Shockwave & EMTT
Acoustic pulses that remodel tissue, magnetic fields that reach 18 cm deep — two energies we run in tandem, because together they outperform either one alone.
How the tandem works
Extracorporeal shockwave therapy (ESWT) delivers mechanical acoustic pulses into injured musculoskeletal tissue, triggering the biological responses that drive repair: enhanced circulation and new vessel formation, increased collagen synthesis, activation of mesenchymal stem cells and VEGF, modulation of pain signaling, and breakdown of calcific deposits.
EMTT (Electromagnetic Transduction Therapy) works through a different physics entirely: oscillating high-energy magnetic fields at 100–300 kHz that stimulate cellular activity up to 18 cm below the surface — depths no acoustic handpiece can reach. The applicator never touches you; sessions run 5–20 minutes and are typically sensation-free.
Because the two act through different mechanisms at different depths, we usually run them in tandem within the same visit — shockwave working the target tissue, EMTT amplifying the response from below. A randomized trial in rotator cuff tendinopathy found the combination outperformed shockwave alone; the citation lives in our research library.
Shockwave is also part of how we diagnose. During your initial evaluation, Dr. DeWald pairs diagnostic ultrasound with probing passes of focused shockwave: the ultrasound lets him see the suspect structure, and the focused pulses let him — and you — feel it, reproducing your exact pain when they cross the true generator. Two independent confirmations, before a single treatment decision is made.
Full-toolkit, certified delivery
Florida Regen is among the few clinics nationwide running both Radial Pressure Wave (RPW) and Focused Shockwave (FSWT). Focused waves concentrate high-intensity energy at precise points up to 12 cm deep — for tendinopathies, calcific deposits and periarticular degeneration. Radial waves spread energy across broader superficial tissue (3–4 cm) — for myofascial pain and soft-tissue adhesions.
Dr. DeWald holds ISMST (International Society for Medical Shockwave Treatment) certification, is separately credentialed in EMTT, and serves as faculty at the American Shockwave Training Institute — teaching physicians the same techniques used in this clinic. Modality, energy settings and the tandem sequence are chosen clinically for your tissue, not read off a protocol card.
Your tandem series, step by step
See it, feel it
Diagnostic ultrasound shows the suspect structure; probing focused-shockwave passes confirm it by reproducing your exact pain — then we set the plan.
Shockwave session
Minutes of acoustic pulses on the target — radial, focused or both — dialed to your comfort.
EMTT amplification
In the same visit, the magnetic field applicator works the deeper tissue while you simply lie back — no contact, typically no sensation.
Loading guidance
Between sessions you get specific do-this-not-that loading instructions so the tissue remodels under the right stress.
Conditions the tandem commonly helps
- Plantar fasciitis & Achilles tendinopathy
- Tennis & golfer's elbow
- Rotator cuff & calcific shoulder tendinitis
- Gluteal & hip tendon pain
- Spine and large-joint conditions needing depth
- Chronic tendon pain unresponsive to physical therapy
Who it’s for
Anyone whose tendon or joint pain has outlasted rest, PT or cortisone — and patients whose orthobiologic protocol can be amplified with layered energy-based treatment.
Common questions about shockwave & EMTT
Why do you use them together?
Different physics, different depths, one goal. Shockwave delivers a mechanical stimulus into the target tissue; EMTT drives cellular activity well below it. Run in tandem, each covers what the other can't reach — and the trial data on combination treatment points the same direction.
What do the sessions feel like?
Shockwave is a strong tapping you'll feel but won't dread, dialed to your comfort with nothing needing numbing. EMTT is the opposite experience: the applicator never touches you, and most patients feel nothing at all.
How many sessions will I need?
Three to five tandem visits, spaced across a few weeks so each builds on the last.
What is diagnostic focused shockwave?
Focused shockwave doubles as a search tool. Swept across the region at diagnostic settings, the pulses stay quiet over healthy tissue and reproduce your familiar pain the moment they cross the damaged structure — confirming by feel what the ultrasound shows by eye. Both happen in your first evaluation.
Can the tandem be combined with PRP?
That stack is one of our favorite plays for chronic tendons — orthobiologics to supply the repair biology, shockwave and EMTT to demand the remodeling, deliberately timed.
Is there any downtime?
None from either modality. Patients drive themselves home and train the same day, with loading guidance from us.
Give a stubborn tendon new orders — from two directions.
One evaluation sets the plan: radial or focused, EMTT layered where depth matters, and a series matched to your tissue.