Last updated: August 14, 2026 | Author: Dr. Amanda Myers, DC, MS
Nobody books shockwave therapy because they are curious. They book it because a tendon has hurt for eight months, rest did nothing, and the next conversation was going to involve a needle or a surgeon.
So the first question is almost always the same one: how many shockwave therapy sessions is this actually going to take, and how will I know if it is working?
How many shockwave therapy sessions do you need?
Most tendon conditions need 3 to 6 shockwave therapy sessions, spaced 5 to 10 days apart. Plantar fasciitis and tennis elbow often respond in 3 to 4. Long-standing Achilles or gluteal tendinopathy usually needs 5 to 6. You should see a measurable change by session 3 — if nothing has moved, the plan is wrong, not the dose.
Why the spacing between sessions matters more than the number
Shockwave does not numb anything. It provokes a repair response in tissue that stopped repairing. Acoustic pressure waves create controlled micro-trauma, which restarts blood vessel formation and collagen turnover in a tendon that had gone quiet.
That response takes days to run. Stack sessions too close together and you interrupt the healing you just triggered. Space them too far apart and the stimulus fades before the next one lands. Five to ten days is the window, which is why a course of shockwave therapy sessions runs over four to eight weeks rather than four to eight days.
This is not a passive treatment. What you do between sessions decides most of the outcome.
How many shockwave therapy sessions by condition
| Condition | Typical sessions | Spacing | When you should feel a change |
|---|---|---|---|
| Plantar fasciitis / heel pain | 3–5 | 7 days | After session 2–3 |
| Tennis or golfer’s elbow | 3–4 | 5–7 days | After session 2–3 |
| Achilles tendinopathy | 4–6 | 7–10 days | After session 3 |
| Patellar tendinopathy (jumper’s knee) | 4–6 | 7 days | After session 3 |
| Gluteal tendinopathy / hip | 5–6 | 7–10 days | After session 3–4 |
| Calcific shoulder tendinopathy | 3–5 | 7–10 days | After session 2–3 |
These are ranges, not promises. How long the problem has been running matters more than which tendon it is.
Does shockwave therapy hurt?
During: it is uncomfortable, not agonising. Most people describe a deep, rhythmic thudding that gets more intense over the tender spot. We dial intensity to what you can tolerate and it typically takes 5 to 10 minutes per area.
After: mild soreness or a dull ache for 24 to 48 hours is normal and is part of the response, not a sign something went wrong. You should not need to stop your day.
How will you know it is working?
Not by how you feel walking out. Tendon pain has a lag. Track these instead:
- First-step pain. The heel pain in your first ten minutes each morning is the cleanest marker for plantar fasciitis — the whole reason plantar fasciitis keeps coming back is that people stop as soon as this eases.
- Load tolerance. How long you can walk, run or stand before it complains. This shifts before resting pain does.
- Recovery time. How long it aches after activity. Going from two days to two hours is real progress even if peak pain has not changed.
- What you can do again. Stairs. Hills. A full match. This is the marker that actually matters.
Why sessions alone will not finish the job
Shockwave restarts repair. It does not tell the tendon what load to be strong for, and it does not fix the reason the tendon was overloaded in the first place.
If your calf cannot absorb load, the Achilles takes it. If your hip will not rotate, the knee pivots instead. That is why every course here runs alongside progressive loading rehab and, where the mechanics call for it, adjustments and custom orthotics made in our Lombard office. Treating only the painful tendon is why people come back a year later with the same problem — the same trap behind most recurring back pain.
The detail on what shockwave changes inside the tissue is in our companion piece on shockwave therapy for chronic tendon pain. If you want the service and pricing detail, that lives on our shockwave therapy page.
Who is not a candidate?
Shockwave is not appropriate if you are pregnant, have a bleeding disorder or are on anticoagulants, have an active infection or open wound over the area, have a tumour or growth plate in the treatment field, or have a nerve or circulatory condition affecting the area. Acute injuries with swelling and lost function need assessment and imaging first, not acoustic waves. We screen for all of this before session one.
What a course looks like here
Assessment first — what is actually failing, and why it was loaded that way. Then a planned number of shockwave therapy sessions with a reassessment built in at session 3, loading rehab that progresses every week, and mechanical work where your movement pattern is driving it. Athletes recovering from court and racquet sports often overlap this with the work in our pickleball injuries guide.
We see patients from Lombard, Glen Ellyn, Wheaton, Villa Park, Elmhurst and across DuPage County.
Shockwave therapy sessions FAQ
How many shockwave therapy sessions are needed for plantar fasciitis?
Usually 3 to 5, spaced about a week apart. Most people notice first-step morning pain easing after the second or third. Finishing the course matters — stopping early is the most common reason it returns.
How long does each shockwave therapy session take?
The shockwave itself runs 5 to 10 minutes per area. With assessment, setup and the rehab review, plan on 20 to 30 minutes in the office.
How soon after shockwave therapy can I exercise?
Light movement the same day is fine and usually encouraged. Avoid heavy loading of the treated tendon for about 48 hours, then resume the progressive loading plan. Complete rest between sessions works against the treatment.
What if I have had 3 sessions and nothing has changed?
Then we stop and reassess rather than book more. No change by session 3 usually means the diagnosis needs revisiting, the loading rehab is not progressing, or something mechanical upstream is still overloading the tissue.
Does insurance cover shockwave therapy?
Most plans do not cover it, so it is typically self-pay. We give you the full cost of the planned course up front, not session by session.
Is shockwave therapy the same as ultrasound therapy?
No. Ultrasound delivers low-intensity sound waves for a mild thermal effect. Shockwave delivers high-energy acoustic pressure waves specifically to provoke a repair response in degenerated tissue. Different mechanism, different result.
Book your New Patient Discovery Assessment
If a tendon has hurt for months and rest has done nothing, the number of sessions is the second question. The first is why it stopped healing. Book your New Patient Discovery Assessment at True Health Chiropractic and Acupuncture in Lombard.
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