Tendon problems become more common as we get older. Stiffness, slower healing and recurring pain are all linked to changes inside the tendon itself. A couple of patients have recently asked whether shockwave can actually reverse some of this age-related change. The answer is not simple, but new cellular research gives us a clearer picture. What we do know in our clinic, is that patients receive pain-free or pain improvement outcomes after a course of shockwave therapy. In that regard alone, shockwave can make you ‘feel’ young and therefore act younger.
Our case study
This idea makes sense when you think of a patient, from Bedworth, who recently came into our Coventry clinic. For years he had been able to hop easily over the small garden wall outside his home. After developing patellar tendinopathy, he stopped jumping and began walking the long way around via the steps instead. This simple change had a psychological effect. It made him feel as though he was aging before his time. Experiences like this show how tendon problems influence not only movement but also confidence and self-perception. Four sessions of shockwave therapy, and the confidence returned as the pain reduced. The wall was leapt over again without issue.
What happens when tendons age
Tendons are made from tightly organised collagen fibres. When they age, several things happen. First, the collagen becomes less springy and starts to lose some of its tidy arrangement. This is called disorganisation.
Second, the number of healthy tendon cells drops. These cells are responsible for producing new collagen and keeping the tissue strong.
Third, the tendon can develop microtears and thickened areas. These are common in the Achilles, plantar fascia and patellar tendon. Over time, reduced blood supply and repeated load make these changes harder for the body to repair on its own. Weight control can be important in this regard too, when excess weight overloads tendons it can be problematic.
There are also different types of tendon damage. Reactive tendinopathy is an early, swollen phase. Degenerative tendinopathy is a later stage where the tendon contains weakened, worn fibres. Many long-term injuries are a mixture of both.
What shockwave appears to do at a cellular level
Laboratory studies suggest that shockwave may stimulate several positive responses inside the tendon.
One effect is increased activity from the remaining tendon cells. When these cells become more active, they produce healthier collagen.
Another effect is improved blood flow in the surrounding tissues. Better circulation brings oxygen and nutrients needed for repair.
A third effect is a mild mechanical signal that encourages collagen fibres to reorganise. This may help a degenerative tendon behave more like a younger, healthier structure.
These changes do not happen overnight, but they help explain why many people notice gradual improvements over several weeks.
How clinics combine therapies for aging tendons
In practice, the best results often come from combining shockwave with load-based rehabilitation. Strength training helps the tendon use the new collagen in a functional way.
At our clinic we sometimes pair shockwave with K-Laser treatment. The latest K-Laser models are designed to improve circulation and reduce inflammation, making them a useful partner for stubborn degenerative tendons. Some patients respond well to the combination, especially in long standing Achilles and plantar fascia cases.
Bottom line
Shockwave is not a magic switch that makes an old tendon instantly new. However, evidence suggests it can encourage healthier cellular activity, better collagen organisation and improved healing capacity. For many people this is enough improve function and give the tendon a more youthful behaviour over time and as we saw with our patient from Bedworth, confidence returned once the pain reduced.
