Use of extracorporeal shockwave therapies for athletes and physically active individuals: a systematic review.

Researchers pulled together 56 studies involving nearly 1900 athletes and active people to see what extracorporeal shockwave therapy, or ESWT, could actually do for sports injuries. ESWT uses focused shock waves aimed at damaged tissue, and it's been floating around sports medicine clinics for a while now, but the evidence has been scattered. Looking at the higher-quality studies in particular, the team found that ESWT appeared to help on its own for plantar fasciitis (heel pain), lateral epicondylitis (tennis elbow), and proximal hamstring tendinopathy (deep hamstring pain).

It also seemed to work better when combined with exercise for medial tibial stress syndrome (shin splints) and osteitis pubis (groin pain in athletes). A real practical benefit was that most athletes tolerated the treatment well and kept training, with minimal side effects reported. The overall picture suggests ESWT might be useful in certain situations, either alone or alongside exercise, but the field still needs stronger research to pin down exactly when and how to use it best.

This study looked at how well shockwave therapy works for active people dealing with common sports injuries. The researchers found encouraging signs, particularly for heel pain, tennis elbow, and certain hamstring and groin injuries.

In many cases, the therapy seemed to work better when people combined it with exercise and kept doing their activities during treatment, rather than stopping completely. One thing that stood out was how well athletes generally tolerated the treatment, with very few reporting serious side effects. That said, the strength of the evidence varies depending on which injury you're dealing with.

Some conditions have more solid research backing them up than others, and more studies are needed to understand the full picture of what shockwave therapy can and cannot do.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review offers a useful map of where ESWT sits in the sports injury landscape based on current evidence. The authors included a reasonable spread of study quality, though nearly half came from lower-level designs (case series and reports), and only about a third were level I randomised controlled trials.

For the conditions with the strongest level I evidence, ESWT appears to have a role as monotherapy for plantar fasciitis, lateral epicondylitis, and proximal hamstring tendinopathy, with somewhat clearer support when combined with exercise for medial tibial stress syndrome and osteitis pubis. The practical finding that athletes tolerated the intervention well and maintained training is clinically relevant, suggesting ESWT doesn't necessarily create the activity restrictions some other treatments demand. However, the variability in outcomes across conditions and the gaps in mechanistic understanding mean ESWT remains a conditional option rather than a standard go-to.

The authors' call for higher-level research is well-founded, and practitioners will likely benefit from waiting for future trials that more clearly define patient selection and optimal dosing protocols.