“Shockwave” can refer to several things depending on what you’re looking for, and all of them have undergone major changes in recent years. Adobe Shockwave Player, once a staple of internet browsing, was permanently discontinued in 2019. Shockwave Medical, the company behind a groundbreaking cardiovascular device, was acquired by Johnson & Johnson in 2024. And shockwave therapy as a medical treatment continues to evolve, with strong evidence for some uses and an uncertain regulatory path for others.
Adobe Shockwave Player Is Gone for Good
If you’re wondering what happened to the Shockwave plugin that used to power web games, animations, and interactive content, Adobe pulled the plug on April 9, 2019. Shockwave Player reached its official end of life on that date, and you can no longer download it from Adobe’s website.
The reasons were straightforward. Web standards had evolved well beyond what Shockwave was built for. HTML5, WebGL, and modern JavaScript frameworks could handle the interactive content that once required a dedicated plugin, and major browsers were already phasing out plugin support entirely. Adobe had previously ended Flash Player at the end of 2020 for similar reasons, but Shockwave actually died first. If you still have old Shockwave content you want to run, there’s no official way to do it through a modern browser.
Johnson & Johnson Bought Shockwave Medical
Shockwave Medical, the Silicon Valley medtech company known for its cardiovascular devices, was acquired by Johnson & Johnson. The deal closed on May 31, 2024, folding Shockwave into J&J’s MedTech division. The acquisition was driven by one product in particular: Shockwave’s intravascular lithotripsy (IVL) platform, the first and only commercially available system of its kind for treating calcified artery disease.
The purchase gave J&J a strong position in four of the largest and fastest-growing segments of the cardiovascular device market. Combined with its existing heart recovery and electrophysiology businesses, the company now considers itself a category leader across those areas. J&J expects Shockwave to eventually generate at least $1 billion in annual sales, making it one of the company’s priority platforms.
For patients, the brand name still exists. Shockwave’s products continue to be developed and sold under the Johnson & Johnson umbrella. In March 2024, just before the acquisition closed, the FDA cleared a new peripheral IVL catheter. And J&J has since launched a next-generation “forward” IVL platform designed to treat the most severely calcified lesions that older catheters couldn’t even cross. The company is also investigating a technology called the Reducer, designed to redistribute blood flow within the heart for patients with chronic chest pain that doesn’t respond to standard treatments.
How Intravascular Lithotripsy Works
Shockwave Medical’s core technology borrows a concept from kidney stone treatment and applies it inside blood vessels. A catheter with a small balloon is threaded to the site of a calcified blockage in an artery. The balloon inflates at low pressure, and emitters inside it fire pulses of sonic energy directly into the hardened plaque. Each pulse creates tiny cracks in the calcium deposits, both on the surface and deeper within the artery wall.
What makes this different from simply forcing a balloon open at high pressure (which is what traditional angioplasty does) is that the sound waves soften the calcium without damaging the surrounding tissue. After the calcium is fractured, the artery becomes flexible enough that a stent can be placed at much lower pressures than would otherwise be needed. A typical treatment involves at least two rounds of ten pulses per segment of artery, with the balloon briefly deflated between rounds to let any bubbles disperse. Doctors can then use imaging to confirm that the calcium actually cracked.
Shockwave Therapy for Pain and Injuries
Outside of the cardiovascular world, “shockwave therapy” usually refers to extracorporeal shockwave therapy (ESWT), a treatment used by orthopedic doctors, sports medicine specialists, and physical therapists for conditions like plantar fasciitis, tennis elbow, and chronic tendon injuries. This is a completely separate technology from Shockwave Medical’s devices, though the underlying physics (using pressure waves to affect tissue) is related.
The clinical evidence for orthopedic shockwave therapy is largely positive. A systematic review of all randomized controlled trials listed in the PEDro database found that roughly 82% to 89% of studies showed shockwave therapy performed significantly better than placebo or alternative treatments. The typical protocol involves three sessions spaced one week apart, with 2,000 impulses per session at the highest energy level a patient can tolerate. Results tend to be best for chronic conditions that haven’t responded to rest, stretching, or physical therapy alone.
Insurance coverage is a different story. Some major insurers, including UnitedHealthcare, classify ESWT as “unproven and not medically necessary” for musculoskeletal and soft tissue conditions, which means they won’t cover it. Out-of-pocket costs vary widely by provider and region, but you should expect to pay for most or all sessions yourself unless your specific plan says otherwise. The FDA-approved use for ESWT is limited: high-energy treatment for plantar fasciitis has a dedicated billing code, but many other applications use temporary or investigational codes.
Shockwave Therapy for Erectile Dysfunction
Low-intensity shockwave therapy (LiSWT) has gained attention as a potential treatment for erectile dysfunction, marketed heavily by men’s health clinics. The current reality is less exciting than the marketing suggests. LiSWT is not FDA approved for ED. The American Urological Association stated in 2021 that there was insufficient evidence to support shockwave therapy in the routine management of erectile dysfunction.
There’s also an important distinction between devices. True low-intensity shockwave machines are classified by the FDA as Class II medical devices that require medical supervision. Radial pressure wave devices, which are sometimes marketed as “shockwave” therapy, are Class I devices. The FDA considers them equivalent to vibrators. They produce much lower energy and far less tissue penetration. If you’re considering this treatment, knowing which device a clinic actually uses matters, because the two categories are not interchangeable despite often being sold under the same name.