Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes reviews the use of ESWT to address sports-related injuries for in-season athletes to accelerate return to play. 45
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Patient compliance, the role of modalities
Exercise is often uncomfortable but needed for patients suffering from Achilles tendinopathy and plantar fasciitis. 17 Adding modalities such as shockwave and laser therapy can help manage pain in the clinic which can open doors to more advanced loading exercises. Keeping pain in check can help promote steady progress over the 3-4 week course of treatment commonly needed to restore higher levels of function when adding ESWT to a plan of care (POC).
Quick review of how to use shockwave for runners:
• ESWT is a trusted treatment option for clinicians treating pain associated with a variety of tendinopathies, with unique advantages relative to other interventional treatments. • RPW technology is the most commonly used ESWT device globally. This is partially due to the lower costs associated with these devices which makes them an attractive entry point into shockwave technology. While cost is one factor, RPW popularity is primarily due to its effectiveness in helping to treat tendon disorders. A 2015 systematic review showed that RPW treatments were 88.5% effective when compared to other treatments for common musculoskeletal pathologies. FSW was found to be 81.5% effective in the same study. 3 While the physical properties of the RPW differ from the FSW, RPW has been repeatedly shown to be as effective in treating soft tissue pathologies in the extremities as FSW where tendons are relatively superficial. 3 • FSW can provide higher energy treatments at depths of up to 12.5 cm. While potent, FSW has the ability to be more precise with the energy it delivers and at specified depths. This is ideal for clinicians that utilize diagnostic ultrasound to identify the depth and degree of soft tissue lesions they are treating. FSW is very simple to use as it allows clinicians to apply specific energy levels (mJ/mm 2 ) at precise depths by dialing in the desired energy flux density (EFD) on the screen and then setting the treatment depth of the focal area by choosing the correct stand-off that fits on the handpiece.
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