New York Сity
Sports Physical Therapy

Regenerative Treatment

For any athlete, whether their sport is their profession and passion or simply passion, an injury poses a threat to their continuation of being involved in their favourite sport, or even their career.

While orthopaedic surgeons suggest to operate the injury to restore function, physiotherapists generally suggest traditional physical therapy and avoid an operation at all costs. Very few, however, suggest an alternative, non-invasive treatment, which could actually provide viable results for the athlete. Additionally, when it comes to chronic pain, they suggest for the sufferer to either lay off the sport for a while or quit it entirely. What if it were possible to address chronic pain and severe injuries (such as either completely or partially torn tendons) through the use of a non-invasive technology to regenerate the damaged tissue and prompt the body to heal itself and accelerate the process?

Regenerative treatment revolves around the concept of either partial or complete regeneration of the damaged issue. The technology New York City’s Sports Physical Therapy clinic uses is called Extracorporeal Shockwave Therapy. This technology has been around for a number of years now, but only recently has been applied in the sports and orthopedic medicine, due to the qualities it posses in regard to stimulation of tissue regeneration.

Extracorporeal ShockWave Therapy (ESWT)

Extracorporeal shockwave therapy, which is based on the Extracorporeal Pulse Activation Technology (ESWT), has been around for quite some time already, taking origins from the use of acoustic waves to break down gall and kidney stones. Approximately twenty years ago, it has been tried in the treatment of neuromuscular conditions and had unexpected results. It has been successful in treatment of issues causing chronic pain and significant results are achieved quickly. It has then evolved into being used in the treatment of stress fractures, various tendinopathies and repetitive stress injuries and sporting injuries.

The benefit of this treatment lies in its non invasive nature. Orthopedic surgeons often rush to operate on their patient, when it can be entirely avoided through the use of alternative treatments. The disadvantage of surgery and the reason why it should always be left as the last resort option in injury rehabilitation process is the fact that any surgical intervention leaves its footprint on the functionality of the part that has been operated on. Additionally, a surgery may lead to further complications, limit movement of the joints, damage small nerves where the surgical cut is made, and increased probability of contracting an infection, thus prolonging the rehabilitative process. This may have serious consequences for the athlete.

Regenerative treatment using ESWT offers a noninvasive restoration of the damaged tissue, and the treatment has no such side effects that a surgery would. However, in some cases, regenerative treatment may not be enough to fully rehab the injury and a surgical intervention may be needed. Therefore, the earlier the condition is tackled with the regenerative treatment such as ESWT, the better results can be expected.

The conditions ranges that this technology can successfully tackle and treat include:

  • Fractures in the bone and bone nonunions
  • Tendinitis of joints (a type of repetitive stress injury generally caused by inflammation from overuse of those joints)
  • Bursitis (another type of repetitive stress injury caused by inflammation from overuse, and is related to the bursa sack located in between large joints that helps prevent excessive wear and tear processes)
  • Partial tears of the tendons
  • Chronic pain and chronic inflammation
  • Acute and chronic pain occurring in trigger points (neck, back, shoulders)

However, it is not limited to just treating the conditions listed above and includes a far wider variety of sports injuries than just listed. It also helps the reversal of some degenerative processes caused by repetitive use of the tendons and joints. While many in the orthopedic field are just turning their attention to this technology, NYC’s Sports Physical Therapy clinic has been utilizing this technology for a number of years, having used it successfully on over two thousand patients, including professional and recreational athletes.

Extracorporeal Pulse Activation Technology Explained

The way EPAT works, is through fast and condensed high frequency acoustic pulses sent to the area that is being treated for rehabilitation of neuromusculoskeletal disorders.Those pulses, in a way, create micro-tears on the capillary level in the tissue or tendon and irritate the tissue in such a way, that it prompts an increased blood flow to the area. This causes heightened growth indicators to increase in the tissue (e.g. eNOS, BMP, etc), and with an increased oxygenation of the region, and signals to the body to turn on its self healing processes and repair itself. In the cases of chronic pain and chronic inflammation occurring, ESWT triggers the mast cells prevalent to the inflammation processes to increase activity and so the inflammation process, in particular the compounds the process releases, is used to help the regeneration.

These are the results of the treatment that can be achieved with extracorporeal shockwave therapy.

  • Regeneration and repair of damaged tissue
  • Promotion of cell growth
  • Pain trigger points release (This occurs due to muscle tissue first shortening and then thickening in time, resulting in either chronic or acute pain, often occurring in the neck, back and shoulders regions. When the muscle tissue excessively contracts, it limits the blood flow to that area, thus resulting in a buildup of toxins and other waste particles in that region that irritate in that region’s nerve endings, causing the muscle tissue to contract some more. Thus, this process results in either acute or chronic pain, until the metabolic crisis is resolved through the use of ESWT.)
  • Collagen stimulation (One of the most important components in tissue regeneration, which can be prompted to increase in amount and form collagen fibers through ESWT. The fibers that were created in the process of treatment arrange in an elongated structure, thus creating tough tendon fibers.)

The Procedure involving ESWT

Local anesthetic is generally administered in the area that will be treated by the extracorporeal pulse activation technology. The recipient may still feel a tingling sensation during the procedure, and slight numbness after it, but overall – it is a painless treatment. The treatment is spread out into several sessions, depending on how advanced the injury is and the damage existing. Each session is approximately 30 minutes, during which acoustic waves are applied to the tissue that is being regenerated. Ultrasound is used for both diagnostic and precise navigation of the acoustic pressure waves throughout the treatment. Thus, it is also immediately visible the progress that the patient is making with the sessions.


NYC’s Sports Physical Therapy clinic’s approach in tackling injuries is unique to its rounded approach in treating athletic injuries. The cross-knowledge of orthopedic, sports medicine, and neuromusculotoskeletal disciplines, combined with years of experience, enable the professionals working at NYCSPT to get to the core of the issue. Lead by Dr who was a student of the famous Charles University Medical School in Prague and has been part of the international society of medical shockwave for the last 7 years, the clinic specializes in alternative non-invasive treatments offered for both professional and recreational athletes. Over two thousand patients have been treated with this technology already and the treatment has helped many to return to their sport. In each and every case, an individual approach is taken to include all the potential variables that could impact the recovery and develop a treatment program which would be most optimal for the person.

For those who have undergone the regenerative treatment, in order to understand how you can prevent suffering a similar injury and decrease your chances of one, you should consider Injury Prevention program offered at NYCPST. There, all elements of your performance, gait and biomechanical analysis results will be looked at to determine which are the risk areas for you.