Who should not do shockwave therapy?

Several groups should not use shockwave therapy, including people with blood clotting disorders, active infections or open wounds at the treatment site, implanted pacemakers or metal hardware near the target area, and anyone who is pregnant.

Shockwave therapy works by delivering mechanical pressure waves into tissue — that same mechanism is why certain conditions make it contraindicated. The pressure wave stimulates circulation and a localized inflammatory response, which is beneficial for chronic tendinopathies but dangerous over active infections, malignancies, or areas with compromised blood coagulation. Radial ESWT devices like the Kalecope Q60 and T800 should also never be applied directly over the spine, skull, or major nerve trunks.

• Absolute contraindications for shockwave therapy include: active malignancy at the treatment site, blood coagulation disorders, and cardiac pacemakers.
• Shockwave therapy is contraindicated during pregnancy, regardless of treatment area.
• Kalecope radial devices should not be applied over the spine, skull, major nerve trunks, or open wounds.
• Metal implants (screws, plates) near the target tissue are a contraindication for direct shockwave application at that site.
• Children under 18 with open growth plates should not receive shockwave therapy on or near those areas.