What is shockwave therapy?

Shock wave therapy is a type of electrotherapy widely used in physiotherapy, orthopaedics and sports medicine. It is an electronic device with multifunctional abilities aiming to reduce pain and promote healing.

How does shockwave therapy work?

The transducer is sending acoustic waves into targeted tissue. In other words, sound waves are being sent into the targeted area which are transmitted via the special transducers head. Depending on the desirable outcome and area to treat there are many treatment settings that the specialist can select ie. Bone, tendon, ligament or muscle.

During the process, your therapist will locate the sore area. Then, a therapist will apply some conductive gel onto the area, adjust the apparatus to the suitable setting and apply the transducers head directly onto the area where sound waves will be delivered.

What can shockwave therapy treat?

Shock wave therapy treats many common orthopaedic conditions. The list includes Achilles, knee, hamstring, elbow and shoulder tendinopathies, plantar fasciitis, lateral epicondylitis (tennis elbow) and rotator cuff tendonitis with and without calcification. In addition, the therapy can treat and help to alleviate symptoms of chronic musculoskeletal pain, femoral head necrosis, patellar knee jaw and osteoarthritis.

On the other hand, in non-orthopaedic setting, the treatment can also be applied to reduce cellulitis.

Is shockwave therapy painful?

Most of the time the shock wave therapy can be uncomfortable and painful at times. However, the settings of the treatment should be adjusted to the level that is tolerable for you, hence, communicate your experience to your therapist during your treatment.

How often I should use the shockwave therapy?

This very much depends on the condition treated. For example, if you have an Achilles tendinopathy which is 2 years old, it is likely that you will have to receive a treatment 2 times per week for few weeks. On the other hand, an acute lateral epicondylitis will need 2 – 4 treatments spread out within 4 or more weeks, that will probably be enough.

Benefits of shock wave therapy:

Main benefits of the shock wave therapy are: it relieves pain, enhances healing of the tissue and restores function. Shockwave therapy increases blood supply and the proliferation of tissue, that´s why you achieve the benefits. Proliferation simply means rapid reproduction of targeted cells, which may be bone, tendon, ligament or muscle.

Side effects of shock wave therapy:

After completing the treatment, the area treated might start feeling sore. The soreness might remain for couple of days and vast majority of the time is not debilitating.

We hope this information is useful for you. If you have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. If you like this blog, please share! We are always happy to help.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029898/#:~:text=Thus%2C%20the%20shock%20waves%20are,tendinopathy%20(3%2D5).

https://online.boneandjoint.org.uk/doi/pdf/10.1302/0301-620x.81b5.0810863

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The Hamstring muscle group consists of three muscles which are located at the back of your thigh. The primary function of the hamstring is to bend your knee, but it also assists in moving your hip back. 

Hamstring injuries are one of the most common injuries in sports. Particularly in sports which require repetitive movement, fast acceleration and deceleration, and change in direction. This includes, but not limited to: football, rugby, basketball, running and cycling. One of the main reasons why hamstring muscles are prone to injuries is because it is a biarticular muscle, meaning it spans two joints, which are the bottom of your hip and the knee.

Because the muscle is biarticular, it constantly has to perform two different tasks every time we run. For example, when a person is pushing off to initiate the run the knee is being extended and straightened. Simultaneously, the hip is being extended too. However, because of the attachment sites of the hamstring muscle, it almost has to be able to contract and stretch at the same time to allow this to happen. It places a significant amount of strain on the muscle.

Other potential reasons for hamstring strains are insufficient strength and length of the muscle or muscle having to overcompensate for the weaker links such as glutes, your bottom muscles, and weak core. The muscles may also be predisposed to injury by biomechanical alterations in the body, particularly the pelvis area and the knees. Common hamstring injuries are listed below:

• Hamstring strains
• Pes Anserine tendinopathy
• Pes Anserine bursitis

Hamstring strains

Hamstring strains are the most common hamstring injuries. Strain is a tear in the muscle and it can occur in the muscle belly, which is the middle of your hamstring, or at the tendons, which are there to connect the muscle to bone. 

• Symptoms: You would usually feel sharp pain anywhere at the back of your thigh during the physical activity. Depending on the severity of the strain, you may also see bruising at the back of your thigh and feel indentation or a lump.
• Causes: Injuries most commonly occur while sprinting, accelerating or decelerating vigorously, or going for a sliding tackle in football. There are few predisposing aspects for hamstring strain. Most often it gets injured due to insufficient strength and length. 
• Self-management: Strengthening and stretching the hamstrings. Eccentric loading is known as being one of the most effective types of strengthening exercises.

Pes Anserine tendinopathy

Pes Anserine tendinopathy is an overuse related injury. It affects the hamstring attachment site which is at the inside of the knee just below the kneecap.

• Symptoms: Pain at the inside of the knee just below the kneecap which comes on with physical activity. Depending on the severity of the injury, it may persist and worsen with activity or it may ease off with activity.
• Causes: repetitive use of the muscle and insufficient stretching. 
• Self-management: stretching, strengthening and foam rolling. Eccentric loading is known to be great in treating tendinopathies. You will have to moderate the physical activity.

Pes Anserine bursitis

Pes Anserine bursitis is known as the inflammation of the bursae which is located at the inside of the knee below the kneecap. Bursae is a sac filled of fluid which prevents the friction of the tendon over bone.

• Symptoms: Pain at the inside of the knee just below the kneecap which is worsening with physical activity. Visual puffiness of the area might also be present.
• Causes: repetitive overuse of the muscle and lack of flexibility.
• Self-management: stretching, foam rolling and moderating the physical activity.

Exercises:

Bridge on heels:

Lie on your back. Bend your knees to approximately 70 degrees and lift your toes up towards the ceiling. Relax your neck and shoulders and have them flat of the floor. Push your hips up maintaining the toe elevation.

Sets: 2
Reps: 12
Hold: 3 seconds

Hamstring walk outs:

Lie on your back. Bend your knees and have your toes pointing up. Push your hips up and taking small steps walk out as far as you feel comfortable. Then walk back in again and lower your hips down.

Sets: 2
Reps: 5 walk outs

Foam rolling the hamstrings:

Place the foam roller underneath the back of your thigh. Slowly move your body up and down on the foam roller. Stop and hover at the tender areas for the tension to ease off.

Sets: 1
Reps: 1
Time: 45 seconds

Hamstring stretch:

Lie on your back. Use a towel to wrap under your foot and keeping your knee straight bring your leg up towards you. You can move the leg in and out to stretch different areas of the hamstring.

Sets: 1
Reps: 1
Hold: 30 seconds

Nordic curls:

Find a solid, heavy object which will be able to support you. Fix your feet or ankles under it. Get into kneeling position. From there engage your hamstrings and glutes and lower yourself down with control as far as you feel comfortable. Then disengage and allow your body to drop down. Ensure to catch yourself using your arms, then push off into the starting position and repeat.

Sets: 2
Reps: 8

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help.

If you like this blog, please share!

The post 3 Common hamstring injuries appeared first on Perea Clinic.