With the rapid development of medical technology, ESWT has gained popularity and acceptance worldwide, so it is gradually being used in the treatment of various musculoskeletal disorders, and in the early 1990 s it was used to treat tendon disorders. In the early 1970 s, ESWT was adopted in medicine as a urinary tract lithotripsy procedure ( 7). And it has gradually developed into a way to treat animals in addition to humans ( 6). It is capable of reducing and reversing damage to damaged tissues or promoting the healthy growth of normal tissues through mechanical stimulation at the molecular, cellular, or tissue level ( 9). ESWT is a mechanical therapy that can alter the chemical environment of the injury site utilizing of mechanical pulsed pressure waves ( 8). When other conservative treatments for tendinopathy have failed, ESWT is often used as an effective alternative to surgery. Due to the greater complications usually associated with surgical treatment, tendinopathies are most often treated conservatively, which includes local drug injections, medication, exercise therapy, physical therapy, and so on ( 7). In general, surgery may be considered for patients who have had poor results with conservative treatment for more than 6 months. Imperfect and slow repair of tendinopathies is the reason for the early retirement of many equines ( 4).ĭepending on the severity of the tendinopathy, its treatment can be divided into two types: surgical and conservative treatment therapy. It can cause pain and, in severe cases, even the onset of disability, which can affect the activities of the daily life of humans while also having a huge impact on animals such as dogs, rabbits, rats, etc., especially horses ( 4– 6). Tendinopathies account for a great proportion of musculoskeletal disorders and can occur in all age groups. ![]() Hyperextension and overuse of tendons are considered to be primary factors in the development of tendinopathy ( 3). To effectively transmit muscle forces to the bones, tendons need to withstand the forces generated by muscle loading ( 1, 2). Tendons are highly differentiated connective tissues that connect muscle to bone in the musculoskeletal system. Further studies on the biological response of ESWT for tendon injuries in vivo are needed in the future in order to provide better management to patients. Although ESWT has been used clinically for the treatment of tendinopathies for nearly decades, less is known about the experimental studies of its biological effects on tendon tissue. The purpose of this review is to summarize the biological responses generated by ESWT in tendinopathy through a comprehensive review of the published literature. Finally, it helps tissue regeneration by controlling inflammation. ESWT has a positive impact on the interactive chain of biological response, enhancing the signaling pathways of angiogenesis through mechanical conduction, and promoting cell proliferation and collagen formation. ![]() Several basic studies have shown that ESWT with lower energy flux densities can produce some biological responses in vivo to tendinopathy and may accelerate the initiation of the healing process in injured tendons. In clinical practice, when other conservative treatments fail, extracorporeal shock wave therapy (ESWT) is normally used as an efficient alternative to surgical management. The management of tendinopathy is typically conservative. It accounts for a large proportion of musculoskeletal disorders which can occur in all age groups. Tendinopathy is a degenerative disease of the tendons caused by prolonged overstretching or overuse of the tendons. 2The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.1School of Physical Education, Southwest Medical University, Luzhou, China.Yixuan Chen 1 † Kexin Lyu 1 † Jingwei Lu 1 † Li Jiang 1 Bin Zhu 1 Xueli Liu 1 Yujie Li 1 Xinyue Liu 1 Longhai Long 2 Xiaoqiang Wang 2 Houping Xu 2 * Dingxuan Wang 1 * Sen Li 2 *
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