How effective is shockwave therapy for tendinopathy?

Tendinopathy is a broad term for tendon pain and reduced load tolerance. It can affect the heel, elbow, shoulder, knee, or other areas, and the same treatment should not be assumed to work identically in each location. Shockwave therapy delivers controlled sound waves to a chosen area with the aim of changing pain sensitivity and supporting the body's response to tendon loading.

A careful assessment helps separate tendinopathy from a partial tear, joint problem, nerve pain, or referred pain. Duration of symptoms, recent activity changes, tendon strength, and the ability to follow a graded exercise plan all influence the likely experience. Improvement is usually monitored through practical function rather than a single feeling after treatment.

Ask which tendon is involved and what finding supports the diagnosis. Combine any shockwave sessions with a staged loading programme, such as isometric work followed by controlled strengthening when appropriate. Modify the activity that triggered the flare without stopping all movement, because complete rest can make returning to normal load harder.

Record a task that matters to you, such as climbing stairs, gripping, running, or reaching. Review that task with your clinician after the agreed interval. Ongoing sharp pain, increasing weakness, or a mismatch between symptoms and the proposed tendon should prompt reassessment.

Get prompt assessment for a sudden pop, bruising, a new gap or deformity, or an abrupt loss of strength after loading a tendon. Seek urgent help for severe swelling, redness with fever, spreading numbness, or inability to use the limb. A planned review is sensible when symptoms steadily worsen or function remains limited despite following the programme.

Which tendon is affected, and how certain is the diagnosis? What load should I reduce, and which exercises should I progress? How will we measure whether shockwave therapy is helping rather than irritating the tendon?