New Study: Running-Related Injuries No Match
for Shock Wave
How do you keep your runners in motion, given
that 4 out of 5 of them experience running-related injuries annually?
While running remains one of the most popular
forms of exercise worldwide, runners commonly experience injuries related to
their activity of choice. With over 13 million runners crossing the finish line
yearly in the U.S., it’s essential to study the most effective
The findings of a large case-cohort study were
recently published in The Journal of Foot & Ankle Surgery.
Researchers evaluated the outcomes of 94 runners receiving Extracorporeal Pulse
Activated Technology (EPAT) for running-related injuries, including plantar
fasciitis and lower-extremity tendinopathy (Achilles, posterior tibialis,
Want to delve deeper into the detailed
findings of the efficacy of EPAT in the treatment of lower extremity
running-related injuries? You
can view the study in its entirety by going straight to the source; click here to view the complete
What is shock wave treatment and how does it
EPAT (Extracorporeal Pulse Activation
Technology), also known as ESWT or shock wave therapy, is the most promising
and innovative approach to treating acute and chronic musculoskeletal pain and
connective tissue disorders. It’s backed by evidence and is a regenerative
solution proven to deliver impressive outcomes.
A wide range of evidence shows several
proposed direct effects of shock waves on damaged tissue and the indirect
effects of shockwaves on regulating the local metabolic and inflammatory
What are the standard treatments for
Typical treatments for runner-related injuries
include modified activity, anti-inflammatory drugs, and physical therapy. Other
forms of intervention, including corticosteroid injection, are often sought out
by runners who have not had success with typical protocols. The feasibility of
corticosteroids for these conditions is debatable, given the degenerative
etiology of most tendon and soft tissue conditions plus the genuine concern for
What methodology was used in the study on EPAT
for running-related injuries?
The population studied included runners with
lower-extremity running-related injuries (RRI’s) who sought treatment from Dr.
Adam Tenforde of Spaulding Rehabilitation in Cambridge, MA at his outpatient
running medical clinic. Chart reviews were performed by three authors (Matthew
Mitchkash, MD, David Robinson, MD, Adam Tenforde, MD) from August 2017 to
September 2019 for all patients in the study.
For research purposes, the injury, clinical
and treatment characteristics, demographics, and functional outcomes were
included. A running-related injury was defined as a condition that interfered
with regular training and ability to compete for over seven days.
What shock wave device and procedure was used
in the study?
All practitioners used the same STORZ Medical
radial pressure wave device for all treatments. Patients with hamstring
tendinopathy received a minimum of 4 EPAT sessions intending to meet 4 bars of
pressure. For all other conditions, EPAT treatment was used over a minimum of 3
weekly sessions, with additional sessions as needed to obtain an optimal
Frequency and pressure ranged from 12 to 15 Hz
and 2 to 5 bar, primarily dictated by patient comfort. No topical or regional
anesthetic was used during treatment, and patients were directed to stop using
nonsteroidal anti-inflammatory medications and icing during treatment until
What did the study reveal about EPAT/ESWT for
Impressive outcomes prevailed as initially
hypothesized by the researchers. Overall, 74 runners (79%) met their respective
minimal clinically significant difference for functional outcome measures,
regardless of age, sex, body mass index, or chronic nature of the
A mean of 4 treatments resulted in a
clinically favorable outcome, with 95% achieving it by 5 treatments.
In conclusion, a majority of runners with all
types of lower-extremity injuries and dysfunction respond favorably to EPAT/ESWT.
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