Recently, extracorporeal shock wave therapy (ESWT) has become an alternative in the treatment of spasticity. A byproduct of extracorporeal shock wave lithotripsy, ESWT has emerged as a noninvasive management option for tendon and other pathologies of the musculoskeletal system with minimal unwanted side effects such as temporary skin redness and pain during treatment. Prior studies on tendinopathy showed that ESWT can be as or more effective than other forms of treatment such as eccentric exercise, traditional physiotherapy, steroid injections and surgery. There are two different types of extracorporeal shock waves - focused (fESWT) and radial (rESWT) - and several modes of operation of focused and radial extracorporeal shock wave generators.