Current evidence of extracorporeal shock wave therapy in chronic Achilles tendinopathy.
Chronic Achilles tendinopathy has been described as the most common overuse injury in sports medicine. Several treatment modalities such as activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading are known as standard treatment mostly without proven evidence. After failed conservative therapy, invasive treatment may be considered. Extracorporeal shock wave therapy (ESWT) has been successfully used in soft-tissue pathologies like lateral epicondylitis, plantar fasciitis, tendinopathy of the shoulder and also in bone and skin disorders. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is still lacking. In plantar fasciitis as well as in calcific shoulder tendinopathy shock wave therapy is recently the best evaluated treatment option. This article analysis the evidence based literature of ESWT in chronic Achilles tendinopathy. Recently published data have shown the efficacy of focused and radial extracorporeal shock wave therapy.
Dept. Orthopaedic Surgery and Traumatology, University Schleswig Holstein, Campus Kiel, Arnold Heller Strasse 3, 24105 Kiel, Germany; Technical University of Munich, Dept. Orthopedics and Traumatology, Ismaninger Straße 22, D-81675 Munich, Germany. Electronic address: Gerdesmeyer@aol.com.
Ludger
L
Gerdesmeyer
Stosswellenzentrum-wien.at, AUVA Trauma Center Meidling, Ludwig Boltzmann Institute dir exp. and clin. Traumatology, Austria.
Rainer
R
Mittermayr
Dept. Orthopaedic Surgery and Traumatology, University Schleswig Holstein, Campus Kiel, Arnold Heller Strasse 3, 24105 Kiel, Germany.
Martin
M
Fuerst
Suite G3B, Norwest Private Hospital, 9 Norbrik Drive, Bella Vista, NSW 2153, Australia.
Munjed
M
Al Muderis
Dept. Orthopaedic Surgery and Traumatology, University Schleswig Holstein, Campus Kiel, Arnold Heller Strasse 3, 24105 Kiel, Germany.
Richard
R
Thiele
Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301, USA.
Amol
A
Saxena
Technical University of Munich, Dept. Orthopedics and Traumatology, Ismaninger Straße 22, D-81675 Munich, Germany.
Hans
H
Gollwitzer
D000125:Achilles Tendon / Q000293:injuries*; D012090:Cumulative Trauma Disorders / Q000628:therapy; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D052256:Tendinopathy / Q000628:therapy*