I’ve never thought of myself as a particularly immobile person, but when it comes to my ankles I am so far from ideal range it’s ridiculous. This has, unfortunately, led to a string of injuries throughout my running life from chronic achilles tendonitis to mechanically induced stress fractures. Back in 2020 my left achilles flared up massively and it got to the point where my physio, Joe, who I’ve gone to for years, recommended shockwave therapy.
What is achilles tendonitis?
Whatever the cause (acute injury or built 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 characterised by a lump from the damage.
For me, the day-to-day symptoms included extreme stiffness when sitting/lying for long periods of time and a painful lump just above the insertion point at my heel. At its worst, I was in daily pain and struggling with running. The stiffness meant I was unable to put my heels down when I first got out of bed!
What is shockwave therapy?
Extracorporeal Shockwave therapy (ESWT) is a non-invasive treatment for musculoskeletal soft tissue, using shockwaves to deliver a mechanical force to the targeted tissue. This force stimulates tendon cell metabolism, initiating a repair process.
Tendons do not have a good blood supply and so only really get stimulation to repair when they are loaded. This is one of the things that makes tendonitis so often a chronic condition. It’s a delicate balance between enough and too much load. Shockwave therapy creates the stimulation to repair without the load.
How my treatment worked.
Joe recommended a course of four treatments, spaced out 1-2 weeks apart. It was best if I rested my achilles for 2-3 days after each course of treatment, so as not to aggravate them in an already vulnerable state. This meant, with running 3 days per week (all easy and no speedwork), I would go to have the treatment the afternoon after a run.
The treatment started off at a conservative intensity and number of shocks, increasing each time I visited. I wouldn’t say it was “painful”, as such, but it was uncomfortable. As the tendon itself is sore, what I can only describe as repeatedly flicking it was never going to be a walk in the park! But it’s also over really quickly.
Results of shockwave therapy.
Joe always said it would take about 12 weeks to see a result because this is the natural healing timeframe of any tendon. Funnily enough, almost bang on 12 weeks after finishing treatment I felt able to finally increase my running. I worked my way up to longer distance runs and added in some faster sessions. I even walked normally out of bed in the mornings!
In fact, this would forever be my guide! Having a benchmark like how your achilles feel in those first few steps makes it easier to manage niggles and injuries.
Almost a year on…
It’s now been just over a year since I started my shockwave treatment with Joe. I believe I made a full recovery after having the treatment, but I was always at risk of it returning as the underlying cause still existed. I haven’t dedicated as much time as I should have to increase my range of motion and, unfortunately, a trail run with shoes that had too low a heel drop for me meant a flare-up roughly halfway through the year.
I’ve kept things manageable over the racing season, but with the result achieved last time, I’m confident I can get back to where I was with a top-up treatment. Shockwave isn’t a miracle cure so we still need to find what works and doesn’t work for us in terms of prevention and management.
Have you ever had shockwave therapy or had it recommended to you? I’m a big believer in it and would love to hear what others think, too!
About Forge Physio
Forge Physio is an independent physiotherapy practice providing shockwave, and other physiotherapy treatments, out of the City of London and locally in Essex. They also work with recognised insurance companies to provide treatment through policy claims.
