At One Health Osteopathy Clinic, we use Extracorporeal Shockwave Therapy (ESWT) as part of a comprehensive, evidence-informed approach to treating running injuries, particularly chronic tendinopathy.

This guide explains how shockwave therapy works, who it’s suitable for, and what the treatment process involves.

What Is Shockwave Therapy?

Shockwave therapy is a non-invasive treatment that uses high-energy acoustic waves delivered to injured tissue. These sound waves stimulate a biological healing response in areas where recovery has stalled, particularly in chronic tendon conditions.

It is commonly used for:

• Achilles tendinopathy
• Plantar fasciitis
• Patellar tendinopathy (jumper’s knee)
• Proximal hamstring tendinopathy
• Greater trochanteric pain syndrome (outer hip pain)

For runners, these are some of the most frequent overuse injuries.

Why Runners Develop Chronic Tendon Pain

Tendons adapt to load — but marathon training and high mileage can sometimes exceed the tendon’s capacity. When recovery does not keep up with demand, tendon structure may change.

Chronic tendinopathy often involves:

• Degenerative tendon changes
• Reduced collagen organisation
• Thickening of the tendon
• Localised pain with loading

Importantly, chronic tendon pain is not usually an inflammatory condition. This is why rest alone or anti-inflammatory treatments often fail to resolve the issue.

How Shockwave Therapy Works

Research suggests shockwave therapy may:

• Stimulate collagen production
• Promote tissue regeneration
• Improve local blood circulation
• Reduce pain sensitivity
• Trigger cellular repair mechanisms

It essentially “restarts” the healing response in chronically overloaded tendon tissue.

Multiple clinical studies show good evidence for shockwave therapy in treating:

• Chronic Achilles tendinopathy
• Plantar fasciitis
• Patellar tendinopathy

It is particularly effective when combined with progressive loading exercises, rather than used in isolation.

What to Expect at Your First Appointment

At One Health Osteopathy Clinic in Tunbridge Wells, shockwave therapy is never delivered without assessment.

Step 1: Comprehensive Assessment

Your osteopath will:

• Take a full injury and training history
• Assess biomechanics and movement patterns
• Examine the painful tendon
• Identify contributing factors such as stiffness or weakness

Shockwave therapy is recommended only if clinically appropriate.

What Happens During Shockwave Treatment?

If shockwave therapy is indicated, here’s what typically happens:

1. Gel is applied to the treatment area.
2. A handheld device delivers acoustic waves to the affected tendon.
3. The session usually lasts 5–10 minutes.

Does It Hurt?

You may feel discomfort during treatment — particularly over sensitive tendon areas, but intensity is adjusted to remain tolerable. Most runners describe it as uncomfortable but manageable.

Pain often reduces significantly after a few sessions.

How Many Sessions Are Needed?

Most protocols involve:

• 4 to 6 sessions
• Usually spaced one week apart

Improvement is often gradual. Some runners notice changes after 3–4 sessions, while others experience progressive improvement over 6–12 weeks as tissue adaptation occurs.

Should You Stop Running During Treatment?

Not necessarily.

Complete rest is rarely recommended for tendinopathy. Instead, your osteopath will guide:

• Load modification
• Adjusted mileage
• Temporary reduction in speed work
• A structured strengthening programme

Shockwave therapy works best alongside progressive tendon loading, not instead of it.

When Is Shockwave Therapy Most Effective?

Shockwave therapy is typically most helpful when:

• Pain has persisted for more than 8 weeks
• Symptoms have not improved with exercise alone
• There is localised tendon pain with loading
• Imaging confirms degenerative changes (if performed)

It is less commonly used for acute muscle strains or early inflammatory injuries.

Benefits of Shockwave Therapy for Runners

For suitable candidates, shockwave therapy may:

• Reduce chronic tendon pain
• Improve tolerance to loading
• Speed up return to higher training intensity
• Reduce reliance on pain medication
• Support long-term tendon adaptation

When combined with osteopathy treatment and rehabilitation, it forms part of a comprehensive running injury plan.

Shockwave Therapy at One Health Clinic

At One Health Osteopathy Clinic, we integrate:

• Detailed biomechanical assessment
• Hands-on osteopathy treatment
• Shockwave therapy (if appropriate)
• Individualised strengthening programmes
• Return-to-running guidance

Our goal is not just pain relief, but restoring tendon capacity so you can continue running confidently and safely.

Is Shockwave Therapy Safe?

Shockwave therapy is considered safe when delivered by trained professionals. Side effects are typically mild and may include:

• Temporary soreness
• Mild redness
• Local tenderness for 24–48 hours

It is not suitable for certain medical conditions, which will be screened during
assessment.

Final Thoughts

Chronic tendon pain can be frustrating, especially when it disrupts marathon training. Shockwave therapy offers an evidence-based, non-invasive option for runners whose symptoms have not improved with exercise alone.

When combined with osteopathy treatment and progressive strengthening, it can help:

• Reduce pain
• Stimulate tendon healing
• Improve load tolerance
• Support a safe return to running