Should you try shockwave therapy for PHT recovery?

tendinopathy is a challenging condition that can affect athletes and non-athletes alike. In this podcast episode, we dive into the use of shockwave therapy for proximal hamstring tendinopathy (PHT) recovery. We’ll cover the basics of shockwave therapy, who it benefits the most, and the important factors to consider when using this treatment. Join us on this journey to understand how shockwave therapy can be a valuable tool in the management of PHT.

Introduction: Overcoming Proximal Hamstring Tendinopathy

Proximal hamstring tendinopathy, or PHT, can be a frustrating and painful condition for both athletes and individuals leading an active lifestyle. In this podcast episode, we will explore the potential of shockwave therapy as a treatment option for PHT. Our goal is to provide you with the knowledge and practical insights needed to make informed decisions about your recovery journey. Join us as we delve into the world of shockwave therapy and its relevance to PHT.

Meet Your Host: Brodie Sharp

Before we dive into the details of shockwave therapy, let’s get to know your host, Brodie Sharp. He’s an online physiotherapist and a recreational athlete who has battled with chronic proximal hamstring tendinopathy himself. Brodie is the creator of the Run Smarter series, a resource designed to help individuals understand their conditions, explore evidence-based treatments, and debunk common misconceptions. Whether you’re an athlete or not, this podcast aims to educate and empower you to overcome PHT. Stay tuned for valuable insights and actionable takeaways in today’s lesson.

Understanding Shockwave Therapy

In this episode, we’ll discuss shockwave therapy and its potential role in PHT recovery. Brodie shares a conversation with Benoit Matthew, an advanced practice physio, sonographer, and expert in shockwave therapy. Benoit has extensive experience in treating conditions such as hip, groin, and running injuries. Shockwave therapy is the focus of their discussion, and we’ll explore what it is and how it can be beneficial.

Shockwave Therapy: What Is It?

Shockwave therapy, often referred to as extracorporeal shockwave therapy (ESWT), is a non-invasive treatment that utilizes high-energy sound waves to stimulate the body’s natural healing response. The therapy has been in use for over 40 years, with its origins in breaking kidney stones. The sound waves generated by shockwave therapy are highly powerful and are naturally found in nature during events like thunderstorms and sonic booms.

These high-energy sound waves are capable of inducing microtrauma and inflammation in chronic tendon conditions. This controlled microtrauma helps kickstart the healing process in tendons that have reached a state of stagnation. In essence, shockwave therapy acts as a reset button for the body, prompting it to initiate the healing process. This treatment has gained recognition and approval from regulatory bodies like the US FDA and has a long history of use in various fields, including cosmetic, urological, neurological, and orthopedic applications.

Shockwave Therapy: Beneficial for Specific Conditions

Shockwave therapy is not a one-size-fits-all solution; its effectiveness can vary depending on the specific condition and the stage of that condition. For lower limb tendinopathies, such as plantar fasciitis, Achilles tendon issues (both mid-portion and insertional), patellar tendon problems, lateral hip pain, and proximal hamstring tendinopathy, shockwave therapy has shown promise in clinical studies.

The suitability of shockwave therapy for a particular patient is determined by factors such as the duration and stability of their symptoms. It is essential to use shockwave therapy during the chronic stage of a condition, typically after a minimum of three months of symptoms and following an initial period of rehabilitation. Shockwave therapy is not recommended for patients with acute or highly reactive symptoms, as it may exacerbate their pain. Proper patient selection is crucial for successful outcomes with this treatment.

The Dosage of Shockwave Therapy

Understanding the appropriate dosage of shockwave therapy is essential to achieve the desired results. Shockwave therapy is not a quick fix; it is part of a comprehensive treatment plan that involves rehabilitation and strengthening exercises. The optimal dosage of shockwave therapy typically falls within the range of three to five sessions, with the possibility of extending to six sessions in specific cases. It is crucial to provide a sufficient number of sessions to elicit a cumulative effect, as the full benefits of shockwave therapy become evident in the weeks following treatment.

Patients need to recognize that shockwave therapy is a tool to reduce pain and initiate the healing process, but it does not replace the importance of rehabilitation. The healing process takes time, and the full benefits of shockwave therapy become evident approximately 12 weeks after the last session. Therefore, the approach to shockwave therapy should be viewed as “three plus 12,” signifying three weeks of shockwave treatment followed by 12 weeks of targeted rehabilitation. This combination ensures that the tendon not only heals but also becomes stronger and more resilient.

Avoiding Common Pitfalls

It’s crucial to understand that shockwave therapy should not be viewed as a standalone solution or a quick fix before an important event or race. Patients should not expect immediate results from this treatment. Using shockwave therapy to mask pain before an event is not advisable, as it can lead to overexertion and potential injuries. Instead, it’s recommended to plan shockwave therapy well in advance and consider the cumulative effect it offers, which becomes evident after the treatment cycle and during the subsequent rehabilitation period.

Additionally, proper patient selection is vital to the success of shockwave therapy. Patients with extremely high pain levels or those who are in the acute, reactive phase of their condition are not ideal candidates for this treatment. Shockwave therapy is most effective for those with stable, chronic symptoms, typically rated at a pain level of no more than five out of ten. The pain should be more of an achy discomfort than sharp or severe. Selecting the right patients at the appropriate stage of their condition is key to a successful outcome.


In this episode, we’ve explored the potential of shockwave therapy as a valuable tool in the treatment of proximal hamstring tendinopathy and other lower limb conditions. Understanding the principles of shockwave therapy, patient selection, and appropriate dosages are essential for a successful recovery journey.

Proximal hamstring tendinopathy can be a challenging condition, but with the right knowledge, treatments, and patience, individuals can overcome it. Shockwave therapy, when used in the right context and as part of a comprehensive treatment plan, can be a helpful step toward recovery. Remember that healing takes time, and shockwave therapy is a catalyst that kickstarts the process, leading to improved tendon health and strength.