Description
This session will present the key findings of the 2025 international modified Delphi consensus published in the British Journal of Sports Medicine on the use of extracorporeal shockwave therapy (ESWT) in sports and musculoskeletal medicine. Faculty including Hye Chang Rhim, Kristina Quirologico, Adam Tenforde, Joshua Romero and Jennifer Soo Hoo will review how 41 international experts achieved consensus on 69 clinical statements addressing terminology, indications, procedural parameters, contraindications and side effects. Core objectives are to (1) standardize shockwave terminology (distinguishing focused ESWT from radial pressure wave therapy), (2) clarify evidence-informed indications across tendinopathies and bone stress injuries, and (3) provide practical, consensus-based treatment parameters that can be implemented in everyday sports medicine practice. The session will combine didactic review of consensus data with case-based discussion to translate recommendations into clinical decision-making. Topics will include energy dosing classifications, session frequency (typically 3–5 treatments spaced 1–2 weeks apart), pain thresholds, avoidance of local anesthesia and NSAIDs, integration with rehabilitation, and specific considerations for tendon versus bone pathology. Areas where consensus was not achieved—particularly procedural aspects of bone treatment—will be highlighted to stimulate discussion and identify research priorities. Attendees will leave with a structured, standardized framework to optimize shockwave utilization, improve methodological consistency, and enhance patient outcomes.
Learning Objectives
After completing this live activity, the participant should be able to:
- Define standardized shockwave terminology, including distinctions between focused extracorporeal shockwave therapy (ESWT) and radial pressure wave therapy, and classify energy levels (low, medium, high) according to consensus recommendations.
- Describe evidence-informed clinical indications for shockwave therapy across common tendon and bone pathologies in sports medicine, including appropriate patient selection.
- Demonstrate appropriate procedural parameters for tendon and bone conditions, including energy titration, treatment intervals, number of sessions, pain thresholds, and integration with rehabilitation.
- Apply consensus-based recommendations to clinical case scenarios in order to optimize treatment planning, minimize complications, and identify areas requiring further research.
Accreditation Statement
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
CME Credit Designation
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) designates this live activityfor a maximum of 0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Disclosure Statement
In accordance with ACCME’s Standards for Integrity and Independence in Accredited Continuing Education, AAPM&R requires all individuals who are in a position to affect the strategic direction of AAPM&R and/or control the content of an educational activity to disclose all financial relationships with any ineligible company within the last 24 months. The ACCME defines an “ineligible company” as any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
Disclosures are made in written form prior to the start of the educational activity, and any potential conflicts of interest that exist are mitigated prior to the start of the activity through AAPM&R’s Conflict of Interest Disclosure and Resolution Policy Process. Individuals in a position to affect the strategic direction of AAPM&R and/or control content and their disclosed financial relationships are listed below.
No other planners, faculty, or individuals in control of content disclosed any relevant financial relationships.
Principle Faculty
Name, Credential(s): Company Name, Nature of financial relationship;
Adam Tenforde MD, FAAPMR - Nothing to disclose
Jennifer Soo Hoo MD, FAAPMR - Nothing to disclose
HC Rhim MD - Nothing to disclose
Joshua Romero MD, FAAPMR - Nothing to disclose
Kristina Quirolgico MD, FAAPMR - Nothing to disclose
AAPM&R Medical Education Committee
Name, Credential(s): Company Name, Nature of financial relationship
Rachel Brakke Holman, MD - Nothing to Disclose
Sarah M. Eickmeyer, MD - Nothing to Disclose
Chelsea D. Frost, MD, MS - Nothing to Disclose
David J. Haustein, MBA,MD,MBA - Relationships to Disclose
Sarah K. Hwang, MD - Nothing to Disclose
Ravi E. Kasi, MD - Nothing to Disclose
Caroline Pupke, DO - Nothing to Disclose
Monica E. Rho, MD - Nothing to Disclose
McCasey R. Smith, MD - Nothing to Disclose
Jennifer A. Soo Hoo, MD - Nothing to Disclose
Brionn K. Tonkin, MD - Nothing to Disclose
Stephanie Tow, MD - Nothing to Disclose
Justin L. Weppner, DO - Nothing to Disclose
Alexandra G. Wolfe, DO - Nothing to Disclose
FDA Disclosures
All faculty members for this activity have disclosed they do not intend to discuss or demonstrate any pharmaceutical or medical device for which FDA clearance has not been approved.