Shockwave, laser, and TECAR for crash injuries — what they do and when they help.

Medstar uses a Class IV high-power laser. The treatment is a form of photobiomodulation, which means light energy is applied to tissue with the aim of supporting the body's own recovery processes. It is not the same as the low-level cold laser many clinics use. A Class IV laser delivers more energy to the tissue, so it can reach deeper structures than a cold laser does.

We say this plainly because the terms get muddled. People often call any clinic laser a cold laser. Medstar's is not a cold laser. How much it helps depends on the tissue being treated and how irritable it is at the time, which is why it is used as one part of a plan rather than on its own.

TECAR stands for capacitive and resistive energy transfer. In everyday terms, it is a device-based treatment that aims to warm and stimulate tissue at depth, deeper than a surface heat pack reaches. The capacitive mode targets softer tissue closer to the surface. The resistive mode targets denser tissue such as tendon and bone. Your physiotherapist selects the mode that suits the area being treated.

TECAR is used to help an area tolerate movement and loading more comfortably, so the real work of the recovery, the exercise progression, can carry on. It is a helper, not a cure, and we judge its value by how your symptoms and function respond over a block of sessions.

Shockwave therapy, also called EPAT, which stands for extracorporeal pulse activation technology, applies pressure waves to a specific area of tissue. There are two broad types. Radial shockwave spreads the energy out near the surface. Focused shockwave concentrates it at a set depth. The physiotherapist chooses based on the tissue and the problem.

Shockwave is most often considered for certain longer-running tendon problems, the kind that have not settled with time and loading alone. It is not a first-week treatment for a fresh crash injury. As a rule, shockwave is not used on acutely inflamed tissue in the early days after a crash.

None of these tools is a stand-alone fix. Each one is an adjunct, paired with the load progression your physiotherapist sets at the assessment. The exercise and graded loading do the heavy lifting in a crash recovery. Laser, TECAR, and shockwave are there to help an area tolerate that work or to nudge a stubborn tissue along.

Timing matters. In the first week or two after a crash, tissue is often irritable, and the focus is on settling symptoms and starting gentle, graded movement. Shockwave in particular is generally held back until that early phase passes, and only used if the tissue and the stage of recovery call for it. Response depends on the tissue, the depth, and how acute things are, so we reassess after the first block and keep using what is clearly helping.

Medstar was the first clinic on the North Shore to offer Class IV high-power laser, and it is the only North Vancouver clinic with TECAR therapy. That gives our physiotherapists more options to draw on when an area needs help tolerating movement or when a stubborn tissue is slow to respond.

Having the equipment does not mean we use it on every visit. The assessment decides what fits. If a modality is right for your stage of recovery, your physiotherapist will explain why and what to expect. If it is not, we will use the session time on what helps more.

These modalities are delivered within physiotherapy care, so coverage runs through your physio sessions rather than through a separate approval. When your physiotherapy is open under ICBC, the in-session tools your physiotherapist chooses are part of that treatment. There is no extra line item you need to ask ICBC to pre-approve.

If you want the full picture of what is pre-approved and how billing works, our guide to what ICBC covers in the first 12 weeks lays out the session counts and the paperwork you need to start.