As podiatrists, we often embrace new tools and technologies, shockwave therapy being one of the most promising in recent years. In this episode of the Podiatry Legends Podcast, I talk with musculoskeletal podiatrist James Ferrie, who has over 14 years of experience using both radial and focused shockwave therapy in clinical practice.
James didn’t just give us a science lecture; he broke down real-world strategies, clinical pearls, and game-changing observations that can immediately improve your outcomes with shockwave.
James Ferrie’s previous episode 368: Point of Care Ultrasound
The Power of Timing
One of the biggest takeaways? It’s not just about using the device; it’s about when you use it. James emphasises that many podiatrists apply shockwave too early or too aggressively, particularly on acute-on-chronic presentations. That “cytokine soup” he describes needs to settle before introducing radial therapy; otherwise, you’re setting yourself and your patient up for failure.
Radial vs Focused Shockwave
Most clinics use radial shockwave, and that’s fine; it covers 85–90% of conditions, especially superficial issues like plantar fasciitis and Achilles tendinopathy. However, James explains that focused shockwave, though less common, allows for deeper, more targeted treatment, particularly when tissues are hypersensitised or a regenerative response is needed.
His combination approach—using both radial and focused, depending on tissue state and depth shows that shockwave therapy isn’t one-size-fits-all.
Avoiding Common Mistakes – Over or Underdosing
We also discuss the dangers of applying shockwave without a proper understanding of dosing. Many clinicians rely solely on patient tolerance or generic settings. But as James shared, understanding energy flux density, therapeutic zones, and the total energy dose over multiple sessions is what separates average outcomes from excellent ones. Too much or too little, and you will not get the desired results.
Support for New Graduates
This episode isn’t just for seasoned practitioners. James offers heartfelt advice for new grads, emphasising the value of mentorship, structured consults, and surrounding yourself with experienced clinicians. It’s a reminder that great podiatry isn’t taught in lectures; it’s learned from experience and community.
“We’re not researchers, but we’re practising every day. That’s real-world data worth learning from.”
A Must-Attend Event
James is also helping bring the first-ever GDT Summit to Australia (August 16–17, 2025, Melbourne). With hands-on workshops, case study presentations, and expert clinicians across multiple disciplines, it’s the ideal event if you’re ready to take your shockwave skills to the next level.
To Receive Special Discount – $440 per Ticket – CLICK HERE
Whether you’re new to shockwave or looking to refine your technique, this episode is packed with clinical gold. Hit play, take notes, and if you’re serious about improving patient outcomes, check out the GDT Summit.
If you have any questions about this podcast episode or are looking for a speaker for an upcoming event, please email me at tyson@podiatrylegends.com, and we can discuss the range of topics I cover.
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