Case Study: Extra Corporeal Shockwave therapy
February 18, 2017
A female client, 30 years old, approached Physiotherapy Matters with complaints of pain in her left Achilles, which had been ongoing for 11 months.
Her symptoms started after the birth of her daughter in which she became more active: increasing her walking to 10,000 steps per day and attending the gym and classes. The client’s pain was aggravated by factors such as walking, stairs, walking after rest and putting pressure on her Achilles, and she was unable to run or participate in sport. With no improvement in symptoms an ultrasound scan confirmed she was suffering with Achilles tendinopathy, one of the most common overuse injuries that can affect athletes and non-athletes.
The client’s pain level was rated at 7/10 constant pain. Her functional Achilles pain score, measured using the VISA-A questionnaire, was 24/100 which suggested severe impairment. She presented with a tight calf, poor single leg balance and control of heel raises, tender on light palpation of Achilles with swelling and a palpable lump.
ESWT is a non-invasive, specialist treatment that works by passing a very low energy shockwave through the affected area, helping to initiate a healing response. The National Institute for Health and Clinical Excellence (NICE) has reviewed the evidence for ESWT and recommended it as an effective treatment option for conditions including plantar fasciitis, Achilles tendinopathy, tennis elbow and calcific shoulder tendinitis.
The treatment, was performed using the state-of-the-art Swiss Dolorcast Master – a radial shockwave therapy machine – and each session consisted of mid-portion Achilles treatment and a myofascial treatment of gastrocnemius and soleus (calf muscles). After each treatment, our client reported immediate pain relief in standing, walking and stretching.
The four sessions of ESWT were carried out weekly alongside stretches, an eccentric loading programme and modification of activity to offload the tendon, with this activity being continued for six weeks post treatment completion.
On the final session, the client reported 70% improvement in her symptoms, and her pain score had lowered to 0-2/10 intermittent pain, VISA-A increased from 24 to 44/100 in 3 weeks.
The client reported less pain on walking, when taking stairs and standing. Functionally she had improved her single leg balance, muscle length and eccentric control of single leg heel raises.
So far this is the best the client has felt in 11 months and she reports a significant improvement in symptoms following her ESWT treatment.
Speaking of the results she said: “I am thrilled with the results of the Extra Corporeal Shockwave therapy; three months ago, I could barely walk down the stairs, now I am back at the gym three days per week and enjoying working on my fitness.
“My day to day life has improved too with only occasional stiffness in my Achilles when I get out of bed in the morning rather than constant pain all day. I am confident that with continued stretching and loading exercises I will be back to 100% within the coming months.
“The treatment was really quick and Summer Cusack, a Physiotherapist from Physiotherapy Matters, was fantastic as she was really understanding of my problem and gave me great advice. I would definitely recommend Extra Corporeal Shockwave therapy to others.”
If you would like further information on ESWT, please contact us on:
Tel: 0191 285 8701 or Email: firstname.lastname@example.org