For athletes, post-surgical recovery has always been focused on two main questions: how well does the tissue or bone heal, and how soon can they return to activity? It’s about how quickly and effectively they can return to peak performance. Yet, traditional rehabilitation models don’t take this into account. It’s long been the standard of care to approach rehabilitation timelines as fixed models based on our understanding of the body’s healing process. These guidelines have remained unchanged even as advances in technology and our understanding of biology have changed. The assumption is that healing happens at a fixed pace. Rehabilitation timelines have remained static, but healing doesn’t happen at a specific, predetermined pace or even at the same pace for everyone. What if the recovery timelines are not only malleable but based on the rehabilitation plan itself?
A groundbreaking 2025 pilot study is challenging the current standard as it relates to recovery timelines. While this is a small pilot study and larger controlled trials are needed, the early findings are clinically compelling and warrant further investigation. The findings from this study suggest that when ESWT and EMTT are integrated into standard rehabilitation, patients feel less pain earlier, exhibit earlier signs of healing, and have a faster return to activity.
Specifically with regards to recovery time, ESWT and EMTT have the potential to shorten the gap between surgery and activity, something that rehabilitation alone can’t offer athletes. The study shows the use of ESWT and EMTT may offer more than just short-term relief in the immediate post-surgical window. It suggests that not only can recovery improve with the use of ESWT and EMTT, but it has the ability to change the recovery timeline altogether, giving providers new influence over how rehabilitation timelines and expectations are viewed.
Basing Timelines on Biology
In this matched case-control pilot study, 10 post-operative patients received one session of focused ESWT plus two sessions of EMTT within three weeks of surgery, while 10 matched controls received standard care. The combined-treatment group had substantially lower pain at weight bearing, better early radiographic healing, and a significantly shorter mean time to return to activity.
The study showed return to activity averaged 13.2 weeks in the ESWT + EMTT group compared with 22.4 weeks in controls. That’s a meaningful change in an athlete’s recovery timeline. Not only does this challenge current timelines, but it raises questions about how we view them altogether. What if providers have influence over the length of recovery based on their methodology? What if biology is more responsive in the healing process rather than just a linear progression through a series of stages? If human biology can respond faster with the use of ESWT and EMTT, shouldn’t the timeline be adjusted to reflect that?
For athletes, every additional week of downtime can mean lost conditioning, diminished skill retention, and a longer road back to competitive form. By helping shorten this window, ESWT and EMTT offer a way to preserve performance while supporting safe recovery. The study implies that the use of ESWT and EMTT can not only help athletes recover well but has the potential to allow clinicians to shape when recovery happens. If pain decreases faster, healing signs appear earlier, and return to play occurs sooner, providers are no longer managing the recovery timeline, they’re setting the pace of it. The study suggests ESWT and EMTT could allow practitioners a more active role in returning athletes to play, more than managing a timeline, they could help determine the length of it.
From Following Timelines to Creating Them
The study suggests that the combination of human biology and modern technology can move faster than the current, accepted rehabilitation standards and practices suggest. Providers who understand how to use this technology stand at the forefront of modern rehabilitation and post-surgical care. As the consensus on how rehabilitation timelines are viewed changes, the landscape for providers shifts too. This is more than integrating a modality into rehabilitation programs. It’s a change in a provider’s role within the healing process. More than an additional modality to incorporate, integrating Shockwave into post-op recovery plans is a conscious approach to rehabilitation. Kinas Medical partners with providers to understand how Shockwave can change the game for their practice by collaborating on how to apply the technology within a broader framework to support better outcomes and smarter progression through recovery.
Kinas works with providers to understand how they can go from a passive approach to rehabilitation to impacting timelines, decision-making, and return-to-activity strategy. We’re here to help change the conversation around recovery at 770.612.8245 or email info@kinasmedical.com.
This blog post is based on the study: Saxena et al. (2025). Journal of Orthopaedic Surgery and Research. https://doi.org/10.1186/s13018-025-06420-9. Devices referenced: Duolith™ and Magnetolith™ by Storz Medical AG.**