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Angiogenesis : the ingrowth of new blood vessels into the injured tissue to markedly improve blood supply and thereby promote and enhance tissue regeneration and healing, by way of including the up-regulation of the pivotal angiogenic growth factors, and the significant phosphorylation of endothelial vascular endothelial growth factor receptor 2. In addition to the sprouting of existing vessels, namely angiogenesis, ESWT has been shown to induce the recruitment of endothelial progenitor cells for de novo vessel formation or known as vasculogenesis.
ESWT has been effectively used in the treatment of: avascular necrosis, bone death due to compromised and/ or lack of blood supply; anterior cruciate ligament reconstruction healing, the functional outcome of ligament reconstruction relies on restoration of adequate blood supply and firm healing of the tendon to the bone; shoulder rotator cuff tendinopathy, the inability of the supraspinatus rotator cuff tendon to fully heal and recover after injury can be attributed to its poor anatomical vascular supply and muscle ischaemia, decreased and inadequate blood flow to muscle tissue due to several mechanisms including muscle spasms.
Chondrogenesis : promote and enhance the formation of new cartilage in joints, and healing and repair of injured cartilage tissue by way of inducing angiogenesis in the surrounding vascularized articular tissues and promoting chondrocyte proliferation, migration and regeneration
ESWT has been shown to significantly relief pain, improve spinal range of motion and decrease disability in individuals suffering from degeneration or arthritis of the spine, an unavoidable consequence of aging of the human body, and a common cause of neck, back, and referred arm and leg pain. ESWT has been shown to be greatly more effective versus articular corticosteroid injection in the treatment ofosteoarthritis of the knee in reducing pain and increasing movement and function. Osteoarthritis of the knee has doubled in the last decade due to recent exponential increases in life expectancy, obesity and sedentary life style, and can be considered the most common joint disease and leading causes of disability. ESWT is a novel additional beneficial treatment in individuals suffering from rheumatoid arthritis, a common autoimmune disease that can causesevere disability and reduce human lifespan.
Osteogenesis: promote and enhance the formation of new bone and enhance healing and repair of injured bone tissue, by wat of inducing angiogenesis in the bone tissues, promoting osteoblast proliferation, migration and regeneration, and in addition by inducing mechanical reactions of the bone lacunae-canalicular network to tensile, shear and compression forces.
ESWT has been effectively used in enhancing recovery and reducing excessive scar tissue formation of damaged ankle ligaments after an ankle sprain. Despite the high prevalence, disability and severity of lifestyle-limiting symptoms that follow ankle sprains, they are often misinterpreted as benign injuries that will resolve quickly with limited treatment. ESWT has been effectively used to reduce painful excessive scarring after hand surgery. Detrimental and excessive scar tissue formation after musculoskeletal injury can significantly hinder treatment recovery time and rehabilitation, and prevent the active individual and athlete from participating sooner in their sports activity.