treatment of complex foot and ankle injuries, combining it with biomechanics, orthotics, bracing, rehabilitation, and surgery when needed.
Precise Diagnosis
Dr. Hoy specializes exclusively in foot and ankle pathology. Before performing shockwave therapy, he performs a detailed biomechanical and structural evaluation to determine the exact source of pain.
Many chronic foot injuries involve multiple overlapping structures—tendons, ligaments, joints, and fascia. Identifying the correct structure is critical for success.
Advanced Imaging and Clinical Assessment
A podiatric physician can utilize:
• Magnetic resonance imaging (MRI)
• X-rays when necessary
• Biomechanical gait analysis
• Structural foot evaluation
This allows shockwave therapy to be targeted precisely to the injured tissue.
Integrated Treatment Approach
Shockwave therapy is most effective when integrated into a comprehensive treatment plan. Dr. Hoy may also recommend:
• Custom orthotics
• Activity modification
• Bracing or immobilization
• targeted rehabilitation
• injection therapy when necessary
Because Dr. Hoy evaluates and manages the complete foot and ankle condition, treatment decisions are coordinated rather than fragmented. ESWT may be combined with biomechanics, orthotics, bracing, rehabilitation, activity modification, or surgical consultation when appropriate.
Medical Management of Complex Conditions
Patients with conditions such as Ehlers-Danlos Syndrome, chronic ligament instability, or degenerative tendon disease often require physician-level expertise.
Shockwave therapy is not simply a modality—it is part of a medical treatment strategy designed to restore long-term function.
Benefits of Shockwave Therapy
Shockwave therapy is one of the most effective non-surgical treatments available for chronic foot and ankle pain.
Benefits include:
• Non-invasive treatment
• No anesthesia required
• No surgical risks or infection
• No incisions or scarring
• Minimal downtime
• Rapid return to activity
• Stimulates natural healing
• Over 80% patient satisfaction
Specifically, with radial shockwave:
• No injections or anesthesia required
• Walk in, walk out treatment
• Immediate return to normal daily activities
In many cases, ESWT provides outcomes comparable to or better than surgery—without the risks, complications, or prolonged recovery time.
What to Expect During Treatment
Initial Consultation
Your first visit includes a comprehensive evaluation with Dr. Hoy to determine the cause of your pain and whether shockwave therapy is appropriate.
If ESWT is recommended, we will review:
• medical eligibility
• treatment expectations
• activity restrictions during therapy
• the number of sessions required
Treatment Schedule
Because healing is stimulated biologically, multiple sessions are necessary to achieve optimal results.
Most patients receive:
• 3 weekly treatments
• Follow-up evaluation at 6 weeks
• Additional treatments (4–5 total) if medically necessary
Before Treatment
In some cases, patients may be asked to stop anti-inflammatory medications prior to treatment, as these can interfere with the body’s natural healing response stimulated by shockwave therapy.
During the Procedure
Shockwave therapy is performed in the office and typically takes the length of a regular half hour visit. Unlike some focused shockwave protocols, no anesthesia or sedation is needed.
A handheld device delivers acoustic pressure waves directly to the injured tissue, stimulating the healing response.
This is a quick, office-based procedure that requires no anesthesia and allows patients to remain weight-bearing immediately after treatment.
Recovery After Shockwave Therapy
Patients are usually able to walk immediately after treatment.
Dr. Hoy may recommend:
• Rest and elevation
• Gentle stretching exercises
• Supportive footwear
• Temporary reduction in high-impact activities
• Orthotic devices if needed
Although some patients feel better quickly, it is important to follow your physician’s instructions to allow the tissue to heal properly.
Pain relief can begin within a few weeks as the healing response develops.
Is Shockwave Therapy Safe?
Yes. EPAT shockwave therapy is FDA-cleared and widely used worldwide.
Clinical studies and decades of use demonstrate that ESWT is very safe when performed by a trained medical professional. Rare complications have been reported in the medical literature, but these are अत्यremely uncommon when the procedure is performed by a qualified physician.
Possible temporary side effects may include:
• Mild soreness
• Bruising
• Temporary swelling
• Tingling or numbness
Serious complications are extremely rare.
Who Is Not a Candidate for ESWT?
Shockwave therapy may not be appropriate for patients who:
• Are pregnant
• Have cancer
• Have bleeding disorders
• Take medications that interfere with clotting
Dr. Hoy will review your medical history to ensure the treatment is safe for you.
Cost and Insurance
In many cases, shockwave therapy is not separately covered by insurance, even though it is widely supported by clinical evidence.
At Seattle Foot and Ankle Center, shockwave therapy is typically incorporated into your evaluation and management office visit.
Costs depend on the complexity and time involved in your visit and may apply to:
• copay
• deductible
• coinsurance
Patients should check with their insurance provider regarding coverage for evaluation and management visits.
Patient Success Story
“Dr. Hoy is a gem. Not only is he a master of his craft, but he’s familiar with Ehlers-Danlos Syndrome… With ongoing care and as-needed shockwave therapy treatments every six weeks, I feel the most ‘normal’ I’ve felt in years. I’m incredibly grateful and highly recommend Dr. Hoy and Seattle Feet.”
— Sara E.
When Referral to a Foot & Ankle Specialist May Help
Patients with persistent tendon, ligament, or bone-related foot and ankle pain may benefit from specialist evaluation when:
- Symptoms continue despite appropriate rehabilitation
- The diagnosis remains uncertain
- Pain repeatedly returns after treatment
- There is concern for tendon injury, instability, or biomechanical overload
- Recovery is not progressing as expected
Collaborative care often produces the best outcomes. Rehabilitation and specialist evaluation are complementary — not competing — approaches.
Frequently Asked Questions About Shockwave Therapy (ESWT) in Seattle
ESWT is a non-invasive treatment that uses acoustic pressure waves to stimulate healing in injured tendons, ligaments, bones, and soft tissue. It promotes natural tissue regeneration, increases blood flow, and reduces chronic inflammation—all without surgery, anesthesia, or significant downtime.
Dr. Hoy uses shockwave therapy for chronic or stubborn injuries, including:
Heel Pain:
Plantar fasciitis
Heel spurs
Tendon Injuries:
Achilles tendonitis
Posterior tibial tendonitis
Peroneal tendonitis
Anterior tibial tendonitis
Flexor and extensor tendonitis
Ligament Injuries:
Chronic ankle sprains
Partial ligament tears
Capsulitis
Plantar plate injuries
Other Conditions:
Lisfranc injuries
Sinus tarsi syndrome
Bone malunions or delayed fracture healing
Chronic overuse or sports-related injuries
Shockwave therapy delivers high-energy acoustic waves to the injured tissue. This:
Stimulates cellular metabolism and tissue repair
Increases blood flow to damaged areas
Reduces inflammation
Breaks up scar tissue and calcifications
Activates your body’s natural healing response
Most patients notice significant pain relief within a few weeks.
Dr. Hoy is a board-certified podiatric physician specializing exclusively in foot and ankle injuries. His expertise ensures:
Precise diagnosis: Identifying which tendon, ligament, or joint is causing pain
Targeted treatment: Accurate shockwave application for best outcomes
Integrated care: Coordinating orthotics, rehabilitation, bracing, or injections when needed
Management of complex conditions: Including chronic ligament instability, degenerative tendon disease, or connective tissue disorders
Initial Consultation: Comprehensive evaluation and discussion of treatment goals.
Treatment Sessions: Typically 3 weekly sessions, 30 minutes each. Additional 2 sessions may be recommended.
Procedure: Acoustic waves are applied to the injured area. No anesthesia is needed.
Recovery: Patients can walk immediately. Dr. Hoy may recommend temporary activity modification, stretching, supportive footwear, or orthotics.
Yes. ESWT is FDA-cleared, non-invasive, and widely used globally. Temporary side effects may include:
Mild soreness
Bruising
Swelling
Tingling or numbness
Serious complications are extremely rare when administered by a trained podiatric physician.
ESWT may not be appropriate for patients who:
Are pregnant
Have cancer
Have bleeding disorders or take blood-thinning medications
Dr. Hoy reviews your medical history to ensure safety
Clinical studies and decades of use demonstrate that ESWT:
Provides over 80% patient satisfaction
Can achieve results comparable or superior to surgery
Offers rapid return to activity without surgical risks or incisions
Coverage varies. While many insurance plans may not cover ESWT directly, it is usually incorporated into your evaluation and management office visit. Patients should check with their insurance provider regarding copay, deductible, and coinsurance for the evaluation and management office visit.
Patients often ask whether focused shockwave is better than radial shockwave. The answer depends on the injury being treated.
In many published focused shockwave protocols, treatment at higher therapeutic energy levels may require local anesthesia or conscious sedation because of discomfort during the procedure. By contrast, radial shockwave therapy is typically performed comfortably in the office without anesthesia, allowing patients to remain fully weight-bearing and return to normal activities immediately afterward.
Patients often describe radial shockwave as a high-energy, highly targeted deep tissue massage. Areas of severe chronic injury or degeneration may feel more sensitive during treatment, which often helps localize the most pathologic tissue.
Dr. Hoy has successfully used radial shockwave therapy since 2018 for hundreds of chronic foot and ankle tendon, ligament, and bone injuries with excellent clinical outcomes.
While focused shockwave can be useful in certain situations, radial shockwave remains highly effective for many foot and ankle conditions and continues to be a mainstay of treatment in this practice.
Treatment success depends more on accurate diagnosis, proper patient selection, and precise application than simply the type of machine used.
Schedule a Shockwave Therapy Consultation in Seattle
If you have chronic heel pain, Achilles tendonitis, or a lingering foot or ankle injury, extracorporeal shockwave therapy may help you heal without surgery.
Dr. J. John Hoy has been treating chronic foot and ankle tendon, ligament, and bone injuries with shockwave therapy since 2018 and has helped hundreds of patients return to work, sports, and daily life..
Contact Seattle Foot and Ankle Center today to schedule your evaluation and learn whether ESWT is right for you.
In pain? Don’t wait. Early treatment leads to faster recovery. Urgent appointments available. Read about Conditions We Treat. Request an Appointment 5am-5pm M-F or online. Call: 206-682-8741 or Contact Us. If you like our content, please link it to your website and Collaborate With Us. Thank you.