Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine (2020) 19, 309 - 316

Research article
One Session of Extracorporeal Shockwave Therapy-Induced Modulation on Tendon Shear Modulus is Associated with Reduction in Pain
Zhi Jie Zhang1, Wai Chun Lee1, Siu Ngor Fu2, 
Author Information
1 Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
2 Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong

Siu Ngor Fu
✉ Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
Email: Amy.fu@polyu.edu.hk
Publish Date
Received: 06-01-2020
Accepted: 09-02-2020
Published (online): 01-05-2020
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ABSTRACT

The aim of the study was to examine the immediate effect of 1 session of extracorporeal shockwave therapy (ESWT) on patellar tendon stiffness and to explore the relationship between the change in tendon stiffness and the pain intensity. Thirty-four male athletes aged 22.2 ± 3.8 with patellar tendinopathy were recruited. The participants were randomized into ESWT and sham groups. The ESWT group received 1500 impulses of ESWT at 4 Hz with maximal tolerable pain intensity and the sham group received intensities below 0.08 mJ/mm2. Supersonic Shearwave Imaging (SSI) was used to measure tendon shear modulus (an index of tissue stiffness), and a visual analogue scale was used to quantify the pain intensity during compression with 10 lb (4.535 kg) pressure directed on the most tender part and then during a single-leg declined-squat test. A significant reduction in tendon shear modulus (from 57.4 ± 25.5 kPa to 40.6 ± 17.6kPa, p = 0.001) was detected in the ESWT receiving ESWT with an intensity from 0.13-0.33 mJ/mm2 but not the sham group (from 47.7 ± 17.1 kPa to 41.0 ± 12.7 kPa; p = 0.06). In the ESWT group, the change in tendon shear modulus was associated with the change in the intensity of pain during single-legged declined-squat test (ρ = 0.55; p = 0.023) but not pressure pain (p > 0.05). These findings suggest that one session of ESWT induces reduction of tendon stiffness in volleyball and basketball players with patellar tendinopathy. The reduction in tendon stiffness is associated with reduction in pain during single-legged declined-squat test.

Key words: Tendon shear modulus, extracorporeal shockwave therapy, patellar tendinopathy, single-leg decline squat test


           Key Points
  • One session of ESWT induced a reduction in tendon stiffness among athletes with PT.
  • The reduction in tendon stiffness is related to self-perceived pain
  • Such findings may be one of the mechanisms of ESWT for treating PT.
 
 
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