Extracorporeal Shockwave Therapy (ESWT) – treatment for Achilles tendinopathy and plantar fasciitis



Achilles tendinopathy is prevalent and potentially incapacitating in athletes involved in running sports. It can render an athlete out of action for several months. However, it is not always associated with excessive physical activity. It is a degenerative, not an inflammatory condition which is why it is called tendinopathy rather than tendinitis. Chronic pain seriously affects our private and working life and our physical fitness.

At Feet First we recommend EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT) for the treatment of achilles tendinopathy and also plantar fasciitis. After only 4 or 5 sessions, over 80% of patients report painlessness or significant pain reduction. Extracorporeal shock wave therapy (ESWT) is a modern and highly effective treatment method; high-energy sound waves are introduced into the painful areas of the body. With this innovative treatment, pathological alterations of tendons, ligaments, capsules, muscles and bones can be eliminated.

Extracorporeal Shockwave Therapy (ESWT)

How do shock waves work?
Shock waves accelerate the healing process by activat­ing the body’s self-healing powers. They stimulate the metabolism and enhance the blood circulation. Dam­aged tissue gradually regenerates and eventually heals.

What causes Achilles Tendinopathy?
Excessive loading of the tendon during vigorous activities is regarded as the main cause. Damage to the tendon can occur even if it is stressed within normal limits when frequent micro trauma is not given enough time to heal resulting in fibre damage. Other factors also contribute such as blood supply to the tendon, gastrocnemius-soleus dysfunction, body weight, high arched feet, and lateral ankle instability. Excessive pronation predisposes the achilles to tendinopathy.

What are the symptoms?
Classic features are pain and swelling of the Achilles tendon, the gradual onset of morning stiffness which is often worse on days after a run. The pain/stiffness will typically “warm-up” during the first 5-10 minutes of a run. This feature often stops people seeking help as they initially run through the pain.

How is the therapy performed?
The therapist localises the pain region by palpation. A skin gel is then applied to the treatment area to allow the shock waves to be introduced into the body almost painlessly and without any loss of energy. After these preparations, shock waves are released as the shock wave applicator is moved over the pain region in a circular motion.

Duration and frequency of the therapy
The therapy session takes approximately 10 minutes depending on the disorder to be treated. In general, 5-8 therapy sessions are necessary at weekly intervals.

Extracorporeal Shock Wave Therapy has virtually no risks or side-effects.

Disorders that can be treated
Heel Pain
Achilles tendon pain
Shin pain/tibial stress syndrome
Patellar tendinitis (jumper’s knee)


Just a quick line to thank you for recommending the Shock Wave Therapy as a solution to my nagging ankle problem. The three session course made a considerable difference and accelerated the healing process. The ankle now feels normal again. Thank you. Mike Ashford
I have suffered from pain and stiffness in the Achilles area of my heel for some time, which refused to respond to common treatments. My podiatrist suggested ESWT (Extracorporeal Shockwave Therapy). It seemed an odd sort of treatment but was simple to administer and didn’t stop me continuing my normal activities. I had 2 courses of three sessions, by the end of which a real improvement could already be noticed and healing continued thereafter, as my own body repaired the earlier damage. I have now been totally free of pain for over 2 years with no re-occurence at all. A brilliant result. Mrs Penny
In late June this year, I damaged my Achilles and leg tendons quite severely and, as a result, could hardly walk. A & E were more concerned about the possibility of DVT above all else and, when this was ruled out, diagnosed Soft Tissue and said go back to your GP for a referral. Stupidly I didn’t do this. My tendons were not healing and I was in trouble when quite by chance I saw the Feet First ad in Look Local, and saw that they now fix Achilles problems.
I’ve visited Jenny Klose before and on her recommendation I started a course of Shockwave Therapy Treatment in early August which has now completed in late October after 5 sessions. The improvement has been quite spectacular. Although I remain slightly lame for other structural reasons, I have no pain or difficulty with my tendons whatsoever. The treatment has not been cheap but worth every penny, being little short of miraculous in my view. Richard
I am writing to thank you for your help with the advice and ESWT treatment. Things have made a dramatic improvement and I would say my feet are 95% there. I still wear the orthotics but can now walk about 45 minutes without discomfort and things are continuing to improve. I felt very safe in your hands that at last I had found someone who I could trust and who knew what they were doing, warm and friendly. I would not hesitate to recommend you to anyone with feet problems. Thanks again. Louise.