How the four differ in plain terms.
- TECAR delivers deep warming from inside the tissue, using a radiofrequency current at around 500 kHz to relax and prepare muscle, tendon, and joint tissue before hands-on work and exercise.
- Shockwave delivers strong mechanical pressure pulses to stir up healing in stubborn, long-standing tendon problems that have not settled with other care.
- Class IV laser uses concentrated light energy to influence inflammation and cell activity in the treated area.
- Therapeutic ultrasound uses sound waves for gentle, shallow heating, and the evidence for a strong deep effect is weaker than for the others.
- None of them is a cure on its own. Your physiotherapist chooses which fits your problem, and they are frequently combined inside one plan.
Four tools, four different jobs.
It is easy to lump these machines together because they all live in a physiotherapy clinic and all claim to help pain heal. In practice they work in very different ways. The clearest way to think about it is by what each one actually does to the tissue, because that is what decides which problem it suits.
TECAR is about heat. It warms tissue from the inside so a tight or sore area relaxes and moves more freely, which makes the hands-on treatment and exercise that follow more comfortable and more useful. Shockwave is about mechanical force. It sends firm pressure pulses into a stubborn tendon to wake up a stalled healing response, and it can feel fairly intense. Class IV laser is about light energy reaching the tissue to influence inflammation and cell activity. Therapeutic ultrasound is about gentle heating from sound waves, milder and shallower, with a weaker evidence base for any strong deep effect.
Side by side at a glance.
| Question | TECAR | Shockwave | Class IV laser | Ultrasound |
|---|---|---|---|---|
| Mechanism | Deep heat made inside the tissue by a radiofrequency current at around 500 kHz | Mechanical pressure pulses sent into the tissue | Light energy that influences inflammation and cell activity | Sound waves that create mild, shallow heating |
| Best for | Relaxing and preparing tight or sore muscle and joint tissue before rehab | Stubborn, long-standing tendon problems that have stalled | Settling inflammation and supporting tissue in the treated area | Mild surface heating as a small supporting step |
| What it feels like | A pleasant, deep warmth as the electrode moves over the area | Firm tapping or pulsing that can feel intense for short bursts | Usually little to no strong sensation, sometimes mild warmth | Gentle, often barely noticeable, sometimes slight warmth |
| Typical use | Often early in a session to open the door to hands-on work and exercise | Targeted sessions on a specific chronic tendon over a short course | Applied to a defined area as one supporting step in a visit | A small adjunct, used less now as newer tools have arrived |
| Standalone or adjunct | Adjunct inside a physiotherapy plan, never on its own | Adjunct, paired with loading exercise for the tendon | Adjunct alongside hands-on care and exercise | Adjunct, a minor part of a wider plan |
A simple which one for which problem guide.
Here is a plain way to think about it, with the firm reminder that an assessment, not a web page, decides your actual path. If the main issue is a tight, stiff, or sore area that needs to relax and move better before you can train it, deep warming with TECAR is often a sensible early step. If the main issue is a stubborn tendon problem that has dragged on for months and has not responded to exercise alone, shockwave is the tool built for that kind of stalled case.
If the area is irritated and inflamed and the goal is to calm it while you work on it, Class IV laser is the option aimed at that. Therapeutic ultrasound sits in a smaller role now. It can offer mild heating as a minor supporting step, but it is rarely the centre of a modern plan and its evidence for a strong deep effect is weaker. In many real cases the honest answer is a combination over time rather than a single pick, which is exactly why having all of these under one roof matters.
The clinician chooses, and they are often combined.
The most important point on this whole page is that you do not have to choose the machine yourself. A registered physiotherapist assesses the area, considers how long you have had the problem and how it behaves, and decides which of these tools fits, if any. Often the answer is more than one across a course of care. TECAR might warm and ready an area at the start of a visit so the hands-on work and exercise land better, while shockwave is reserved for a separate session on a chronic tendon.
None of these tools is a treatment by itself. Each one is an adjunct, meaning a supporting tool, inside an active rehabilitation plan, and the lasting improvement comes from that rehab work rather than the device. Because Medstar offers TECAR, shockwave, and Class IV laser in-house, your physiotherapist can match the tool to the problem without sending you elsewhere. To go deeper on a specific pairing, read TECAR compared to shockwave, TECAR compared to laser, and TECAR compared to ultrasound. For general health questions in British Columbia you can also check HealthLinkBC.
Common questions.
Which is best, TECAR, shockwave, laser, or ultrasound?+
There is no single best one. They are four different tools that do different jobs. TECAR delivers deep warming to relax and prepare tissue, shockwave delivers strong pressure pulses to stir up stubborn chronic tendon problems, Class IV laser uses light energy to influence inflammation and cell activity, and therapeutic ultrasound uses sound waves for gentle heating. The right choice depends on your specific problem, how long you have had it, and how it responds. Your physiotherapist makes that call after assessing you, and the same person often uses two of them together over a course of care.
Can these treatments be combined?+
Yes, and they often are. A common pattern is to use TECAR early in a session to warm and relax an area so that hands-on work and exercise are more comfortable, then use shockwave on a separate visit to target a stubborn tendon. They are not rivals fighting for the same slot. They are tools a physiotherapist reaches for at different moments inside one plan. None of them replaces the active rehabilitation that drives lasting recovery.
Is TECAR just a stronger version of ultrasound?+
No. They both create heat, but in different ways and to different depths. Therapeutic ultrasound uses sound waves and produces fairly mild, shallow heating, and the evidence for a strong deep effect is weaker. TECAR uses a radiofrequency current at around 500 kHz to generate heat from inside the tissue itself, which reaches deeper layers more comfortably. They are related in spirit but are not the same machine, and we treat them as separate tools.
Does Medstar offer all four of these?+
We offer TECAR, shockwave therapy, and Class IV laser therapy in our North Vancouver clinic. As far as we are aware, Medstar is the only clinic in the Metro Vancouver area that offers TECAR. Because all of these sit inside a physiotherapy plan rather than being sold on their own, your assessment decides which, if any, fit your case. If you would like the honest one-on-one comparisons, the dedicated pages below go deeper on each pairing.
How do I know which one I need?+
You do not have to work it out alone, and you should be cautious of anyone who promises a single machine will fix you. The sensible route is an assessment with a registered physiotherapist who examines the area, asks how long you have had the problem, and explains which tool fits and why. That conversation, not a label on a device, is what tells you the right path.
Related reading
The only TECAR on the North Shore