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Can Shockwave Therapy Improve Tendon Metabolism?

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Metabolic Influences on Risk for Tendon Disorders

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 920))

Abstract

Shockwave treatments are commonly used in the management of tendon injuries and there is increasing evidence for its clinical effectiveness. There is a paucity of fundamental (in vivo) studies investigating the biological action of shockwave therapy. Destruction of calcifications, pain relief and mechanotransduction-initiated tissue regeneration and remodeling of the tendon are considered to be the most important working mechanisms. The heterogeneity of systems (focussed shockwave therapy vs. radial pressurewave therapy), treatment protocols and study populations, and the fact that there seem to be responders and non-responders, continue to make it difficult to give firm recommendations with regard to the most optimal shockwave therapy approach. Specific knowledge with regard to the effects of shockwave therapy in patients with metabolic tendon disorders is not available. Further fundamental and clinical research is required to determine the value of shockwave therapy in the management of tendinopathy.

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Abbreviations

CGRP:

calcitonin gene-related peptide

EFD:

energy flux density

EH:

electrohydraulic

EM:

electromagnetic

F-SWT:

focused shockwave therapy

IL:

interleukin

MMP:

matrix metalloproteases

PE:

piezoelectric

R-PWT:

radial pressure wave therapy

SWT:

shockwave therapy

TGF-β1:

transforming growth factor β1

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Author information

Authors and Affiliations

  1. Center for Sports Medicine, UMC Groningen, 30.001, 9700 RB, Groningen, The Netherlands

    Johannes Zwerver

  2. Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Henk van der Worp

  3. Centre for Hip, Health and Mobility, University of British Columbia, Vancouver, Canada

    Charlotte Waugh

  4. Department of Physical Therapy, Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada

    Alex Scott

Authors
  1. Johannes Zwerver
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  2. Charlotte Waugh
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  3. Henk van der Worp
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  4. Alex Scott
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Corresponding author

Correspondence to Johannes Zwerver .

Editor information

Editors and Affiliations

  1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Paul W. Ackermann

  2. McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada

    David A. Hart

Glossary

Energy flux density, (EFD, in mJ/mm2)

a term used to reflect the flow of shockwave energy in an area perpendicular to the direction of propagation. Shockwave dosage is broadly divided in high (EFD > 0.12 mJ/mm2) and low (EFD ≤ 0.12 mJ/mm2) energy delivery.

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© 2016 Springer International Publishing Switzerland

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Zwerver, J., Waugh, C., van der Worp, H., Scott, A. (2016). Can Shockwave Therapy Improve Tendon Metabolism?. In: Ackermann, P., Hart, D. (eds) Metabolic Influences on Risk for Tendon Disorders. Advances in Experimental Medicine and Biology, vol 920. Springer, Cham. https://doi.org/10.1007/978-3-319-33943-6_26

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