Softwave Technology
(Extracorporeal Shockwave Therapy)

SoftWave Technology, a form of Extracorporeal Shockwave Therapy (ESWT), is a non-invasive medical treatment that uses low-intensity, unfocused acoustic shockwaves to stimulate healing, reduce pain, and promote tissue regeneration. Here’s a clear explanation of how it works:

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The History of Softwave Technology

The technology behind lithotripsy, specifically extracorporeal shockwave lithotripsy (ESWL), was discovered through a combination of serendipitous observation, scientific inquiry, and engineering innovation, with roots in the mid-20th century. Here’s a concise overview of its development:

The story begins during World War II when researchers noticed that shockwaves from underwater explosions, like those from depth charges, could cause internal injuries to sailors without visible external damage. This observation led to studies on how pressure waves interact with the human body. In the 1950s, physicist William S. Filler at the University of Illinois explored shockwaves further, noting their ability to fragment brittle materials while leaving elastic tissues unharmed—a principle that would later become central to lithotripsy.

The breakthrough came in the 1960s at Dornier, a German aerospace company. Engineers, including Hubertus Lutz and Hans-Joachim Reichenberger, were studying the effects of shockwaves on aircraft components, specifically how high-speed flight caused pitting on metal surfaces due to atmospheric shockwaves. During one experiment, they observed that a shockwave generated by a high-speed water droplet hitting a surface could shatter a glass plate placed nearby. Intrigued, they began exploring medical applications, hypothesizing that controlled shockwaves might break up kidney stones, which are also brittle, without harming surrounding soft tissues.

Dornier partnered with urologists, including Dr. Ferdinand Eisenberger, to develop this concept. By 1974, they had built a prototype device using an electrohydraulic method: a high-voltage spark discharge in water created a shockwave, which was then focused using an ellipsoidal reflector. The ellipsoid’s geometry ensured that the shockwave converged at a focal point outside the device, where the kidney stone would be positioned, maximizing energy delivery to the stone while minimizing damage to surrounding tissues. Early tests on kidney stones in vitro showed promise, fragmenting the stones into small, passable pieces.

The first human trial occurred in 1980 in Munich, Germany, under the supervision of Dr. Christian Chaussy, a urologist who had joined the project. A 58-year-old patient with kidney stones was treated using the Dornier HM1 (Human Machine 1) lithotripter. The patient was submerged in a water bath to couple the shockwaves to the body, and X-ray imaging guided the positioning of the stone at the shockwave’s focal point. The treatment successfully fragmented the stones, which the patient passed naturally, marking the first non-invasive kidney stone treatment.

The technology was refined through the early 1980s, with the Dornier HM3 model becoming the first commercially available lithotripter in 1984. It received FDA approval in the U.S. that same year, revolutionizing kidney stone treatment by eliminating the need for invasive surgery in many cases. The HM3 used a water bath for wave transmission, but later models adopted gel-based coupling to improve patient comfort and portability.

The discovery of lithotripsy was a classic case of cross-disciplinary innovation: wartime observations of shockwaves, aerospace engineering insights, and medical collaboration converged to create a groundbreaking therapy. By 2025, lithotripsy remains a standard treatment for kidney stones, with over 90% success rates for stones under 2 cm, though challenges like stone recurrence and the need for repeat treatments persist. Its principles also paved the way for technologies like SoftWave, which adapted shockwaves for tissue regeneration.

How does Softwave work?

Cellular Activation: The mechanical stress from shockwaves activates your own stem cells production (within 45 min) and releases growth factors, promoting tissue regeneration and healing.

1# Generation of Shockwaves

The tech behind Softwave's shockwaves was actually discovered accidently while testing depth charges in WWII and later in testing jets at supersonic speeds. As our understanding of how high speed flight increased reaserches in medical world were able to harness this power in the treatment of renal calculi (kidney stones) and urolithiasis (urinary tract stones) called lithotripsy. Softwave Technology uses about 10% of the energy and force used in lithotripsy but the concept is exactly the same. SoftWave devices generate a patented parabolically focused acoustic shockwaves (travelling at 3,355 miles/hour) which generate parallel electrohydraulic acoustic waves that provide the largest and deepest penetration and diagnostic capability than any type of shockwave therapy available on the market. These waves are low-energy, broad-focused pulses that penetrate tissues without causing damage and activating the bodies healing processes.

2# Delivery to Targeted Areas

The clinician applies a gel to the skin to enhance wave transmission and uses the handheld applicator to deliver shockwaves to the affected area (e.g., muscles, tendons, or joints). The waves travel through soft tissues, reaching depths of up to 4 to 5 inches in depth and has a width of soda can, targeting areas of injury or inflammation stimulating biological and cellular changes. The FDA has cleared and approaved of Softwave Therapy for anything that falls under treatment for inflammation, connective tissue disorders, 2nd degree burns, and improving local blood supply.

3# Biological Effects

The shockwaves trigger a cascade of biological responses in the body:

Increased Blood Flow: Shockwaves stimulate angiogenesis (the formation of new blood vessels), improving circulation to the injured area, which supports tissue repair.

Reduction of Inflammation: Shockwaves modulate inflammatory responses, reducing swelling and pain by removing oxidative stresses in conditions like tendonitis or plantar fasciitis.

Breakdown of Scar Tissue: The waves create a shearing force at the cellular level dissolve calcifications or fibrotic tissue, improving tissue elasticity and mobility.

Pain Relief: Shockwaves desensitize nerve endings and release endorphins, providing immediate and lasting pain reduction.

What to expect with Softwave?

Initial Evaluation: Prior to treatment you will have to undergo Atlas Health and Wellnesses Evaluations ($100) to identify movement impairments that are contributing to your problem. Once your Wellness Evaluation has been complete you can sign up for a discounted mapping session and follow-up visit ($100). Following your mapping session you can decide how you would like to proceed with your care.

1st Treatment: During your first treatment you will undergo a "mapping session" to identify areas of myofascial restriction or inflammatory sensitive areas referred to as "hot spots".

Once the "Hot spots" are identified they are then treated. The first 2 treatments take about 10 minutes to ensure proper mapping of "hot spots". Once the "hot spots" confirmed it is recommended to have at least 4 to 5 treatments on these regions (and only requires 5 min of shocks) to properly stimulate the stem cell activation and local migration.

For the first 15 to 20 hours after treatment you should notice a significant decrease in pain and swelling as well as increased mobility and circulation.

After your first session you will also follow-up each session with exercise that is proscribed by Dr. Hartwig to further enhance the healing process and restore you to maximum functional potential.

3rd to 6th Treatment: By the 3rds Softwave session you ought to see around a 60% to 70% reduction in pain in the region you are being treated. After about 5 to 6 treatments you will have stimulated the maximum stem cell production and will continue from 8 to 12 weeks after your last treatment.

Following the 5th to 6th visit you may wish to hold for 2 weeks between treatments sessions and revisit the region later to ensure no more "hotspots" remain. Or you may choose to use your remaining visits in another region.

You will also be doing exercise with Dr. Hartwig before or after each Softwave treatment to ensure we maximize clinical outcomes.

What conditions can Softwave treat?

General:

Muscle strains / tears, Pre/Post op rehabilitation, Chronic pain, Joint replacements, Osteoarthritis, Repetitive use injuries, Spinal instability, Sprained / torn ligaments, Tendonitis, Tendinopathy

Shoulder and Neck:

Adhesive Capsulitis (frozen shoulder), Degenerative disc disease, Disc bulges / herniations, Headaches (migraine, chronic tension, sinus), Neck pain, Rotator cuff tears / repairs, Shoulder impingement, Shoulder Tendinopathies , Thoracic Outlet Syndrome, Whiplash, Cervical Radiculopathy, Cervical Spondylosis, Cervical Stenosis, and Cervical Sprains/Strains.

Elbow and Wrist:

Carpal tunnel syndrome, Dequervains synovitis, Tennis elbow (lateral epicondylitis), Pronator Teres syndrome, Medial Epicondylitis, TFCC sprains,

Back and Hip:

Degenerative disc disease, Disc bulges / herniations, Femoroacetabular impingement, Low Back Pain, Radiculopathy of the lumbar and sacral spine, Spondylolithesis (slipped / fractured vertebra), Trochanteric Bursitis

Knee:

ACL tears / reconstruction, Iliotibial Band (ITB) Syndrome, Meniscus tears / repairs, Knee Osteoarthritis, Patellofemoral Pain syndrome

Ankle and Foot:

Achilles tendonitis, Plantar fasciitis, Posterior Tibialis Tendon disfunction, and Peroneal Tendonitis.

Can Softwave help with post-operative recovery for orthopedic surgeries?

The simple answer is, yes. While it is not a direct treatment for orthopedic surgeries, it can be used as an adjunct therapy to support recovery after certain orthopedic procedures or to potentially delay or avoid surgery in some cases. Below is an explanation of how SoftWave can be applied to post-surgical recovery for specific orthopedic surgeries, based on its mechanisms and clinical applications. Not only can it support recovery after surgery it can also be done prior to surgery as a means to enhance healing and recovery time via its ability to stimulate stem cell production and migration for up to 6 to 12 weeks (following 5 to 6 Softwave Treatments) after cessation of the device! There is still much more research being done currently because the technology is relatively new to the market (Sofwave, a related ultrasound-based technology, hit the market around 2020, with notable adoption by physicians in the U.S. by August of that year, and its parent company went public in May 2021 but was in the European market as far back as 2010 (thanks FDA.....))

Rotator Cuff Repair

Surgery: Repair of torn rotator cuff tendons in the shoulder.
SoftWave’s Role: Post-surgery, SoftWave can reduce pain, decrease inflammation, and promote tendon healing by stimulating blood flow and collagen synthesis. It may also help with scar tissue management, improving shoulder mobility during rehabilitation.
Evidence: Studies show ESWT improves pain and function in rotator cuff tendinopathies, suggesting benefits for post-surgical recovery.

ACL Reconstruction

Surgery: Reconstruction of the anterior cruciate ligament in the knee using grafts.
SoftWave’s Role: SoftWave can enhance graft integration by improving blood flow and reducing inflammation around the knee joint. It may also alleviate post-surgical pain, allowing patients to engage in physical therapy sooner.
Evidence: ESWT has been studied for knee conditions like patellar tendinopathy, with benefits that could translate to post-ACL recovery.

Meniscus Repair or Partial Meniscectomy

Surgery: Repair or removal of damaged meniscus tissue in the knee.
SoftWave’s Role: SoftWave may support cartilage and soft tissue healing, reduce swelling, and improve knee function post-surgery. It can also address residual pain or stiffness during rehab.
Evidence: Limited studies suggest ESWT may aid cartilage repair, though more research is needed for post-meniscectomy applications.

Achilles Tendon Repair

Surgery: Repair of a ruptured or torn Achilles tendon.
SoftWave’s Role: SoftWave can accelerate tendon healing by promoting collagen production and reducing scar tissue formation. It may also improve ankle mobility and reduce post-surgical pain.
Evidence: ESWT is well-documented for Achilles tendinopathy, with studies showing improved tendon repair and function, applicable to post-surgical cases.

Plantar Fascia Release Surgery

Surgery: Partial release of the plantar fascia to treat severe plantar fasciitis.
SoftWave’s Role: Post-surgery, SoftWave can reduce pain, promote tissue healing, and prevent excessive scar tissue, aiding faster recovery and return to weight-bearing activities.
Evidence: SoftWave is FDA-cleared for plantar fasciitis, with studies showing significant pain reduction and functional improvement, supporting its post-surgical use.

Carpal Tunnel Release

Surgery: Release of the transverse carpal ligament to relieve median nerve compression.
SoftWave’s Role: SoftWave may reduce post-surgical inflammation, alleviate residual pain, and improve wrist mobility by enhancing blood flow and tissue repair.
Evidence: ESWT has been explored for nerve-related pain and inflammation, suggesting potential benefits for post-carpal tunnel recovery.

Spinal Surgeries (e.g., Discectomy, Laminectomy)

Surgery: Procedures to address herniated discs or spinal stenosis.
SoftWave’s Role: SoftWave may help manage post-surgical back pain, reduce muscle spasms, and improve tissue healing around the surgical site. It can support rehab by easing discomfort during physical therapy.
Evidence: ESWT is less studied for spinal conditions, but its anti-inflammatory and pain-relieving effects could aid recovery, particularly for myofascial pain post-surgery.

Joint Arthroscopy (e.g., Shoulder, Knee, Ankle, Hip)

Surgery: Minimally invasive procedures to repair cartilage, ligaments, or labrum.
SoftWave’s Role: SoftWave can reduce post-operative swelling, promote soft tissue healing, and enhance joint function, aiding quicker return to activity.
Evidence: ESWT’s benefits for joint-related conditions (e.g., osteoarthritis) suggest it could support arthroscopic recovery.

Fracture Fixation (e.g., ORIF - Open Reduction Internal Fixation)

Surgery: Surgical stabilization of fractures using plates, screws, or pins.
SoftWave’s Role: SoftWave may accelerate bone and soft tissue healing, reduce pain, and improve circulation around the fracture site, potentially speeding up rehab.
Evidence: ESWT is used for non-union fractures and delayed healing, with studies showing enhanced bone repair, which could benefit post-ORIF recovery.

**Timing: SoftWave is typically introduced after the acute post-surgical phase (e.g., 2-6 weeks post-op, depending on the procedure), once incisions are healed and the surgeon approves.**

Softwave Technology (Extracorporeal Shockwave Therapy)

The History of Softwave Technology

How does Softwave work?

What to expect with Softwave?

What conditions can Softwave treat?

Softwave Technology
(Extracorporeal Shockwave Therapy)