More Than One Tool: Treating Tendon Injuries the Right Way
This week our shockwave therapy system unexpectedly broke down, meaning we had to cancel and rearrange several treatment sessions while we resolved the issue.
Firstly, we want to say a genuine thank you to the patients who were understanding. As a small clinic, unexpected equipment failures affect more than just a single appointment slot — we had to turn away and reschedule multiple sessions across the week, which impacts both our patients’ treatment plans and the running of a small healthcare business.
The good news is we’ve managed to secure finance for a brand new shockwave system, which will be installed and ready to use from Wednesday afternoon next week. High-quality medical equipment unfortunately doesn’t come cheap — this system costs around £15,000 — but investing in the best tools for our patients is something we take seriously.
But this situation also raises an important point.
Shockwave therapy is an excellent treatment option, but it is not the only effective way to treat tendon injuries.
Shockwave Therapy – Why It Works
Extracorporeal shockwave therapy (ESWT) is widely used for chronic tendon problems including:
- Tennis elbow
- Achilles tendinopathy
- Plantar fasciitis
- Patellar tendon pain
Shockwave delivers high-energy acoustic waves into injured tissue, stimulating biological processes that may promote healing.
Research suggests shockwave therapy may:
- Increase blood vessel formation (angiogenesis)
- Stimulate collagen production
- Encourage tendon remodelling
- Reduce pain through neurological effects
For chronic tendon conditions, particularly when symptoms have been present for several months, shockwave can be a very useful tool.
However, most research also shows that the best results occur when it is combined with proper rehabilitation and loading programmes.
Which brings us to the most important part of tendon treatment.
The Real Key to Tendon Recovery: Load and Rehabilitation
Across sports medicine research, exercise-based rehabilitation consistently remains the gold standard treatment for tendinopathy.
Programmes involving progressive loading — such as eccentric training or heavy slow resistance exercises — have been shown to:
- Improve tendon structure
- Reduce pain
- Restore strength and function
- Improve long-term outcomes
Mechanical loading helps stimulate collagen remodelling and improved tendon alignment, which are fundamental for tendon healing.
In other words, good rehabilitation is the foundation of recovery, regardless of which additional treatment tools are used alongside it.
Laser Therapy: Stimulating Healing at a Cellular Level
Another treatment we frequently use is photobiomodulation therapy (laser therapy).
While shockwave works through mechanical stimulation, laser therapy works through cellular stimulation.
Specific wavelengths of red or near-infrared light penetrate tissue and interact with the mitochondria inside cells, triggering biological processes that support healing.
Research suggests photobiomodulation can:
- Increase cellular energy production (ATP)
- Stimulate collagen synthesis
- Improve local circulation
- Reduce inflammation
- Reduce pain sensitivity
A systematic review of 17 randomised controlled trials involving 835 patients found that laser therapy combined with exercise improved pain and function more than exercise alone in several tendon conditions.
So rather than competing treatments, shockwave and laser simply support recovery in different biological ways.
Why Good Clinics Don’t Rely on One Treatment
Modern musculoskeletal care doesn’t rely on one single machine or modality.
The best outcomes usually come from a combination of approaches, including:
- Structured rehabilitation programmes
- Manual therapy to improve movement
- Adjunct treatments such as shockwave or laser therapy
- Education and long-term load management
Every injury and every patient is different. The goal is always to choose the right tools at the right time.
15 Years of Treating Tendon Injuries
Our clinic has been helping people recover from injury for over 15 years.
During that time we have successfully treated thousands of tendon injuries, long before technologies like shockwave therapy became widely available.
While modern equipment is helpful, successful outcomes still depend far more on:
- Clinical experience
- Accurate diagnosis
- Evidence-based rehabilitation
- Consistent treatment planning
In short, machines help — but good clinical care matters more.
A Small Thank You
The new system will be installed and ready from Wednesday afternoon, allowing us to resume shockwave treatments from Thursday 21st May.
Where possible this week, rather than simply cancelling appointments altogether, we have tried to extend or adapt your appointments to allow other treatment modalities to be used. Our priority is always that you continue progressing with your recovery, even if the treatment approach needs to change temporarily.
After all, the goal is simple — that you get better one way or another.
And finally, it’s worth remembering that we haven’t always had shockwave therapy — but we have always had positive results treating tendon injuries.
Hopefully the alternative treatment you may have received this week has still left you feeling positive and progressing in the right direction.
Thank you again for your understanding and continued support.