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Why buy f-ESWT when you already have radial?

At the start of 2020, Physiquipe adopted the Alpinion Diagnostic Ultrasound (DUS) systems to support our work with focused shockwave (f-ESWT).

With Chris Myers, SMUG Faculty Lead and Clinical Director at Complete Physio

PiezoWave Nothing Beat It V4

At the start of 2020, Physiquipe adopted the Alpinion Diagnostic Ultrasound (DUS) systems to support our work with focused shockwave (f-ESWT).

Working with DUS, we did what everyone probably does and approached one of the top names in the business, Chris Myers, for his thoughts and opinion on the Alpinion technology. After a few meetings, the conversation developed to Shockwave. Chris already had a shockwave system (Swiss Dolorclast, radial shockwave) that he was using fairly regularly. But one thing that came to light, and I am sure he won’t mind us saying, is that there was a lack of knowledge in understanding the difference between radial and focused ESWT.

A few conversations, internal CPD sessions and WhatsApp voice notes later, we installed the Piezowave2 MU60 f-ESWT into his clinic at Fulham road for Chris and his team to review its application. Initially, the trial period was set at 3 months, but after 6 weeks, Chris surprised us and decided to invest and bought the system.

Why buy f-ESWT when you already had radial?

Andy and Dom at Physiquipe introduced me to the Piezowave, I was sceptical at first and to be honest, not convinced with a lot of the claims out there about shockwave. But, they persisted, and taught me the difference between radial pressure wave and focused shockwave, and convinced me to try the system.

One of the biggest turning points seemed to be when we discussed the relationship between DUS and f-ESWT. This got me thinking and it started to make sense. I do a lot of ultrasound-guided injections so when it came to f-ESWT, being able to US-guide and focus the energy of shockwave was appealing and makes a lot of sense.

Complete Physio Shockwave - f-ESWT

What helped Chris and the team decide to get Piezowave2?

I was impressed at the fact they had prepared a lot of background work behind the technology and had condensed all the literature into bitesize presentations for the team and me to go through.

Also, they were always available and very supportive whenever we had any questions, but ultimately, we arranged a trial for us to try the system.

Trying it with patients was the ultimate test. The feedback from patients has been very positive and certainly it is less painful and better tolerated by patients than radial shockwave. It is early days but I have had seen promising results and I look forward to reviewing my clinical audit results in a few months to ascertain its overall effectiveness.

Return on Investment (ROI)

Let’s be honest, f-ESWT isn’t cheap, compared to radial. So how could you financially justify adding f-ESWT when you already have a radial system? Surely that is madness, building the ROI must be difficult…

It cost a significant amount of money, yes, but has a very simple ROI. For every shockwave treatment we carry out at the clinic we charge £100.00. So, I simply multiply this by how many sessions I think we will carry out and my ROI was calculated at two years. This is pretty good and hopefully money well spent!. But the ultimate ROI is in our patient outcomes – WTS!!

pw2_head - f-ESWT

The next steps

Now it is in place, Chris and the team are now using Piezowave2 regularly and we look forward to hearing how he gets on with the system and sharing his results.

I am interested in trying it for calcific rotator cuff tendinopathies and stress fractures. This is an area that radial shockwave is not effective and so this introduces a new treatment modality for these clients.

If you would like to find out more about how Chris uses f-ESWT, he is happy to speak to you and share his thoughts, get in touch with us at

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