WHAT EFFECT DOES ESWT HAVE ON TENDINOPATHIES?
It was believed, in the past, that tendons could not undergo matrix turnover and that tenocytes were not capable of repair. However, it has been shown more recently that Matrix metalloproteinases (MMPs) have a very important role in the degradation and remodeling of the Extra Cellular Matrix (ECM) during the healing process. 12 In a human in-vivo study two groups agreed to having micro dialysis into their Achilles and Patella tendons. 13 There was a pathological group and a healthy group. Both groups received a single application of Radial Shockwave therapy. A five fold increase in the production of MMPs was demonstrated with the pathological group producing three times more MMPs than the healthy group. The research showed that, after a single treated of Radial shockwave, the pathological group reported a 60% improvement in their symptoms. This finding, along with animal studies showing that there is an increase in the quantity of capillaries present four weeks post shockwave therapy, provides some explanation as to why Shockwave therapy provides such good results in tendinopathy management.
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