extracorporeal shockwave therapy for PF and achilles tendinitis

hello fellow runners, im a radiographer who currently specialises in the world of shockwave therapy, dealing with kidney stones but occasionaly the equipment is used  for many orthopaedic ailments including the classic runners complaints  plantar fasciitis, achilles tendinitis, patellar tendinitis and shin splints.  the science behind it is a little vague but specialists believe it encourages blood flow to the area to aid  with the healing process.

Ive been a radiographer for a good few years now and until i joined the company  8 months ago wasnt aware that shockwave therapy was used for anything other than Kidney stones. as a very keen runner myself  ( PB 1hr 27 for half marathon) ive been blighted for years with Plantar fasciitis and was very interested and intrigued when i discovered that the therapy was used to treat the dreaded affliction!!.

my new colleagues were very obliging when i asked if they could treat me to a session or two, The treatment was uncomfortable and can only describe the pain as the feeling you experience when you knock your funny bone (but consistently for around 10 minutes!!) After a couple of treatments I definetly saw an improvement, something in the region of  a decrease in pain and stiffness in the morning of around 75%..i still have the odd twinge but overall i am delighted that it now doesnt dictate my training when im preparing for a race. (recently did edinburgh half in 1hr 32 and had no pain the next morning (very rare).

i was wondering if there are any chronic PF sufferers ( or tendonitis sufferers) who have been struggling for 6 months or more (runners (or non runners welcome) in the notts area who fancies a session or two for free as im trying to gather information as to whether they agree the treatment is valid and actually helpful. There are mixed reviews in the UK medical fraternity. However in the USA it is widely used and approved by the FDA ( food and drugs administration..our equivalent is NICE..national institute for clinical excellence). NICE are a little unsure, they seem to think there is something in it but welcome audits to confirm this.

ANYWAY! i feel im rambling..anyone interested, get in touch, im very keen to find out myself if this treatment works for others.. i know what a bugger PF is!!!


  • Hi Alan
    Ive been suffering with PF since a long run at xmas.
    Been X-Rayed and thats all clear, had Orthotics made about a month ago which are helping alot but i still have inflamation and swelling and uncomfortableness in the PF area that wont clear up. Have finally managed to start running, all be it very carefully and slowly and am not suffering any further effects afterwards.
    Have today booked Docs for next week with a view to getting refered to a specialist as its really annoying me now, and also got my Orthotics review next week.

    What exactly is involved in this Shockwave therapy?, is it similar to the ultrasound but obviously more painful.
    Im in Derby myself and know Nottingham well, where abouts are you based and what sort of appointments are involved.
  • Hi Richardthanks for your e-mail, ESWT is quite different to ultrasound as it generates a high energy pulse 3 or 4 times a second as opposed to Ultrasound that use high frequency low energy waves that just warm the internal tissue. The beneficial effect of the high pressure waves of ESWT is that they in effect re-injure the area to encourage fresh blood to that region,basically giving the body a massive reminder that that the area needs healing.

    in all the hospitals that we work in to treat kidney stones, only Colchester hospital hire us to do their Orthopaedic work, I hear some hospitals have their own machine to treat this kind of thing but not enough in my opinion. The majority of the patients i have spoken to with PF believe that it is helping them. i have replied to your mail with my contact details mate.


  • Hi, I just input shockwave in theh search box and came across this thread. I am having a burning sensation in my heel and I was looking at ESWT as there is a clinic in Milton Keynes which offer this treatment and claim a 75-80% success rate.
    Just wondering Alan, did anyone take you up on your offer and have you any data on the success rate?
  • Hi John

    very sorry i never got back sooner, ive not been on here for quite some time

    i have since purchased a shockwave device and have been treating patients for a few months now at a physiotherpay clinic in the centre of nottingham. The results i am acheiving are excellent, ranging in the 85-90% range..i have been treating everything from Plantar Fasciitis to Golfers elbow.

    did you ever go for treatment? it would be useful to find out how you got on


  • Very, very, very little if any good long term evidence to support ESWT, despite it's increase in usage.

    Caveat emptor....

  • well there is plenty of evidence out there to support its success, it is approved by the FDA in the US for plantar fasciitis, as usual in this country we are still playing catch up even though NICE admit there are encouraging signs.

    I have seen first hand how well it works, it totally cured my bilateral plantar fasciitis and believe me i wasted a LOT of money on physios and podiatrists down the years. You should embrace this new treatment as another arm of the physiotherapy world instead of trying to rubbish it and feel threatened by it..the old stretching and icing doesn't work for everyone my friend and definitely didnt work for me. There are NHS trusts ( Greater Manchester, Essex, Mersyside etc)  in this country that provide this service routinely and free of charge so there must be faith somewhere. Would you like for me to explain how it actually works? Would you even listen?...doubt it

  • Easy fella

    Please park all prejudices at the door, and mind you dont fall of that very high horse....

  • Six physio

    It sounds to me that you are the one being prejudiced here and extremely smug about it too. ( terrible characteristic to have may I add)

    My elderly neighbour had shock wave treatment on her elbow and it has worked wonders, she is now able to carry a bag of shopping without being in agony. I wouldn't think twice about trying it if I needed it.

  • Bit spooky that something was posted on here today about ESWT, as was going to post to see if anyone had had ESWT for achilles tendonitis, and with what results.  Anyway, just had my third and final session of ESWT for my persisting AT this week.  Not much sign of any improvement after the first two sessions but today have noticed a difference after the last session on Thursday. 

     I know the recovery is meant to be gradual but my question was going to be how long does it take to properly see some improvement. I have tried all other treatments without any success so am desperately hoping this is going to work.  Any comments appreciated. Thanks.

  • I should also mention that I have one leg slighter longer than the other (the poorly achilles is the shorter leg) which I had diagnosed many years ago when I had injury probs when playing another sport.  I am waiting to see a consultant podiatrist for some proper bespoke orthotics to hopefully stop the problem reoccuring.
  • Hi - very interested in this thread, Is there any update to your condition Bumble1 ?

  • Last October I suffered an injury to my left Achilles. To cut a long story short after six months of weekly physio, periodsof rest, icing after every run, heel drops twice a day etc etc....It wasn’t improving. There were times when it was difficult to walk on.

    A few weeks ago I got to the point where I’d had enough. I ran one Saturday morning and it hurt over the last half mile or so. I was at the point where I wanted to push myself so hard that I actually damaged it big time so I would HAVE to stop running altogether. No more frustration of being able to run for a few weeks and then having to take more time out.

    A week later I saw my doctor. I knew that if I gave him the chance he would say rest and anti inflamatories would sort it out, so I went in, told him about the last six months and I wanted to be referred to a specialist. He agreed !!

    Apparently, I have “acute non insertional achilles tendonitis”, which is common in older runners who have been running for a number of years. (I’m 55 and have been running for over 30 years).

    This Friday I start ESWT. This entails three sessions a week apart. During the rehab I will be given strengthening exercises to do. Walking is OK but NO running for at least three months after the last session. The consultant says the success rate is 75%. A couple of years ago surgery would probably have been recommended, followed by 12 -18 months recovery, so shock wave therapy is certainly the way to go.

    I’ll post updates here which I hope will help others who are considering this type of treatment.

  • Ay up me duck, how's it now after the 3 sessions? I has the first of three ESWT  today.


  • I found that this treatment was like being prodded quite forceably !! Not painful but uncomfortable.I would say that after the second treatment there was a slight improvement. After the third I was referred to a physio at the hospital. My initial consultation was on Wednesday and we went through all the normal checks. He identified tightness in both calves which restrict my range of movement, and on doing heel raises I dont lift as much as I should do, so for the last three days I have been doing stretching and strenghtening exercises every three to four hours. Prior to the ESTW I had been doing heel raises whilst holding a 5kg weight. Physio said that the weight was nowhere near enough to have any effect and I should have been loading it with 30/40 kg !!  Yesterday my AT was sore again, but I put that down to the exercises.

    According to this physio and the medical profession, some patients have reported success with ESTW, but the sample is not big enough to be conclusive, so its still a bit of a gamble. If you are like me i'll try anything which offers a hope of getting back to running. I suppose the proof will be in 8 - 10 weeks time when I can hopefully put on my trusty Asics 2160's and get out on the road ! Good luck and I hope its a success for you. Keep me updated.

  • PF nailed me twice (once in each foot) for 18 - 24 months each time and I would have gone through a lot to get rid of it. I tried all kinds of things, resting, no running image, night splints, special exercises etc. etc. My GP seemed to think that the shockwave treatment mentioned here was only a last resort & would not refer me.

    In the end I changed my running style & with the tail end of PF still there when I started it I've now not seen a return of PF again. See "Running Desperado" on Kindle for an example.

    There seem to be some "camps" who say that PF is a symptom of how you run. Basically using cushioned/stiff shoes, things that "correct" other problems, heel planting or bad form are all likely candidates for leading you into trouble. Like one of the other posters above, I too have one leg a tad shorter than the other from breaking it and I also use to use the expensive cushioned heel planter running shoes before I got away from the PF problem.

    I don't know what the side effects of the treatment are but now that I'm up & running again with forefoot landing barefoot/minimalist I'm glad I didn't risk it (although at the time I was tempted). Basically, question what you're being told, question how you got the problem, consider carefully things that interfere with you!

    On this occasion I think I agree with my GP, for me this treatment is a last resort but when all you ginniea pigs have been through a proper scientific study & it is proved to be a quick fix then I will sign up too if PF returns but until then there may alreay be a better way...

  • The ESTW is not a quick fix, and certainly not a last resort. It is possible that surgery could be the only solution, but still with no guarantees. A guy at our club had surgery for AT many years ago, and that sorted out his problem. The downside was the recovery period can be 12 to 18 months. The same guy later had ESTW on his other achilles and that too was a sucess, but he returned to running alot quicker.

    I would agree with you PR you need to asertain the cause of an injury, and then take corrective action to try to minimise re occurances. Unfortunately it doesnt allways work that way, and injury is part and parcel of a runners life. It happens to the professionals and they are surrounded by physios, podiatrists, dieticians, doctors and all manner of medical types.

    Intersting that you say your GP would't refer you. What would your answer have been if he had said yes ?

  • Ay up me duck said: "Intersting that you say your GP would't refer you. What would your answer have been if he had said yes ?"

    At the time I was still running with a heel plant form and I thought that was the way to go. I was very fed up with being on the bench for so long particularly when it happened in the other foot with 6 weeks of recovering the first time. I get the endorphin high very easily so I'm hooked & I miss that fix from exercise when I can't do any. The answer (at the time) is, I would have said yes.

    I am still glad that I managed to avoid the shockwave treatment now but I have had to put up with a vast recovery period (about the same as having the treatment by the sound of it... hmmm!). This was then followed by the long process of learning to change my style of running but that was interesting, less painful (from what is described) and fun.

  • I find Shockwave very beneficial and treat elite athletes on a regular basis in Milton Keynes.

    Visit www.shockwavetherapymiltonkeynes.co.uk for further information and by all means send me an email for any confidential feedback/advice.

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