Shockwave Therapy vs. Exercise: What Works Best for the Hamstring?

Summary

In this conversation, Blake Withers interviews Aidan Rich, a sports and exercise physiotherapist, about his research on proximal hamstring tendinopathy and the recent randomized control trial comparing physiotherapy and shockwave therapy. Aidan shares his journey into the field, the challenges of designing the study, and the importance of education in treatment. They discuss the nuances of exercise rehabilitation, patient experiences, and the surprising results of the trial, which showed no significant difference between the two treatment methods. Aidan emphasizes the need for individualized care and the potential for future research in this area.

Paper links:

Main RCT: https://journals.sagepub.com/doi/10.1177/03635465251391134

https://pubmed.ncbi.nlm.nih.gov/41037932/

https://pubmed.ncbi.nlm.nih.gov/40469642/

https://www.jsams.org/article/S1440-2440(25)00275-0/pdf

Aidan Rich:

PhD Candidate | APA Titled Sports and Exercise Physiotherapist | State Manager
A dedicated and passionate physiotherapy professional with extensive experience in both academic research and clinical management. Currently pursuing a PhD with the topic of 'Physiotherapy for Proximal Hamstring Tendinopathy,' where he has conducted two randomised trials. In addition to his academic pursuits, he oversee the clinical, financial, and cultural performance of a network of 20 physiotherapy and sports medicine clinics across Victoria. His role involves ensuring the highest standards of patient care, optimising financial performance, and fostering a positive and collaborative work environment.

Chapters

00:00 Introduction and Background of Aidan Rich

03:48 The Evolution of Tendinopathy Treatment

08:30 Shockwave Therapy: Insights and Experiences

13:13 Designing the RCT: Methodology and Protocols

18:20 The Exercise Program: Structure and Rationale

23:07 Education in Rehabilitation: Importance and Implementation

28:39 The Benefits of Resistance Training

29:52 Qualitative Insights from RCT Participants

31:36 Surprising Strength Outcomes in Rehabilitation

33:42 Effect Modifiers in Treatment Response

35:20 Clinical Applications of Shockwave Therapy

37:01 Patient Preferences in Treatment Choices

38:00 Individualized Treatment Approaches

39:04 Evaluating Shockwave Therapy Effectiveness

41:22 Challenges in Designing Effective Trials

43:22 Comparative Outcomes in Tendinopathy Treatments

45:43 Acute Responses to Shockwave Therapy

48:36 Key Takeaways for Clinicians

50:59 Future Directions in Research