However this effect, listed as negative by Rompe et al (1998), has been shown by Wang, Huang & Pai (2002) to be a positive factor! Wang, Huang & Pai et al (2002) demonstrated that shockwaves enhance neovascularization with formation of new capillary and muscularised vessels at the tendon-bone junction of the achilles tendons in dogs. In their study, a statistically significant increase of capillary formation was found with higher energy shock wave (0.60 mJ/mm 2), which also caused more tissue reaction and potential damage to the tendon tissue. Rompe et al (1998) demonstrated the effects of shockwave on the achilles tendon (in rabbits), and suggested that low energy flux density of less than 0.28 mJ/mm 2 should not be used clinically. Shockwave has been used primarily to treat chronic tendinopathy, which is an overuse syndrome categorised by pain/tenderness due to mucoid and chondroid degeneration, formation of plump tenocytes, increased fibroblastic and myofibroblastic cells and absent inflammatory cells (Wang et al., 2007). Wang (2012) reviewed the studies in shockwave and tendinopthies in great detail. There are lots of studies investigating the effects of shockwave therapy on tendinopathies.
Tendinopathy (insertional and mid substance):Ĭommon Conditions: Achilles tendinopathy, Patella tendinopathy (jumpers knee), Quadriceps tendonitis, Lateral/medial epicondylitis (tennis and glofers elbow), Rotator cuff tendinopathy, Hand tendons (De Quervains etc.), Hamstring tendonitis, Tibialis anterior/peronei tendonitis (shin splints), Foot tendons, Bicep/tricep tendonitis. These are generally referred to as the tissue effects of shockwave. These micro structural or cellular effects often culminate together to have macro effects on actual parts of the body. The ones which can currently be proven are explained here. There are many claims for the micro or cellular effects of shockwave. Some of these effects are positive and some negative. Radial shockwave has direct and indirect effects on various structures (cells and hence tissues) throughout the body.
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