title: Current concepts of shockwave therapy in stress fractures.
abstract: Stress fractures are common painful conditions in athletes, usually associated to biomechanical overloads. Low risk stress fractures usually respond well to conservative treatments, but up to one third of the athletes may not respond, and evolve into high-risk stress fractures. Surgical stabilization may be the final treatment, but it is a highly invasive procedure with known complications. Shockwave treatments (ESWT), based upon the stimulation of bone turnover, osteoblast stimulation and neovascularization by mechanotransduction, have been successfully used to treat delayed unions and avascular necrosis. Since 1999 it has also been proposed in the treatment of stress fractures with excellent results and no complications. We have used focused shockwave treatments in professional athletes and military personnel with a high rate of recovery, return to competition and pain control. We present the current concepts of shockwave treatments for stress fractures, and recommend it as the primary standard of care in low risk patients with poor response to conventional treatments.
authors: Fenway Medical Shockwave Medicine Center, Universidad El Bosque, Bogotá, Colombia. Electronic address: chazleal@gmail.com.
authors: Carlos
authors: C
authors: Leal
authors: Instituto Humanitas, Milan, Italy.
authors: Cristina
authors: C
authors: D'Agostino
authors: Unidad Medica Deportiva, Policia Nacional de Colombia, Bogota, Colombia.
authors: Santiago
authors: S
authors: Gomez Garcia
authors: Fenway Medical Shockwave Medicine Center, Universidad El Bosque, Bogotá, Colombia.
authors: Arnold
authors: A
authors: Fernandez
mesh_terms: D001265:Athletic Injuries / Q000628:therapy; D012090:Cumulative Trauma Disorders / Q000628:therapy; D015775:Fractures, Stress / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D040542:Mechanotransduction, Cellular; D008889:Military Personnel; D010146:Pain / Q000517:prevention & control; D059408:Pain Management
keywords: Bone overuse; Bone turnover; Mechanotransduction; Shockwave therapy; Stress fractures