Biological Effects and Impact of Shockwave Therapy on Tendons

February 6, 2023  |  By CuraMedix

Biological Effects and Impact of Shockwave Therapy on TendonsIn medical circles, Extracorporeal Shockwave Therapy (ESWT) is recognized as an innovative technology and treatment that effectively enhances blood circulation and is shown to accelerate healing rates of a multitude of challenging musculoskeletal conditions. Its efficacy has been proven time and again for numerous conditions, and medical professionals across multiple disciplines recognize the power of shockwave therapy in game-changing patient outcomes. 

That said, staying abreast of the latest findings about shockwave remains invaluable. A newly published study examines scientific literature on the effects and impact of ESWT on tendons. This exhaustive exploration included 7,120 titles — all were reviewed, and researchers eliminated reviews and clinical trials to retain only in vivo or in vitro studies on human and animal tendon tissue. Consider checking the complete study published in Biomedical Reports 18: 15, 2023. This study on ESWT, “Biological Effects of Extracorporeal Shockwave Therapy in Tendons: A systematic review” is authored by Daniela Poenaru, Miruna Ioana Sandulescu, and Delia Cinteza at the Carol Davila University of Medicine and Pharmacy, in Bucharest, Romania

Insights abound in this comprehensive study and further amplify the importance of this non-invasive modality redefining medicine today. 

Materials and Methods of the Systematic Review

Researchers reviewed PubMed and Cochrane Library articles, meeting their determined criteria from papers available in abstracts from 1998 – 2021. The search methodology included the following:

  • Searching for keywords: extracorporeal shock wave, biological effects, human tendon, animal tendon 
  • In vivo or in vitro studies on human and animal tendon tissue, with ESWT application, the full text of 23 records was examined.
  • Studies with quantitative assessment of pain and function were excluded.
  • 7,120 titles that were manually checked to exclude reviews and clinical trials

The literature review is summarized within the study via an expansive Excel spreadsheet. The comprehensive systematic review breaks down findings into the following categories:

  • First author’s name and year of study
  • Type of tendon (human or animal – in vivo or invitro)
  • ESWT doses applied
  • Moments of the analysis
  • Outcomes
  • Histopathologic changes
  • Biomechanical changes
  • Mechanical properties

Results were analyzed to ascertain the optimal dose for achieving the maximum biological effect. Additionally, researchers noted possible consequences of non-optimal dosing. 

Primary Biological Effects of ESWT Application on Tendons

Researchers investigated the biological effects of ESWT on angiogenesis, cellularity, ECM (extracellular matrix), and biomechanical properties of the tendons.

The published studies revealed variability of optimal doses when comparing in vivo and in vitro studies and among different tendons. In terms of cell viability and ECM, it is clear that ESWT brings about a significant dose-related effect.

Biologically speaking, Extracorporeal Shockwave Therapy influences neovascularization in the tendon tissue producing extensive capillary activity. Shockwave therapy acts in two ways, on a cellular and extracellular level, both of which benefit the tendon structure. ESWT is a game-changing treatment for tendons that:

  • Trigger tenocyte proliferation (blast-like) activations
  • Foster enhanced protein synthesis
  • Deliver enhanced mobility by reinvigorating the typical structure of the tendons
  • Contribute to accelerated collagen turnover
  • Increase lubricin expression dependent upon dosage 
  • Bring about the restoration of mechanical load-to-failure
  • Generate vastly improved biomechanical outcomes 

These are just a few of the numerous positive effects and outcomes; examine the study in its entirety for a thorough review of the impact of ESWT in the treatment of tendons. Treated tendons display enhanced biomechanical properties, ensuring increased resistance to stress.

ESWT Promotes Tendon Healing

Extracorporeal Shockwave Therapy is known to awaken the body’s natural healing processes. It is a regenerative therapy that brings new life back to damaged tendons, thus relieving pain and promoting the restoration of compromised tendons producing the biological effects noted previously. This non-invasive treatment approach gives medical practitioners non-surgical options for challenging tendinopathies.

Tendinopathies are quite common in sports medicine among athletes. Explore related articles on Achilles Tendinopathy, Tibialis Posterior Tendinopathy, and Rotator Cuff Tendinopathy.

Harness the Power of Shockwave for Optimal Outcomes and Practice ROI 

In addition to treating tendons, ESWT has been extensively used to manage musculoskeletal disorders like unhealed fractures, lateral epicondylitis, greater trochanteric pain syndrome, medial tibial stress syndrome, osteoarthritis, fracture nonunion, spasticity, and more. 

Adding the right technologies can attract new patients (who are seeking the treatment by name) while simultaneously boosting practice ROI. One thing is clear — the more you know about ESWT and other regenerative solutions from CuraMedix, the more seamlessly you can integrate them into your practice.

It’s important to note that shockwave and EMTT can be used independently or in combination with biologics and ultrasound-led technology to improve your patients’ regenerative potential. Additionally, with regenerative treatment, patients can avoid further damage to an area that is already compromised and has degenerated because of poor blood flow, tissue injury, overuse, or some other cause.

Medical professionals often appreciate hearing experiential feedback from other practitioners to learn what they have to say about shockwave and EMTT. With that in mind, be sure to watch the webinar Treating From Head to Toe Using Shock Wave, EMTT and More and be inspired by how Dr. David Cunningham successfully incorporated regenerative technologies into his practice earning new patients and generating a robust ROI. 

Have questions and wonder what the impact of adding EPAT/ESWT/EMTT to your continuum of care might look like? We’re here to answer any questions and are happy to connect you with one of our team experts — Contact us today!

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Topics: ESWT, EMTT, shockwave