Non-invasive · FDA-cleared
EPAT shockwave therapy.
Extracorporeal Pulse Activation Technology, low-frequency acoustic pressure waves delivered through a hand-held applicator to chronic tendinopathy and entheseal pain. No needles. No anesthesia. 10–15 minute weekly sessions.
EPAT
What is EPAT?
EPAT delivers low-frequency radial pressure waves: acoustic energy generated by a pneumatic applicator and coupled to your tissue through ultrasound gel. The waves propagate through skin and into the target tendon, enthesis, or fascia.
The mechanical stimulus produces a measurable biological response: increased local perfusion, growth-factor release, downregulation of substance P, and stimulation of tissue-repair signaling. It's a non-invasive way to trigger many of the same downstream cascades that biologic injections aim to recruit.
EPAT is FDA-cleared (Class II) for musculoskeletal use and is supported by Level 1 evidence for several of its primary indications, most notably plantar fasciitis, Achilles tendinopathy, and chronic tennis elbow.
Honest framing.
EPAT is FDA-cleared as a therapeutic device, not as a cure. We frame outcomes the same way we frame PRP, pain reduction and functional improvement supported by the literature, with response variable by indication, severity, and patient.
EPAT is often the first-line tool we reach for in chronic tendinopathy when patients want a non-invasive option, or as a combination with PRP in stubborn cases.
What it treats
Chronic tendinopathy and entheseal pain.
EPAT works best on chronic conditions: pain that's been present at least 6 weeks and hasn't responded to rest, rehab, or activity modification.
Plantar fasciitis
Chronic heel and arch pain. EPAT's signature indication.
Achilles tendinopathy
Insertional and midportion Achilles pathology.
Tennis elbow
Lateral epicondylitis that hasn't responded to rest and bracing.
Patellar tendinopathy
"Jumper's knee" at the patellar tendon insertion.
Rotator cuff
Calcific and non-calcific rotator cuff tendinopathy.
Trochanteric pain
Greater trochanteric pain syndrome (gluteal tendinopathy).
Hamstring origin
Proximal hamstring tendinopathy, runners, cyclists, prolonged sitting.
Case-by-case
Other chronic entheseal & musculoskeletal pain, evaluated individually.
How it works
What to expect during a visit
Each session is brief and in-clinic, no prep, no recovery time. The therapeutic effect is cumulative across the series.
Targeted exam
Localize the symptomatic structure; confirm the target is in EPAT-amenable depth and tissue.
Coupling & setup
Ultrasound coupling gel applied at the treatment site; energy level set to indication and tolerance.
Pulse delivery
2,000–3,000 pulses delivered through the hand-held applicator across the target area. Some patients describe mild discomfort that subsides immediately when the applicator stops.
Return to activity
No recovery time. Return to normal activity right away. Sessions repeat weekly.
The cadence
Most patients complete a 4–6 session series over 4–6 weeks, with response typically assessed after the full course is finished. Maintenance sessions are rare and case-dependent.
The device
How the device works.
EPAT uses a pneumatically generated, radially-propagating pressure wave. Different from focused-shockwave (ESWT) systems, which deliver higher peak pressure at a more localized focal point.
The EPAT applicator. Pneumatic generation, radial propagation. Hand-held throughout the session.
Is this you?
When EPAT is the right first step.
EPAT is the right next step for many patients with chronic tendinopathy. It's not the right tool for acute injuries, joint-space arthritis, or deep structural pathology.
✓ Likely a fit
- Chronic tendinopathy or fasciitis (> 6 weeks of symptoms)
- Failed PT, activity modification, and conservative care
- Want a non-invasive option before considering injections
- Plantar fasciitis, Achilles, tennis elbow, patellar, or rotator cuff tendinopathy
- Can commit to 4–6 weekly sessions
Frequently asked
EPAT questions.
Does EPAT hurt? +
Most patients describe moderate discomfort during the pulse delivery, somewhere between a deep tissue massage and a tapping sensation, and the discomfort stops immediately when the applicator stops. Energy levels can be adjusted to your tolerance. No anesthesia is needed.
How is this different from "shockwave" I've heard about? +
EPAT is a radial pressure wave system, energy spreads radially from the applicator and is best for surface-to-moderate-depth musculoskeletal targets. Focused shockwave (ESWT) uses a different mechanism that concentrates energy at a deeper focal point. Both are useful; EPAT is what we use for the indications above.
How quickly will I feel better? +
Most patients report noticeable improvement by sessions 3–4, with maximum response 6–12 weeks after the final session, the biological cascade EPAT triggers continues unfolding after the treatment series is complete. Some patients respond faster, some take longer.
Can I combine EPAT with PRP? +
Yes, and often we do. EPAT and PRP target overlapping cellular cascades through different mechanisms. For stubborn tendinopathy that hasn't fully resolved with EPAT alone, combining the two is a common approach. We discuss this on a case-by-case basis.
Does insurance cover EPAT? +
Coverage is variable. Some commercial plans cover EPAT for plantar fasciitis with documented failure of conservative care; most do not. We provide transparent pricing per session and supply HSA/FSA reimbursement documentation where applicable.
Related therapies
Adjacent options.
Schedule an EPAT consultation
Find out if EPAT is the right first step.
Dr. Glowney examines you and recommends honestly: sometimes that's EPAT alone, sometimes EPAT + PRP, sometimes another path entirely. Non-invasive options are taken seriously here.
Or call 720-550-6175