RADIAL PROTOCOL
Radial protocol values
Pressure (bar): 2
Pulses: 2000
Frequency: 10 Hz
Applicator: 15 mm
Total Energy: 103 mJ/mm²
Number of Sessions: 3 (1 session per week)
Medical Information
The patellar tendon connects the inferior pole of the patella to the tibia. Patellar tendinopathy (PT), commonly referred to as “jumper’s knee,” is a chronic injury caused by overuse of the patellar tendon.
Its main clinical symptom is pain at the inferior pole of the patella. This condition is diagnosed based on its clinical symptoms. Imaging studies should be used to rule out other causes of knee pain or to confirm the diagnosis of PT when there is diagnostic uncertainty.
As with other tendinopathies, the etiology of PT is still not fully understood, although repetitive overload is considered a major contributing factor. However, histological examination of biopsy samples obtained from patients undergoing surgery for chronic symptoms has shown that chronic PT is associated with degenerative changes within the tendon. Consequently, the condition is more accurately described as a “tendinopathy” rather than a “tendinitis,” and resembles the pathology observed in other overuse tendon disorders, such as Achilles tendinopathy.
Athletes show a very high prevalence of PT, reaching up to 40% among elite basketball and volleyball players. The condition can become debilitating, preventing athletes from returning to sport for prolonged periods ranging from 6 months to more than 2 years.
Treatment of PT should begin with conservative management approaches such as rest, physiotherapy, eccentric strengthening exercises, orthotic support, and nonsteroidal anti-inflammatory drugs (NSAIDs). Patients who do not respond to conservative treatment within six months may be considered for Radial Shock Wave Therapy (RSWT®). Surgery should be considered in the most persistent cases of PT. Numerous arthroscopic and open surgical procedures have been described; however, there is currently no consensus regarding the optimal surgical approach.
STUDIES
Crupnik J Eccentric loading plus radial shock wave therapy in the treatment of chronic patellar tendinopathy. Abstracts 12th International Congress of the International Society for Musculoskeletal Shock wave Therapy, Sorrento, Italy, 2009, 26-27
Lohrer H, SchÖll J, Arentz S Achillodynie und Patellaspitzensyndrom – Ergebnisse der Behandlung austherapierter, chronischer Fälle mit radialen Stosswellen. Sportverl Sportschad 2002; 16: 108-114
FOCAL PROTOCOL
Focal protocol values
Penetration Depth: 5–15 mm
Total Energy Flux Density per Shock Wave Emission: 0.089–0.271 mJ/mm²
Number of Sessions: 3–5 (at intervals of 5–12 days)
Frequency: 2–6 Hz
Pulses: 1000–3000
Medical Information
Patellar tendinitis (jumper’s knee) is a condition caused by overuse of the patellar tendon due to repetitive, unusual, and/or acute stress in the area where the tendon attaches to the bone. Jumping activities, and particularly landing after a jump, place maximum stress on the patellar tendon. Therefore, athletes involved in sports that require frequent jumping, such as volleyball, basketball, high jump, or long jump, as well as runners and football players, are especially prone to developing patellar tendinitis.
Patients with patellar tendinitis / jumper’s knee typically report pain around the patella during physical activity. In advanced stages of the condition, pain may become chronic and persist even at rest. The treatment of patellar tendinitis with focused shock wave therapy has become an established ESWT treatment option.
STUDIES
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