Los Altos, CA
Understanding the different types of shockwave therapy treatment helps you have a much better conversation with your provider — and at PhysioFit, we want you to walk in knowing exactly what we’re doing and why. Here’s a plain-language breakdown of Radial Pulse Wave, Focused Shockwave, and EMTT — what each one does, what it’s best for, and how we use them together to get results that one type alone simply can’t deliver.
PhysioFit’s OrthoPulse Ultra 50 — Focused Shockwave (FSW), Radial Pulse Wave (RPW), and EMTT in one system.
- There are three distinct shockwave therapy types used at PhysioFit — Radial Pulse Wave (RPW), Focused Shockwave (FSW), and EMTT — each working at different depths and on different tissue targets.
- Each type has specific strengths — and knowing the difference helps you understand exactly what your treatment plan is doing and why.
- The real power comes from using them together — strategically combined based on your specific condition, the tissue depth involved, and where you are in recovery.
- You don’t need to pick the right one yourself — that’s what a thorough evaluation is for. But understanding them helps you ask better questions and trust the process.
- If you’re not sure which is right for your situation, one phone call with our team is all it takes to find out.
Why There Are Three Types of Shockwave Therapy Treatment
The body is not one uniform tissue. Your tendons sit at a different depth than your bones. Your pelvic floor is accessed differently than your rotator cuff. A scar near the surface needs a different approach than deep joint inflammation. No single wave type is optimal for every condition — which is why the most advanced shockwave therapy treatment systems combine multiple technologies.
At PhysioFit, we use the OrthoPulse Ultra 50 — a system that integrates all three wave types in one platform. This gives our therapists the ability to layer approaches within a single session, targeting the same problem from different angles and depths for results that are faster and more durable than any single wave type alone.
The Three Shockwave Therapy Types: What Each One Does
Radial Pulse Wave (RPW / EPAT)
Radial Pulse Wave therapy sends acoustic pulses outward from the probe in a spreading pattern — covering a wider treatment area without going as deep as focused shockwave. Think of it like dropping a stone in water and watching the ripples spread outward through your soft tissue.
RPW is the workhorse of surface and mid-depth tissue treatment. It’s highly effective for tendons, muscles, ligaments, and fascia — and it has a well-established track record for conditions like plantar fasciitis, tennis elbow, Achilles tendinopathy, and hip flexor tightness. It’s also one of the primary approaches for pelvic floor conditions — pain, sexual dysfunction, and bladder or bowel dysfunction — where broad coverage of the pelvic region is needed.
Best for: tendon and muscle conditions, soft tissue adhesions and scar tissue, wider areas of pain or tightness, pelvic floor dysfunction, body contouring in specific areas.
What you’ll feel: A rhythmic tapping or pulsing sensation in the treatment area. Most patients find it comfortable. Any soreness typically resolves within a day.
Focused Shockwave (FSW)
Focused Shockwave delivers high-energy acoustic waves to a precise, targeted point deep in the body. Where RPW spreads outward, FSW converges inward — like the difference between a floodlight and a laser. This precision allows it to reach tissue that RPW and manual therapy simply cannot access.
FSW is the tool of choice for deep tissue problems — bone pathology, calcifications, deep joint inflammation, and chronic pain that “exercise and physical therapy can’t touch.” If you’ve been told the problem is deep, or you’ve had imaging showing calcific deposits, bone stress reactions, or deep tissue involvement, FSW is likely going to be a central part of your plan.
It’s also highly effective for deep pelvic floor conditions — particularly where internal structures are involved and surface-level treatment hasn’t produced adequate results.
Best for: calcific tendinopathy, bone stress, deep joint pain, deep scar tissue, chronic conditions that haven’t responded to surface treatment, deep pelvic floor dysfunction.
What you’ll feel: A more concentrated, focused pressure at the treatment point. Some patients feel mild soreness afterward, similar to a deep tissue workout — a sign the tissue is responding.
EMTT — Extracorporeal Magneto-Transduction Therapy
EMTT is the fan favorite at PhysioFit — and the one that surprises people most, because it often produces outstanding results without any significant sensation during treatment. Instead of acoustic waves, EMTT uses high-energy electromagnetic fields that pass through the body and directly activate cellular repair processes.
Here’s what makes it special: while RPW and FSW primarily work by creating mechanical stimulation that triggers healing, EMTT works at the cellular level — activating the mitochondria (the energy centers of cells), improving circulation by driving more red blood cells to the damaged tissue, and reducing inflammation from the inside out. The result is that the tissue gets exactly what it needs to heal — more oxygen, more nutrients, and a primed cellular environment — without any mechanical impact at all.
EMTT is often the first recommendation for patients where we want to create a strong healing foundation before layering in more targeted wave therapy. It’s also the gentlest option for patients who are sensitive, recently post-surgical, or in an acute flare — and its effectiveness for osteoarthritis, herniated discs, fractures, and carpal tunnel is particularly well-documented.
Best for: osteoarthritis, fracture healing, herniated discs, carpal tunnel, systemic inflammation, pelvic floor conditions, sensitive patients, post-surgical recovery, and as a foundation layer under RPW or FSW.
What you’ll feel: Very little to nothing during treatment. Mild warmth is occasionally reported. Most patients are surprised at how gentle it is given how effective it can be.
Comparing the Three Shockwave Therapy Types at a Glance
| Feature | RPW (Radial) | FSW (Focused) | EMTT (Magnetic) |
|---|---|---|---|
| Mechanism | Acoustic pulse, spreads outward | Acoustic wave, converges deep | Electromagnetic field, cellular |
| Depth | Up to 6 cm | Up to 12.5 cm | Deep and systemic |
| Coverage | Broad surface area | Precise targeted point | Broad cellular |
| Best tissue target | Tendons, muscles, fascia, pelvic floor | Bone, deep joints, calcifications, deep tissue | Cells, circulation, inflammation, bone, joints |
| Sensation | Rhythmic tapping — comfortable | Concentrated pressure — mild soreness after | Minimal — often nothing felt |
| Best for acute cases | Yes | Moderate — start lower intensity | Yes — gentlest option |
| Best for chronic cases | Yes | Yes — especially deep/stubborn | Yes — excellent foundation layer |
Why the Combination of Shockwave Therapy Types is More Powerful Than Any Single Approach
Here’s what separates PhysioFit’s approach from clinics that offer only one type of shockwave therapy treatment: we use all three together, sequenced and layered based on your specific condition, tissue depth, and stage of recovery.
A typical combined session might look like this:
- EMTT first — to prime the cellular environment, improve circulation to the target area, and reduce baseline inflammation before any mechanical stimulation is applied
- FSW next — to deliver precise high-energy treatment to the deepest point of pathology — the calcification, the bone reaction, the deep joint inflammation that nothing else reaches
- RPW to finish — to cover the broader surrounding tissue, address surface adhesions and tension, and reinforce the healing stimulus across the whole region
The result is a treatment that addresses your condition on every level simultaneously — deep and surface, precise and broad, mechanical and cellular. No single shockwave therapy type achieves all of this.
Conditions That Respond Especially Well to Combined Shockwave Therapy
- Chronic tendinopathy (Achilles, patellar, rotator cuff, plantar fascia) — RPW + FSW
- Calcific tendinopathy — FSW primary, EMTT for cellular support
- Osteoarthritis (hip, knee, shoulder) — EMTT + FSW for deep joint
- Herniated disc — EMTT + FSW for deep disc and nerve environment
- Pelvic floor dysfunction (pain, bladder/bowel, sexual dysfunction) — RPW + EMTT + FSW depending on depth
- Post-surgical recovery and scar tissue — RPW for surface, FSW for deep adhesions, EMTT for cellular repair
- Stress fractures and bone healing — EMTT primary, FSW for targeted stimulation
- Carpal tunnel syndrome — EMTT + RPW for nerve and soft tissue
Frequently Asked Questions About Shockwave Therapy Types
How do I know which shockwave therapy type is right for me?+
Can all three types be used in the same session?+
Does shockwave therapy treatment hurt?+
How many sessions of shockwave therapy will I need?+
Is shockwave therapy treatment covered by insurance?+
One conversation with our team is all it takes. We’ll listen to your symptoms, ask the right questions, and tell you exactly which combination of shockwave therapy types makes the most sense for your situation — before you even decide to book an appointment.
ABOUT THE AUTHOR
Kim Gladfelter, MPT, OCS, FAAOMPT
Women's Health Physical Therapy Specialist at PhysioFit Physical Therapy & Wellness
Kim Gladfelter is a physical therapist, Pilates instructor, educator, author, and co-founder of PhysioFit Physical Therapy & Wellness. She is known as a keen, well-rounded expert of healing through movement and women’s health specialist in the Silicon Valley area.
Kim has helped men and women of all ages to stay active and feel their best. She also writes about managing pain in her health columns, blogs and the local Los Altos Town Crier newspaper as well as reaches out to the local community, support groups, schools, libraries, and sports centers to advise and educate on body awareness and therapeutic exercise.