A NEW TREATMENT FOR TENDON INJURIES

Shockwave therapy has been around for the last 15 to 20 years and has rapidly gained traction around the world for its ability to heal and regenerate tissue, specifically for those stubborn tendon injuries (Ie. Tendinitis)(1 & 2).

What is it?

Shockwave therapy was originally developed to treat kidney stones\, however researchers soon discovered its benefit in musculoskeletal conditions. Shockwaves, or sound waves, are generated outside the body utilizing a practitioner held device. These shockwaves are transmitted into the body’s tissues and have two primary effects. First, it produces a mechanical force on the point of application (1). Second, it produces cavitation of micro bubbles within the tissue, which through physiological mechanisms produce tissue repair (1). Ultimately, these shockwaves generate improved blood supply and tissue regeneration. This is particularly beneficial for tendon injuries. The application of shockwave therapy to tendon injuries helps vascularize the tissue, leading to a cascade of biological processes and healing the injured tendon (2).

Is shockwave therapy the same as ultrasound?

Shockwave therapy is vastly different from therapeutic ultrasound. Shockwave pattern is uni-phasic with higher peak pressure compared to ultrasound. The peak pressure has been found to be approximately 1000 times that produced by ultrasound (1). The increased pressure is responsible for the biological response within the body.

Is this the same therapy for kidney stones?

Lithotripsy is the treatment of kidney stones using high-energy shockwaves to disintegrate kidney stones. Although the mechanisms by which treating kidney stones and musculoskeletal disorders are the same, the application is different. In lithotripsy the goal is to disintegrate the stone in order for it to pass more easily. In musculoskeletal conditions the goal is to generate extracellular response, which leads to tissue regeneration and repair.

Is shockwave therapy safe?

Shockwave therapy is an affordable, non-surgical option for musculoskeletal injuries. It is safe and well tolerated by patients without any major complications (3).*

What can shockwave therapy treat?

Shockwave therapy has been found to be effective for the treatment of the following conditions (1):

• Plantar fasciitis
• Golfer’s elbow
• Tennis elbow
• Patellar (knee) tendinitis
• Achilles tendinitis
• Calcifying tendinitis of the shoulder
• Rotator cuff tendinitis
• Shin splints
• Frozen shoulder

Shockwave has also been investigated to treat bone fractures and accelerate healing on non-union bone fractures.**

*Please talk to your health-care practitioner to discuss if shockwave therapy is safe for you.

**The use of shockwave therapy for injuries other than musculoskeletal are solely within Medical Physicians’ scope of practice.

Reference

(1) Wang, C.J. (2012). Extracorporeal shockwave therapy in musculoskeletal disorders. Journal of Orthopaedic Surgery and Research 7:11.

(2) Notarnicola, A. & Moretti, B. (212). The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscle, Ligaments and Tendons Journal 2(1): 33-37.

(3) Furia, J.P. (2005). Safety and efficacy of extracorporeal shock wave therapy for chronic lateral epicondylitis. The American Journal of Orthopedics 34(1): 13-9