Shockwave (ESWT) and EMTT
Shockwave and EMTT stimulate tendons, joints and soft tissue to calm pain and support healing, on their own or alongside PRP and stem cell treatment.
Quick answer
Shockwave therapy (ESWT) and EMTT are non-invasive treatments that stimulate healing and calm inflammation in tendons, joints and soft tissue. Dr. Tortland uses radial and focused shockwave and EMTT on their own for tendon pain, calcific tendinitis and arthritis, and around PRP or stem cell injections to prepare tissue and speed recovery.
Time per session
5 to 20 minutes
Anesthesia
Usually none
Typical course
A few sessions, tailored
Downtime
Usually none
Timeline
Builds over several weeks
Imaging
Ultrasound exam first
Needles
None for shockwave or EMTT
Devices
Storz Medical radial, focused and EMTT
Definition
Shockwave therapy (ESWT) delivers radial or focused acoustic pulses into injured tissue, and EMTT delivers magnetic pulses through the skin, with no needle and no incision.
Tendons, ligaments and joints that heal slowly often have poor blood flow and ongoing irritation. Shockwave is thought to trigger a healing response in the treated tissue and, in calcific tendinitis, can help break down calcium deposits. EMTT's magnetic pulses reach deeper tissue and are used for joint and tendon pain, including arthritis.
Dr. Tortland uses radial shockwave (EPAT or softwave), focused shockwave and EMTT, all on Storz Medical devices. Radial shockwave spreads energy over a larger, shallower area. Focused shockwave reaches a precise depth. The choice depends on what the exam and ultrasound show.
Indications
Tendon, ligament and joint problems that have not settled with rest and rehabilitation, confirmed on exam and ultrasound.
Condition pages and related reading from Dr. Tortland:
Calcific tendinitisPlantar fasciitisTennis elbowGolfer's elbowAchilles tendinopathyPatellar tendinopathyHip bursitisRotator cuff tendinopathyPartial rotator cuff tearKnee osteoarthritisHip osteoarthritisShoulder osteoarthritisThumb base arthritisPRPStem cell treatmentHydrodissectionRecovery after treatmentAll treatmentsCan focused shockwave help identify pain sources? (Dr. Tortland's paper)ESWT for plantar fasciitisTennis elbow: non-surgical optionsCorticosteroid injections and tendon damage in tennis elbow (MRI study)Step by step
01
Dr. Tortland examines the painful area and uses ultrasound to see the tendon, joint or deposit, so the right device and settings are chosen.
02
Radial shockwave covers a wider, shallower area. Focused shockwave targets a precise depth. EMTT reaches deeper tissue with magnetic pulses. They can be used alone or together.
03
For patients planning PRP or stem cells, a few sessions before the injection can prepare the tissue. Others begin with sessions alone.
04
A session on the day of the injection is added when it fits the plan. The injection itself is guided by live ultrasound.
05
A few sessions after PRP or stem cell treatment can support recovery and help it move along faster. Dr. Tortland's clinical team gives your specific instructions.
06
Dr. Tortland follows up about six weeks to three months after treatment, compares your symptoms with where you started, and adjusts the plan.
Candidacy
Comparison
| Option | What it does | Needles and downtime | Best for |
|---|---|---|---|
| Radial shockwave (EPAT, softwave) | Spreads acoustic pulses over a wider, shallower area of tendon and muscle | No needle, no anesthesia, usually no downtime | Plantar fasciitis, tennis elbow, tight or irritated soft tissue |
| Focused shockwave | Aims acoustic energy at a precise depth, such as a tendon or calcium deposit | No needle, usually no anesthesia, usually no downtime | Calcific tendinitis, deeper tendon problems |
| EMTT | Magnetic pulses reach deep tissue and joints through the skin | No needle, no skin contact, no downtime | Arthritis, joint and tendon pain, recovery support |
Frequently asked
Radial and focused shockwave can feel like firm tapping or deep pressure, and focused treatment can be uncomfortable over a tender spot. Settings are adjusted to what you can tolerate. EMTT is usually painless: a strap sits over the area while magnetic pulses are delivered.
It depends on the problem and the plan. When shockwave or EMTT supports an injection, Dr. Tortland builds up with a few sessions before, adds one on the day of treatment, and may add a few afterward. Stand-alone courses are also a few sessions, set after your exam.
Radial shockwave (EPAT or softwave) spreads energy over a larger, shallower area and suits broader tendon and muscle problems. Focused shockwave concentrates energy at a precise depth, which suits a deeper tendon or a calcium deposit. Dr. Tortland chooses after your exam and ultrasound.
EMTT (extracorporeal magnetotransduction therapy) uses magnetic pulses that pass through the skin and clothing to reach deep tissue. Shockwave uses acoustic pulses applied with a handpiece. EMTT is used for joint and tendon pain, including arthritis, and the two can be combined.
Dr. Tortland uses them to prepare the tissue before treatment and to support recovery afterward. Sessions often begin ahead of the injection, include the day of treatment, and continue after if needed. The aim is to help recovery move along faster. Research on this combination is still developing, and results vary.
It is one option. Research on shockwave for rotator cuff problems, including calcific tendinitis, is mixed, so Dr. Tortland confirms the deposit on ultrasound first. For milder cases he uses radial or focused shockwave and EMTT, and for larger deposits he adds ultrasound-guided needle lavage with barbotage or Tenjet.
They may ease pain and inflammation in arthritic joints and support function, and Dr. Tortland often pairs them with PRP or stem cell treatment. They do not rebuild worn cartilage, and results vary from person to person.
No. Dr. Tortland's practice is out of network and direct pay, in order to provide un-rushed, comprehensive care. The initial evaluation and comprehensive diagnostic workup is $500.00, and the office confirms your treatment plan and costs before any sessions are scheduled.
Sources
01
Surace SJ, Deitch J, Johnston RV, Buchbinder R. Shock wave therapy for rotator cuff disease with or without calcification. Cochrane Database Syst Rev. 2020;3:CD008962. DOI
02
Lan X, Li L, Jia Q, et al. Physical modalities for the treatment of knee osteoarthritis: a network meta-analysis. Aging Clin Exp Res. 2025;37(1):121. DOI
03
Guede-Rojas F, Rodriguez-Lagos L, Carvajal-Parodi C. Effectiveness of radial extracorporeal shockwave therapy versus other electrophysical modalities on pain and functionality in plantar fasciitis: a systematic review and meta-analysis. Foot Ankle Spec. 2026. DOI
04
Singh P, Kurapatti M, Koehne N, et al. The statistical robustness of literature on extracorporeal shockwave therapy for the treatment of plantar fasciitis. J Foot Ankle Surg. 2026. DOI
05
Storz Medical. Extracorporeal magnetotransduction therapy (EMTT): scientific basis, clinically tested. Manufacturer information. Source
06
Ribeiro da Silva T, et al., Tortland PD. Beyond Therapy: ESWT as a Diagnostic Modality in Musculoskeletal Medicine. Bioengineering. 2026;13(11):1245. DOI
Related
Book an evaluation in Glastonbury, CT, or a telehealth consultation if you are traveling from elsewhere in New England. Dr. Tortland will examine the area, review your imaging and tell you whether shockwave, EMTT or an injection plan fits.