Shockwave Therapy · Lambert Sports Clinic · Surbiton

Shockwave Therapy for Knee Pain & Patellar Tendinopathy

Knee pain is one of the most common reasons people seek physiotherapy, affecting athletes, active adults, and those in physically demanding occupations. For certain knee tendon conditions — particularly patellar tendinopathy — shockwave therapy (ESWT) may be considered when conservative management has not provided sufficient relief.

This article focuses on the role of shockwave therapy in knee pain, with particular attention to patellar tendinopathy, the condition for which the evidence base in shockwave is strongest.

Patellar Tendinopathy — Jumper's Knee

Patellar tendinopathy, sometimes called jumper's knee, involves changes in the patellar tendon — the tendon that connects the kneecap (patella) to the shin bone (tibia). The condition is characterised by pain at the lower pole of the kneecap, typically worsened by loading activities such as jumping, squatting, stairs, and rising from a seated position.

It is particularly common in athletes involved in explosive, repetitive loading sports — including football, basketball, volleyball, squash, padel, and court sports generally. However, it also occurs in recreational exercisers who have recently increased their training load.

What Does Shockwave Therapy Do for Patellar Tendinopathy?

Shockwave therapy delivers acoustic energy pulses to the patellar tendon through the skin using a handheld probe. In chronic tendinopathy, the tendon tissue undergoes degenerative changes and becomes stuck in a non-healing state. Shockwave is thought to disrupt this cycle by stimulating a renewed healing response in the tissue, and may also influence the nerve fibres that transmit pain signals.

The evidence base for shockwave therapy in patellar tendinopathy is positive. Multiple clinical studies have demonstrated that a course of shockwave therapy, combined with a progressive tendon loading programme (such as heavy slow resistance training), can produce significant and sustained improvements in pain and function.

When Is Shockwave Considered?

Shockwave therapy for patellar tendinopathy is typically considered when:

• Symptoms have been present for 3 months or more
• A structured physiotherapy programme including progressive tendon loading has been consistently applied
• Symptoms have not adequately improved despite appropriate management
• Clinical assessment confirms suitability

Shockwave is not typically the first treatment for acute or recent-onset knee tendon pain — physiotherapy and load management are the appropriate first-line approach.

What to Expect

At Lambert Sports Clinic, your initial appointment includes a full physiotherapy assessment to confirm diagnosis and assess suitability for shockwave. A course of 3 to 6 weekly shockwave sessions is usually recommended, with progress reviewed throughout. Each session takes approximately 20 to 30 minutes. Shockwave is always delivered alongside a continuing rehabilitation programme — exercise is an essential part of the treatment, not optional.

Other Knee Conditions

It is important to note that shockwave therapy for the knee is primarily indicated for patellar tendinopathy. Other causes of knee pain — including patellofemoral pain syndrome, meniscal problems, ligament injuries, and osteoarthritis — require different assessment and treatment approaches. A physiotherapy assessment at Lambert Sports Clinic will establish the correct diagnosis and guide the most appropriate treatment for your specific knee problem.

Physiotherapy for Knee Pain

Whether or not shockwave therapy is indicated, physiotherapy forms the foundation of knee pain management. Assessment of lower limb strength and mechanics, progressive loading of the affected structures, and guidance on activity modification and return to sport are all core elements of physiotherapy for knee pain at our Surbiton clinic.