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Extracorporeal Radial Shockwave Medicine

Published: December 10, 2018

History of Shockwave Medicine at Back In Motion Bribie Island 

Back In Motion Bribie Island was one of the early adopters of extracorporeal radial shockwave medicine in Queensland. We have been utilising the technology for the past eight years. Back In Motion Bribie Island initially invested considerable time in conducting in house clinical trialling of several radial shockwave machines, to ensure our clients got the best clinical outcomes. We also invested heavily in the training of the  staff, traveling as far as Europe to attain international accreditation in the medical application of shockwave therapy; and have keep up to date with the latest medical shockwave research by conducting regular literature reviews, and attending regular international conferences (ISMST). 

Shockwave medicine has been proven to assist with pain relief and accelerated healing to people with stubborn, painful tendon injuries as well as musculoskeletal, orthopaedic, and sports-related injuries over the past 21 years. 

Our tissues take longer to heal where blood flow sparse, one tissue is tendon. Tendon injuries can cause a lifetime of pain for many people, with trauma from continued overuse leading to inflammation, degeneration and weakening of the tendon - even tendon rupture.

What is shockwave therapy?

Unlike the name suggests, extracorporeal radial shockwave is not an electric shock, it is actually an acoustic soundwave. What is unique about the soundwave is that it is an actual shockwave. A shockwave is characterised by a very rapid rise and a rapid drop in pressure. Shockwave medicine delivers acoustic shockwaves at low frequency to injured areas of the body via a hand-held device through a conducting gel. These pulses stimulate/accelerate the body’s natural healing process, by increasing blood flow (through a process called neovascularisation), reducing pain producing substances (substance p) and stimulating cellular repair (attract repair cells to the target tissue), thereby reducing pain and improving tissue function.  

Benefit of shockwave medicine 

At Back In Motion Bribie Island we see many clients with chronic tendon and musculoskeletal injuries. We always recommend shockwave medicine as “best practice” for these types of injuries. The clinical results we observe, and the literature supports this therapy in nearly all instances. It is important that your injury is assessed by an appropriately trained physiotherapist, to ensure that shockwave medicine is right for you. 

Clinical trials have shown that shockwave therapy has an up to 90%per cent success ratein some conditions in only three to five sessions. 

Research has shown that targeting these areas with extracorporeal shockwave, increases new blood vessel formation, stimulates cellular regeneration, thereby accelerate the body’s natural healing ability 2

In addition to immediate pain relief for many conditions, through a combination of shockwave and traditional physiotherapy plus rehabilitation exercises, most clients can expect to return to pre-injury capability. In fact, in a landmark study by Rompe et al, 3 showed that combining shockwave tmedicine and exercise rehabilitation (such as that prescribed by a physiotherapist) provided superior to shockwave medicine or rehabilitation exercises given in isolation. 

Shockwave therapy can be used to treat conditions including Achilles pain, plantar fasciitis, tennis elbow, golfers’ elbow, jumper’s knee, shin splints, gluteal tendinopathy and shoulder tendinopathy (with calcification), frozen shoulder, musculoskeletal disorders, and heel spur pain4.

Clients recommended for shockwave therapy should expect to have on average three to five shockwave session, at one-week intervals. Most clients will begin to see improvements in a little as three sessions. 

Steroid injection side effects

Glucocorticoid (cortisone) injections are something many of our clients are considering or have already tried before we first meet them. There are a few things to consider with glucocorticoid injections. They have been shown to have a negative effect on tendons, these negative consequences included reduced cell viability, reduced cell proliferation, reduced collagen synthesis, increased collage disorganisation and necrosis (cell death); and reduced mechanical properties of the tendon5. This emerging evidence supports the notion that glucocorticoid injections of tendons result in long-term harm to tendon tissue and associated cells. 

In a study (meta-analysis) on rotator cuff tendinosis, glucocorticoid injection at best provided transient pain relief and did not modify the progression of the disease6. Another study using steroid (dexamethasone) injections for plantar fasciitis, only showed benefits (reduced pain) for the first 4 weeks7. In another study on tennis elbow, when comparing results of shockwave therapy vs corticosteroid injection, steroid showed equal benefit at 4 weeks. However, at 12 weeks, shockwave therapy provided superior results long term results8.  Finally, in a randomised control study of greater trochanteric pain syndrome (lateral hip pain) in 229 volunteers, shockwave therapy was shown provide superior results over the steroid injections9

We use the Swiss DolorClast® Method 

All Back in Motion practices use the Swiss DoloClast® radial shockwave devices, the most clinically proven radial shockwave machine on the market. In a recent PEDro review (2018), 30 of 45 the randomised controlled trials were performed in a Swiss DolorClast® radial shockwave machine. In 80% of the studies, the Swiss DolorClast® method reported better clinical outcomes that the control, meaning the results were statistically significant.   

Are all shockwave therapy machines the same? 

We get asked this question a lot, and we recently heard a great analogy from a Swiss DolorClast®master trainer. It would be like saying that a Ferrari and a Hyundai are the same, because they are both cars. The answer is yes, they are both cars, but their power, acceleration, road handling and breaking performance are very different. Similar with the Swiss DolorClast®, this isthe Ferrari of radial shockwave machines! Swiss Dolorclast® were the developers of extracorporeal radial shockwave therapy. Back in 1999, the “Swiss DorloClast® Method”, was developed after several years of research and  milions invested. This became the new standard in extracorporeal radial shockwave therapy. All other radial shockwave machine are copies. The clinical research to date backs the clinical effectiveness of the machine. Whilst there might be individuals or business offering cheaper forms of this therapy, it is likely, that you would get an inferior result if they are not using a Swiss DolorClast®machine. 

No obligation Free initial Assessment 

“If you think your pain could be tendon related, book in a free initial, obligation free assessment, to see if shockwave therapy is right for you.” Call Back In Motion Bribie Island on 3408 6608 

 

Referenced list 

1 Am J Sports Med 2007 35(6):972-8 

2 J Orthop Res 2003 21(6):984-9

3 Am J Sports Med 2009 37(3):463-70 

4 Int J Surg 2015 24:113-222

5 Seminars in Arthritis and Rheumatism 2014 (43):570-6

6 Clin Orthop Relat Res 2017 475:232-43

7 British Medical Journal 2012 344:e3260

8 J Phys Ther Sci 2015 27(12):3755-8

9 Am J Sports Medicine 2009: 1981-90 

 

Written By Gavin Corica, Physiotherapist and Internationally Accredited Shockwave Therapist (ISMST)