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Differences between a Physio and Chiropractor When Shock Wave Is Administered

At the Wimbledon Clinic, the home of the London Shock Wave & Sports Injury Department, patients often ask what’s the difference between a Chiropractor and a Physio as they typically have been recommended this physio treatment is called ESWT or Extracorporeal Shock Wave Therapy. 

Think about shock wave focused with chiropractor or physio


Your experience visiting a Physio or Chiropractor may not be clear-cut. One pair of hands is different to another, and each shock wave or sports injury clinic may have made different equipment investments (older radial unit vs the newer Focused Units as an example). Then, of course, you have the experience of the practitioner how many cases have they seen of your type of condition and have they seen and treated a sub-set of suffers like you with ESWT?

The above results in the overall parcel of care being different or comparable, pivoting on the individual treating you.

As a Sports Chiropractor who has been treating patients with radial shock wave therapy for over 10 years and focused on SWT for 2 years, I know more about the ins and outs of the Chiropractic profession and the treatment of shock wave therapy than a Physio who has been doing the treatment for less time.

While in no way considering myself or being allowed (by law) to call myself; a Physio, I have a great deal of respect for the Physiotherapy profession, and we even have a physio that uses our focused shock wave machine on the Wimbledon clinic site. I do use tools traditionally linked with the physio profession creating this cross-over effect.

Both Physiotherapy and Chiropractic share a common aim: To get you better, and both professions aim to enable your body to heal from within. Our goal is often to provide stimulation or body/ movement coaching to get this innate healing kick-started, shock wave therapy, regardless of who it stimulates.


Chiropractic traditionally strongly emphasises achieving optimum joint alignment, particularly of the joints in the spine, to maintain optimum health. Chiropractors emphasise the exact position of misalignments and the direction in which correction must occur. They are trained to use x-rays to aid in this process (although they may use other methods to avoid x-ray exposure, i.e pictures). Physiotherapists recognise the potential for misalignments but only in posture and movement patterns, but they do not receive the same training in x-ray analysis as Chiropractors.

Many assume that shock wave therapy is a primary treatment for tendinopathy, which is true. The muscle cords' "tendons" pathology/ condition is traditionally confined to the physiotherapy team. However, due to their radiographic training, sports Chiropractors are uniquely placed to treat with Focused Extracorporeal Shock Wave Therapy.

Why Are Chiropractors Uniquely Placed To use focused ESWT?

First and foremost, the SWT technology was designed around calcific deposits seen on x-ray analysis, which a physio is unlikely to access. Some physios may use ultrasound technology to scan the tendon, but radiography is still the best medium.