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Musculoskeletal and Sports Medicine

Session: Extracorporeal shockwave therapy improves pain and function compared to control in patellar tendinopathy: a systematic review and meta-analysis

Extracorporeal Shockwave Therapy Improves Pain and Function Compared to Control in Patellar Tendinopathy: A Systematic Review and Meta-Analysis

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 7
Disclosure(s):
Seth Spicer, MS, ATC, CSCS, FMS: No financial relationships to disclose
Jared Garfinkle, Other: No financial relationships to disclose
Background and/or Objectives:

Background: Patellar tendinopathy (PT), or jumper’s knee, is a chronic, debilitating condition frequently affecting athletes and active individuals. Despite the prevalence and impact of PT, effective non-invasive treatment options remain limited. Extracorporeal shockwave therapy (ESWT) has emerged as a promising intervention, yet its clinical efficacy remains incompletely established.

Objective: To evaluate the effectiveness of ESWT in improving pain and function in individuals with PT through a systematic review and meta-analysis.

Design:

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Studies reporting pre- and post-treatment VAS and/or VISA scores following ESWT were included. Random-effects models were used to pool outcomes, with risk of bias assessed using RoB2 and ROBINS-I, and certainty of evidence rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method.

Setting : Systematic review and meta-analysis

Participants : Humans with patellar tendinopathy.

Interventions: Treated with extracorporeal shockwave therapy.

Main Outcome Measures: Pain and functional improvement using visual analog scale (VAS) and Victorian Institute of Sport Assessment (VISA), respectively.

Results: 13 studies were included. ESWT was associated with a mean VAS reduction of 2.53 and a mean VISA increase of 20.22, both exceeding minimal clinically important difference thresholds (VAS: 1.2; VISA: 7.3). Large effect sizes were observed for both outcomes (VAS d = –1.54; VISA d = 1.76). While heterogeneity was high, most ESWT arms showed consistent clinical benefit. Randomized trials generally had low risk of bias; non-randomized studies had higher bias but minimal influence on pooled effects.

Conclusions: ESWT significantly reduces pain and improves function in PT, with effects exceeding clinically meaningful thresholds. It represents a viable non-invasive treatment option for patients not responding to conservative care.