Shockwave therapy may aid early return to sport

A 14-year-old soccer player achieved fracture consolidation and clearance for unrestricted sports participation at 8 weeks, although the treatment's contribution remains uncertain.

By
Andrea Surnit
October 19, 2026
3 min

MDSpire News

Overview

A case report describes a 14-year-old soccer player with a displaced medial clavicle fracture who received focused electrohydraulic extracorporeal shockwave therapy alongside nonoperative care and was cleared for unrestricted sport on Day 59. Although this was earlier than the anticipated recovery period and a published systematic-review mean of 103 days, the single-patient report cannot establish that shockwave therapy accelerated healing.

Background

Clavicle fractures in adolescents are commonly managed nonoperatively, and return-to-sport decisions are based on clinical and radiographic recovery. The medial clavicle in adolescents presents particular assessment considerations because the medial physis may remain unfused into early adulthood. Shockwave therapy has been used in other musculoskeletal contexts, including tendinopathy, but this case report does not establish its efficacy for pediatric fracture healing. The authors identify the findings as hypothesis-generating and call for prospective studies in pediatric populations.

Data Highlights

Measure	Case report finding
Patient and injury	14-year-old female soccer player; displaced right medial clavicle fracture
Shockwave treatment	Started Day 4; 18 sessions through Day 57; 1,500 shocks per session at 0.05–0.06 mJ/mm²
Imaging and function	Early callus was seen on Day 15; Day 59 radiographs showed robust callus and consolidation, with a stable examination, full functional shoulder use, and no pain
Return to sport	Cleared for unrestricted participation about 8 weeks after treatment began; a cited systematic review reported a mean return-to-play interval of 103 days
Follow-up and safety	At about 1 year, the patient was asymptomatic; no treatment-related adverse events or neurovascular complications were reported
Evidence limitations	Single patient, no comparison group, no standardized pain or functional measures, and no independent blinded radiographic review

Key Findings

Nonoperative management was recommended on Day 3, with an anticipated recovery period of at least 12 weeks; focused electrohydraulic shockwave therapy began on Day 4.
The patient reported less pain after the first session and improved shoulder movement by the fifth session; by Day 21, she could raise her arm overhead and perform daily activities.
Day 15 imaging showed early callus, and Day 59 imaging showed robust callus formation and fracture consolidation. Orthopedic examination documented mechanical stability, full functional shoulder use, and no pain.
After carrying a heavy backpack, Day 50 radiographs showed mild apparent separation at the fracture site. The authors noted that premature loading might have contributed, while differences in radiographic positioning or magnification could also explain the appearance; backpack use was stopped.
Unrestricted sport clearance occurred around 8 weeks after treatment began, compared with a 103-day mean return-to-play interval cited from a systematic review; the authors cautioned that differences in populations and fracture characteristics limit direct comparison.
At approximately 1 year, the patient had no recurrent pain, functional limitation, reinjury, or additional treatment. Healing was not reassessed radiographically at that visit, and the case design does not establish treatment efficacy.

Conclusion

The case describes radiographic consolidation and unrestricted sport clearance by Day 59 after adjunctive focused shockwave therapy for an adolescent medial clavicle fracture. Its uncontrolled, single-patient design leaves the treatment’s effect on healing uncertain.