Extracorporeal Shock Wave Therapy (ESWT) for football injuries



What is Extracorporeal Shock Wave Therapy


The football4football injury team access the most credible and proven injury experts, medical services and rehabilitation products used in football. One new technology that's come up is the use of Extracorporeal Shock Wave Therapy (ESWT).  Professional footballers we speak to revealed the treatment is now part of their injury recovery plans.   

For those who don't know, ESWT is a non-invasive treatment that uses shock or sound waves to help heal various musculoskeletal conditions.
Mainly working well on connective tissues like tendons and ligaments, Shock waves are NOT electrical shocks. 


A patient receiving extracorporeal shockwave therapy on her achilles tendon with a CS1 device.


What football injuries does ESWT treat?


These are examples of common football injuries Extracorporeal Shock Wave Therapy (ESWT) treats.

 1. Plantar Fasciitis: A painful foot condition characterised by inflammation of the thick band of tissue connecting the heel bone to the toes, often causing stabbing pain in the heel. Players struggle to plant their foot or even put boots on. 


 2. Tennis/Golfer's Elbow: These overuse injuries result in pain and tenderness on the inner or outer side of the elbow. Goalkeepers repeatedly throwing the ball out have suffered from this. Extracorporeal Shock Wave Therapy can target the affected tendons, stimulate healing, and relieve the discomfort associated with these conditions.


 3. Shoulder Impingement: Shoulder impingement occurs when the rotator cuff tendons compress between the upper arm bone and the shoulder blade. ESWT can help reduce inflammation and promote healing, alleviating pain and restoring range of motion, especially for goalkeepers.


 4. Achilles Tendinopathy: This condition involves pain and stiffness in the Achilles tendon, which connects the calf muscles to the heel bone. Treatment can stimulate tissue regeneration in the affected area, enhancing mobility and reducing pain when footballers sprint or in the jumping phase. 


 5. Hip Bursitis: Hip bursitis is inflammation of the bursa, a fluid-filled sac that cushions the hip joint. Extracorporeal Shock Wave Therapy can alleviate pain and swelling in the hip, allowing patients to resume their daily activities. We've had case studies where footballers have complained about this issue. 


 6. Knee Osteoarthritis: Osteoarthritis is a degenerative joint disease that affects many footballers, especially post-career. There is limited evidence that treatment can help with cartilage regeneration. There has, however, been a success in reducing pain and improving joint function for players suffering from knee osteoarthritis.

There are cases where the treatment becomes part of recovery post anterior cruciate ligament surgery. 




A woman footballer receiving ESWT treatment on her Achilles tendon at a clinic




Here's some extended information on Extracorporeal Shockwave Therapy based on enquiries by football4football members in our football injuries section.


How is Extracorporeal Shock Wave Therapy carried out?


Doctors, physiotherapists, or certified partitioners of the equipment carry out the treatment. 

A device generates these shock waves outside your body, hence the term "extracorporeal," meaning "outside the body." Conducting gel is applied to the skin. The ESWT machine is hand-held, with interchangeable heads that is targeted or spread out over the affected area by the therapist.

The shock waves travel up to 6 centimetres through the skin and into the tissues, to start cell activity, and blood flow, releasing healing proteins, creating molecules that begin the growth of new tissue. Shock waves stimulate the body's natural healing process and help break down scar tissue or calcifications, which often cause pain and stiffness.

Sessions of the treatment last between 15 minutes and half an hour in one sitting. It is worth noting that there is a ‘weird pain’ felt, as described by one player we observed having treatment. The settings for the machine ranges from 1 to a level 10. Therapists suggest an intensity of 5 as a good start point to work from first time around, depending on your pain comfort level.

ESWT treatment is relatively quick and without surgery, anaesthetic or medication. After treatment, you can usually continue with daily activity and light training (under professional supervision if you're a full-time player). Depending on your condition, a few sessions or a series of treatments are done. Players football4football have carried out research with have often noticed improvements straightaway.



A keeper trying to save a ball


How effective is ESWT for treating football injuries?


The effectiveness of shockwave therapy in accelerating the healing process for musculoskeletal injuries has seen many scientific papers recommend its use. Furthermore, those who offer Extracorporeal Shock Wave Therapy report a high success rate, particularly for football-related injuries. Shockwave therapy's ability to enhance blood flow and stimulate soft tissue repair is making it an ideal treatment for footballers with injuries who want to reduce inflammation, promote tissue regeneration, and alleviate pain. 



Two footballers running on a field, show the flexibility of their Achilles tendons.



Benefits of Extracorporeal Shock Wave Therapy for football injuries


The benefits of Extracorporeal Shock Wave Therapy for football injuries from our research include:


 1. Non-Invasive: Offer patients a non-invasive treatment option, eliminating the need for surgery or prolonged medication use. This makes it an attractive choice for individuals looking for natural and minimally disruptive solutions to their musculoskeletal conditions.


 2. Pain Relief: Has proven to be highly effective in providing pain relief for various musculoskeletal conditions. By triggering the body's natural healing mechanisms, these treatments target the root cause of the pain, offering long-term relief rather than just masking the symptoms.


 3. Improved Joint Mobility: Joint mobility is crucial for football performance and maintaining a high quality of daily life. ESWT can help improve joint function by reducing inflammation and promoting tissue repair. This enables players to regain mobility and range of motion they may have lost due to the pain of a condition.


 4. Reduced Recovery Time: Unlike surgeries or invasive procedures, ESWT requires minimal downtime for recovery and enhanced tissue regeneration. Patients can usually resume their normal activities shortly after treatment, experiencing minimal disruption to their daily routines.


 5. Affordable Alternative: Traditional medical interventions for musculoskeletal conditions, such as surgery or ongoing medication use, can be costly and inconvenient. 




Are there potential side effects of shockwave treatment for footballers?


Though ESWT is generally safe, like any other treatment, it may have possible side effects, including passing soreness, minor bruising, or skin inflammation at the treatment site. However, these are usually short-lived and mild. 


How will ESWT be used by football physiotherapists in the future?


The immeasurable value ESWT brings to football physiotherapy paints a hopeful future where high-speed recovery becomes a norm rather than an exception. As research and technology continue to evolve, it's plausible to expect ESWT to shape football physiotherapy in a way that underscores the effective management of injuries and streamlined performance enhancement.


A physio points as an injured soccer player sits on the ground.


How much does Extracorporeal Shock Wave Therapy cost? 


Prices can vary from region to region and clinic to clinic. We've seen ranges of £80 to £500 depending on the number of courses and extra treatments included in their therapy package. 



Where can I get Extracorporeal Shock Wave Therapy? 


Sometimes, treatment is given on the NHS via a GP when patients haven't had success with other treatments like painkillers, rest, ice therapy, standard physiotherapy, or steroid injections. You will likely need to go to an independent clinic or physiotherapist offering Extracorporeal Shock Wave Therapy.


It's worth noting that while Extracorporeal Shock Wave Therapy is beneficial, it is not a miracle cure. Combined with physiotherapy exercises, sufficient rest and occasional modifications to training routines or equipment can maximise its effect. 

If you are struggling with a persistent injury that is not responding to traditional treatments, discussing Extracorporeal Shock Wave Therapy with your doctor or a physiotherapist would be worthwhile.



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