Shockwave for Pediatric Sports Injuries: From Sidelines to Starting Line, Faster

Pre-season and in-season training place significant physical demands on young athletes, often pushing them to peak intensity.

The Urgency of Pediatric Sports Injuries

Early injuries can derail athletes for extended periods of time to include weeks and sometimes months before the season even gets underway.

Physicians nationwide are seeing that sports injuries among juvenile athletes are on the rise, especially among the younger ones, who are most active in youth sports, playing a different sport each season and working with a variety of muscles, often with inadequate time to rest.

There is considerable concern about how juvenile sports injuries can cause problems.

An unexpected injury can:

• Derail a season.
• Impact and delay healthy physical development.
• Be associated with the risk of long-term musculoskeletal impact.

Pediatricians and other medical professionals are under pressure to help young people recover as quickly as possible, all the while seeking to protect the young patient athlete's future joint and bone health.

Pediatric Sports Injuries: A Growing Challenge

Pre-season and in-season training demand high intensity, placing growing athletes at increased risk for injury. Such challenges can impact both the young athlete and the physician treating them.

Consider the trends, risks, and costs of downtime associated with juvenile athletic injuries.

1. Rising trends: Overuse injuries, ACL tears, and Tommy John surgeries are now appearing in younger athletes. These patterns reflect the increased intensity of youth sports and the  cumulative stress placed on developing joints and growth plates.
2. Unique risks: Because their musculoskeletal systems are still developing, pediatric athletes have vulnerable growth plates that require special consideration. Even routine training loads can contribute to sports injuries when growth and skeletal maturity are not yet complete.
3. Downtime costs: Time away from sport affects more than performance; pediatric athletes may experience physical deconditioning, slower progress in training, and the emotional impact of being sidelined from their peers.

It is critical to recognize pediatric sports injuries as a growing challenge. Their consequences affect both short-term performance and long-term health.

Why Consider Shockwave for Young Athletes with Pediatric Sports Injuries?

Traditional care for pediatric sports injuries typically includes rest, bracing, and NSAIDs. These are known to fall far short of what's needed, which means juvenile athletes on these protocols may not reach full recovery, and that is cause for concern.

Radial Pressure Wave (EPAT) and Focused Shockwave (ESWT) are  evidence-based technologies that provide a non-invasive option for reducing pain, stimulating repair, and supporting accelerated and safer return to play.

Shockwave offers a first-line, non-invasive, regenerative alternative to conventional care.

Benefits of shockwaves for pediatric sports injuries:

• Non-invasive alternative to surgery, appropriate for skeletally immature patients.
• Reduces pain through neuromodulation and improved local circulation.
• Stimulates repair by promoting angiogenesis and tissue regeneration.
• Accelerates return-to-play, shortening recovery timelines without compromising safety.
• Minimizes reliance on long-term NSAIDs or opioids.
• Avoids surgery to prevent growth disruption, and avoid risk to skeletally immature patients.
• Reframing treatment approach and symptom management changes everything by addressing underlying biology (angiogenesis, neuromodulation, tissue repair).

Clinical Data: Evidence Behind Shockwave in Pediatric Sports Injuries

Explore key studies supporting ESWT/EPAT in youth athletes:

Study 1: Focused Extracorporeal Shockwave for Youth Sports-Related Apophyseal Injuries: Case Series

Journal: Journal of Orthopaedic Surgery and Research, Authors: Shafshak T, Amer M

Findings: This retrospective case series examined 22 adolescent athletes (ages 11–15) with Osgood–Schlatter and Sever's disease treated with focused ESWT. Most patients achieved complete pain relief after one to three sessions, with 63% returning to sport within two weeks and no adverse events reported. Findings highlight ESWT's strong safety profile and its ability to accelerate pain resolution and return-to-play timelines in growth-related apophyseal injuries.

Study 2: Shockwaves on Epiphyseal Growth Plates

Journal: Shock Wave Berlin Abstract Book, Authors: Brix C, Lohrer H, Nauck T, et al.

Findings: In two retrospective reviews, adolescent patients with recalcitrant Osgood–Schlatter and Sever's disease received radial shockwave. Long-term follow-up (5–7 years) demonstrated high VISA-P and VISA-A scores, with most patients returning to full sport participation and no reported side effects. This early clinical evidence established shockwave as a safe and effective treatment for growth plate overuse syndromes, challenging the notion that conservative care alone is sufficient.

Study 3: Extracorporeal Shockwave Therapy and the Handstand-Position Radiography for Proximal Humeral Epiphysiolysis in Elite Gymnasts: A Report of Two Cases

Journal: Cureus, Authors: Omodani T, Takahashi N, Takahashi K

Findings: This case report described two elite gymnasts with proximal humeral epiphysiolysis. One athlete treated with focused ESWT experienced rapid bone repair, near-complete pain relief, and a safe return to international competition within three months; markedly faster than reported recovery with rest alone. The findings suggest ESWT's potential to promote bone healing and reduce recurrence risk in high-performance youth athletes.

Study 4: Extracorporeal Shockwave in Osgood–Schlatter and Sever's disease

Journal: Sportverletz Sportschaden, Authors: Lohrer H, Nauck T, Schoell J, et al.

Findings: In one of the earliest prospective reports, Lohrer and colleagues evaluated adolescents with Osgood–Schlatter and Sever's disease treated with radial pressure wave therapy. Patients demonstrated significant long-term pain reduction and functional improvement, with durable results at 3–7 years of follow-up. Importantly, no adverse effects on open growth plates were observed, helping establish ESWT as a safe modality in pediatric populations.

These featured studies provide a clear foundation: from early evidence establishing safety in growth-related conditions to newer research confirming rapid pain resolution, faster return to sport, and long-lasting outcomes.

For physicians treating pediatric sports injuries, shockwave technology is evidence-based. This non-invasive alternative bridges the gap between conservative management and having to undergo surgical intervention.

Practical Applications in Pediatric Sports Medicine

Shockwave has demonstrated utility across a range of pediatric sports injuries, particularly those driven by overuse and growth-related stress.

5 common pediatric sports injuries treatable with shockwave:

1. Osgood–Schlatter disease (knee)
2. Sever's disease (heel)
3. Patellar and Achilles tendinopathies
4. Lateral epicondylopathy ("Little League Elbow")
5. Tibial stress syndromes (shin splints, stress fractures)

Clinical takeaway:

Shockwave supports safe and accelerated return to sports, allowing young athletes to get off the sidelines and back into play by targeting the biological root of pain and dysfunction, not just symptoms.

While the applications are broad, careful attention to safety and treatment protocols is essential when working with skeletally immature athletes.

Clinical Considerations: Safety and Protocols

Shockwave has demonstrated value across various pediatric sports injuries, particularly those driven by overuse and growth-related stress.

• Energy levels and dosing: Lower energy flux densities are recommended in pediatric protocols.
• Session structure: Typically 3–5 sessions at 1-week intervals for overuse conditions; longer monitoring for bone stress injuries.
• Growth plates: Must be respected and handled with care. Treatment zones should avoid direct application over active physis.
• Team-based approach: Physicians, medical professionals, and athletic trainers coordinate to reintegrate youth athletes safely.

While these applications show strong promise, optimal outcomes depend on adhering to age-appropriate safety measures and treatment protocols.

Looking Ahead: Innovation in Youth Sports Medicine

As evidence continues to mount, Shockwave is poised to play an even greater role in youth sports medicine, reshaping how physicians approach prevention, treatment, and long-term athlete health.

• Pediatric sports medicine is shifting from surgery-first to regenerative-first approaches.
• Shockwave is part of an expanding toolkit (with EMTT and orthobiologics) to protect long-term musculoskeletal health.
• Early intervention with non-invasive modalities may reduce the risk of chronic conditions or recurrent injuries into adulthood.

Conclusion: From Bench to Play — Faster, Safer, Smarter

Pediatric sports injuries are common in young athletes whose drive to compete often outpaces the resilience of developing musculoskeletal systems. Shockwave offers physicians a safe, evidence-based option to accelerate recovery while protecting long-term growth and function.

Shockwave is a clinically validated, safe, and effective option for pediatric sports injuries.

Using Shockwaves to treat pediatric sports injuries is a game-changer that has a safe and transformative impact on young athletes. Physicians treating patients with Shockwave enable quicker return to play for juvenile athletes, reduce reliance on drugs or surgery, and safeguard long-term athletic potential.

Providers can explore protocols, training, or device assessments to integrate Shockwave into pediatric sports injury management.

Have questions? Contact us and we'll connect you with a Shockwave technology expert.