Shock-wave therapy is a fantastic technology that is revolutionising the treatment of tendon pain. At the Tendon Pain Clinic we only use the finest Swiss EMS shock wave machines on which most of the shock wave research has been conducted.  We use both the radial type of shock-wave therapy and the focussed type depending on what we are treating and sometimes switch between the two types as needed to optimise the results of treatment.

Shock-wave therapy has become increasingly popular in recent years for treating tendinopathies because it works well.  We use it regularly at The Tendon Pain Clinic as it is safe, non-invasive and easy for patients to fit in to their schedules (“treatment in your lunch break”). The most common question that we get asked by our patients is ‘how does shock-wave therapy work?’  So here goes.

Firstly it does not involves electrical shocks! The shocks are actually acoustic (sound) waves that are generated by the handpiece. When the hand piece is placed on the surface of the skin the waves are delivered through the skin as a small shock wave that spreads inside the affected tissue.

Imagine shock-waves as ripples passing through the body’s tissues similar to when you throw a stone into water. When these ripples collide with tendon cells they cause vibrations, which in turn set off a series of healing responses.

Pain relief – shock-wave therapy has a profound ability to decrease pain and patients often notice this immediately after treatment. It does this by decreasing the amount of something called substance P.  This a chemical closely associated with producing pain.  Shock wave therapy also causes the destruction of unnecessary pain fibres that grow into a tissue after an injury and mediate pain.

Healing– the shock waves activate a healing response by causing the body to release natural chemicals at the site of treatment.  The key actions of these chemicals are to increase the blood flow into the injured tissue and to increase tendon and bone healing cells. Shock waves also break down calcification that occurs in damaged tendons.

We are experts in using Shock Wave Therapy and we teach on its use regularly to other practitioners. To see how Shock-wave Therapy could help you please get in touch.

What is it and who gets it?

Jumper’s knee (aka patella tendinopathy) causes pain at the front of the knee.  It is an overuse condition caused by doing too many explosive movements that overload the patella tendon. Up to 20% of jumping athletes, particular those who play basketball and volleyball, suffer from this problem but it can also occur in those who play other sports. It often starts with mild pain but this often builds up over time if not treated.  The condition can last for many years and can be difficult to cure.  In some cases it has been responsible for ending an athlete’s career.

If you have jumpers knee there will be pain just below your knee cap that gets worse with activity. Most people will report a stiff knee in the morning especially after playing sport the day before.

How is it treated?

The best way to prevent this problem is to include some heavy lower limb weight training into your fitness programme twice a week.

If you have, or think you have, this condition get a professional assessment so that the right treatment can be started to prevent the condition getting worse. Treatment starts with specific exercises but other specialised treatments may be required, such as shock-wave therapy or, less commonly, PRP (platelet-rich plasma) injections.

What is it?

Shin splints affects up to 35% of runners from beginners to elite, as well as affecting people who participate in jumping and running sports and other active people.

It causes severe pain over the shin that often severely limits running and sports.  It can be incredibly disabling and sometimes occurs in both legs together.

How is it treated?

In short by rest.  Despite 40 years of research there still isn’t an established and clearly effective treatment that is better than prolonged rest.  This rest often has to continue for many weeks and activities have to be modified.

Prolonged rest isn’t always a good thing, not least because runners and sports people get very frustrated when they can’t be active. After resuming activity after a period of rest, shin splints can return with a vengeance, causing further pain and inactivity.

At The Tendon Clinic we are using new and innovative methods to tackle this difficult problem and are getting great results for grateful patients.  Our patients are often able to resume activity much more quickly.  If you are suffering, get in touch.

Looking to shed a few pounds after the festive season? Many people’s New Years resolutions involve some form of gym activity.  Here are our tips on how to reduce your chances of a tendon injury when you hit the gym.

Quantity – One of the biggest risk factors for tendon pain is an increase in the total amount of work done. An example of this would be performing multiple repetitions and multiple sets of particular exercise, for example, 6 sets of 10 repetitions. If you are unaccustomed to the gym it is safer and better to start at say 3 sets of 8-10 repetitions and to work up gradually from there.

Intensity – This is the amount of physical power that the body uses when performing an activity.  As a general rule tendons can cope with slow heavy exercises well but problems arise when explosive pylometric forces are incorporated too soon into training.  For example performing box jumps and jumping squats is a lot harder for tendons than squats and lunges.

Frequency – This is the number of times you train per week. Typically people return to the gym and look to go most days to get fitter quicker. Unfortunately this often leads to injury as training more than 4 times per week increases injury by 40%. Your body needs 24 hours between sessions for tissues to recover so take a day off between training days.

Variety – Most tendon pain is due to the repetitive nature of loading.  If you perform the same exercise with the same weights over and over again it will overload tissues quickly.  Mix up your training using different exercises and splitting your training into lower body and upper body segments. This will not only help to avoid tendon pain, but will also make for a much more interesting work out.

Sudden Changes – The biggest principle that underpins all of the above is sudden changes in people’s function.  Tendons and most tissues in the body require 12 weeks to adapt.  Tendons don’t like sudden changes (see our news story about this). If you push too hard and fast there is a considerable risk of developing tendon pain.  Always introduce exercises gradually.

We wish you all the best with your New Year’s resolutions to get fitter and more active.  We hope that all will go well, but if you are struggling with a gym injury, then do get in touch with us for specialist assessment and treatment of your problem so that you can get back to those resolutions quickly!

An interesting report from the USA demonstrates the harmful effect of sudden training changes on tendons.

In 2011 the National Football League  (NFL) went through a unique ‘lockout’ period.  Due to contractual issues players were banned from all club facilities and medical staff during the ‘lockout’ period.  As a result pre-season was cut from 14 weeks to just 17 days!

Analysis of injuries that year showed the devastating results of a short off-season. Usually there are 4-6 Achilles tendon ruptures in an entire NFL season, however, in 2011 there were 12 ruptures in just 5 weeks.  When comparing timelines that was a 4-fold increase in rupture rates!

Unfortunately Achilles ruptures are serious injuries and 1/3 of players failed to return to competition.  The sudden increase in training for these athletes put their tendons at high risk.

It is important to gradually increase your training to avoid similar problems, as tendons need at the least 6-8 weeks to adapt.  Our experts can help you to plan your training to help avoid tendon injuries.

Tendinopathies tend to come on gradually and it is common to ignore the pain when it is mild and to keep on training.  This is understandable.  It is not until the pain prevents sports and training, and causes pain even on normal daily activities that people seek help.

It is important to heed the warnings of mild early pain and to reduce your training.  If you carry on training (as many of us do) and things get much worse, then seek specialist help early.  Our results show that early treatment of tendon pain results in a quicker recovery in many cases…but only if the right treatment is suggested.