ESWT works through a process called mechanotransduction. The shockwaves act as mechanical stressors that trigger biochemical changes at a cellular level. This influences:
- Gene expression
- Cell growth and differentiation
- Protein synthesis
- Apoptosis (programmed cell death)
- Tissue regeneration
Notably, recent studies show ESWT stimulates lubricin production, a key molecule in tendon and septa function.