🎥 Chapters
00:00 Understanding Shoulder Pain and Labral Tears
0:26 The Shoulder Labrum and Why It Tears: Repetitive Movements, Throwing Ball and Swinging Racket
1:08 Different Types of Shoulder Labral Tears
1:17 Shoulder Pain: Signs and Symptoms of a Labrum Tear
1:39 Extracorporeal Shockwave Therapy (ESWT) for Shoulder Labral Tears
2:09 Why Exercises Are Crucial for Healing Shoulder Labral Tears
2:41 How Piezowave Shockwave Therapy Promotes Healing for Shoulder Labral Tears
3:10 The Science of Piezowave Shockwave Therapy
3:19 Case Studies: Success Stories with Shockwave Therapy for Shoulder Labral Tears
Shoulder Labral Tear and Shockwave Therapy
Shoulder pain helped with Shockwave therapy
Extracorporeal Shockwave Therapy (ESWT) has emerged as a non-invasive treatment option for labral tears, particularly in the shoulder joint. Labral tears are common injuries affecting the cartilage rim surrounding the socket of the shoulder joint. They can result from trauma, repetitive motion, or degenerative conditions, causing pain, limited mobility, and functional impairment. In our office we use Piezowaves low-energy focused shockwaves for shoulder labral tears. ESWT aims to alleviate pain, promote tissue repair, and improve overall hip joint function.
Could ESWT really heal a shoulder tear?
Over 50% of people over 50 have a labral tear. This causes chronic inflammation, weakness, instability and early degenerative changes in the shoulder joint complex. However, there is hope with ESWT. The shockwaves penetrate the skin and soft tissues, reaching the injured labrum and surrounding structures. Upon reaching the targeted area, the shockwaves trigger biological responses, including breaking up of brittle calcifications, increased blood flow, recruitment of healing factors and stimulation of tissue regeneration with new collagen formation. This process facilitates the repair of damaged labral tissue and promotes the resolution of inflammation, ultimately leading to pain relief and improved function.
Will a moderate to severe labral tear be like it was when you were 18 years old? No, but it will be greatly improved and the surrounding supporting structures will be improved also. Keep in mind, your shoulder has a lot of cogs in the wheel. Conditions like tendinopathies, calcific tendonitis and even adhesive capsulitis often accompany labral tears but can all be helped with shockwave therapy. Keep in mind, the effectiveness of ESWT for labral tears varies depending on the severity MRI findings and how motivated you are with the home care. Your rotator cuff and scapular stabilization muscles must take over the role of some of your ligamentous tissue while it heals.
With each shockwave treatment and perfect workout, the burden of pain lifts, replaced by a renewed sense of vitality, possibility and strength.
Is shockwave therapy safe for labral tears?
In our office, we use the Piezowave. This emits low energy focused shockwaves at prescribed depths. This is unlike radial shockwave where the wave form is different, it is unfocused and the power diminishes as it goes deeper. When the reps came to show us radial shockwave we were left bruised and even scabbed up. We do not recommend Radial Shockwave for labral tears or any tears. So, yes, low energy focused shockwave is very safe. However, radial shockwave is generally considered safe but may have some unintended consequences of skin irritation, hematoma, bruising and even tendon, ligament and nerve damage. This is not the case with focused shockwave therapy. If at all possible, make fESWT your first choice.
There is another type ESWT called high-energy extracorporeal shockwave therapy. This is used in lithotripsy for kidney stones. It is attractive for orthopedic problems because it requires fewer visits. However, anesthesia is needed to numb the area due to the extreme pain it causes. In some studies, the anesthesia has been shown to decrease the regenerative effectiveness of the therapy. Breaking up scar tissue is one of the great effects of ESWT but, to complete the healing process, there must be the regeneration of the tissue. Here high-energy shockwave lacks and, once again, low-energy focused shockwave is the clear choice for your precious shoulder.
Research indicates that ESWT can significantly reduce pain and improve hip function in patients with labral tears, both in the short and long term. Furthermore, ESWT has been found to be well-tolerated, with minimal adverse effects reported. A thorough evaluation and consultation with us are essential to determine the most appropriate treatment approach for you and your labral tear.
In conclusion, Extracorporeal Shockwave Therapy represents a promising non-invasive treatment option for labral tears, offering pain relief, improved function, and potential avoidance of surgery. ESWT holds considerable promise in the management of sholder joint pathology, providing you with a valuable alternative to traditional surgical interventions.
Get Shockwave Therapy
Dr Adam Fields is a practicing chiropractor in the Bay Area in Northern California and helps people daily in his office with many challenges that can be helped by shockwave therapy from tendinopathies, arthritis, cartilage regeneration, post surgical scar tissue, pelvic pain, altered biomechanics and more. He uses Endonasal Cranial Adjusting, the Muncie Technique, Extracorporeal Shockwave Therapy (ESWT), Class IV Laser Therapy, posture correction, lifestyle modification, muscle work, and other techniques to help his patients.
You can reach Dr Fields for in-person (Los Gatos and San Jose, California) or telehealth appointments here.
Shockwave therapy research related to the shoulder
Chen, Y., Lyu, K., Lu, J., Jiang, L., Zhu, B., Liu, X., Li, Y., Liu, X., Long, L., Wang, X., Xu, H., Wang, D., & Li, S. (2021). Biological response of extracorporeal shock wave therapy to tendinopathy in vivo (review). International Journal of Molecular Medicine, 47(2), 1-12. https://doi.org/10.3892/ijmm.2021.4859
Chou, W. Y., Wang, C. J., Wu, K. T., Yang, Y. J., Cheng, J. H., & Wang, S. W. (2021). Comparative outcomes of extracorporeal shockwave therapy for shoulder tendinitis or partial tears of the rotator cuff in athletes and non-athletes: Retrospective study. BMC Musculoskeletal Disorders, 22(1), 1035. https://doi.org/10.1186/s12891-021-04886-4
Wang, C. J., Wang, F. S., Yang, K. D., Weng, L. H., Hsu, C. C., Huang, C. S., & Yang, L. C. (2003). Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. Journal of Orthopaedic Research, 21(6), 984-989. https://doi.org/10.1016/S0736-0266(03)00104-9 “Shock wave therapy induces the ingrowth of neovascularization associated with early release of angiogenesis-related markers at the Achilles tendon-bone junction in rabbits. The neovascularization may play a role to improve blood supply and tissue regeneration at the tendon-bone junction.”
Schroeder, A. N., Tenforde, A. S., & Jelsing, E. J. (2020). Extracorporeal shockwave therapy in the management of sports medicine injuries. Current Sports Medicine Reports, 19(1), 37-42. https://doi.org/10.1249/JSR.0000000000000676