Extracorporeal shockwave therapy for tendinopathy: A literature review of techniques, working mechanisms and protocols

Extracorporeal shockwave therapy is increasingly used to treat tendinopathy. Some think of extracorporeal shockwave therapy as being controversial as a treatment. Reasons for this are varying results of treatment in clinical studies, a great diversity in protocols and shockwave generators and lack of knowledge about the exact wxorking mechanisms. The aim of this article is to describe extracorporeal shockwave therapy as a treatment option for tendinopathy. First a description of shockwaves is given. Then the generation of shockwaves, working mechanisms and important treatment parameters are described. Special attention is given to the differences between focused shockwaves and radial pressure waves. Although there is a large body of research into extracorporeal shockwave therapy, more research is needed to settle the controversy surrounding this therapy.