We ask Osteopath James Woledge about the benefits of shock wave therapy

James has been using shock wave therapy for nearly 10 years and has been teaching and podcasting about it since 2017. He mentors beginners through to advanced practitioners using STORZ MEDICAL radial and focused devices. James runs two multi-disciplinary clinics in Suffolk and Kent.

How did you start your journey with shock wave?
My journey with shock wave started in 2013 after becoming interested in plantar heel pain and Achilles tendon issues. Nearly everything works in the short-term, but patients kept coming back complaining of relapses. This may be good for repeat business but it’s not good for the soul, especially when you leave college thinking you have the skills to cure all ills. An old friend from the British School of Osteopathy had mentioned this soundwave thing, so I followed it up at one of the national trade shows. I got one to try for a few months so I could throw it at my list of stubborn plantar fasciitis patients with encouraging results. I did some research and decided to buy into one of the accepted leaders in the field – STORZ MEDICAL. I now own radial and focused devices across my clinics supplied by Venn Healthcare.

What percentage of your patients have shock wave?
I would say that 50% of my patients are now »shock wave patients«. But this is because I have developed a patient list/practice that specialises in chronic tendinopathies and plantar fasciitis. Many patients are not candidates for shock wave and I’m a passionate advocate against using it on »everyone for anything« just because you have a machine.

What conditions do you see the most?
I see an enormous number of lower extremity problems from plantar fasciitis to GTPS (gluteal tendinopathy) and shin splints. I am also starting to see more calcific tendonitis patients as I now use ultrasound imaging to assess all my patients.

What conditions do you think respond the best to shock wave therapy?
Certainly, plantar fasciitis and GTPS are the best responders and the most common. They are relatively easy to treat as they are easily accessed, plus patients tend to find the treatment less painful than other areas.

How has shock wave advanced your practice?
It has shone a light on many conditions we osteopaths are historically poor at. I’m sure that might raise a few eyebrows but my undergraduate education on tendon related disease and its management was very little. Getting involved in shock wave encourages you to upskill in soft tissue-based pathology and evidence-based rehab strategies.

I still combine traditional osteopathic thought and skills to treat these conditions but I think it right that we should strive to increase our knowledge, based upon the evidence, to ensure we appropriately treat these patient groups.

Shock wave has certainly broadened my practice life and kept me interested! If I was still seeing 20 – 30 lower back pain patients per week, I would be bored stupid. This week alone I will see one delayed tibial bone union (focused shock wave works well on these) three calcific tendonitis patients and two proximal hamstring tendinopathies. Alongside ultrasound imaging this is an exciting week for me!

As a well-respected educator on shock wave therapy, where do you see the future of the technology?
I think its mainstay will be in the musculoskeletal field but with an ever-growing list of evidence-based conditions such as chronic low back pain or shin splints. It’s no longer just a tendon machine. Its use in urology for example for Peyronie’s disease, CPPS and erectile dysfunction is becoming much more widely accepted and our clinic is typical of a trend that’s seen a year-on- year doubling of these patient groups.

This interview was kindly provided by Venn Healthcare.