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I’m pleased to announce that extracorporeal shockwave therapy (ESWT) is now available with London Running Physio at the Run-Fast Sports Clinic based in London’s largest independent running retailer The Running Works.
What is shockwave therapy (ESWT)?
Shockwave or ESWT has been in use for the past 30 years but has only become widely used in the treatment of tendon problems over the past 10 years.
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Shockwave is a non-invasive treatment which uses a device to produce high-energy acoustic shockwaves that are transmitted through the surface of the skin to the target tissue. The most common form of shockwave therapy used clinically are radial shockwaves which are mechanical – not electrically generated waves. The body responds by increasing metabolic activity around the treatment site to encourage and expedite a natural healing process.
What is shockwave used for, and is there any decent evidence for its use?
There is growing evidence that supports the efficacy of shockwave therapy in the treatment of both upper and lower limb tendinopathies such as calcific tendinitis in shoulders, ‘tennis elbow’, gluteal, patella and Achilles tendinopathy as well and plantar fasciitis (or plantar fasciopathy).
Whilst shockwave is not a ‘cure all’ or a ‘silver bullet’, success rates of up to 60-70% have been documented in research literature. The use of shockwave therapy has been recommended for certain conditions by NICE (National Institute for Health and Care Excellence) guidelines for the management of chronic tendinopathies involving conditions such as plantar fasciitis, Achilles tendinopathy and tennis elbow.
A 2014 systematic review by Mani-Babu et al supports the adjunctive role of shockwave therapy noting that:
‘It is evident that there are enough high-quality studies evaluating the effectiveness of ESWT and it is evident that ESWT can play a role in the treatment of patients with lower limb tendinopathies alongside progressive loading and flexibility management’
Is shockwave therapy safe and how long does treatment take?
Shockwave is a recognised treatment in the UK and there are no major safety concerns associated with ESWT. A course of treatment typically consists of 3-4 sessions with a typical treatment interval of 5-10 days. Treatment usually takes 5-10 minutes per session.
What are the advantages of shockwave therapy?
- Shockwave therapy is a non-invasive treatment, therefore there is no need for medication, injections, or surgery.
- Shockwave therapy may result in an immediate reduction in pain.
- There is no need for extended periods of rest from sporting activity (usually a 48 hour period of rest from loading the treated area is recommended).
You can read more about how shockwave therapy has been used in my physiotherapy practice to great effect in both elite and non-elite marathon runners, as a very useful adjunct to more ‘traditional’ physiotherapy treatment in my blog here.
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