Summary
Physical therapist Ernie Dixon and operations manager Katie Gagley join host Ben Rogers to discuss extracorporeal shockwave therapy for both musculoskeletal conditions and erectile dysfunction (HISwave). Ernie explains the physics of ESWT including energy delivery measured in megajoules and bars of pressure, where each bar penetrates one centimeter of tissue, and how treatment targets specific injured areas with a sound head. Katie shares practical insights from treating 45-50 HISwave patients, reporting no dissatisfied patients after completing the six-treatment protocol done twice weekly over three weeks. Results typically appear by the third or fourth session, with patients noticing improved morning erections first. The episode also discusses combining shockwave with PRP (platelet-rich plasma) injections for enhanced results in severe ED cases, and the role of the SHIM score questionnaire in assessing ED severity and tailoring treatment protocols.
Key Points
- Energy penetration scales linearly: 1 bar equals 1 centimeter of tissue depth, up to 3 bars for 3 centimeters
- Six-treatment HISwave protocol done twice weekly over three weeks with no dissatisfied patients reported
- Results typically appear by the third or fourth treatment, starting with improved morning erections
- SHIM score questionnaire determines mild, moderate, or severe ED to tailor treatment intensity
- Combining shockwave with PRP injections produces enhanced results for severe ED cases
- Musculoskeletal applications include plantar fasciitis (FDA approved 2000), tennis elbow (FDA approved 2002), rotator cuff, and IT band syndrome
- Maintenance treatments every 3-6 months are recommended to sustain benefits
Key Moments
Energy penetration explained in bars and centimeters
Physical therapist Ernie Dixon explains shockwave energy delivery: each bar of pressure penetrates one centimeter of tissue. The sound head is placed directly over the injured area and the frequency in hertz is combined with energy in megajoules to produce the therapeutic effect.
"like one bar will penetrate one centimeter of tissue. Two bars would be two centimeters of tissue and three bars would be three centimeters."
Zero dissatisfied patients after 50 HISwave treatments
Operations manager Katie reports that after approximately 45-50 HISwave treatments for ED, they have never had a dissatisfied patient who completed the full six-treatment protocol. Results typically begin at the third or fourth session.
"I can successfully say we've never had a disappointed patient after their series of six treatments."
Combining shockwave with PRP for severe ED cases
For severe ED, combining HISwave with PRP (platelet-rich plasma) injections produces enhanced results. The PRP's growth factors supercharge the healing response initiated by shockwave, with about half of patients opting for this combination.
"by doing the P-shot or the PRP shot, the platelets have a growth factor. So that helps stimulate the tissue even more. So it just sort of accelerates that."
