The Role of Extracorporeal Shockwave Therapy in Return to Competition for Endurance Runners: Two Case Reports

Reilly, Julia M.; Tenforde, Adam S.

doi:10.1002/pmrj.12241

Cited by 5 publications

(10 citation statements)

References 10 publications

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“…The highest risk for bias for the ROBINS-I for non-RCTs was the Mitchkash et al 2020 study. JBI assessment results are summarized [ Table 6 ], with three studies appraised as high-quality [ 1 , 2 , 3 ] and three as moderate-quality [ 4 , 5 , 6 ].…”

Section: Resultsmentioning

confidence: 99%

“…Other variables that warrant further investigation that may have affected clinical outcomes include load intensity specificity and tempo with exercise selection. Of the 13 studies, only two studies were specific in their load intensities either by RPE or by the percentage of 1RM [ 6 , 20 ], with six studies lacking specificity of either “moderate/high load” or “progressive” [ 7 , 15 , 16 , 17 , 22 , 35 ], and five studies lacking the reporting of exercise intensity in general [ 5 , 18 , 21 , 23 , 24 ]. Furthermore, of the 13 studies, only two [ 6 , 7 ] commented on loading rates associated with exercise, making it difficult to further analyze differences observed in clinical outcomes across studies.…”

Section: Discussionmentioning

confidence: 99%

“…Current recommendations are drawn from available evidence on pathology and pain in other tendinopathies [ 4 ]. Features of tendinopathy include collagen fiber disorganization, angiofibroblastic hyperplasia, and increased mucoid ground substance [ 5 ]. The most commonly recommended treatment for PHT is eccentrics, as extrapolated from the management of most tendinopathies [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Conservative Interventions for Proximal Hamstring Tendinopathy: A Systematic Review and Recommendations for Rehabilitation

Dizon

Jeanfavre

Leff

et al. 2023

Sports

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Knowledge of muscular forces and adaptations with hamstring-specific exercises can optimize exercise prescription and tendon remodeling; however, studies investigating the effectiveness of the current conservative management of proximal hamstring tendinopathy (PHT) and outcomes are lacking. The purpose of this review is to provide insights into the efficacy of conservative therapeutic interventions in the management of PHT. In January 2022, databases including PubMed, Web of Science, CINAHL, and Embase were searched for studies assessing the effectiveness of conservative intervention compared with that of a placebo or combination of treatments on functional outcomes and pain. Studies that performed conservative management (exercise therapy and/or physical therapy modalities) in adults 18–65 years were included. Studies that performed surgical interventions or whose subjects had complete hamstring rupture/avulsion greater than a 2 cm displacement were excluded. A total of 13 studies were included: five studies compared exercise interventions, while eight studies investigated a multimodal approach of either shockwave therapy and exercise or a hybrid model incorporating exercise, shockwave therapy, and other modalities, such as ultrasound, trigger point needling, or instrument-assisted soft tissue mobilization. This review supports the notion that the conservative management of PHT may best be optimized through a multimodal approach incorporating a combination of tendon-specific loading at an increased length, lumbopelvic stabilization exercises, and extracorporeal shockwave therapy. With regard to hamstring-specific exercise selection, PHT may be optimally managed by including a progressive loading program at combined angles of the hip flexion at 110 degrees and the knee flexion between 45 and 90 degrees.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Conservative Interventions for Proximal Hamstring Tendinopathy: A Systematic Review and Recommendations for Rehabilitation

Dizon

Jeanfavre

Leff

et al. 2023

Sports

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“…In contrast, activity may be maintained during treatment with ESWT. A case report in a 25‐year‐old female marathon runner illustrates how completion of a marathon was possible with radial ESWT treatment over 6 weeks with a favorable response 5 . In older patients with intrasubstance tearing, we would advise use of radial ESWT at lower initial energy settings to reduce the theoretical risk for tendon injury but would generally allow for continued activity with eccentric exercises as long as symptoms were improving.…”

Section: Drs Tenforde and Robinson Rebutmentioning

confidence: 99%

Extracorporeal Shockwave Therapy Versus Platelet‐rich Plasma for Achilles Tendinopathy

Tenforde

Robinson

Borg‐Stein

et al. 2020

PM&R

Self Cite

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“…However, there are limited data to understand effectiveness before 3 months 13 17. A case report documented success in treating mid-portion AT in a female runner with radial ESWT who was able to actively train for a marathon during treatment18; however, no high-level studies have been performed to document treatment success in a population of runners.…”

Section: Introductionmentioning

confidence: 99%

Research protocol to evaluate the effectiveness of shockwave therapy, photobiomodulation and physical therapy in the management of non-insertional Achilles tendinopathy in runners: a randomised control trial with elective cross-over design

Tenforde

Vogel

Tam

et al. 2022

BMJ Open Sport Exerc Med

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BackgroundAchilles tendinopathy (AT) is a common overuse injury in runners. While the mainstay of treatment for AT is tendon loading exercises (physical therapy and exercise programme (EXER)), some patients have refractory symptoms. Extracorporeal shockwave therapy (ESWT) and photobiomodulation therapy (PBMT) have each been evaluated to facilitate tendon healing; the influence of combining treatments is unknown and limited studies have been completed in runners. This randomised control study, with an elective cross-over at 3 months, will evaluate the efficacy of three forms of treatment of non-insertional AT: (1) EXER (loading programme specific to Achilles tendon combined with physical therapy); (2) EXER and ESWT; (3) EXER, ESWT and PBMT. Sixty runners will be assigned using block randomisation into one of three treatment groups (n=20). After 3 months, each participant may elect a different treatment than previously assigned and will be followed for an additional 3 months. The EXER Achilles loading programme will be standardised using the Silbernagel at-home programme. The primary outcome of interest is treatment group responses using the Victorian Institute of Sports Assessment—Achilles (VISA-A) Score. Secondary outcomes include the Patient-Reported Outcomes Measurement Information System—29 questions, the University of Wisconsin Running Injury and Recovery Index, heel raise to fatigue test, hopping test and ultrasound measurements. We will also capture patient preference and satisfaction with treatment. We hypothesise that the cohorts assigned EXER+ESWT+PBMT and EXER+ESWT will see greater improvements in VISA-A than the EXER cohort, and the largest gains are anticipated in combining ESWT+PBMT. The elective cross-over phase will be an exploratory study and will inform us whether patient preference for treatment will impact the treatment response.Trial registration numberNCT04725513.

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The Role of Extracorporeal Shockwave Therapy in Return to Competition for Endurance Runners: Two Case Reports

Cited by 5 publications

References 10 publications

Comparison of Conservative Interventions for Proximal Hamstring Tendinopathy: A Systematic Review and Recommendations for Rehabilitation

Comparison of Conservative Interventions for Proximal Hamstring Tendinopathy: A Systematic Review and Recommendations for Rehabilitation

Extracorporeal Shockwave Therapy Versus Platelet‐rich Plasma for Achilles Tendinopathy

Research protocol to evaluate the effectiveness of shockwave therapy, photobiomodulation and physical therapy in the management of non-insertional Achilles tendinopathy in runners: a randomised control trial with elective cross-over design

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