Out with the old in with the new!
Physiotherapists and orthopaedic medical professionals whom have kept on the cutting edge of research advances will have largely moved away from many of the electrotherapeutic modalities of the 90’s such as ultrasound and shortwave. However, a relatively new therapy, inspired by lithotripsy (the process of breaking down kidney stones) has shot to fame.
Shockwave, first focused, now radial has been showing incredibly promising results for pain conditions and tendon dysfunction. Much of the research has been focused around tendon issues such as:
Lateral Epicondilitis (Tennis Elbow)
Achilles Tendinopathy (Joggers Heel)
Insertional Hamstring Tendinopathies
Moreover, many of the leading proponents of shockwave such as Dr Ulrich Dreiskliker have been advocating radial shockwave for trigger point therapy.
No other non-surgical orthopaedic treatment has had so many independently validated studies published as ESWT.
How it Works
Shockwaves cause increased blood circulation and angiogenesis (formation of new vessels). This leads to a reduction in concentration of chemicals that sensitise structures to pain.
It is suggested that repeated applications of shockwaves actually help prevent certain slow pain pathways (C-fibres) releasing substance P, therefore reducing pain.
The stimulation of of mesenchymal stem cells induced by the shockwave to increase in number and differentiate to the appropriate tissue.
Nitric oxide which is a vessel dilating gas and pain inhibitor is also released by shockwaves
For Tissue Regeneration
New collagen fibres form due to the release of various growth factors such as VEGF.
Improved cellular proliferation (growth) and collagen synthesis to with a penetration depth of 2-3cm with radial shockwave.
And a bonus….
Studies have also shown that Radial Shockwave is one of the only forms of therapy that has good evidence for reducing cellulite!