shockwave tendon therapy

Shockwave Tendon Therapy

WHAT IS EXTRACORPEAL SHOCK WAVE THERAPY?

Shockwave therapy is a new technology using shockwaves to treat chronic painful musculoskeletal injuries. A shockwave is a very intense but short energy wave that travels faster than the speed of sound and extracorpeal refers to the transmission of the shockwave from outside the body.

Shockwave therapy was originally used as a treatment for kidney stones in the 1980s. The physiological effects of this treatment also demonstrated effects on tissue healing and as such the technology has been utilised in musculoskeletal injury management.

HOW DOES SHOCKWAVE THERAPY WORK?

We use the Longest Radial Shockwave Therapy Device which generates sound waves by an air compressor driving a projectile through a cylinder onto a shock transmitter.

Shockwave therapy helps with improving local blood flow to facilitate healing, stimulation of fibrobasts to increase collagen production, reduce pain through the reduction in substance P (a pain producing chemical), reduce local muscle tension and help breakdown calcific deposits.

Shockwave therapy generally helps is alleviating pain and restoration of function in approximately 60-70% of cases. Generally Shockwave therapy is indicated in chronic conditions that have failed Physiotherapy conservative management.

WHAT CONDITIONS DOES SHOCKWAVE TREAT?

• Plantar fasciitis and heel spurs
• Achilles tendinopathy
• Gluteal tendinopathy
• Calcific tendinitis of shoulder
• Patellar tendinopathy
• Tennis elbow (lateral epicondylagia)
• Other insertional tendinopathies
• Muscle strains
• Calcified heamatomas
• Shin splints
• Recalcitrant trigger points
• Osgood Schlatters disease

WHAT CAN YOU EXPECT?

Shockwave therapy is applied through a hand held device that is placed over the injured area. Patients often describe the noise as sounding like a small jack hammer. Shockwave therapy is generally tolerated well by patients with very few side effects. There can be some discomfort during treatment especially over bony prominences however there are measures we can take to reduce the intensity of the treatment. Generally there will be an immediate reduction in pain due to the effects on your pain pathways but there can be some soreness for 24 hours post treatment. Some short-term side effects include- redness over the treated area and swelling.

We incorporate exercise prescription into your rehabilitation program combined with your shockwave treatment.

HOW MANY TREATMENT SESSIONS WILL I NEED?

Generally patients require 6-8 sessions over a 4-6 week period with 4-7 days between sessions. Treatment generally takes between 5-10 minutes.

ARE THERE ANY PRECAUTIONS/CONTRAINDICATIONS FOR SHOCKWAVE
TREATMENT?

Yes. Please see blow:

• Cortisone injections in the injured area within 4 weeks on commencing treatment.
• Blood thinning medications
• Cancer around the treated area
• Pregnancy
• Nerve or blood supply being too close to the affected area

WHAT IS THE EVIDENCE?

There is extensive research including Randomised Control Trials into the therapeutic effects of Extracorpeal Shockwave Tendon Therapy on a range of musculoskeletal conditions. See below a list of references for your referral.

• Rompe et al 2008, Eccentric Loading Compared with Shock Wave treatment for Chronic Insertional Achilles Tendinopathy, J Bone Joint Surg Am 2008; 90: 52-61
• Han et al 2009, Effect of Extracorporeal Shock Wave Therapy on Cultured Tenocytes, Foot and Ankle International, 30: 93-98
• Furia et al 2007, Extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis and Achilles tendinopathy, Current Opin Orthop 2007; 18: 101- 111
• Rompe, JD; Radial Shock Wave Therapy- Where do we stand today?; Translation from Medical Special, Apr 2006
• Cocchio et al 2006, Effectiveness of Radial Shockwave Therapy For Calcific Tendonitis of the Shoulder: Single Blind Randomised Clinical Study. Physical Therapy. 2006.
• Chang et al 2012. Comparitive Effectiveness of Focus Shockwave Therapy of Diferent Intensity Levels and Radial Shockwave Therapy for Treating Plantar Fasciitis: A systematic Review and Network Meta-Analysis. Arch Phys Med and Rehabilitation, Vol 93.