Can Shockwave Therapy Treat Achilles Tendinopathy?

What is Achilles Tendinitis?

Achilles tendinitis is a common condition that classically affects athletes in jumping or running sports. The pain, inflammation and impaired physical function from Achilles tendinitis can be especially difficult and limiting for athletes trying to stay active and if left untreated, the condition often gets worse over time. 

Extracorporeal Shockwave Therapy, or ESWT, is used to treat a variety of different musculoskeletal conditions including and especially Achilles tendinitis. To understand why ESWT is used so much for Achilles tendinitis we need to take a closer look at the Achilles tendon. 

Achilles tendonitis Image Credit: Mayo Clinic

Achilles tendinitis, is a common cause of heel pain stemming from an injury of the tendon and connective tissue that attaches the calf muscles to the heel bone. This tendon allows for walking, running, jumping and standing on the balls of your feet. When the tendon is put under excess strain, especially repeatedly over a long period of time it can become inflamed and painful. It tends to affect men more often than women and is sometimes associated with bone spurs at the back of the heel. Biomechanical factors that distribute excessive strain to the Achilles tendon are an important risk factor and are important to address in treating this condition. 

What are Achilles Tendinitis Treatment Options?

Achilles Tendinitis is often treated with various options including physical therapy, orthotics, orthobiologic injections like platelet rich plasma or bone marrow concentrate, and surgery. However, it has the reputation of being a difficult condition to resolve, which is likely because of the tendon’s load requirements in combination with its poor blood supply. 

Shockwave Therapy

ESWT involves the delivery of controlled Shock Wave Energy into the tendon in order to stimulate angiogenesis (new blood flow), decrease inflammation and help the tendon remodel.

A systematic review published in the Foot & Ankle International journal concluded that ESWT was a safe and effective option for Achilles tendinitis especially when combined with eccentric exercises and should be performed before surgery is considered. Systematic reviews are extremely useful because they can aggregate data from multiple studies and can make conclusions based on the preponderance of available evidence rather than results from one specific study. 

Achilles tendinitis can be debilitating, especially for people who like dynamic sports or running. Depending on the severity of the condition and the nuances of each patient, you and your doctor should come up with a treatment plan that is right for you. Using the shockwave device can be an important part of that treatment plan so ask your medical provider if it is an option in your specific case. 

If you have been diagnosed with this or have any questions regarding this conditions, our experts are here to help!

References

1. Al-Abbad H, Simon JV. The effectiveness of extracorporeal shock wave therapy on chronic Achilles tendinopathy: a systematic review. Foot Ankle Int. 2013 Jan;34(1):33-41.

2. Kearney R, Costa ML. Insertional Achilles tendinopathy management: a systematic review. Foot Ankle Int. 2010 Aug;31(8):689-94.

3. Featured Image Credit: Canva

About The Author
Ignatios Papas, DO

Ignatios Papas, DO

Ignatios Papas, DO, is a non-surgical orthopedic physician specializing in Physical Medicine and Rehabilitation at Regenexx® at New Regeneration Orthopedics.
Ignatios Papas, DO

Ignatios Papas, DO

Ignatios Papas, DO, is a non-surgical orthopedic physician specializing in Physical Medicine and Rehabilitation at Regenexx® at New Regeneration Orthopedics.

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