02/09/2026
I had a message from a prospective client this morning so thought it was worth posting about the 'question' and some reasons for my answer.
The 'client' mentioned they have 'Tennis Elbow' and by the sounds of it, has been having treatment in whatever country they are based. They are coming to Competa soon and asked if I offered 'Shock Wave Therapy' and if so, could they book in for some.
So firstly, I do NOT offer Shock Wave. I don't actually think much of it and i'll give my reasons for that in a mo.
I do have an Ultrasound machine but I think I've used it on maybe 2 or 3 clients since I've been in Spain (7.5 years) and not that much when I was in UK. Why? Because I think in the main it is a lazy option from the therapist. They can perform 5-15 minutes of Ultrasound and set you on your way, charge good money, not expend much energy, and get more clients through the door.
Yes, there are a few occasions I will use Ultrasound, like with Ligament injuries.
But for soft tissue injuries, manual work is much more effective.
So how does Shock Wave work? (this won't be in-depth)
Shock Wave therapy works by sending high-energy acoustic (sound) waves directly into damaged tissues to trigger the body's natural healing mechanisms.
The main aspect of the treatment is that it 'damages' the nerve endings meaning you feel less pain - doesn't look at the cause, just the symptoms.
It will break down tissue, such as scar tissue or calcification, and initiate a new healing process. It can be VERY painful and take many sessions.
I know several clients in the UK that tried it. I only know of one that felt benefit. The others have no real benefit and said they'd never go through the pain again - you think my sessions can be painful!
So what would I do for this client's Tennis Elbow?
Firstly, question them on the cause. What activity brought on the pain? Was it a different strain on the body? Does anything you do help the pain?
Test the various structures of the arm - wrist flexors/extensors, then work on releasing what I find is 'tight' and strengthen what I find is 'weak'. Provide homework to mimic my treatment (release/strengthen).
I could be lazy and apply 10 minutes of Ultrasound, take your money, get you back for 10 sessions, and hope for the best, but that's not why I got into this line of work.
Yes, you could be pain free after a few or more sessions but if you haven't addressed the (possible) cause, the problem will return when you start back with the activity that caused it.
Always work on the cause and NOT just the symptoms...