# Wound healing in dogs: Focused shock wave therapy for complex wounds Thursday, 17 September 2026 8 Hits [  ](//www.storzmedical.com/images/easyblog_articles/3432/dog-with-bandage-wound-healing.jpg "Wound healing in dogs: Focused shock wave therapy for complex wounds") For complex wounds, focused shock wave therapy can complement veterinary treatment as part of a multimodal approach. This is illustrated by a case documented by rehabilitation specialist Kirsten Häusler involving a female German Shepherd that developed an open wound in the area of the tarsal joint while a toe fracture was being treated with a splint. Splints and bandages are necessary for certain injuries to protect and stabilise the affected structures. At the same time, pressure, friction and moisture can place stress on the skin. If this results in a wound, it presents an additional challenge alongside the original injury in terms of treatment and rehabilitation. The situation can be particularly challenging when the wound is located near a joint or tendon insertion. In addition to wound care, the function of the adjacent structures and the rehabilitation of the original injury must also be taken into account. ## Why the location of the wound matters The healing process of a wound is influenced not only by its size and depth, but also by its anatomical location. If the wound is located near a joint or tendon insertion, the affected tissue is subjected to stress with almost every movement. At the same time, prolonged immobilisation can impair the mobility of the surrounding structures. Treatment must therefore take into account both the restoration of skin integrity and the function of the adjacent structures. Regular checks of the skin, padding and bandage are important to identify potential problems at an early stage. ## Focused shock wave therapy as a complementary treatment option In cases involving complex or delayed healing, physical therapy modalities can complement veterinary wound care. However, they do not replace professional assessment of the wound or necessary measures such as cleaning, infection control, wound dressing and appropriate bandage management. During focused shock wave therapy, mechanical impulses are delivered specifically into the tissue. The cells respond to these stimuli and convert them into biological signals. This process is known as mechanotransduction. Experimental investigations and findings from human medicine describe various biological processes in this context. However, their transferability and clinical significance for wound treatment in animals must be assessed on an individual basis: - Stimulation of cell permeability1 - Improved tissue supply through the release of eNOS2 - Release of growth factors, such as VEGF2 - Cell regeneration, activation of stem cells and associated regenerative processes3 - Improved blood circulation through angiogenesis4 - Antibacterial and anti-inflammatory effects5 The following case study demonstrates how focused shock wave therapy can be used in practice within a multimodal treatment approach. ## Case study: Wound at the tarsal joint of a German Shepherd Quibble, a five-year-old female German Shepherd, developed an open wound in the area of the tarsal joint during several weeks of splinting for a toe fracture. Friction, displaced padding and moisture penetration had placed stress on the skin. Due to the location on the calcaneus and close to the Achilles tendon insertion, swelling was also present in a functionally sensitive area. In consultation with the treating veterinary clinic, it was decided not to apply another rigid splint and the wound care protocol was adjusted. A combination of low-level laser therapy and focused shock wave therapy was used as an adjunctive treatment. The wound was initially treated with a Class 3B laser. Focused shock waves were then applied using a sterile gel pad. Shock wave treatment was performed with 1000 pulses, an energy flux density of 0.07 to 0.1 mJ/mm2 and a frequency of 6 Hz. A total of six sessions were carried out.\* During the documented course of treatment, the wound closed. At the same time, the swelling around the calcaneus decreased. The function of the affected hind limb was additionally monitored using objective gait analysis. As several measures were combined, the observed outcome cannot be attributed to any single component of the treatment. ## What does this case demonstrate for clinical practice? The case study illustrates that, when treating wounds near joints and tendon insertions, not only the skin injury but also its cause, anatomical location and potential functional effects should be taken into account. Regular checks of splints and bandages are important to identify stress caused by pressure, friction or moisture at an early stage. The documented course illustrates how wound care, low-level laser therapy, focused shock wave therapy and functional follow-up assessments were used within a multimodal treatment approach. **Learn more about the applications of shock wave therapy in veterinary medicine and discover our treatment systems for small animals.** \*The parameters used describe an individual case and do not constitute a general treatment recommendation. ## References 1. Huang, C., et al. (2013). Mechanotherapy: revisiting physical therapy and recruiting mechanobiology for a new era in medicine. Trends in Molecular Medicine, 19(9), 555 – 564. [https://doi.org/10.1016/j.molmed.2013.05.005](https://doi.org/10.1016/j.molmed.2013.05.005 "Read the study on mechanotherapy, mechanobiology and the therapeutic effects of mechanical forces in medicine.") 2. Ha, C. H., et al. (2013). Extracorporeal shock wave stimulates expression of the angiogenic genes via mechanosensory complex in endothelial cells: Mimetic effect of fluid shear stress in endothelial cells. International Journal of Cardiology, 168(4), 4168 – 4177. [https://doi.org/10.1016/j.ijcard.2013.07.112](https://doi.org/10.1016/j.ijcard.2013.07.112 "Read the study on extracorporeal shock wave therapy, angiogenesis and mechanosensory signalling in endothelial cells.") 3. Weihs, A. M., et al. (2014). Shock wave treatment enhances cell proliferation and improves wound healing by ATP release-coupled extracellular signal-regulated kinase (ERK) activation. The Journal of Biological Chemistry, 289(39), 27090 – 27104. [https://doi.org/10.1074/jbc.m114.580936](https://doi.org/10.1074/jbc.m114.580936 "Read the study on shock wave therapy, cell proliferation and improved wound healing through ATP-mediated ERK activation.") 4. Mittermayr, R., et al. (2011). Extracorporeal shock wave therapy (ESWT) minimizes ischemic tissue necrosis irrespective of application time and promotes tissue revascularization by stimulating angiogenesis. Annals of Surgery, 253(5), 1024 – 1032. [https://doi.org/10.1097/sla.0b013e3182121d6e](https://doi.org/10.1097/sla.0b013e3182121d6e "Read the study on extracorporeal shock wave therapy (ESWT), ischemic tissue protection, angiogenesis and tissue revascularization.") 5. Moretti, B. et al. (2008). Extracorporeal shock waves down-regulate the expression of interleukin-10 and tumor necrosis factor-alpha in osteoarthritic chondrocytes. BMC Musculoskeletal Disorders, 9(16), 1471 – 2474. [https://doi.org/10.1186/1471-2474-9-16](https://doi.org/10.1186/1471-2474-9-16 "Read the study on extracorporeal shock wave therapy (ESWT), osteoarthritis and its effects on inflammatory markers in cartilage cells.") 0