ANATOMICAL AREAS



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GLOSSARY OF DISEASES

NameTissueType of pathologies
Acute and chronic muscle aches and pain Muscle Pain management
Acute and chronic cervical and lumbar pain Muscle Idiopathic cervical and low back pain
Acute and chronic soft tissue wounds Skin Wounds
Adhesive capsulitis Joint Capsulitis
Calcifying tendinitis of the shoulder Tendons Tendinopathy
Cellulite Skin Cellulite
Chronic distal biceps tendinopathy Tendons Tendinopathy
Chronic proximal hamstring tendinopathy Tendons Tendinopathy
Diseases secondary to trigger points and myofascial Pain Muscle Myofascial pain syndrome
Golfer’s elbow Tendons Tendinopathy
Greater trochanteric pain syndrome Tendons Tendinopathy
Insertional Achilles tendinopathy Tendons Tendinopathy
Knee osteoarthritis Joint Osteoarthritis
Medial tibial stress syndrome Tendons Tendinopathy
Mid-body Achilles tendinopathy Tendons Tendinopathy
Osgood-Schlatter disease Bone Disturbance of musculoskeletal development
Patella tip syndrome Tendons Tendinopathy
Plantar fasciopathy Tendons Tendinopathy
Primary and secondary lymphedema Skin Lymphedema
Primary long bicipital tenosynovitis Tendons Tendinitis
Proliferative connective tissue disorders Connective tissue Fibrosis
Spasticity Central nervous system Cerebral palsy and stroke
Stress fractures Bone Fracture
Subacromial pain syndrome Tendons Tendinopathy
Superficial nonunions Bone Fracture
Tennis elbow Tendons Tendinopathy
Trigger points Muscle Myofascial pain syndrome
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MORE INFORMATION

A stress fracture is defined as a small crack in a bone. Some authors have also considered severe bruising within a bone as stress fracture. Stress fractures are usually the result of overuse and repetitive activity.

Because the weight-bearing bones of the foot and lower leg must absorb the high repetitive forces involved in walking, running and jumping, these bones are especially vulnerable to stress fractures. They are common in soccer and basketball players as well as in runners. Very often, stress fractures occur when athletes change their activities or suddenly increase the intensity of workouts. Stress fractures may also occur during normal daily activities when certain diseases (such as osteoporosis) impair normal bone integrity.

The bones most often affected by stress fractures are the tibia, the fibula, the second and third metatarsals in the foot, the calcaneus (heel), the talus (a small bone in the ankle joint) and the navicular (a bone on the top of the midfoot). The key to recovery from a stress fracture in the foot or ankle is to refrain from high impact activities for an adequate period of time. If patients suffering from a stress fracture fail to do this, the healing process may be delayed and ultimately, the affected bone may break completely.

Extracorporeal shock wave therapy (ESWT) was introduced as treatment for stress fractures in 2009 (Moretti et al., Ultrasound Med Biol 35:1042-1049).

However, prospective, controlled trials on ESWT for stress fractures have not yet been published.

CLINICAL EVIDENCE


Clinical trials confirming the effectiveness and safety of radial shock wave therapy (RSWT®) using the Swiss DolorClast® device for stress fractures are currently underway.
Pre-published data indicating that RSWT® is effective and safe in the treatment of stress fractures is based on (i) anecdotal reports by many users of RSWT®, (ii) the proven effectiveness and safety of RSWT® for fracture nonunions of superficial bones (Silk et al., Foot Ankle Int 2012;33:1128-1132; Kertzman et al., J Orthop Surg Res 2017: in press), (iii) the finding that radial shock waves generated with the Swiss DolorClast® device (RSWs) induced new bone formation in an animal model in vivo (Gollwitzer et al., Ultrasound Med Biol 2013;39:126-133) and (iv) the finding that RSWs induced proliferation of human osteoblastlike cells in vitro (Diaz-Rodriguez et al., Adv Sci Lett 2012;17:325-329).

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TREATMENT PROTOCOL

Number of treatment sessions 3 to 5
Interval between two sessions 1 week
Air pressure Evo Blue® 2 to 3 bar
Air pressure Power+ 1.5 to 3 bar
Impulses 2,000 to 3,000 on the painful spot
Frequency 8Hz to 12Hz
Applicator 15mm
Skin pressure Light to moderate

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