Increasingly, orthobiologics continue to gain interest in regenerative medicine and musculoskeletal healing.
We’ll explore how Extracorporeal Shock Wave Therapy (ESWT) and Extracorporeal Magnetotransduction Therapy (EMTT) can advance orthobiologic outcomes for improved patient success. Level 1 studies support ESWT and EMTT technologies and demonstrate their value in optimizing patient recovery for an ever-expanding list of conditions.
To fully recognize the impact of these advancements, it's critical to understand the science behind orthobiologics and regenerative medicine and how these innovative treatments are redefining the future of medicine and musculoskeletal care.
Understanding Orthobiologics and Regenerative Medicine
Orthobiologics has emerged as a powerful medical tool for pursuing non-surgical solutions to musculoskeletal injuries. These treatment options ignite the body's natural healing processes by harnessing biologically derived substances, offering a revolutionary approach to orthopedic and sports medicine care.
Orthobiologics Definition: Orthobiologics is fast becoming a cornerstone of regenerative medicine and a rapidly evolving field of interest. These treatments are derived from organic substances in the body, including platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and adipose-derived stem cells. They are regularly used in orthopedics, sports medicine, and regenerative medicine as non-surgical treatment options for advancing musculoskeletal healing.
Orthobiologics can accelerate healing in bones, muscles, tendons, and ligaments. These orthobiologics and regenerative medicine treatments leverage the body's natural regenerative capacity to:
- Foster tissue repair
- Minimize inflammation
- Enhance recovery from injuries and degenerative musculoskeletal conditions
Orthobiologics rely on the precise percutaneous placement of treatment types (PRP, etc.) using precise image guidance. These regenerative treatments provide innovative, non-surgical solutions beneficial for acute orthopedic injuries and chronic degenerative musculoskeletal conditions.
This regenerative approach is being recognized as one of the newer and more promising treatment options for muscle, joint, and soft tissue injuries.
While orthobiologics focus on enhancing the body’s innate healing potential, innovative evidence-based technologies like Extracorporeal Shockwave Therapy (ESWT) and Electromagnetic Transduction Therapy (EMTT) take a different yet complementary approach. These modalities stimulate cellular repair and regeneration through targeted mechanical and electromagnetic energy, further expanding the potential for non-invasive musculoskeletal patient care.
A Closer Look at Shockwave and EMTT
Let’s dive into the Art and Science of Shockwave Therapy and EMTT.
For clinicians seeking a deeper understanding of terminology and technical distinctions across shockwave technologies, explore our Shockwave Definitions: A Complete Glossary of Terms, Abbreviations & Acronyms.[EL1]
Shockwave awakens healing via a cascade of biological effects, stem cell activation, and angiogenesis. Two types of shockwave technology should be considered: radial and focused. Each offers unique benefits in advancing patient healing and recovery.
Radial Pressure Wave(EPAT®) has been a game-changer in orthopedics for over 30 years. Designed to target broad yet superficial treatment areas, this technology emits acoustic waves that increase blood flow, stimulate healing, and promote new tissue growth. It is especially efficacious for conditions including plantar fasciitis, myofascial pain, and chronic tendinopathies.
Focused Shockwave (ESWT) delivers higher energy impact and faster impulses than radial waves, which allows for precision targeting of deeper tissues. This makes ESWT an exceptional choice for treating localized pain, chronic tendinopathies, bone stress injuries, non-unions, deep trigger points, and more.
Extracorporeal Magnetotransduction Therapy (EMTT) relies upon high-frequency electromagnetic energy to reduce inflammation and stimulate cellular function. It is a relatively new form of magnetic therapy, revolutionizing regenerative medicine and rehabilitation.
By expanding the treatment options available to practitioners, EMTT is recognized as a highly effective therapy ideal for treating lower back pain, arthritis, and inflammation of tendons and joints.
Regenerative Shockwave and EMTT work independently, in tandem, and as complementary treatments to be added to biologics, increasing the efficacy of orthopedic clinical procedures.
When and Why to Combine Orthobiologics with Shockwave and EMTT
Emerging research continues to validate these outcomes, including findings highlighted in Science Validates: ESWT and EMTT Accelerate Bone Regeneration for Faster Healing, which reinforce the biological rationale for combination therapy.
Combining orthobiologics and regenerative medicine technologies, ESWT and EMTT, enables practitioners to create a stronger biological response that amplifies healing outcomes.
Dr. Brice Blatz, MD, frequently pairs orthobiologics with shockwave and EMTT, noting improved pain relief, function scores, and reduced bone lesion size. Studies show that Shockwave activates PRP, thereby accelerating the release of healing factors.
Dr Blatz's passion for combining orthobiologics with Shockwave and EMTT is revealed in two inspiring webinar presentations. You won’t want to miss these engaging webinars:
- Combining Shockwave and Orthobiologic Therapies: Part 1
- Combining Shockwave and Orthobiologic Therapies: Part 2
In the presentation, Dr. Blatz highlights this integrative approach as a key advancement in regenerative medicine. Combination treatment does the following:
- Energizes PRP and Boosts Cellular Regeneration: ESWT stimulates mesenchymal stem cells, amplifying PRP’s regenerative effects.
- Treats Bone Lesions: Focused shockwaves dramatically enhance the synthesis of biologics into bone tissue.
- Addresses Myofascial Pain and Trigger Points: Radial Pressure Wave optimizes circulation and diminishes muscular dysfunction.
Both presentations delve into best use cases, including:
- Osteoarthritis with Bone Marrow Lesions: Alleviate pain and inhibit joint degeneration.
- Chronic Tendinopathies: Maximizes PRP’s healing impact on tendons.
- Non-Union or Delayed Union Fractures: Facilitates bone healing.
- Post-Surgical Recovery: Ignites tissue repair and enhances rehabilitation.
This combined approach maximizes patient recovery, reduces pain, and may help delay invasive procedures.
Next, we’ll explore a case study that involves orthobiologics, ESWT, and EMTT for more clinical insights.
Clinical Application: A Patient Success Story
It’s crucial to share clinical case successes, and below, you’ll find highlight excerpts from a published patient success story titled “Regenerative Medical Professional Successfully Combines ESWT, EMTT, and Orthobiologics to Treat Pelvic Floor Pathologies.” We encourage you to read the complete patient success story, but have featured key information below.
- The Problem: A 36-year-old female was diagnosed with a left inferior pubic ramus stress fracture and a longstanding labral tear with hip pain.
- Also, the patient had pubic symphysis pain, SI joint pain, and pelvic floor weakness and pain
- The Solution: Combination therapy, including orthobiologics and regenerative medicine technologies (Shockwave and EMTT)
- Key outcomes included:
- Significant pain reduction after ESWT and EMTT treatments
- Further pain reduction post-PRP and PPP injections
- Improved function and accelerated recovery
- Patient is free of postpartum pelvic floor pain and enjoying a renewed active lifestyle
- Best practices for practitioners on implementing this approach:
- Utilizing the full power of what’s available in your medical toolbox
- Synergistic approach to healing, combining therapies, benefits patient outcomes, and reduces recovery timelines
Dr. Aneesh Garg, DO, who treated the patient in this study, is redefining sports medicine at his practice, Dynamic Athlete, in Boulder, Colorado. His reliance on orthobiologics and regenerative medicine technologies provides an innovative approach that heals patients and alleviates their pain without unnecessary stress, downtime, or surgery. By combining regenerative modalities, he gives his patients the highest level of care—no scalpel required.
Practical Implementation for Medical Practices
To optimize patient outcomes, integrating Shockwave and EMTT with orthobiologics requires a strategic approach:
- Modality Integration: Combine these treatment approaches within existing protocols to improve healing timelines and recovery.
- Treatment Protocols: Arrange treatments strategically, starting with EMTT to activate cellular signaling, followed by Shockwave to activate regeneration.
- Ideal Applications: Common conditions benefiting from this combination include tendinopathies, joint degeneration, and non-healing injuries.
By incorporating all three, clinicians can offer a powerful, non-invasive solution for accelerated recovery and pain relief.
Advancing Orthobiologics and Regenerative Medicine with Shockwave and EMTT
While using ESWT and EMTT combined with orthobiologics is still an emerging protocol, early clinical outcomes suggest significant potential for enhancing tissue healing and recovery. These non-invasive advanced modalities open a new world of possibilities for amplifying the effects of orthobiologics, giving patients and physicians more effective, non-surgical solutions.
Though research on the combination approach is still evolving, the growing adoption of regenerative methodologies highlights their value in modern musculoskeletal patient care. As the field continues to grow and advance, those practitioners willing to embrace innovation can stay at the forefront of patient care. By offering cutting-edge, evidence-informed solutions that improve patient outcomes, medical practitioners implementing such procedures will have the opportunity to advance practice growth and patient outcomes.
Frequently Asked Questions
Which patient profiles benefit most from combining orthobiologics with Shockwave and EMTT, and who may not be an ideal candidate?
Patients with chronic tendinopathies, osteoarthritis with bone marrow lesions, stress fractures, and non-healing musculoskeletal injuries show the strongest response, particularly when conservative care has failed. Ideal candidates are those seeking non-surgical solutions with localized pathology amenable to biologic and energy-based stimulation.
What is the recommended sequencing and timing when integrating EMTT, Shockwave (Radial Pressure Wave vs Focused Shockwave), and orthobiologic injections within a treatment protocol?
Best practices suggest initiating EMTT to stimulate cellular activity, followed by Shockwave therapy to activate regenerative signaling, with orthobiologic injections integrated to amplify the healing response. This sequencing is designed to optimize biologic uptake and tissue regeneration.
How does Shockwave biologically “activate” PRP or other orthobiologics, and what evidence supports this synergistic effect?
Shockwave therapy stimulates angiogenesis, stem cell activation, and mechanotransduction, thereby enhancing PRP signaling and accelerating regenerative cascades. Clinical studies and physician-reported outcomes demonstrate improved pain reduction and functional recovery when combined.
How do outcomes with combined ESWT/EMTT and orthobiologics compare to orthobiologics alone for common conditions like tendinopathies, osteoarthritis, or bone marrow lesions?
Combination therapy, applying both ESWT and EMTT, has been shown to improve pain scores, functional outcomes, and tissue healing beyond orthobiologics alone. Physicians report faster recovery timelines and enhanced biologic efficacy when regenerative modalities are added.
Under what clinical circumstances can Radial Pressure Wave and Focused Shockwave treatments be used together in conjunction with PRP to enhance regenerative outcomes?
Radial and focused Shockwave treatments can be strategically combined to address both superficial and deep pathology within a single treatment plan, optimizing circulation, cellular activation, and targeted tissue regeneration. When layered with PRP, this integrative approach enhances biologic uptake, supports angiogenesis, and accelerates healing across complex or multi-layered musculoskeletal conditions.
What practical considerations should practices evaluate before implementing this combined regenerative approach?
Practices should assess protocol integration, staff training, patient education, and the strategic layering of modalities to maximize outcomes. A synergistic, well-structured workflow improves efficiency, patient satisfaction, and clinical results.
Now is the time to evaluate the possibilities and refine best practices in regenerative medicine.
Contact us today, and we’ll connect you with a device expert who can answer your questions and provide insight tailored to your practice needs.
