ISMST · ESWT Certification Course · Clinical Module 10
Shockwave Therapy for Bone Healing Disorders
From delayed unions and non-unions to stress fractures, learn how Extracorporeal Shockwave Therapy (ESWT) reactivates stalled bone healing — with union rates comparable to revision surgery, without the operating room.
Co-authored and validated by: Priv.-Doz. Dr. Rainer Mittermayr · part of the official ISMST–ESWT online certification faculty
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One-time payment · €599 incl. VAT · 12 months full access
ISMST-certified curriculum
One module of the official ISMST–ESWT online certification course.
Led by Dr. Mittermayr
Co-authored and validated by Priv.-Doz. Dr. Rainer Mittermayr.
Interactive clinical cases
28 chapters with 16 interactive activities and self-assessment checks.
Evidence-based
Recommendations anchored in published clinical research, free of industry bias.
What you’ll learn
From stalled fracture healing to solid union
In this module, you will explore and interact with material on using Extracorporeal Shockwave Therapy (ESWT) in the treatment of bone indications.
ESWT for bone indications requires using high-energy focused shock waves to stimulate bone healing in conditions like delayed unions, nonunions, or avascular necrosis. This contrasts with low-energy ESWT, often used for soft tissue conditions, where the goal is to reduce pain and inflammation without causing tissue disruption. The key differences lie in energy level, depth of penetration, focal zone size, and biological targets - bone treatments aim to promote regeneration, while soft tissue treatments focus among others on modulation of inflammation and vascular stimulation.
You will explore clinical treatments of approved indications, the process from diagnosis to initial treatment, the limitations and contraindications, and finally, advanced and experimental treatments.
Taught at physician level — structured clinical evidence, treatment rationale and interactive case examples, not device marketing.
After this module you will be able to:
- Identify viable non invasive ESWT treatment options for presenting bone conditions.
- Explain key differences to low-energy treatments as well as advantages of ESWT vs. standard of care.
- Justify a non-invasive approach
- Discuss appropriateness of ESWT as well as efficacy, risks and therapy outcomes.
Inside the module
5 guided study units, chapter by chapter
Every chapter combines concise clinical text with imagery, interactive elements and knowledge checks. Here is what module 10 covers — the full teaching is inside the course.
Exploring ESWT for Bone Indications
Clinical Indications and EvidenceHistory and Where We Are NowESWT vs SurgeryMechanisms of Action in Bone TissueHigh- vs. Low-Intensity ESWTSafety and Contraindications
Case report
Introduction and RelevanceCase Report: ESWT for Non-union of metatarsalCase Report: WristCase Report: Femur
Treatment of Non-Union
Definition and Diagnostic Criteria for NonunionIndications and Suitability for ESWTPre-Treatment Evaluation and Patient SelectionTreatment Protocols and ParametersPatient Positioning and TargetingPost-Treatment Care and Follow-UpLimitations, Risks, and Complications
Treatment Cost
Therapeutic Cost ConsiderationsDirect Procedural CostsAnesthesia and Facility UseHealing and ComplicationsRecovery Time and Productivity LossCost-Effectiveness in Patient Selection
Patient Enhanced Quality of Life
Invasiveness and Patient ComfortPain Management and Anesthesia RequirementsRecovery Time and Return to Daily ActivitiesRisk of Complications and Psychological ImpactTreatment Convenience and Accessibility
From the evidence
A taste of what the module teaches
Up to 90%
Union rates reported in clinical studies of ESWT for fracture nonunions, varying by anatomic location — with healing rates comparable to revision surgery but significantly fewer complications, which is why ESWT is increasingly used as a first-line treatment.
Schaden et al., International Journal of Surgery 201515–30%
Share of tibial fractures in which healing is delayed — up to 15% of closed and up to 30% of open fractures. The module shows how a non-invasive biological stimulus can restart stalled healing before revision surgery is considered.
Module 10.6 — Patient Quality of LifeWatch the experts at work
Treatment demonstrations, step by step
Every clinical module includes video demonstrations by the ISMST faculty — on real patients and in the WaveVision VR environment. No VR headset required.
Non-union fractures — focused shockwaves · Dr. Rainer MittermayrFull video available inside the course
Treat bone healing disorders with confidence — get ISMST-certified.
Introductory price · approx. $699€599 one-time · VAT included · 12 months access
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For medical professionals · eligibility confirmed at registration · includes the complete certification course with all 10 clinical modules, foundations and exam · see the full course
Page last updated: 25 August 2026