How the MASTERPULS® icon has changed my daily practice - An interview with Paul Hobrough

Paul Hobrough has worked with focused and radial shockwave systems for many years in elite sport and complex musculoskeletal practice. He teaches internationally, mentors clinicians worldwide, and was one of the first clinicians globally to receive the new MASTERPULS® icon system in clinical practice.

The following conversation reflects his direct clinical experience using the device daily.

Paul, you were one of the first clinicians to receive the new MASTERPULS® icon. What was your first impression?

Yes, I was fortunate to receive one of the very first units, so there was a real sense of responsibility to properly test it in real clinical conditions.
My first impression was that it felt different immediately. Not just visually, although I do think it looks exceptional, but in how the energy behaved in tissue. When you have worked with shockwave for years, you develop a feel for transmission and control. The icon felt more deliberate, more precise.

That matters when shockwave is central to your treatment philosophy.

What has changed in your daily clinical work since introducing the icon?

Efficiency has improved, but not in a rushed sense. I can reach therapeutic pulse counts more quickly, and in my subjective opinion, patients tolerate higher frequencies far better than with previous systems I have used.

The key shift is that I can deliver a meaningful dose of shockwave without the treatment feeling aggressive. That changes the dynamic in the room. I am able to focus on tissue response rather than managing discomfort.

In my wider blueprint around regenerative therapy, intelligent dosing is everything. It is not about delivering more energy, it is about delivering the right energy with control. The icon supports that approach very well.

Why do you think patients are tolerating higher intensities more comfortably?

It is rarely one single factor. It is the parameter  range, the refinement of the transmitters, and the consistency of energy transmission working together.

My patients say that the treatment feels deeper but smoother. There is less superficial irritation. For dense myofascial tissue, trigger points, or conditions such as Dupuytren’s contracture, that refinement becomes obvious very quickly.

When you treat a high volume of patients across different indications, you notice those subtleties.

We have introduced a new Quick-Lock mechanism to simplify transmitter changes during treatment sessions. Why is that important?

Because it changes behaviour.

With older systems, if changing applicators interrupts your flow, you simply do it less often. That limits how individualised your treatment can be.

With the Quick-Lock system, it takes seconds. It is seamless. I now change transmitters multiple times within a single session depending on tissue depth and density. That has made my treatments more precise.

Shockwave should not be generic. It should be tailored in real time. This feature genuinely supports that.

How does the »Endurance« handpiece compare to what you have used previously?

Ergonomics are more important than people realise. I treat full days, often complex cases, and I also teach internationally. I hold the handpiece like a pen, and the balance is right. I can work for hours without forearm fatigue building.

The integrated feedback on the display allows me to stay visually connected with the patient rather than constantly checking the console. That improves flow and presence, which is underestimated in clinical care.

What role does the high-frequency Burst Mode play in your treatments?

A significant one.

Higher frequency delivery allows a dense pulse application with better tolerance in most of my patients. From a neurophysiological perspective, rapid pulse delivery influences how nociceptive input is perceived. In simple terms, patients are less reactive while I am still delivering a therapeutically meaningful stimulus.

That means more consistent dosing across sessions, which ultimately may support better outcomes.

How are you using the V-ACTOR® in combination with shockwave?

Often briefly at the start. Around thirty seconds can be enough to settle superficial sensitivity and prepare the tissue for further steps.

That short preparation phase improves the quality of the shockwave session that follows. It is efficient and clinically logical. I see it as part of an integrated regenerative approach rather than a separate tool.

Has your overall workflow changed?

Yes, it has become clearer.

The interface, pulse count visibility, and structured feedback help me stay precise with dosing. When you are refining protocols, mentoring clinicians globally, and speaking internationally about standards in shockwave therapy, consistency becomes non-negotiable.

Small workflow improvements accumulate into meaningful clinical gains over time.

What feedback are you hearing from patients?

Very consistent comments. Deeper, smoother, more controlled.

Some patients report noticing progress earlier than they have with previous treatments. Of course, outcomes depend on many variables, but when feedback becomes consistent across different patient groups, you take note.

That is the real test for me: daily clinical reality.

Your overall conclusion on the MASTERPULS® icon?

For me, this is not just another device. It represents a step forward in how radial shockwave can be delivered.

I have worked with shockwave therapy through multiple generations of technology. Being involved early with this system, and contributing clinical feedback into its development, has been important. If we want standards to rise globally, experienced clinicians need to help shape the tools we use.

The MASTERPULS® icon aligns with where I see regenerative therapy heading, more precision, more intelligent dosing, better patient tolerance, and stronger integration into modern musculoskeletal care.
And yes, I do love the aesthetic as well. It looks modern, professional, and refined. That matches the clinical environment I have built and the direction I am pushing towards internationally.

Technology should feel as progressive as the thinking behind it. This one does.

Paul, thank you very much for sharing your experience with us.