They are three different tools that reach different tissue. Focused shockwave is true shockwave: the energy converges at a focal zone below the skin, so it can reach a deep tendon insertion or bone. Radial pressure wave is strongest at the skin and spreads out as it goes deeper, which suits broad, superficial muscle and fascia, and it is not shockwave. EMTT is not a sound wave at all; it is a pulsed electromagnetic field that covers a wide, deep area. A clinic with only one device fits every problem to that device. With all three, the plan fits you.
If you have been living with a tendon or joint that will not settle, you do not have months to spend on the wrong machine. Here is what each tool actually does, and why having all three changes your plan.
What each tool actually does
Focused shockwave: deep and precise
Focused shockwave shapes the pressure wave so it converges at a focal zone below the skin. That is what lets it reach a deep tendon insertion, calcific deposits or bone. In a 250-patient, double-blind FDA trial in chronic plantar fasciitis, focused shockwave reduced heel pain more than placebo (Journal of Bone and Joint Surgery, 2015). It is what we mean when we say shockwave. More on focused shockwave at Dynamic Athlete.
Radial pressure wave: broad and superficial
Radial devices send a pressure wave that is strongest where the applicator touches the skin and spreads out as it travels. That makes them useful for broad, superficial areas: tight muscle, fascia, trigger points. It is a real tool with its own trials: in 245 patients with chronic plantar fasciitis, radial treatment cut heel pain scores by 72% against 45% with placebo (American Journal of Sports Medicine, 2008). But it is not shockwave, and it cannot put its peak energy at depth. Our focused vs radial comparison goes further.
EMTT: a magnetic field, not a sound wave
Extracorporeal magnetotransduction therapy uses a high-energy pulsed electromagnetic field. There is no acoustic wave, and the field covers a wide, deep area rather than a point. In a 126-patient, double-blind trial in knee arthritis, rotator cuff and lumbar joint pain, pain at 12 weeks averaged 2.2 out of 10 with EMTT against 4.2 with sham. In 86 patients with rotator cuff tendinopathy, adding EMTT to shockwave reduced pain more than shockwave alone at 24 weeks. See EMTT in Boulder.
Why stacking them matters
Many real problems are layered: a deep tendon insertion under tight, guarded muscle, or an arthritic joint with irritated tissue around it. Focused shockwave for the deep target, EMTT for the wider field, radial for the superficial layer when it is part of the pain. That is the whole idea of Dynamic Shockwave+. For a side-by-side table of the three, see our focused, radial and EMTT comparison.
When one tool is probably not enough
These are the situations where a single-device plan tends to stall, and where having all three changes the conversation.
- A deep tendon insertion (hip, hamstring, Achilles, shoulder) that radial alone never reached
- Calcific tendinitis, where the deposit sits below the reach of a surface pressure wave
- Arthritis with pain spread across the joint and the tissue around it
- Pain that is layered: a deep target under tight, guarded muscle
- A plan that already failed on one device, with nothing else to offer
Before you book, ask
- Is your device focused shockwave, or a radial pressure wave?
- Do you also offer EMTT, and when would you combine them?
- Who decides the settings, and who trained them?
The question most clinics cannot answer well
Ask which device they own. If the answer is one radial unit, every problem you bring in will be treated with that one unit. That is not a plan, it is an inventory.
Frequently asked questions
Is radial or focused shockwave better?
Neither is better in general; they reach different tissue. Focused shockwave converges its energy at a focal zone below the skin, so it suits deep targets like a tendon insertion, calcific deposits or bone. Radial pressure wave is strongest at the skin and spreads out with depth, so it suits broad, superficial muscle and fascia. In a small randomized trial in patellar tendinopathy, a tendon close to the skin, the two performed about the same. Radial is not true shockwave. The better choice is the one matched to the depth of the problem, and sometimes that is both.
What is the difference between EMTT and ESWT?
ESWT, extracorporeal shockwave therapy, is an acoustic pressure wave. EMTT, extracorporeal magnetotransduction therapy, is a high-energy pulsed electromagnetic field with no acoustic wave. Focused ESWT concentrates energy at a target, while EMTT covers a wide, deep field. They can be used together: in a randomized trial of 86 patients with rotator cuff tendinopathy, shockwave plus EMTT reduced pain more than shockwave with sham EMTT at 24 weeks.
What are the main types of shockwave therapy?
The two devices usually sold as shockwave are focused shockwave and radial pressure wave. Only focused is true shockwave; radial is a separate, more superficial pressure-wave treatment. EMTT is often offered alongside them but is an electromagnetic therapy, not a shockwave.
How deep does radial shockwave penetrate?
Radial pressure wave is strongest at the skin and loses energy as it spreads, so its effect is concentrated in superficial tissue. Focused shockwave is designed to deliver its peak energy at a focal zone below the skin. If your problem sits deep, like a hip or hamstring tendon insertion, depth is the reason focused shockwave is the primary tool.
Why do some clinics only offer one type?
Usually because they own one device. Radial units cost less, so they are more common. That is not a judgment of the clinic, but it does mean every problem gets the same tool. Ask which device a clinic uses before you book.
Does Dynamic Athlete use all three?
Yes. Dynamic Shockwave+ delivers true focused ESWT and EMTT every session on the Storz gold-standard system, with radial pressure wave added when the problem calls for it. Dr. Garg founded and directs the American Shockwave Training Institute, where he trains other clinicians and physicians on focused shockwave.
Is shockwave covered by insurance?
Usually not. Most plans treat shockwave as out-of-pocket. HSA and FSA funds commonly apply, and Cherry financing is available. We give you the full cost of the plan before you start.
Find out which tool your problem needs
Same-week evaluations with Aneesh Garg, DO, CAQ, founder of the American Shockwave Training Institute. We examine the tissue, tell you which tools fit and why, and give you the full cost up front. HSA and FSA funds commonly apply, and Cherry financing is available.
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1790 30th Street Suite 270 · Boulder, CO 80301 · 303-997-1733