I've never considered myself a particularly immobile person, but when it comes to my ankles, I'm so far from ideal range, it's ridiculous. This has unfortunately led to a number of injuries in my running life, from chronic Achilles tendonitis to mechanically-related stress fractures. In 2020, my left Achilles tendon was severely damaged and it got to the point where my physical therapist Joe, who I had been seeing for years, recommended shockwave therapy.
Shock wave therapy. The magnetic field, rehabilitation.
” data-medium-file=”https://fitcetera.co.uk/wp-content/uploads/2021/10/shockwave-2-e1635369777566-300×240.jpg” data-large-file=”https://fitcetera.co.uk/wp-content/uploads/2021/10/shockwave-2-e1635369777566.jpg” alt=”” class=”wp-image-6734″/>Shockwave therapy.
What is Achilles tendonitis?
Whatever the cause (acute injury or building up over time), Achilles tendonitis is inflammation/swelling of the Achilles tendon – the stiff band of tissue that connects the calf to the ankle. This causes pain, stiffness and is sometimes characterized by a bump due to the injury.
My everyday symptoms included extreme stiffness when sitting/lying down for long periods of time and a painful bump just above the puncture site on my heel. At worst, I was in pain every day and had difficulty walking. The stiffness meant I couldn't put my heels down when I first got out of bed!
What is Shockwave Therapy?
Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment of the soft tissue of the musculoskeletal system that uses shock waves to apply mechanical force to the target tissue. This force stimulates the metabolism of the tendon cells and initiates a repair process.
Since tendons do not have a good blood supply, they are only properly stimulated when they are stressed. This is one of the reasons why tendonitis so often becomes a chronic condition. It's a delicate balance between enough and too much stress. Shockwave therapy stimulates repair without stress.
How my treatment worked.
Joe recommended a course of four treatments, one to two weeks apart. It would be best if I gave my Achilles tendon two to three days of rest after each treatment so as not to aggravate it in an already fragile condition. This meant that if I ran three days a week (all easy and no speed training), I would go for treatment the afternoon after the run.
Treatment began with a conservative intensity and number of shocks and increased with each visit. I wouldn't say it was “painful” per se, but it was uncomfortable. Since the tendon itself is sore, what I can only describe as repetitive twitching was never a walk in the park! But it's also over very quickly.
Results of shock wave therapy.
Joe always said it would take around 12 weeks to see results as this is the natural healing period of any tendon. Funnily enough, almost twelve weeks after completing treatment, I finally felt able to increase my running performance. I've worked my way up to longer distance runs and added some faster sessions. I even ran out of bed normally in the morning!
In fact, this would be my guide forever! If you have a benchmark, e.g. E.g. how your Achilles tendon feels when taking the first steps will help you deal with discomfort and injuries more easily.
Almost a year later…
It has now been a little over a year since I started my shockwave treatment with Joe. I believe I made a full recovery after treatment, but there was always a risk of the symptoms recurring as the underlying cause still existed. I didn't spend as much time as I should have increasing my range of motion, and unfortunately, a trail run in shoes that had too low a heel height for me led to a flare-up of symptoms about halfway through the year.
I've kept things manageable throughout the racing season, but given the result last time, I'm confident I can get back to where I was with a booster treatment. Shockwave is not a miracle cure, so we still need to figure out what works and what doesn't work for us in terms of prevention and management.
Have you ever had shockwave therapy or was it recommended to you? I'm a big believer in this and would love to hear what others think too!
About Forge Physio
Forge Physio is an independent physiotherapy practice offering shockwave and other physiotherapy treatments in the City of London and locally in Essex. They also work with recognized insurance companies to ensure treatment through insurance claims.
