No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: a randomized controlled trial

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2026-32. doi: 10.1007/s00167-013-2522-z. Epub 2013 May 12.


Purpose: The aim of the study was to compare the effectiveness of focused shockwave therapy (FSWT) and radial shockwave therapy (RSWT) for treating patellar tendinopathy.

Methods: Patients were randomized into two groups. One group received three sessions of FSWT, and the other group received three sessions of RSWT. Both groups also received an eccentric training programme. Follow-up measurements took place 1, 4, 7 and 14 weeks after the final shockwave treatment. The primary outcome measure was the Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire. Secondary outcome measures were pain during ADL, sports activities and the decline squat.

Results: Forty-three subjects (57 tendons) were included in the study. Twenty-one subjects (31 tendons) received FSWT, and 22 subjects (26 tendons) received RSWT. Both groups improved significantly on the VISA-P score, but there were no differences in improvement between the FSWT group (15 points on the VISA-P) and the RSWT group (9.6 points, n.s.). This was also the case for the secondary outcome measures.

Conclusion: There were no statistically significant differences in effectiveness between FSWT and RSWT. It is therefore not possible to recommend one treatment over the other on grounds of outcome. Both groups improved significantly, although it is questionable whether this difference is clinically relevant.

Level of evidence: II.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Athletic Injuries / therapy
  • Female
  • Glucocorticoids / administration & dosage
  • High-Energy Shock Waves / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Patellar Ligament / injuries*
  • Single-Blind Method
  • Tendinopathy / therapy*
  • Treatment Outcome


  • Glucocorticoids