Loughborough University

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Radial Extracorporeal Shockwave Therapy (rESWT) is not superior to “minimal-dose” rESWT for patients with chronic patella tendinopathy; a double-blinded randomised controlled trial

journal contribution
posted on 2023-10-06, 16:00 authored by Patrick WheelerPatrick Wheeler


Investigating outcomes for patients with chronic patella tendinopathy following radial extra-corporeal shockwave therapy (rESWT).


22 patients with chronic patella tendinopathy were recruited for this DB-RCT from a single NHS Sports Medicine clinic. Participants were randomized equally to either 3 sessions of “therapeutic-dose” or “minimal-dose” rESWT respectively, alongside a structured and progressive home exercise program. Participants: 86% male, mean age 36.1±12.5 years, symptom duration: 30.4±32.7 months. Maximum 6-month follow-up, with interim data at 6-weeks, and 3-months.


Improvements were seen in both groups, with an improvement of pain by about 35% across all time periods; these within-group improvements were seen at the interim (6-week, 3-month) and final (6-month) study period. However, no differences were seen between-groups at any time period, suggesting non-superiority of “therapeutic” over “minimal-dose” ESWT. There were no changes seen in markers of general health or levels of recorded physical activity.


Small sample sizes limit firm conclusions, but this study has failed to show any superiority of rESWT compared to “minimal-dose” rESWT in patients with chronic patella tendinopathy, when performed alongside a structured home exercise program (progressive loading, flexibility, and balance components). The findings from this study do not support the current recommendations, that of three sessions of radial-ESWT performed at weekly intervals at the “maximally comfortably-tolerated dose”.



  • Sport, Exercise and Health Sciences

Published in

Muscles, Ligaments and Tendons Journal


CIC Edizioni Internazionali


  • AM (Accepted Manuscript)

Publisher statement

This is the author’s version of a work that was accepted for publication in MLTJ - Muscle, Ligaments and Tendons Journal. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in MLTJ - Muscle, Ligaments and Tendons Journal [VOL#, ISSUE#, (DATE)

Acceptance date




Publisher version


  • en


Prof Patrick Wheeler. Deposit date: 4 October 2023