Efficacy of the extracorporeal shock wave therapy in athletes with patellar tendinopathy

Patellar tendinopathy (PT) is a chronic musculoskeletal disorder frequently observed in athletes engaged in jumping sports and is characterized by pain and functional impairment due to repetitive loading. Among conservative management strategies, eccentric exercise has the highest level of evidence; however, many athletes remain symptomatic and experience delayed return to sport. Extracorporeal shock wave therapy (ESWT), a non-invasive treatment modality, has recently gained attention as an adjunct intervention in tendinopathy management. Nevertheless, the evidence regarding its efficacy in PT remains inconsistent. This thesis aimed to investigate the clinical effectiveness of ESWT combined with eccentric exercise in athletes with PT . This study was designed as a prospective, randomized controlled clinical trial in accordance with CONSORT guidelines. Twenty-six athletes meeting the inclusion criteria were randomly allocated using block randomization into two groups: the exercise-only group (n=13) and the exercise + ESWT group (n=13). While a 6-week eccentric exercise program xvi was applied to the control group, the experimental group received the same 6-week eccentric exercise program in addition to focused ESWT, administered once a week for the first three weeks (a total of three sessions). Assessments were conducted before the treatment, at the 3rd week, and at the 6th week. Primary outcomes included pain (Numeric Rating Scale) and function (The Victorian Institute of Sport Assessment Patella), while secondary outcomes included maximal vertical jump, single-leg hop distance, single-leg decline squat test, kinesiophobia (Tampa Scale of Kinesiophobia), pain catastrophizing (Pain Catastrophizing Scale), and quality of life (12- Item Short Form Survey). Results demonstrated significant improvements in pain and function scores in both groups. However, the ESWT group exhibited more pronounced reductions in pain and greater functional gains, particularly at week 3. Although the between-group differences diminished by week 6, the addition of ESWT appeared to provide early advantages. In conclusion, ESWT combined with eccentric exercise accelerated short-term pain reduction and functional recovery in athletes with PT. These results suggest that ESWT can be considered a valuable adjunct to exercise-based rehabilitation programs and support the integration of multidimensional approaches for the management of PT.