Regenerative Sports Medicine: ESWT the Newest Disruptor

July 30, 2021  |  By Elise Hamann

Regenerative Sports Medicine - ESWT the Newest DisruptorJust as Amazon has disrupted the way we shop; shock wave is disrupting sports medicine and how to best treat pain. Before the advent of shock wave therapy, sports medicine treatment relied heavily on corticosteroids injections and surgery to relieve patients plagued with the pain of musculoskeletal disorders and injuries. Today, we live in a world where considering those invasive options at the outset can be viewed as possibly dangerous and likely unnecessary – there’s a better way.


Extracorporeal Shock Wave Therapy for Best-in-Class Outcomes

In the exceptionally competitive world of sports medicine, standing out by offering the most innovative treatments is more important than ever. Traditional approaches to sports medicine have their place and value, certainly, but relying solely on those approaches can lead to mediocre outcomes or worse.  

Thanks to the power of breakthrough, evidence-backed medical technology like ESWT (Extracorporeal Shock Wave Therapy), medical professionals can now offer non-invasive treatment options shown to deliver outstanding outcomes for a variety of musculoskeletal conditions. From weekend warriors to elite athletes, patients are seeking fast, effective solutions to treat their pain and dysfunction. 


ESWT: The Regenerative Sports Medicine Game-Changer 

A recent article by renowned physicians Allison Schroeder, MD of the Mayo Clinic, Adam Tenforde, MD of Spaulding Rehabilitation Hospital, and Elena Jelsing, MD of the Mayo Clinic, was published in Current Sports Medicine Reports. This publication by the American College of Sports Medicine focuses on the use of ESWT in the management of sports medicine injuries. For those dedicated to staying abreast of the latest in sports medicine, this article is not to be missed; dive in to read it in its entirety

Treatment of musculoskeletal conditions in athletes with Extracorporeal Shock Wave Therapy (ESWT) is increasingly popular as evidence continues to mount supporting its use. ESWT treatment protocols can be adjusted in the clinical setting: flexibility exists in applying energy-flux density, the number of impulses, type of shock wave (focused or radial), number/frequency/duration of the treatment session, area of application, and postprocedural therapy protocols. The scientific evidence supports that ESWT can safely be used to treat a multitude of musculoskeletal conditions in athletes, including rotator cuff tendinopathy, lateral elbow epicondlyopathy, greater trochanteric pain syndrome, hamstring tendinopathy, patellar tendinopathy, Achilles tendinopathy, other tendinopathies, plantar fasciopathy, bone stress injuries, and medial tibial stress syndrome. 

In-season athletes can benefit significantly as ESWT requires no downtime away from sport and may result in quick benefits. Additionally. ESWT in conjunction with physical therapy has been shown to facilitate longer-term gains in function and optimize healing outcomes.


Extracorporeal Shock Wave Therapy Basics 

Historically, the best-documented usage for Extracorporeal Shock Wave Therapy (ESWT) was initially reported by Dr. Christian Chaussy back in 1980 in the successful treatment of kidney stones in a lithotripsy procedure and continues to be effective in this setting today.

Thereafter, ESWT was studied in orthopedics with impressive results. Nowadays, the evidence in support of Extracorporeal Shock Wave Therapy is substantial and growing. Sports medicine clinicians find it exceptionally useful to treat musculoskeletal injuries in athletes. 

There are two types of shock wave used in clinical settings: focused shock wave (ESWT) and radial pressure wave (EPAT). See details about each in the chart below.

ESWT VS. EPAT COMPARISON CHART 

 

FOCUSED SHOCK WAVE (ESWT)

RADIAL PRESSURE WAVE (EPAT)

SOURCE

Electrohydraulic, electromagnetic, piezoelectric devices

Pneumatic/ballistic devices

MAXIMAL ENERGY LEVEL

Higher

Lower

DEPTH OF MAXIMUM FORCE

Deeper 

Peak force at superficial structures, attenuated energy at greater depths

 

While the mechanisms of action are still being researched, it’s surmised that shock wave has mechanical and cellular effects which stimulate tissue healing and alter pain signaling. The accepted hypothesis is that ESWT vibrations stimulate regeneration and healing as a consequence of mechanotransduction. Additionally, analgesic and anti-inflammatory effects reduce pain experienced by patient athletes.


The Advantages of ESWT/EPAT in Sports Medicine Practice

Shock wave boasts a host of benefits and non-invasively treats the root cause of pain and dysfunction. By facilitating healing and accelerating recovery timeline, shock wave therapy is a tool of inestimable value in the sports medicine clinical setting.

The International Society for Medical Shockwave Treatment has summarized numerous indications for the use of shockwave. Musculoskeletal indications relevant to a sports medicine practice include the following:

Tendon Pathologies
Bone Pathologies
  • Delayed healing/nonunion
  • Stress fracture
  • Osgood Schlatter disease
  • Medial tibial stress syndrome
  • Bone marrow edema
  • Avascular necrosis
  • Osteochondritis dissecans
Muscle Pathologies
  • Myofascial pain
  • Muscle strain without discontinuity

For a thorough examination of selected pathologies mentioned above, refer to the complete study Extracorporeal Shockwave Therapy in Management of Sports Medicine Injury”. Contraindications to shock wave treatment include a malignant tumor in the treatment area, pregnancy, lung tissue in the treatment area, epiphyseal plate in the treatment area, brain or spine in the treatment area, and finally, severe coagulopathy.  

In conclusion, ESWT and EPAT are safe treatments for peripheral musculoskeletal conditions in athletes and require no downtime, which means little to no time away from sport. Because shock wave reduces pain, inflammation and improves function quickly, athletes suffering from any of the above dysfunctions can benefit from outstanding healing outcomes. Shock wave treatment can be combined with other treatment modalities, like EMTT, and should be used to supplement physical therapy to achieve long-term benefits.


Ready to Harness the Disruptive Power of Shock Wave Therapy?  

You can become a medical disruptor in your region. The time for fitting in has passed, now is the time to stand out by offering the best in regenerative medicine. Offering non-invasive, non-surgical treatment options to your athletes is a winning scenario for both practice and patient. By adding the right new treatment options, you’ll attract a steady stream of athletes as patients, ranging from amateur to elite.

We welcome conversations and are here to assist whenever you’re ready. Contact us today to speak with a shock wave expert. 

The more you know about EPAT, ESWT and other regenerative solutions from CuraMedix, the more effectively you can integrate them into your practice. Take a closer look at the science behind the technology by reading Shock Waves in Sports Medicine from the Level 10 Series.

Topics: Research, ESWT