Boosting Tendon Recovery with Targeted Exercise
Tendon pain can be stubborn. Whether it’s an aching Achilles, a grumpy shoulder, or a sore elbow that just won’t settle, many people feel frustrated when rest, massage or stretching only bring short-term relief.
At Active EP, we see this all the time — and the good news is, there’s a growing body of research showing that Radial Shockwave Therapy (RSWT), when combined with targeted exercise, can help tendons heal faster, stronger and with less pain.
💡 What It Is & Why It Matters
Radial Shockwave Therapy (RSWT) uses high-energy acoustic waves delivered through the skin to stimulate tissue repair. The device we use — the Swiss-made EMS DolorClast® — converts compressed air into controlled sound waves that trigger a local healing response.
This biological response creates the perfect environment for exercise rehabilitation to do its job — rebuilding strength and load tolerance.
📚 The Evidence: Exercise Is Still the Hero
Research led by Associate Professor Peter Malliaras consistently shows that progressive loading exercises remain the strongest evidence-based treatment for tendon pain.
So where does Shockwave fit? It’s not a replacement for exercise — it’s an enhancer. Studies show RSWT can reduce pain and sensitivity in the early phase of rehab, helping patients tolerate exercise sooner and progress more effectively (Rompe et al., 2015; Jayaseelan et al., 2021).
⚖️ RSWT vs. Other Tendon Treatments
| Treatment | What It Does | Limitations | Evidence Summary |
|---|---|---|---|
| Exercise Therapy | Builds tendon load capacity and resilience. | Requires consistency and time. | Strongest evidence (Malliaras et al. 2013). |
| Radial Shockwave Therapy | Stimulates healing, reduces pain, complements exercise. | Temporary discomfort, requires 3–6 sessions. | Moderate-to-strong evidence as adjunct (Jayaseelan et al. 2021). |
| PRP (Platelet-Rich Plasma) | Injected growth factors. | Mixed results, invasive, costly. | Inconsistent evidence (BJSM 2021). |
| Corticosteroid Injections (CSI) | Reduces inflammation short-term. | High recurrence, may weaken tendon. | Short-term relief only (Coombes et al. 2010). |
In short:
Exercise = foundation
Shockwave = accelerator
PRP/CSI = short-term fixes without long-term adaptation.
🏥 How RSWT Works in Practice at Active EP
At Active EP, Shockwave Therapy forms part of a structured four-step approach:
Each session takes about five minutes. Most patients notice a difference after the first 2–3 treatments, and improvements continue over the following weeks as exercise loading increases.
🎯 Common Conditions Treated with RSWT
🚫 Myths to Bust
❌ “Shockwave replaces rehab.”
It’s a complement, not a cure-all. The long-term gains come from exercise.
⚡ “Pain means it’s not working.”
Some mild discomfort during treatment is normal — it indicates the tissue is being stimulated to heal.
💨 “One session fixes everything.”
Most people need 3–6 sessions plus ongoing exercise to achieve lasting results.
💪 Summary: Science Meets Strength
🏋️ Exercise remains the foundation
The gold standard for tendinopathy rehabilitation.
⚡ Shockwave accelerates recovery
Helps reduce pain and sensitivity so exercise can start sooner.
🧠 Together, they’re stronger
Address both biology (healing) and mechanics (movement), leading to faster, more durable outcomes.
References
Malliaras P., Barton C., Reeves N., Langberg H. (2013). Achilles and patellar tendinopathy loading programmes: a systematic review comparing clinical outcomes and mechanisms. Sports Medicine.
Jayaseelan D. J. et al. (2021). Combined effects of radial shockwave therapy and eccentric exercise for chronic tendinopathy: a systematic review. J Orthop Sports Phys Ther.
Rompe J. D. et al. (2015). Radial shockwave combined with eccentric loading improves outcomes in chronic Achilles tendinopathy. Am J Sports Med.
Coombes B. K. et al. (2010). Efficacy and safety of corticosteroid injections for tendinopathy. Lancet.
British Journal of Sports Medicine (2021). Consensus statement: Treatment of tendinopathy.