Dynamic Neuromuscular Rehabilitation

Dynamic Neuromuscular Rehabilitation

Dynamic Neuromuscular Rehabilitation

FAQs

What is Extracorporeal Shockwave Therapy ?

Extracorporeal Shockwave Therapy ( ESWT) is innovative biological , highly effective and non-invaisive ttreatment for many orthopedic disorders of muscle and tendon. ESWT treatment belongs to the new type of treatments call regenerative orthopedics.

Why is ESWT considered a biological treatment?

ESWT therapy promotes self tissue healing( tissue regeneration) on a cellular level through activation of bodyies own healing responses on a cellular level.

Is ESWT a really new treatment ?

ESWT has been used in medicine for nearly 30 years for fragmentation of kidney stones(lithotripsy).

ESWT new application called orthotripsy (treatment of diseased tendons with shockwave) has been used in Europe with much success for nearly 15 years. Recently with multiple new research investigations in the field of regenerative orthopedics and biological treatments different types of ESWT technologies are gaining polpularity in US.

What kind of energy is used in ESWT ?

ESWT uses sonic(acoustic) or mechanical energy to treat diseased tissues in musculoskeletal system.

How does ESWT promote healing ?

  1. The strong mechanical pulse exerts pressure and a tension force on the afflicted tissues (damaged cells). The mechanical or acoustic signal is transduced within the cell into biochemical signal. This appears to create an increase in cell membrane permeability allowing ( mechanotrunsduction) which promotes new localized circulation (neovasculogenesis) and metabolism by cellular respone of releasing special enzymes called growth factors (TGF,VEGF AND eNOS) which are the main precursors of tissue healing .
  2. ESWT can remodel damaged tissues by modulating tissue plasticity.
  3. ESWT breaks down pathological deposits of calcium in the soft tissues which is followed by a absorption of the calcium. Excessive deposits of calcium in soft tissue is believed to be the underlying pathological condition for many types of musculoskeletal pain (e.g. painful shoulder tendonosis/tendinitis).
  4. ESWT stimulates osteoblast activity (bone cells) which is responsible for healing and new bone growth.
  5. Lastly, ESWT is thought to diminish pain by stimulating what is known as the "gait control mechanism".

In summation, acoustic waves that are transmitted through the surface of the skin are spread into the body and the body responds with increased metabolic activity around the area of the pain. This stimulates and accelerates the healing process and is especially useful for those suffering from chronic heel, shoulder, knee (patellar tendon), achilles, elbow and back pain.

Are there any side effects observed with ESWT?

The only possible side effect observed in 3% of population is mild bruising.

What are the indications for ESWT?

  1. Rotator cuff tendinopathy
  2. Plantar fascitis/fasciopathy
  3. Tennis elbow (radial epicondilitis)
  4. Golfers elbow (medial epicondilitis)
  5. Tendinosis calcarea (painful limitation of shoulder movement due to calcification of shoulder tendons )
  6. Bursitis ( Bursitis is inflammation of a bursa. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.)
  7. Patellar tendonitis ( jumpers knee)
  8. Tibialis anterior syndrome
  9. Achilles tendonitis
  10. Achillodynia
  11. Heel spur
  12. Various chronic enthesiopathies (painful irritation of tendon attachments due to overexertion and improper strain, or due to a degenerative process)
  13. Various sports injuries
  14. Painful trigger points(acute and chronic painful neck,back, shoulder and etc. due to chronically shortened and thickened muscle tissue)

Many other conditions not listed above

How is ESWT treatment performed?

It is a consensus of the worlds scientific community involved in ESWT research that ESWT SHOULD ONLY BE PERFORMED AFTER TISSUE IMAGING WITH DIAGNOSTIC ULTRASOUND OR MRI.

Targeted therapy with diagnostic ultrasoun is preferd.

What are the expected results?

The beneficial effects of ESWT are often experienced after only 4 treatments. Some patients report immediate pain relief after the treatment, although it can take up to four weeks for pain relief to begin. The procedure eliminates pain and restores full mobility, thus improving your quality of life. Over 80% of patients treated report to be pain free and/or have significant pain reduction.

What if I have a special health condition?

The safety and effectiveness of the ESWT procedure has not been determined on people with the following health conditions. Your doctor will provide you with information about how these and other conditions might affect the determination to perform the ESWT procedures.

  1. Malignancies
  2. DVT (Deep Vein Thrombosis)

How is the treatment performed?

Your medical professional localizes the pain region by IMAGING WITH ULTRASOUND. Coupling gel is then applied to the treatment area to ensure waves to be introduced into the body almost painlessly and without any loss of energy. After these preparations, ESWT waves are released via the applicator and moved over the pain region in a circular motion.

What is the duration of the treament and how many treatments will I need?

Treatment sessions take approximately 5-10 minutes depending on the disorder to be treated. Generally, 4 treatment sessions are necessary at weekly intervals.

What will happen after the treatment/procedure?

You will receive posttreatment instructions from your physician to follow during your recovery.