Shockwave Therapy for Tendinopathy
Shockwave therapy for tendinopathy utilizes acoustic waves applied to the affected area, stimulating the body’s natural healing response. This non-invasive therapy increases blood flow, promotes neovascularization, and triggers the release of growth factors, facilitating tissue repair and regeneration. Furthermore, it targets calcifications, reduces inflammation, and provides pain relief, leading to improved symptoms and functional recovery in individuals suffering from tendinopathies.
What is tendinopathy?
Tendinopathy refers to a condition characterized by damage or degeneration of a tendon. Tendons are thick, fibrous cords that connect muscles to bones, enabling movement and providing stability to joints. Tendinopathy can occur in various parts of the body, such as the shoulder, elbow, wrist, hip, knee, or ankle.
Tendinopathy typically develops as a result of repetitive overuse, excessive strain, or age-related degeneration. It can also be caused by acute injuries or certain systemic conditions. Common types of tendinopathy include tendinitis (inflammation of the tendon) and tendinosis (degeneration of the tendon without significant inflammation).
Symptoms of tendinopathy include：
Pain: Tendinopathy typically presents with localized pain in the affected tendon. The pain may be dull, achy, or sharp and may worsen with movement or activity.
Tenderness: The tendon may feel tender to the touch or when pressure is applied directly over it.
Swelling: Inflammation can lead to swelling or mild puffiness around the affected tendon.
Stiffness: Tendinopathy may cause stiffness in the joint or surrounding area, making movement uncomfortable or restricted.
Weakness: Weakened tendon structures can result in a feeling of weakness in the affected limb or joint.
Reduced range of motion: Tendinopathy can limit the normal range of motion in the joint, leading to difficulty in fully flexing, extending, or rotating the affected body part.
What are the different tendon conditions?
Tendinopathies are conditions that affect tendons and commonly manifest as pain and swelling. Some of the most frequently encountered tendinopathies by healthcare providers include:
Achilles tendinitis: This condition involves the Achilles tendon, which is the largest and strongest tendon in the body. It connects the calf muscles to the heel bone.
Patellar tendinitis: The patellar tendon, also known as the kneecap tendon, connects the bottom of the kneecap to the top of the shinbone (tibia). It functions as a ligament, connecting bone to bone rather than muscle to bone.
Rotator cuff tendinitis: The rotator cuff comprises a group of tendons and muscles that provide stability to the shoulder joint.
Other common tendinopathies include:
Tenosynovitis: This condition affects the tendons in the wrist and thumb.
Golfer’s elbow (medial epicondylitis): It involves the tendons on the inner side of the elbow.
Tennis elbow (lateral epicondylitis): This condition affects the tendons on the outer side of the elbow.
Treatment options for tendinopathy
Treatment options for tendinopathy include rest, activity modification, physical therapy to strengthen muscles and improve flexibility, pain management with NSAIDs, orthotics or supports for stabilization, extracorporeal shockwave therapy, corticosteroid injections (in some cases), platelet-rich plasma therapy, and, as a last resort, surgical intervention. The specific treatment approach depends on the severity and location of the tendinopathy.
How can shockwave therapy help tendinopathy?
Shockwave therapy, also known as extracorporeal shock wave therapy (ESWT), is a widely used non-invasive treatment for tendinopathy. This procedure aims to alleviate symptoms and promote healing by delivering high-energy shockwaves to the affected area of the tendon.
Contrary to what the term may imply, shockwaves in this context are acoustic waves rather than electric waves. These shockwaves are generated by a specialized device and precisely targeted to the symptomatic region. When the shockwaves interact with the tissues, they stimulate a cascade of biological responses.
One of the primary effects of ESWT is the promotion of increased blood flow to the area. This heightened circulation helps to accelerate the body’s natural healing process by supplying essential nutrients and oxygen to the injured tendon. Additionally, ESWT is believed to stimulate the release of certain growth factors and promote tissue regeneration.
The term “extracorporeal” in ESWT refers to the fact that the shockwaves are delivered from outside the body. This non-invasive approach allows for targeted treatment without the need for surgical intervention.
“I highly recommend shockwave therapy for tendinopathy due to its remarkable benefits. After just a few treatment sessions, patients often experience significant improvements. This non-invasive procedure stimulates blood flow, accelerates healing, and reduces pain. Its effectiveness has been well-documented, making it an excellent choice for managing tendinopathy. I encourage more patients to consider this treatment option for faster and more effective recovery.”
Scientific Support
Abstracts Worth Recommending
[1] Waugh, C., Morrissey, D., Jones, E., Riley, G., Langberg, H., & Screen, H. (2015). In vivo biological response to extracorporeal shockwave therapy in human tendinopathy: Response of tendinopathy to shockwave therapy. European Cells and Materials 3, 29, 268-280.
[2] Rasmussen, S., Christensen, M., Mathiesen, I., & Simonson, O. (2008). Shockwave therapy for chronic Achilles tendinopathy: a double-blind, randomized clinical trial of efficacy. Acta orthopaedica, 79(2), 249-256.
[3] Pinitkwamdee, S., Laohajaroensombat, S., Orapin, J., & Woratanarat, P. (2020). Effectiveness of extracorporeal shockwave therapy in the treatment of chronic insertional Achilles tendinopathy. Foot & ankle international, 41(4), 403-410.
[4] Vulpiani, M. C., Trischitta, D., Trovato, P., Vetrano, M., & Ferretti, A. (2009). Extracorporeal shockwave therapy (ESWT) in Achilles tendinopathy. A long-term follow-up observational study. Journal of Sports Medicine and Physical Fitness, The, 49(2), 171.
[5] Cacchio, A., Rompe, J. D., Furia, J. P., Susi, P., Santilli, V., & De Paulis, F. (2011). Shockwave therapy for the treatment of chronic proximal hamstring tendinopathy in professional athletes. The American journal of sports medicine, 39(1), 146-153.
[6] Al-Abbad, H., & Simon, J. V. (2013). The effectiveness of extracorporeal shockwave therapy on chronic achilles tendinopathy: a systematic review. Foot & ankle international, 34(1), 33-41.
The Scientific Research behind It
The Effectiveness of Extracorporeal Shockwave Therapy in Lower Limb Tendinopathy: A Systematic Review
https://journals.sagepub.com/doi/abs/10.1177/0363546514531911
Extracorporeal Shockwave Therapy for Patellar Tendinopathy: A Review of the Literature
https://bjsm.bmj.com/content/43/3/163.1.short
Effectiveness and Safety of Shockwave Therapy in Tendinopathies