Image Source: thecarltoddclinic.com
Can You Exercise After Shockwave Therapy?
Yes, you can exercise after shockwave therapy, but it is vital to know when and how to do so safely. The timing and type of exercise depend heavily on the specific condition treated, your individual response to the therapy, and the guidance of your healthcare provider. Jumping back into your usual activities too soon or too intensely can disrupt the healing process that shockwave therapy aims to start.
What is Shockwave Therapy?
Shockwave therapy, often called Extracorporeal Shockwave Therapy (ESWT), is a non-invasive treatment. It uses acoustic waves, like sound waves, to help heal injuries in muscles, tendons, bones, and ligaments.
Think of it like this: a special machine sends these waves into the injured area. When these waves reach the tissue, they create tiny changes. This can help improve blood flow and kickstart the body’s natural healing process. It can also break down calcium deposits in tendons.
ESWT is often used for long-lasting conditions that haven’t healed well with other treatments. Common uses include:
- Plantar fasciitis (heel pain)
- Achilles tendinitis (ankle pain)
- Tennis or golfer’s elbow (elbow pain)
- Rotator cuff tendinopathy (shoulder pain)
- Shin splints (lower leg pain)
- Jumper’s knee (patella tendinopathy)
The goal is to help the body repair itself and reduce pain over time.
Why Caution Matters After Therapy
After shockwave therapy, your body begins a healing response. The waves create tiny bits of stress in the tissue. This planned stress is supposed to tell your body to send more blood and healing cells to the area.
If you do too much too soon, especially high-impact activities, you can put too much stress on the recovering tissue. This can:
- Increase pain (pain after shockwave therapy and exercise)
- Cause more swelling
- Slow down the healing process
- Even make the injury worse
Following ESWT recovery guidelines is key. Your body needs time to use the boost from the shockwaves to build stronger, healthier tissue. Rest and controlled movement are part of this building process.
General Steps for Recovery
The recovery time shockwave therapy requires varies for each person and injury. However, there are general steps and timelines most people follow. These steps help guide you back to your normal activities safely.
A typical plan often looks like this:
- Immediately After Treatment (First 24-72 hours): Focus on rest and avoiding stress on the treated area.
- Early Stage (First Week or Two): Begin gentle movement and specific, low-impact exercises.
- Mid Stage (Weeks 2-4): Gradually increase activity levels and start incorporating light strengthening.
- Later Stage (After 4-6 Weeks, sometimes longer): Slowly return to more demanding activities, including higher-impact exercise if appropriate.
These timelines are just guides. Your physical activity restrictions post ESWT will be specific to you. Always follow the plan given by your doctor or physical therapist.
Right After Your Treatment: The First Few Days
The period immediately after your shockwave therapy session is crucial. Your body has just received a stimulus designed to kickstart healing. You might feel some pain, soreness, or bruising in the treated area. This is normal and often a sign that the therapy is working.
During the first 24 to 72 hours after your session, the main goal is to protect the treated area. This means:
- Avoiding high impact: No running, jumping, or sports that involve sudden stops or starts.
- No heavy lifting: Do not put significant strain on the affected muscle, tendon, or bone.
- Limit strenuous activity: Avoid anything that significantly increases pain or puts a lot of stress on the treated site.
- Listen to your pain: Pain is your body’s signal. If something hurts more than mild soreness, stop doing it.
Consider this time a period of active rest. While you shouldn’t be completely immobile, you must avoid putting significant load through the tissue that was just treated. Think of it as letting the ‘seeds’ planted by the shockwaves start to grow without being stepped on.
Some physical activity restrictions post ESWT might include:
- Avoiding deep squats if your knee was treated.
- Not gripping heavy objects if your elbow was treated.
- Avoiding long walks or standing for extended periods if your heel was treated.
Your therapist or doctor will give you specific instructions based on your condition. Following these rules right after therapy helps set the stage for better healing.
Starting Gentle Movement: Early Post-Treatment Exercises
Once the initial soreness starts to settle, usually within a few days, you can begin very gentle movement. The goal here is not to strengthen the muscle or tendon, but to encourage blood flow and keep the tissue from getting stiff. These are post shockwave therapy exercises designed for mobility and circulation, not stress.
Examples of gentle movement might include:
- Gentle range of motion exercises: Moving the joint through its normal range without any weight or resistance. For example, slowly bending and straightening your ankle if your Achilles was treated.
- Light walking: Short, slow walks on flat surfaces. Pay close attention to pain levels. If walking increases pain, cut it short or wait another day.
- Easy stretching: Gentle stretches that do not cause significant pull or pain. Hold stretches for a short time (e.g., 15-20 seconds) and do not force the stretch.
- Cycling with no resistance: If appropriate for your injury (e.g., knee or hip), very light cycling on a stationary bike can help with blood flow without high impact.
These early exercises should not cause more than very mild discomfort. If you experience sharp pain or significant worsening of symptoms during or after these activities, stop and consult your healthcare provider.
This stage is about preparing the tissue for more work later. It’s like warming up a car on a cold day – you let it run gently before driving fast.
Moving Towards More Activity: The Mid-Recovery Phase
After the first week or two, if your initial symptoms have improved and gentle movement is comfortable, you can start to gradually increase your activity. This is where you might start introducing some light strengthening exercises.
The focus in this phase (typically weeks 2-4) is on:
- Controlled loading: Putting a bit more stress on the tissue than in the first stage, but in a controlled way.
- Building strength gradually: Starting with very light weights or resistance and increasing slowly.
- Increasing duration/distance of activities: Longer walks, maybe introducing low-impact cardio like elliptical training or swimming.
Examples of exercises in this phase could include:
- Light resistance band exercises: Using resistance bands to work the muscles around the injured area.
- Bodyweight exercises: Like calf raises if treating Achilles/plantar fascia issues, or wall push-ups if treating shoulder issues. Start with few repetitions and sets.
- Increased walking duration: Gradually walking for longer periods, still avoiding very uneven ground or hills if they cause pain.
- Swimming or water aerobics: The buoyancy of water reduces impact while allowing movement and gentle resistance.
- Stationary cycling with light resistance: Gradually increasing the resistance on the bike.
It is crucial during this stage to monitor your pain after shockwave therapy and exercise. A little bit of soreness might be acceptable, but sharp pain or pain that lasts for hours or days after activity means you did too much. If this happens, reduce the activity level and give yourself more rest before trying again.
| Activity Type | Immediate Post-Treatment (0-3 days) | Early Stage (Day 3 – 2 weeks) | Mid Stage (2-4 weeks) |
|---|---|---|---|
| High-Impact Exercise | Avoid entirely | Avoid entirely | Avoid entirely |
| Heavy Lifting | Avoid entirely | Avoid entirely | Avoid entirely |
| Gentle Walking | Short, slow walks if pain allows | Gradually increase duration | Longer walks, monitor pain |
| Range of Motion | Gentle, pain-free movements | Continue, may increase reps | Continue as warm-up/cool-down |
| Light Stretching | Gentle stretches, no pain | Continue gently | May increase duration/frequency |
| Low-Impact Cardio | Avoid | Avoid or very light (e.g., bike, short) | Introduce gradually (bike, elliptical, swim) |
| Light Strengthening | Avoid | Avoid | Start with light resistance/bodyweight |
This table gives a general idea. Your specific plan should come from a healthcare professional.
Ready for Higher Impact? Return to Running and Sport
This is often the final stage of recovery and should only happen when you are consistently pain-free during and after lower-impact activities. Returning to running after shockwave therapy or other impact exercise after shockwave too soon is a common mistake that can lead to setbacks.
This stage usually begins no earlier than 4-6 weeks after the last shockwave session, and often later, depending on the injury and your progress.
Key principles for returning to impact:
- Gradual Progression: Start with very short bursts of impact. For runners, this means walk/run intervals (e.g., run 1 minute, walk 4 minutes, repeat). Slowly decrease the walking time and increase the running time over many sessions.
- Monitor Pain Closely: There should be minimal to no pain during the activity. More importantly, check for pain in the hours and day after the activity. If pain spikes, you did too much.
- Listen to Your Body: If you feel increased pain or discomfort, back off immediately. Don’t push through significant pain.
- Consistent Low-Impact Base: Maintain your strength and low-impact cardio base.
- Proper Warm-up and Cool-down: Prepare your body before impact and help it recover afterward.
| Activity Type | Later Stage (4+ weeks) | Progression |
|---|---|---|
| Return to Running | Start with walk/run intervals | Gradually increase running duration/decrease walking |
| Jumping/Hopping | Start with low, controlled jumps | Increase height/frequency slowly |
| Sport-Specific Drills | Begin non-contact, low-intensity drills | Gradually increase intensity and complexity |
| Heavy Strength Training | Begin incorporating heavier weights | Ensure proper form, listen to the body |
Returning to sport or high-impact activity requires patience. It’s better to progress slowly and consistently than to rush and reinjure yourself.
Exercise Tips for Specific Issues: Plantar Fasciitis
Exercising with plantar fasciitis after shockwave therapy follows the general principles, but with a focus on the foot and ankle. Shockwave therapy is commonly used for this painful heel condition.
After treatment for plantar fasciitis, your exercise plan will likely emphasize:
- Immediate Rest: Avoid prolonged standing, walking, and definitely no running or jumping for the first few days.
- Gentle Foot and Ankle Movement: Once soreness eases, start with simple exercises:
- Ankle pumps (pointing toes up and down)
- Ankle circles
- Picking up marbles or a towel with your toes
- Calf and Plantar Fascia Stretching: Gently stretch your calf muscles (both with knee straight and bent) and the bottom of your foot. Do not force these stretches if they cause significant pain directly after treatment. Gradually increase intensity as healing progresses.
- Strengthening Exercises: As recovery moves forward, focus on strengthening the muscles in your foot and lower leg:
- Calf raises (start with two legs, progress to one)
- Toe raises
- Resistance band exercises for ankle strength
- Gradual Return to Walking/Running: This is the critical step. Start with short walks. Pay close attention to heel pain. When ready for running (often weeks or months after treatment), use a walk/run program on soft surfaces. Increase running time very slowly.
- Footwear: Always wear supportive shoes, even indoors, especially in the early stages. Avoid going barefoot.
Rehabilitation after shockwave treatment for plantar fasciitis often includes specific stretches and strengthening guided by a physical therapist. They can ensure you are doing the exercises correctly and progressing at the right pace.
Pay Attention to Your Body: Reading the Signals
One of the most important parts of recovery is learning to listen to your body. Pain is a signal that something is happening. After shockwave therapy, you might have some pain or soreness, which is normal. However, knowing the difference between normal post-treatment discomfort and pain that indicates you’re doing too much is vital.
- Normal Discomfort: This is usually a dull ache or soreness right in the area that was treated. It might feel similar to how the area felt before therapy, or like you’ve worked the muscle hard. This pain often eases with rest and doesn’t get worse with gentle movement. It should gradually improve over hours or a day.
- Pain That Means “Stop”: This is typically sharper, more intense pain. It might feel like the original pain but worse, or a new, sharp feeling. This pain often gets worse with activity and might not go away quickly afterward. It could also come with increased swelling or redness.
If your exercise causes sharp pain, or if mild pain increases significantly during or after activity, or if pain lasts for a long time after you stop, you are likely doing too much. It’s okay to feel a little bit of fatigue or mild discomfort as you start moving more, but significant pain after shockwave therapy and exercise should be a warning sign to back off.
Learn to assess your pain before, during, and after exercise. This feedback helps you adjust your activity level day by day. Some people find it helpful to rate their pain on a scale of 0 to 10. If pain goes above a certain number (e.g., 3/10) during exercise, or if it’s significantly higher the next morning, it might be time to reduce the activity.
Why Your Doctor and Therapist Are Important: Professional Guidance
While general guidelines are helpful, the best plan for when and how to exercise after shockwave therapy comes from healthcare professionals. Your doctor and physical therapist have specific knowledge about your injury, your overall health, and how you responded to the shockwave session.
They can:
- Assess your specific condition: Different injuries and their severity require different recovery plans.
- Develop a personalized exercise plan: They can create a step-by-step program tailored to your needs and progress. This plan is part of your overall rehabilitation after shockwave treatment.
- Show you how to do exercises correctly: Proper form is key to avoiding reinjury. A therapist can guide you.
- Help you manage pain: They can advise on pain relief strategies like ice (if recommended) or over-the-counter medication.
- Monitor your progress: They can see how you are healing and adjust your activity recommendations as needed.
- Determine when you are ready for more impact: They can perform tests or assessments to help decide when return to running after shockwave or other impact activities are safe.
Following generalized advice is a starting point, but incorporating professional guidance ensures your recovery is safe, effective, and optimized for your specific situation. Don’t hesitate to ask questions about physical activity restrictions post ESWT or about the best post shockwave therapy exercises for your condition.
Tips for a Smooth Recovery
Beyond knowing when and how to exercise, there are other things you can do to support your recovery after shockwave therapy:
- Stay Hydrated: Drinking plenty of water is good for overall tissue health.
- Eat a Healthy Diet: Good nutrition provides the building blocks your body needs for repair. Focus on protein, fruits, and vegetables.
- Get Enough Sleep: Sleep is a critical time for the body’s healing processes.
- Manage Swelling (If Present): If recommended by your doctor, gentle elevation or cold packs might help with temporary swelling.
- Avoid Anti-Inflammatory Medication (Unless Directed): Some doctors advise against taking anti-inflammatory drugs (like ibuprofen) right after shockwave therapy because the therapy aims to create a small inflammatory response to kickstart healing. Always ask your doctor.
- Be Patient: Healing takes time. Don’t get discouraged if progress isn’t linear. There might be good days and bad days.
- Celebrate Small Wins: Acknowledge your progress, no matter how small it seems. Returning to running after shockwave or fully engaging in impact exercise after shockwave are long-term goals; focus on the steps getting you there.
Potential Side Effects
While generally safe, shockwave therapy can have some temporary side effects in the treated area. Knowing about them can help you understand what is normal during your recovery time shockwave therapy.
Common temporary side effects include:
- Pain or discomfort during and immediately after the treatment.
- Redness or bruising.
- Swelling.
- Numbness or tingling.
These side effects usually resolve within a few hours or days. If you experience severe pain, significant swelling that doesn’t go down, or any other worrying symptoms, contact your doctor.
Frequently Asked Questions (FAQ)
Q: How soon can I walk normally after shockwave therapy?
A: For many conditions, light, pain-free walking can often begin within a few days after the treatment, as long as it doesn’t cause significant pain. However, if you were treated for a condition that makes walking difficult (like severe plantar fasciitis), your doctor might recommend more rest initially. Always listen to your body and your doctor’s advice.
Q: Can I go back to work the next day?
A: For most jobs that don’t involve heavy physical labor or high impact on the treated area, you can often return to work the next day. If your job is physically demanding or involves the injured body part, you might need a few days off or modified duties. Discuss this with your doctor.
Q: Is it normal to have pain after shockwave therapy when I try to exercise?
A: Yes, it is normal to experience some pain or discomfort (pain after shockwave therapy and exercise) when you first start exercising again. This should be mild and manageable. Sharp, increasing, or long-lasting pain is a sign you are doing too much.
Q: How many shockwave sessions will I need before I can exercise normally?
A: The number of sessions varies, usually between 3 and 6 sessions. Your ability to exercise normally depends on how well you heal between sessions and after the last session. You will gradually increase activity throughout the treatment process and recovery period, not just after the final session. Full return to high-level exercise like return to running after shockwave happens well after the treatment course is finished.
Q: Can I use ice on the treated area?
A: Generally, ice can be used for temporary pain relief after shockwave therapy if recommended by your doctor. However, some practitioners advise against using anti-inflammatory methods like ice or NSAID medication (like ibuprofen) immediately after treatment, as they may interfere with the desired inflammatory healing response. Always check with your healthcare provider.
Q: When can I return to running after shockwave therapy?
A: Returning to running after shockwave therapy typically takes several weeks, sometimes months, after the final treatment session. You should be able to walk comfortably without pain, complete lower-level exercises without issue, and have clearance from your doctor or therapist before starting a very gradual walk/run program. This is one of the last activities you will return to.
In Conclusion
Exercising after shockwave therapy is an important part of the recovery process, helping to rebuild strength and function in the injured tissue. However, the timing, type, and intensity of exercise must be carefully managed.
Immediately after treatment, rest and avoiding strain are key physical activity restrictions post ESWT. As your body begins to heal, you can gradually introduce gentle movements and post shockwave therapy exercises, slowly building towards more demanding activities like impact exercise after shockwave or return to running after shockwave.
Listening closely to your body and managing any pain after shockwave therapy and exercise are vital. Following general ESWT recovery guidelines and your specific rehabilitation after shockwave treatment plan from your doctor and physical therapist will give you the best chance for a successful recovery and a safe return to your desired activity levels. Patience and consistency are your greatest allies on this journey.