Benefits of Shockwave Therapy for Tendinopathy

Shockwave Therapy is a pressure disturbance that moves through a medium. The medium in this case being the tendon. When the wave enters the tissue it will be reflected and refracted around that area. There is clear evidence of an increase in blood flow with Shockwave Therapy, even in tissues with little blood which occurs in chronic tendon injuries. The shockwaves also create an inflammatory response. When a tendon is in a chronic stage of injury the shockwave will create an environment where the tendon can be at an acute stage. This acute stage will then set the tendon up for self-repair, leading to decreases in pain and increases in function.

There are many scientific research studies showing the benefits of Shockwave Therapy on tendon pain. For Patellar Tendinopathy a group from the University of Groningen, Holland reviewed all the literature and came to the conclusion that the use of Shockwave Therapy will increase function and decrease pain1. In a group of athletes with severe Patellar Tendinopathy for on average 2 years, underwent three sessions of Shockwave Therapy, a 50% decrease in pain was recorded after only 3 weeks6.

Achilles Tendinopathy also benefits from Shockwave Therapy when added to eccentric loading of the tendon. After 4 months, there was an increase in function and a decrease in pain for the group who had undergone Shockwave Therapy and eccentric loading compared to those who just did eccentric loading on its own. 82% had ‘completely recovered’ or were ‘much improved’ after the combined treatment2.  The Tendon Clinic uses tendon loading protocols alongside Shockwave Therapy.

Plantar Fasciitis is a very common presentation among walkers and runners. Shockwave Therapy has been shown through research to help decrease pain in Plantar Fasciitis in a group of runners when compared to a placebo3. In Chronic Plantar Fasciitis, Shockwave Therapy administered on just two occasions had a significant effect on pain levels and function at 4, 12 and 24 weeks after treatment4.

A comprehensive review of Shockwave Therapy by Wang5 concluded that:

  • Shockwave Therapy non-invasive therapeutic modality with effectiveness, convenience and safe
  • Shockwave Therapy has the potential of replacing surgery in many orthopaedic disorders without the surgical risks.
  • Shockwave Therapy has complication rates that are low and negligible

References:

  1. Leeuwen MT, et al. Extracorporeal shockwave therapy for patellar tendinopathy: a review of the literature. British Journal of Sports Medicine.
  2. Rompe JD, et al. 2009. Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial. The American Journal of Sports Medicine.
  3. Rompe JD, et al. 2003. Shock Wave Application for Chronic Plantar Fasciitis in Running Athletes. A Prospective, Randomized, Placebo-Controlled Trial. American Orthopaedic Society for Sports Medicine.
  4. Ibrahim M, et al. 2010 Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy. Foot and Ankle International.
  5. Wang C. 2012 Extracorporeal shockwave therapy in musculoskeletal disorders. Journal of Orthopaedic Surgery and Research.
  6. Zwervera J, et al. 2010 Patient guided Piezo-electric Extracorporeal Shockwave Therapy as a treatment for chronic severe patellar tendinopathy: A pilot study Journal of Back and Musculoskeletal Rehabilitation.