I’ve been dealing with knee pain for well over 10 years. Now that’s a long time… but then again I’m pretty old. I’ve recommended knee bands, Glucosamine and am continually on the look for solutions to this affliction. Specifically I’ve been diagnosed with Patellar tendonitis or more commonly known as “Jumpers Knee”. Symptoms include dull aches, sharp pains and old man stiffness.

So when my European physiotherapist suggested “Extracorporeal Shock Wave Therapy” or ESWT, I was intrigued. The basic idea is that a high-energy pulse or “shock” is applied to the area. Historically ESWT has been used successfully to fragment renal stones (hard calcium deposits) in the kidney and urinary track without surgery. You might have heard about “Kidney Stones”, most often in reference to the extreme pain in passing them. The first Shock Wave machine was commercially produced in 1984 and since then the technique has also been applied to other areas of the body. Positive reports are generally received for hips, elbows and shoulders.

Alternative therapies for Patellar tendonitis are surgery… and of course the now famous “Kobe Procedure” in Germany. (Where blood is extracted, centrifuged and returned to the area to promote healing.) These treatments require needles and scalpels and have extended recovery times and may require a large medical budget.

The good news is that ESWT has been found to have no serious side effects, and is part of the Dutch medical plan.

ESTW works by applying a targeted mechanical pressure force and shock to the afflicted area. By varying the frequency, expert practitioners target the patellar tendon while guided by an ultrasound image. The basic idea is that shock waves create cavitation bubbles which then burst and create physical forces…these “forces” break apart the calcium deposits in and on the tendon. Shock wave treatment has also been shown to increase blood circulation in treated areas. This is reported to speedily remove the now pulverized calcium pieces and stimulate the healing process in the tendon.

The first treatment is the most difficult. Imagine your already sensitive and painful knees being hit by a hammer. Now do this two thousand five hundred times. I gripped the sides of the treatment bed, held my breath and took my thoughts to an imaginary tropical island. After 10 minutes of this we took a small break as I caught my breath and wiped the sweat away. My imaginary island was going through a heat wave. Then we did the other knee.

The pain of subsequent treatments decreased with each treatment, and after the third treatment I could feel a noticeable decrease in the overall pain in the knee. This effect was especially apparent the next day after sport, when previous to the ESTW treatments I would walk around like a 80 year old pensioner. We did a total of six (6) treatments of ESTW and I must say it did produce a noticeable decrease in the pain. There was some slight bruising and a bit of redness and of course the pain during the treatment.

Here are the before and after images from the ultrasound.

Before (August 2013)

After (October 2013)

Basically the area’s colored bright white indicate bone or calcification and the black areas indicate trauma or bleeding in the area. Most people will have either a bump on the top of their knee of one on the bottom where the tendon attaches to the bone. In this example the bump is on the top near the kneecap. I can see a small but noticeable decrease in the calcification in the left knee and some reduction trauma in both (less black).

The end result was a decrease in pain after sport activities. Now this could very well have been due to an increase in my pain threshold having endured over fifteen thousand (15,000) hits to each knee, but it’s most likely a combination of the treatment, my time in the gym and my newly acquired resistance to pain.
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