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Rhim HC, Shin J, Kang J, Dyrek P, Crockett Z, Galido P, Wade C, Hollander K, Borg-Stein J, Sampson S, Tenforde AS. Use of extracorporeal shockwave therapies for athletes and physically active individuals: a systematic review. Br J Sports Med 2024; 58:154-163. [PMID: 38228375 DOI: 10.1136/bjsports-2023-107567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To determine the efficacy of extracorporeal shockwave therapy (ESWT) and investigate outcomes following the use of ESWT for athletes and physically active individuals. DESIGN Systematic review. DATA SOURCES We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and searched four databases: PubMed (NLM), Embase (Elsevier), CINAHL Complete (EBSCO) and Web of Science (Clarivate). ELIGIBILITY CRITERIA FOR SELECTING STUDIES Included studies were randomised controlled trials, cohort and case-control studies, cases series and reports that evaluated outcomes following ESWT for athletes, physically active individuals and occupational groups requiring regular physical activity such as military cadets. RESULTS 56 studies with 1874 athletes or physically active individuals were included. Using the Oxford level of evidence rating, included studies were 18 level I (32.1%), 3 level II (5.4%), 10 level III (17.9%), 13 level IV (23.2%) and 12 level V (21.4%). Based on the level I studies, ESWT may be effective alone in plantar fasciitis, lateral epicondylitis and proximal hamstring tendinopathy and as an adjunct to exercise treatment in medial tibial stress syndrome and osteitis pubis in athletes or physically active individuals. In most studies, athletes were allowed to continue activities and training and tolerated ESWT with minimal side effects. CONCLUSION ESWT may offer an efficacious treatment alone or as an adjunct to concurrent exercise therapy in selected sports-related injuries and without major adverse events. Further high-level research is needed to better define the role and clinical outcomes of ESWT.
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Affiliation(s)
- Hye Chang Rhim
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jaehyung Shin
- Foot & Ankle Research and Innovation Lab (FARIL), Department of Orthopaedic Surgery, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jane Kang
- Riverside University Health System, Moreno Valley, California, USA
| | - Paige Dyrek
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Zack Crockett
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | - Pearl Galido
- Western University of Health Sciences, Pomona, California, USA
| | - Carrie Wade
- Countway Library, Harvard Medical School, Boston, Massachusetts, USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
| | | | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
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Kuo SJ, Su YH, Hsu SC, Huang PH, Hsia CC, Liao CY, Chen SH, Wu RW, Hsu CC, Lai YC, Liu DY, Ku NE, Chen JF, Ko JY. Effects of Adding Extracorporeal Shockwave Therapy (ESWT) to Platelet-Rich Plasma (PRP) among Patients with Rotator Cuff Partial Tear: A Prospective Randomized Comparative Study. J Pers Med 2024; 14:83. [PMID: 38248784 PMCID: PMC10820784 DOI: 10.3390/jpm14010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
A rotator cuff tear is a prevalent ailment affecting the shoulder joint. The clinical efficacy of combined therapy remains uncertain for partial rotator cuff tears. In this study, we integrated extracorporeal shockwave therapy (ESWT) with platelet-rich plasma (PRP) injection, juxtaposed with PRP in isolation. Both cohorts exhibited significant improvements in visual analogue scale (VAS), Constant-Murley score (CMS), degrees of forward flexion, abduction, internal rotation, and external rotation, and the sum of range of motion (SROM) over the six-month assessment period. The application of ESWT in conjunction with PRP exhibited notable additional enhancements in both forward flexion (p = 0.033) and abduction (p = 0.015) after one month. Furthermore, a substantial augmentation in the range of shoulder motion (SROM) (p < 0.001) was observed after six months. We employed isobaric tag for relative and absolute quantitation (iTRAQ) to analyze the differential plasma protein expression in serum samples procured from the two groups after one month. The concentrations of S100A8 (p = 0.042) and S100A9 (p = 0.034), known to modulate local inflammation, were both lower in the ESWT + PRP cohort. These findings not only underscore the advantages of combined therapy but also illuminate the associated molecular changes.
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Affiliation(s)
- Shu-Jui Kuo
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung 404327, Taiwan
| | - Yu-Hsiang Su
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan; (Y.-H.S.); (C.-C.H.)
| | - Shih-Chan Hsu
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Po-Hua Huang
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Chia-Chun Hsia
- Department of Education, China Medical University Hospital, Taichung 404327, Taiwan; (Y.-H.S.); (C.-C.H.)
| | - Chin-Yi Liao
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Sung-Hsiung Chen
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Re-Wen Wu
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Chieh-Cheng Hsu
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
| | - Yen-Chun Lai
- School of Medicine, National Taiwan University, Taipei 100233, Taiwan;
| | - De-Yi Liu
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Nien-En Ku
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Jui-Feng Chen
- School of Medicine, China Medical University, Taichung 404328, Taiwan; (S.-J.K.); (S.-C.H.); (D.-Y.L.); (N.-E.K.); (J.-F.C.)
| | - Jih-Yang Ko
- Department of Orthopedic Surgery, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan; (P.-H.H.); (C.-Y.L.); (S.-H.C.); (R.-W.W.); (C.-C.H.)
- Center for Shockwave Medicine and Tissue Engineering, College of Medicine, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan
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Huang H, Xu F, Feng X, Luo Z, Wang Q. Comparative outcomes of extracorporeal shockwave therapy for shoulder tendinitis or partial tears of the rotator cuff in athletes and non-athletes. Int J Surg 2023; 109:4375-4376. [PMID: 37707532 PMCID: PMC10720780 DOI: 10.1097/js9.0000000000000735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/19/2023] [Indexed: 09/15/2023]
Affiliation(s)
- HaoQiang Huang
- Department of Orthopaedics, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu Province
| | - Feng Xu
- Department of Orthopaedics, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu Province
| | - Xinting Feng
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zhiwen Luo
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Qing Wang
- Department of Orthopaedics, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu Province
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De la Corte-Rodríguez H, Román-Belmonte JM, Rodríguez-Damiani BA, Vázquez-Sasot A, Rodríguez-Merchán EC. Extracorporeal Shock Wave Therapy for the Treatment of Musculoskeletal Pain: A Narrative Review. Healthcare (Basel) 2023; 11:2830. [PMID: 37957975 PMCID: PMC10648068 DOI: 10.3390/healthcare11212830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/15/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Extracorporeal shock waves are high-intensity mechanical waves (500-1000 bar) of a microsecond duration with a morphology characterized by a rapid positive phase followed by a negative phase. BACKGROUND Extracorporeal shock waves have been used for pain treatment for various sub-acute and chronic musculoskeletal (MSK) problems since 2000. The aim of this article is to update information on the role of extracorporeal shock wave therapy (ESWT) in the treatment of various pathologies that cause MSK pain. METHODS Given that in the last two years, articles of interest (including systematic reviews and meta-analyses) have been published on less known indications, such as low back pain, nerve entrapments, osteoarthritis and bone vascular diseases, a literature search was conducted in PubMed, the Cochrane Database, EMBASE, CINAHL and PEDro, with the aim of developing a narrative review of the current literature on this topic. The purposes of the review were to review possible new mechanisms of action, update the level of evidence for known indications and assess possible new indications that have emerged in recent years. RESULTS Although extracorporeal shock waves have mechanical effects, their main mechanism of action is biological, through a phenomenon called mechanotransduction. There is solid evidence that supports their use to improve pain in many MSK pathologies, such as different tendinopathies (epicondylar, trochanteric, patellar, Achilles or calcific shoulder), plantar fasciitis, axial pain (myofascial, lumbar or coccygodynia), osteoarthritis and bone lesions (delayed union, osteonecrosis of the femoral head, Kienbock's disease, bone marrow edema syndrome of the hip, pubis osteitis or carpal tunnel syndrome). Of the clinical indications mentioned in this review, five have a level of evidence of 1+, eight have a level of evidence of 1-, one indication has a level of evidence of 2- and two indications have a level of evidence of 3. CONCLUSIONS The current literature shows that ESWT is a safe treatment, with hardly any adverse effects reported. Furthermore, it can be used alone or in conjunction with other physical therapies such as eccentric strengthening exercises or static stretching, which can enhance its therapeutic effect.
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Affiliation(s)
- Hortensia De la Corte-Rodríguez
- Department of Physical Medicine and Rehabilitation, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain
- IdiPAZ Institute for Health Research, 28046 Madrid, Spain
| | - Juan M. Román-Belmonte
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.)
- Medical School, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Beatriz A. Rodríguez-Damiani
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.)
- Medical School, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Aránzazu Vázquez-Sasot
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.)
- Medical School, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Emérito Carlos Rodríguez-Merchán
- Department of Orthopedic Surgery, La Paz University Hospital, 28046 Madrid, Spain
- Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research—IdiPAZ (La Paz University Hospital—Medical School, Autonomous University of Madrid), 28046 Madrid, Spain
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Mazin Y, Lemos C, Paiva C, Amaral Oliveira L, Borges A, Lopes T. The Role of Extracorporeal Shock Wave Therapy in the Treatment of Muscle Injuries: A Systematic Review. Cureus 2023; 15:e44196. [PMID: 37767244 PMCID: PMC10521343 DOI: 10.7759/cureus.44196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
Muscle injuries commonly occur in sports and can be classified as indirect and direct, according to the 2013 Munich Consensus Statement (MCS). Since recent evidence suggests that extracorporeal shock wave therapy (ESWT) improves muscular microcirculation and may increase regeneration after acute muscle injury, we performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines to access the efficacy and safety of ESWT in the treatment of patients with muscle injuries. PubMed and Cochrane were searched to screen for potentially relevant articles and the literature search was last updated in June 2023. The inclusion criteria were randomized controlled trials, observational studies, or case controls published in English, Portuguese, or Spanish that studied the effect of ESWT on indirect and direct muscle injuries in individuals aged ≥18, with at least one of the following reported outcomes: pain on the visual analog scale (VAS), functionality assessed either with disability scales or subjectively, time for return to play (RTP), re-injury rate, and ultrasonographic evaluation. The exclusion criteria were literature reviews, systematic reviews, studies in animals, studies in other languages, studies that failed to meet the targeted population or intervention and studies that didn't report any of the outcomes of interest. The quality of the studies was analyzed using the Cochrane Assessment Tool, the Newcastle-Ottawa Quality Assessment Scale, and the JBI Critical Appraisal Checklist. Eight studies were included in the systematic review (two randomized controlled trials, one prospective observational study, two retrospective observational studies, and three case reports), with a total of 143 adult participants. ESWT was associated with less pain on VAS, better function, reduction of size of lesion on ultrasound evaluation, faster RTP and/or lower re-injury rate in patients with indirect and direct muscle injuries and muscular hematomas, a frequent secondary complication of muscle injuries. The evidence regarding the use of ESWT for these types of injuries is therefore promising. Nevertheless, higher-quality studies are needed in the future to prove its efficacy, better comprehend its mechanisms of action and define treatment protocols (timing, type and parameters of ESWT).
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Affiliation(s)
- Yuriy Mazin
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - Carolina Lemos
- Population Studies, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, PRT
| | - Carolina Paiva
- Physical Medicine and Rehabilitation, Centro de Medicina de Reabilitação da Região Centro-Rovisco Pais, Coimbra, PRT
| | - Luís Amaral Oliveira
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
| | - Andre Borges
- Physical Medicine and Rehabilitation, Centro Hospitalar De Trás-Os-Montes E Alto Douro, Vila Real, PRT
| | - Tiago Lopes
- Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT
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Pasculli RM, Bowers RL. Evidence-based Management of Rotator Cuff Tears (Acute and Chronic). CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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OLIVEIRA VICTOROTAVIOMORAESDE, VERGARA JULIANAMUNHOZ, OLIVEIRA VICENTEFURQUIMDE, LARA PAULOHENRIQUESCHMIDT, NOGUEIRA JÚNIOR LUIZCARLOS, ARLIANI GUSTAVOGONÇALVES. EXTRACORPOREAL SHOCKWAVE THERAPY IN SHOULDER INJURIES: PROSPECTIVE STUDY. ACTA ORTOPEDICA BRASILEIRA 2021; 29:268-273. [PMID: 34629952 PMCID: PMC8478428 DOI: 10.1590/1413-785220212905237628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/24/2020] [Indexed: 12/29/2022]
Abstract
Objective: To evaluate the functional results after the use of extracorporeal shockwave therapy (ESWT) in four groups of patients: tendinopathy, partial rotator cuff injury, adhesive capsulitis and calcareous tendinopathy of the rotator cuff at one month and three months after the end of treatment. Methods: Case series in which patients were evaluated according to the VAS of pain, range of motion of the shoulder, and functional questionnaires DASH and modified UCLA. Results: There was a significant increase in the measure of flexion, lateral rotation and shoulder abduction in the evaluations after treatment in relation to the baseline measurement (p < 0.001) and no evidence of significant difference was found between the post-treatment evaluations at one month and three months follow-up (p > 0.05). There was a significant reduction in the VAS score, increase in the UCLA score and a significant reduction in the DASH score in the post-treatment evaluations in relation to the baseline score (p < 0.001) and a significant improvement in the three-month evaluation in relation to one month (p < 0.05). Conclusion: Extracorporeal shockwave therapy proved to be efficient and safe in the treatment of shoulder pathologies, improving pain, range of motion and functional scores in all groups of patients evaluated in the study. Level of Evidence IV, Case series.
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Alian SM, Zaghlol RS, Khalil SS. Platelet rich plasma versus extracorporeal shock wave therapy in patients with non-calcific supraspinatous tears. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2020. [DOI: 10.1186/s43166-020-00020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To compare the clinical efficacy of platelet rich plasma (PRP) subacromial injection and extracorporeal shock wave therapy (ESWT) on refractory non-calcific partial thickness supraspinatous tendon tear.
Results
Significant improvement in all outcome measures achieved in both groups at 4 weeks follow-up period (the end of treatment course) (P< 0.05). At 12 weeks follow-up period, group I, showed significant improvement in all outcome measures compared to baseline and group II; however, in group II, there was no significant difference compared to baseline; moreover, deterioration in the previous improvement was noticed.
Conclusion
Both PRP (group I) and ESWT (group II) are effective therapeutic methods in the management of refractory non-calcific partial thickness supraspinatous tendon tear; however, PRP (group I) has better long-term effects on both pain and function.
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Kim JH, Kim SH, Kim HR, Lee SH, Yoon SY, Yang JH, Yoo YB, Park KS, Nam SE, Hong S, Min HK. Ultrasonographic evaluation of chronic shoulder pain after breast cancer surgery: single center, cross-sectional study. Sci Rep 2020; 10:16792. [PMID: 33033299 PMCID: PMC7546622 DOI: 10.1038/s41598-020-73769-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/22/2020] [Indexed: 12/20/2022] Open
Abstract
Chronic shoulder pain is a common complication in breast cancer patients after surgery. Chronic shoulder pain after breast cancer surgery was formerly considered as neuropathic pain, however the pathophysiology including structural damages has not been assessed comprehensively. We hypothesized that the structural change could be one of the cause of shoulder pain after breast cancer surgery and evaluated various ultrasonography findings of the shoulder in breast cancer patients with chronic shoulder pain. Patients who were suffering from chronic shoulder pain on unilateral side for at least 3 months after breast cancer surgery were enrolled from a single tertiary hospital. Demographic and clinical data were collected at the baseline. Articular and adjacent structures of both shoulders (painful and contralateral side) were evaluated by ultrasonography. The ultrasonography findings were compared between painful and contralateral sides. Logistic regression analysis was performed to determine the factors associated with abnormal ultrasonography findings. Fifty-two female patients (average age of 55) were enrolled. Significantly more abnormal ultrasonography findings were observed in the painful side than in the contralateral side [39 (75.0%) vs 11 (21.2%), P < 0.001]. The coracohumeral ligament was significantly thicker in the painful side than in the contralateral side (2.48 ± 0.69 vs 1.54 ± 1.25 mm, P < 0.001); adhesive capsulitis was also more frequent in the painful side [14 (26.9%) vs 0, P < 0.001]. Furthermore, patients with a history of breast cancer surgery on the ipsilateral side were associated with abnormal ultrasonography findings and adhesive capsulitis. This study is the first to evaluate ultrasonography in patients with chronic shoulder pain after breast cancer surgery. The results showed that ultrasonography could reveal several structural problems in these patients.
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Affiliation(s)
- Jung Hun Kim
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, 05030, Republic of Korea
| | - Se Hee Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Sang-Heon Lee
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - So Young Yoon
- Division of Oncology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Jung-Hyun Yang
- Department of Surgery, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Young Bum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Kyoung Sik Park
- Department of Surgery, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Sang Eun Nam
- Department of Surgery, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Semie Hong
- Department of Radiation Oncology, Konkuk University Medical Center, Seoul, 05030, Republic of Korea
| | - Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, Republic of Korea.
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Rodriguez-Santiago B, Castillo B, Baerga-Varela L, Micheo WF. Rehabilitation Management of Rotator Cuff Injuries in the Master Athlete. Curr Sports Med Rep 2019; 18:330-337. [PMID: 31503045 DOI: 10.1249/jsr.0000000000000628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Rotator cuff (RTC) injuries are common in master athletes, especially overhead athletes. Risk factors include aging and degeneration as nonmodifiable and volume of activity, muscle weakness, and loss of motion as modifiable. The clinical presentation involves limited range of motion (ROM), pain at rest and at night. Injury classification into traumatic versus nontraumatic and tendinopathy, partial or full-thickness tears helps to establish a treatment plan. RTC injury rehabilitation protocols are criteria-based, multimodal, and divided into four phases. The acute phase addresses pain, inflammation, ROM, and RTC protection. The recovery phase addresses kinetic chain abnormalities, flexibility, and strength, and the functional phase involves exercises directed toward specific sport activities. Return to sports is based on clinical recovery, kinetic chain principles, and adequate sports technique. Nonsurgical management is recommended in most cases, and surgical management is considered if symptoms progress, especially for full-thickness tears.
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Affiliation(s)
- Belmarie Rodriguez-Santiago
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico, School of Medicine, San Juan, PUERTO RICO
| | - Brenda Castillo
- Physical Medicine and Rehabilitation Department-MossRehab, Elkins Park, PA
| | - Luis Baerga-Varela
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico, School of Medicine, San Juan, PUERTO RICO
| | - William F Micheo
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico, School of Medicine, San Juan, PUERTO RICO
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Vitali M, Naim Rodriguez N, Pironti P, Drossinos A, Di Carlo G, Chawla A, Gianfranco F. ESWT and nutraceutical supplementation (Tendisulfur Forte) vs ESWT-only in the treatment of lateral epicondylitis, Achilles tendinopathy, and rotator cuff tendinopathy: a comparative study. J Drug Assess 2019; 8:77-86. [PMID: 31105990 PMCID: PMC6508015 DOI: 10.1080/21556660.2019.1605370] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 04/01/2019] [Indexed: 02/06/2023] Open
Abstract
Objective: The purpose of this study was to determine the efficacy of Extracorporeal Shock Wave Therapy (ESWT) in combination with the dietary supplement Tendisulfur Forte in the treatment of shoulder tendinopathy, lateral epicondylitis, and Achilles tendinopathy. Methods: Patients were sub-divided for each pathology into two equal sized groups of 15: one treated with ESWT supplemented with Tendisulfur Forte, and the other treated with ESWT only. Shoulder functionality was measured through the UCLA shoulder score. Treatment of epicondylitis was assessed with the Mayo elbow score. Achilles tendinopathy was measured with the VISA-A score. Pain through the various groups of the study was measures with the Visual Analog Scale (VAS). Results: Patients in the Tendisulfur Forte group had overall better functional and VAS scale scores for shoulder tendinopathy, elbow epicondylitis, and Achilles tendinopathy. UCLA scores for shoulder tendinopathy showed significant results at 60 days in the Tendisulfur Forte group (p = 0.0002). Mayo scores in the treatment of lateral epicondylitis was significant at 60 days in the study group (p < 0.0001). Achilles tendinopathy was improved in the study group at 30 days (p < 0.0001). VAS scales were significant for each pathology at 60 days (p < 0.0001). In addition, NSAIDs consumption was greatly reduced and, in most cases, stopped in the Tendisulfur Forte Groups. Conclusion: Concerning the results obtained, this paper underlines the effectiveness of combined treatment of ESWT plus Tendisulfur Forte, in the absence of side-effects. Indeed, oral supplementation lead to a faster recovery and better outcomes with a significant reduction in NSAIDs consumption.
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Affiliation(s)
- Matteo Vitali
- Department of Orthopedics and Traumatology, San Raffaele Scientific Institute, Milan, Italy
| | | | - Pierluigi Pironti
- Department of Orthopedics and Traumatology, San Raffaele Scientific Institute, Milan, Italy
| | - Andreas Drossinos
- Department of Orthopedics and Traumatology, San Raffaele Scientific Institute, Milan, Italy
| | - Gaia Di Carlo
- International MD Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Anshuman Chawla
- International MD Program, Vita-Salute San Raffaele University, Milan, Italy
| | - Fraschini Gianfranco
- Department of Orthopedics and Traumatology, San Raffaele Scientific Institute, Milan, Italy
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