Ian Couch is an endurance athlete who’s rowed across the Atlantic twice and is the only person to have crossed the Indian Ocean in a rowing boat. He has set six world records in rowing and has run through the Gobi and Namib deserts. In 2018, Couch suffered from elbow pain due to overuse. The arm was immobilised and he took medication. It helped a bit, but brought no improvement.
Couch consulted his osteopath, who had successfully treated his running injuries in the past. The osteopath administered radial shock waves across three treatments. Prior to treatment, Couch’s elbows hurt at every touch and elbow movement was very limited. After the third treatment, touch no longer caused pain.
“The strength and range of motion of my arm are better than they have been for years and are around 95 per cent of my previous best value,” says Couch after recovering following the ShockWave Therapy. “I unreservedly recommend pressure wave therapy. It’s the best treatment I’ve ever had.”
In a chat with GN Focus, Anil Daniel Prasad, a certified physiotherapist and ShockWave therapist, gives an insight into the therapy.
What is your professional background and association with ShockWave therapy?
I am experienced in evaluating, treating, and helping patients with simple and complex sports, orthopaedic, and occupational health injuries. My interest and success has been in the treatment and prevention of joint pain (shoulder/hip/knee/ankle), myofascial pain, chronic tendon, muscle/ligament injuries and spine conditions such as neck pain, lower back pain and headaches. The treatment approach involves a thorough examination, lifestyle education, manual therapy, dry needling and exercise prescription. I am a certified physiotherapist, orthopaedic manual therapist and ShockWave therapist. I train medical professionals on clinical applications of ShockWave Therapy. I have served as a sports physiotherapist for tennis (ATP Dubai Duty Free Championship), squash (Squash World Champions final) and Polo (UAE polo team 2016 and 2017). I am happiest when working along with the patients and physiotherapy teams for a full recovery.
My treatment approach involves a thorough examination, lifestyle education, manual therapy, dry needling and exercise prescription.
What painful conditions are alleviated by this therapy?
Patients with chronic tendon pain like tennis elbow, patella tendinopathy, Achilles tendinopathy, gluteal tendinopathy and plantar fasciitis, benefit from ShockWave therapy. Steroid injections or surgery are often prescribed for these conditions. However, physicians may wish to reduce the frequency of steroid injections, or patients may choose to delay surgery for personal reasons. ShockWave therapy is the ideal choice in such scenarios. In addition, swelling, reduced mobility of shoulder, neck, knee, elbow, heel, hip, shin and similar conditions benefit from ShockWave therapy. A buildup of calcium in the muscles or tendons creates local, painful conditions that are addressed with ShockWave therapy. Burn victims experience pain relief and restored mobility with ShockWave therapy. Plastic surgeons, cosmetic surgeons and dermatologists are utilising ShockWave therapy for anti-aging treatments, post surgical healing and scar removal.
Does the therapy hurt? How many sessions may be required? And what does recovery look like?
Patients may experience discomfort when energy is delivered to an area that is sore. However, the treatment lasts for a few minutes and the physiotherapist administers the therapy within the patient’s threshold of tolerance. A cluster of three to five sessions take place across one to two weeks, followed by a gap of 12 weeks for tissue regeneration. The picture of recovery is an accelerated progression from pain and mobility restoration.
What is the current trend in administering ShockWave therapy for orthopaedic pain management?
Focused shock waves and radial pressure waves are used in orthopaedic pain management. Physicians are now combining these waves for pain management.
How does the combination help?
Radial pressure waves reach a depth of up to 5cm, and are used when superficial regions of the body are affected. Focused shock waves reach a depth of up to 12.5cm and are used when deeper regions of the body are affected. When the waves are combined, tissue layers are mobilised bringing long-term relief. In many cases, the spectrum of symptoms can only be treated through combined ShockWave therapy.
Any other combinations that help painful conditions?
Soft Tissue Engineering is the umbrella term used for combination therapies that focus on pain management, tissue regeneration and healing. In addition to focused shock waves and radial pressures waves, combination therapy includes Vibration Therapy (Storz Medical V-ACTOR), Suction Wave Therapy (Storz Medical VACU-ACTOR) and Extracorporeal Magnetotransduction Therapy (Storz Medical EMTT.
Can neck pain be treated with ShockWave therapy?
Low-intensity ShockWave therapy is recommended for the neck. Storz Medical has developed the ATLAS transmitter for coverage of the neck region with clinical precision.
Can readers contact you for treatment advice?
Readers may email me at Anildanielprasad@leaderhealthcaregroup.com
Are there resources for medical students and practitioners to acquire more information on ShockWave therapy?
Books that medical students and practitioners may find relevant:
1. Multi-Disciplinary Medical Applications offers articles about the application of extracorporeal shock wave therapy.
2. Shock Waves in Sports Medicine illustrates the applications of extracorporeal shock wave therapy in sports medicine.
3. ESWT in Aesthetic Medicine, Burns & Dermatology provides an up-to-date overview of extracorporeal shock wave therapy in reconstructive surgery, burn surgery and aesthetic surgery.
The titles may be ordered through Level-books.com.
What is your advice to practitioners exploring the possibility of offering ShockWave therapy?
Online forums and peer referrals are helpful in choosing the right configuration. If they choose Storz Medical, I am available for treatment integration and training support. One of the distributors of Storz Medical ShockWave Therapy devices is Leader Healthcare Group. Together, we are able to support practitioners towards healthcare excellence and patient care.
Leader Healthcare Group
Leader Healthcare Group was established in 2009 by Sukhdeep Sachdev, in partnership with friend and investor Greg Leader. The company has completed a decade of growth and market leadership in 2019. With 11 corporate offices across eight countries, the Leader Healthcare Group is poised for the next decade of innovation. GN Focus talks to Sukhdeep Sachdev, Global CEO, Leader Healthcare Group, about healthcare excellence.
There is a selfish and a selfless reason for the goal of healthcare excellence, and it is difficult to separate the two. When I step into a healthcare facility, I feel thankful to see clinicians available round the clock.
Why would a distributor strive for healthcare excellence when they would not be penalised for a faulty device or medical negligence?
There is a selfish and a selfless reason for the goal of healthcare excellence, and it is difficult to separate the two. When I step into a healthcare facility, I feel thankful to see clinicians available round the clock. When I study the national vision for healthcare excellence, I feel thankful to be in this part of the world. As a distributor, Leader Healthcare has a choice to make. Should it import technologies that deliver marginal value, but fill the coffers of Leader Healthcare? Or should it explore the world markets to identify technologies which improve quality of life at minimal cost? When I support healthcare excellence, I support none but myself.