Abdelkader(2021)- rSWT for Achilles Tendinopathy – Double Blind RCT

 

Here are two papers in which radial shockwave, and focused shockwaves on the effectiveness of radial shockwave and focused shockwave in Achilles tendinopathy all the patients were diagnosed and referred by a physician according to the following criteria unilateral non-insertional Achilles tendon up the, that is pain in the Achilles tendon for at least six months and had failed conservative treatment. The above Abdelkader radial shockwave trial on achilles tendinopathy is complex to read. However the conclusion is the combination of calf eccentric loading with stretching exercises resulted in significant improvement in pain functionality scores in patients with non-insertional Achilles tendinopathy.  However adding in the radial shockwave to this combined treatment protocol of stretching exercises and calf eccentric loading significantly resulted in an improvement in the scores in both long-term and short-term in Achilles tendinopathy which is not insertional.

 

Here is a success story several April 2018 in which Helen used Radial shockwves.

 

 

Focused Shockwaves for Insertional Achilles Tendinopathy

 

Disorders of the Achilles tendon are a frustrating cause of post heel pain stop Achilles tendon injuries occur frequently in runners and jumping athletes and are also common in the general population particularly in the overweight persons. The precise causes and natural history of these injuries remain unknown.
Intrinsic risk factors include hyper pronation, varus deformity of the forefoot, leg length discrepancy, and limited mobility of the subtalar joint. X risk factors include excessive mechanical overload and training errors such as increased interval training excessive hill training increased mileage. The risk factors include poor technique, fatigue, obesity and advanced age.

Extra corporal shockwave therapy has been used successfully since the late 1980s for the treatment of various musculoskeletal disorders including plantar fasciitis, shoulder calcification tendinitis, lateral epicondylitis and non-union fractures of the long bone. There are now multiple randomised double blinded clinical trials that support the evidence of shockwave for plantar fasciitis, lateral epicondylitis and calcification of the shoulder. In contrast there only a few reports that investigate the efficiency of shockwave treatment in the treatment of chronic Achilles tendon none of these pilot studies focused exclusively on the insertional form of Achilles tendinopathy

 

The purpose of the trial in the study below Furia is to determine the efficiency of focused shockwaves for the treatment of adults with chronic insertional Achilles tendinopathy

 

Each patient was treated with a total of 3000 shocks    the outcome seemed to improve again follow-up was 12 months and there was a positive outcome. So while the numbers were small nevertheless the series contributes towards valuable information that further focused shockwaves trials and it demonstrates that focus chopped a is a safe and effective procedure that can be used to treat patients with chronic insertional Achilles tendon apathy

 

 

Furia(2006)- SWT for Insertional AT

 

 

 

 

 

 

 

 

 

It is important to have good assessment, which may include diagnostic ultrasound, or an MRI scan as there are many reasons foot pain and heel pain. Helen has completed many courses on rehabilitation for tendons muscles and ligaments and it is essential that the shockwaves whether you’re having radial shockwaves for mid portion Achilles tendinopath or focused shockwaves for insertional tendinpathy that you follow the best practice rehabilation protocols for your intrinic or extrinic factors involved your achilles and foot pain

 

For this condition is great deal more individual, and complex to treat many patients need more than just these three treatments as suggested in current protocols this is due to the fact that tendons have many different intrinsic and extrinsic factors that cause them to be painful and these other factors must be understood and respected.
Your therapist who has shockwave needs to have completed a thorough educational program and keep up-to-date with current knowledge in tendons and soft tissue injuries
here is an excellent example of the new online by physio tutors and Beony Mathews link to Running Rehab and PhysioTutors http://www.physiotutors.com