Extracorporeal Shock Wave Therapy is a relatively new alternative method to surgery for the treatment of many bone and muscle disorders. Currently, targeting of shock waves in the human body is done using either ultrasound or x-ray imaging. Many studies have shown controversial treatment results with conclusions that criticize ultrasound targeting. Here it is shown that targeting of the shock waves inside the body is crucial to the result of a treatment. The two different coupling methods of the shock wave generator onto the patient's body are used with gelatin phantoms to give insight into the actual treatments. As a conclusion, x-ray imaging or inline ultrasound with direct coupling should be preferred. In addition, the path of the shock waves should be vertical to the bone surfaces in order to preserve a focal region in the treated area.