Shockwave Specialist
Pediatric Physiotherapist
I Trained So Many Physios I Put Myself Out Of Business
Nov 3, 2026 — 1 hr 18 min — Spasticity
Thijs Janssen, MSc, is the pediatric physiotherapist who introduced shockwave therapy for spasticity into Dutch rehabilitation. He has trained more than 400 physiotherapists and co-authored a 2025 systematic review on shockwave in children with cerebral palsy.
In this conversation, Uran Berisha and Thijs cover which spasticity responds and which does not, why one session can hold for weeks, how shockwave compares with botulinum toxin, and why focused shockwave, not radial, is the tool for erectile dysfunction and Peyronie's disease. They also get into growth plate caution in children, scars after surgery and C-sections, and why a protocol is not a dose.
An honest look at how a treatment goes from "not in the guideline" to standard care.
In this episode:
- Which spasticity responds, and which does not
- One session vs three: how long the effect lasts
- Shockwave and botulinum toxin, alone or combined
- Radial vs focused, including for ED and Peyronie's disease
- Growth plate caution in children
- Why a protocol is not a dose
Chapters
- 00:00Intro
- 01:29How a knee injury led Thijs to shockwave
- 03:36Finding the research on cerebral palsy and stroke
- 04:03The 10 million euro estimate
- 05:37Why rehab centres hesitate: guidelines and reputation
- 08:12Which spasticity responds to shockwave
- 09:57How many sessions, and how long the effect lasts
- 10:37Combining shockwave with botulinum toxin
- 11:26Radial pressure wave or focused shockwave?
- 12:19Do children tolerate the treatment?
- 13:57Starting out: the first device
- 15:28Training 400 physios and going out of business
- 17:51Why radial is the wrong tool for ED and Peyronie's
- 19:36Results for Peyronie's pain and vascular ED
- 22:04Where to learn Thijs's spasticity course
- 23:49Neuromodulation, Mollii suits, and NESA
- 25:31Inside Unpain Clinic: correct dysfunction, stimulate regeneration
- 29:08Pricing a shockwave session
- 30:07Why Dutch physios use shockwave more than anyone
- 32:16No regulation, no training: the North American problem
- 34:16Growth plates: the one caution with children
- 36:46Bad advice: treating through clothing, oil in the applicator
- 38:14The Dutch physio association and knee osteoarthritis
- 40:12"There's no evidence": the argument that won't go away
- 44:48Bone healing, non-unions, and a radial head fracture
- 47:00Uran's son and a metatarsal fracture
- 49:19Brand wars and the fifty factors behind a dose
- 53:45How Uran teaches shockwave
- 56:51The shockwave device collecting dust
- 58:34Who pays for shockwave: Canada vs the Netherlands
- 1:00:06From the first study to everyday care
- 1:03:46What would speed up adoption in North America
- 1:08:35Post-surgical scars and C-sections
- 1:13:34When to start after a C-section, and episiotomy scars
- 1:14:56What's next: organs and abdominal adhesions
- 1:17:15Wrap-up
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