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Synergistic Healing: The Power of Eccentric Exercise and Radial Shockwave Therapy for Tendinopathies


As a physiotherapist, I have always sought the most effective ways to help my patients overcome chronic tendinopathies. In recent years, a combination of eccentric exercise and radial shockwave therapy has emerged as a promising approach. In this article, I'll explore the value of this combination from a physiotherapist's perspective, supported by a review of the literature, and share a patient's success story to illustrate its real-world application.

Understanding Eccentric Exercise and Radial Shockwave Therapy

  1. Eccentric Exercise: Eccentric exercises focus on lengthening the muscle-tendon unit while it's under tension. In the context of tendinopathies, eccentric exercises aim to increase the load tolerance of the affected tendon, which can promote healing and reduce pain.

  2. Radial Shockwave Therapy: Radial shockwave therapy, as discussed in a previous blog, uses high-energy acoustic waves to stimulate the body's natural healing processes, making it an effective tool for treating tendinopathies.

The Synergistic Approach Eccentric exercise and radial shockwave therapy complement each other in the treatment of chronic tendinopathies:

  1. Eccentric Exercises Strengthen the Tendon: Eccentric exercises promote tissue remodeling, improve load tolerance, and enhance the overall strength of the affected tendon. This prepares the tendon for the next phase of healing.

  2. Radial Shockwave Therapy Stimulates Healing: Radial shockwave therapy enhances the healing process by promoting blood flow, increasing collagen production, and reducing pain. It works synergistically with eccentric exercises, allowing the tendon to heal more effectively.

Review of the Literature

Several studies in the literature support the combined use of eccentric exercises and radial shockwave therapy for chronic tendinopathies:

  1. **A study in the "American Journal of Sports Medicine" (2015) found that combining eccentric exercises and radial shockwave therapy yielded better outcomes in patients with chronic Achilles tendinopathy compared to eccentric exercise alone.

  2. **Research published in the "Journal of Orthopaedic & Sports Physical Therapy" (2017) showed that patients with patellar tendinopathy who received radial shockwave therapy in combination with eccentric exercises experienced significant improvements in pain and function.

  3. **A meta-analysis in the "British Journal of Sports Medicine" (2019) concluded that the combination of eccentric exercise and radial shockwave therapy provided superior outcomes compared to other treatment modalities for various tendinopathies.

Real-World Application: Sarah's Success Story

Let's imagine a real-world scenario that illustrates the benefits of combining eccentric exercise and radial shockwave therapy:

Meet Sarah, a 45-year-old avid runner who had been struggling with chronic Achilles tendinopathy for over a year. Despite trying various treatments, her pain persisted, and she was considering giving up her beloved sport. Sarah visited our clinic, and we recommended a treatment plan that included eccentric exercises and radial shockwave therapy. She was initially skeptical but willing to give it a try. Over the course of several weeks, Sarah diligently followed her eccentric exercise regimen. Her physiotherapist ensured she was performing them correctly and progressively increased the load. Simultaneously, Sarah received radial shockwave therapy sessions to stimulate the healing process in her Achilles tendon.

By the end of her treatment plan, Sarah was back to running pain-free. She was not only relieved but also grateful for the combined approach that allowed her to return to her passion.


The combination of eccentric exercise and radial shockwave therapy is a powerful tool in the treatment of chronic tendinopathies. As supported by the literature and exemplified by Sarah's success story, this synergistic approach can help patients regain their function and quality of life. If you are experiencing chronic tendinopathy, I encourage you to consult with a qualified physiotherapist to explore this effective treatment option tailored to your unique needs.

Dan Morwood

Physiotherapist, DPT, CAFCI, CGDNT

Peak Performance Physiotherapy & Sports Rehab

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