Hove Shockwave — Shockwave Therapy Brighton & Hove

Shockwave Therapy vs Steroid Injections: Which Is Better for Tendon Pain?

Sun, 05 Jul 2026 21:06:24 GMT

Shockwave Therapy vs Steroid Injections: Which Is Better for Tendon Pain?

By Dr Lewis Kingsnorth DC MChiro (GCC Reg. 3359) — Hove Shockwave, 82 Goldstone Villas, Hove

Quick answer: Steroid injections usually give faster short-term pain relief, but research on tendon problems consistently shows the benefit tends to fade — and outcomes at six to twelve months are often no better, and sometimes worse, than other approaches. Shockwave therapy works more gradually, aims to stimulate the tendon's own repair process rather than suppress symptoms, and is recognised by NICE for several tendon conditions with no major safety concerns. For most persistent tendinopathies, a non-invasive, repair-focused approach is a sensible option to consider before, or instead of, repeated injections — but the right choice depends on your diagnosis, which is why every treatment decision should start with a proper assessment.

Why people end up choosing between the two

If you have been struggling with a stubborn tendon problem — plantar fasciitis , tennis elbow , Achilles tendinopathy , jumper's knee or pain on the outside of the hip [editor: link each to its article] — there is a good chance someone has already suggested a steroid injection. It is one of the most common treatments offered for tendon pain in the UK, and for decades it was more or less the default next step when rest and over-the-counter pain relief had not worked.

More recently, extracorporeal shockwave therapy (ESWT) has become the other main non-surgical option, and it is now one of the questions we are asked most often at our Hove clinic: “Should I have shockwave therapy or just get the injection?” The honest answer is that they are very different treatments trying to do very different things — and understanding that difference makes the decision much easier.

How a steroid injection works — and the catch

A steroid injection — provided by a GP or hospital consultant, not by our clinic — works by strongly suppressing inflammation in and around the painful area. When genuine inflammation is driving the pain, it can work quickly and impressively — many people feel substantially better within days.

The catch is that most long-standing tendon pain is not primarily inflammatory. Research over the past two decades has shown that chronic tendinopathy is better understood as a degenerative and failed-healing problem : the collagen structure of the tendon becomes disorganised and the tissue struggles to repair itself. That is why the research picture for steroid injections in tendinopathy is so consistent — and so sobering:

Short term: injections typically outperform other treatments for pain relief in the first few weeks.
Medium to long term: randomised trials in conditions such as tennis elbow have found that people
who had steroid injections often did worse at six to twelve months than those who had physiotherapy or even no active treatment, with higher rates of recurrence.
Repeated injections: steroid injections can weaken tendon tissue over time, and repeated injections are associated with a small risk of tendon rupture. Around the heel, additional risks include thinning of the protective fat pad and, rarely, rupture of the plantar fascia itself.
None of this means steroid injections are “bad” — they remain a genuinely useful tool in the right situation. It means they are a symptom-relief tool, not a repair tool, and for a degenerative tendon problem that distinction matters a great deal.
How shockwave therapy works
Shockwave therapy takes the opposite approach. Instead of suppressing symptoms, it delivers focused acoustic pulses into the affected tissue to stimulate the body's own repair response — increasing local blood flow, encouraging new vessel formation, reactivating stalled healing in the tendon and modulating the nerves that transmit pain.
A typical course involves three to six short sessions , usually a week apart, with no needles, no medication and no meaningful downtime — most people walk out and carry on with their day. Shockwave therapy is recognised in NICE guidance for conditions including plantar fasciitis and Achilles tendinopathy, with no major safety concerns identified when delivered by a trained clinician.
In our experience — and in line with the published evidence — up to around 70% of appropriate candidates report meaningful improvement, with benefits that commonly last 6–12 months and often continue to build as the tendon remodels. Results are best when shockwave is combined with a progressive loading programme, which is exactly how we deliver it.
Head to head: the key differences

Steroid injection

Shockwave therapy

Aim

Suppress inflammation and pain

Stimulate tendon repair and modulate pain

Speed of relief

Fast — often within days

Gradual — typically builds over the course and the weeks after

Durability

Often fades within weeks to a few months; recurrence common in tendinopathy

Commonly 6–12 months in those who respond, often longer as tissue remodels

Invasiveness

Involves a needle through the skin

Non-invasive — applied through the skin surface

Main risks

Tendon weakening with repeated use, fat pad atrophy (heel), skin changes, post-injection flare

Temporary soreness, redness or bruising; no major safety concerns in NICE reviews

Typical course

Single injection (repeats usually limited)

3–6 weekly sessions

Downtime

Often advised to rest the area briefly

None for most people

When an injection may still be the right call

A balanced answer matters here. There are situations where a steroid injection remains a perfectly reasonable choice: genuinely inflammatory problems (such as an inflamed bursa or an inflammatory arthritis flare), cases where rapid short-term relief is needed for a specific reason, or where an injection is being used deliberately to create a window for rehabilitation. These decisions are best made with your GP or consultant, with an accurate diagnosis in hand.

Where the evidence increasingly points the other way is repeated injections into a degenerative tendon . If you have already had one or two steroid injections and the pain keeps returning, that pattern itself is useful information — it suggests the underlying tissue problem has not been addressed, and a repair-focused approach such as shockwave therapy combined with structured loading is worth serious consideration.

What this means for the conditions we treat

The comparison plays out slightly differently by condition. In plantar fasciitis , injections carry specific local risks (fat pad thinning, fascia rupture) that make shockwave an attractive first-line option for persistent cases. In tennis elbow , the twelve-month trial evidence against injections is arguably the strongest of any tendinopathy. In Achilles tendinopathy , most specialists avoid steroid injections near the tendon at all because of rupture risk. In greater trochanteric pain syndrome , injections into the hip's lateral structures often relieve pain temporarily while the underlying gluteal tendinopathy persists. [Editor: link each condition to its article.] For deeper or harder-to-reach tissue we can also combine shockwave with EMTT (magnetotransduction therapy)

Shockwave therapy in Hove & Brighton

Hove Shockwave is based at 82 Goldstone Villas — two minutes' walk from Hove station — and has been part of the Chiropractic First clinic, established in 2006. We use STORZ MEDICAL equipment and offer radial and focused shockwave plus EMTT , one of fewer than 30 clinics in the UK with this combination. Every course begins with a full assessment by Dr Lewis Kingsnorth DC MChiro (GCC registered, 3359) to confirm you are an appropriate candidate — and if you are not, we will tell you and point you in the right direction, including back to your GP where an injection or onward referral is more appropriate. We do not provide injections or prescribe medicines — those decisions sit with your GP or consultant; our role is

When tendon-style pain needs a doctor first: seek prompt medical advice if your pain follows significant trauma, if the area is hot, red and swollen with fever (possible infection), if you felt a sudden “snap” with immediate loss of function (possible rupture), if you have unexplained night pain, weight loss or a history of cancer, or if you have new numbness, weakness or bladder/bowel changes. Steroid injections and shockwave therapy are both inappropriate until these have been excluded. Shockwave is also not used in pregnancy, over active infection or tumour, or in people with certain clotting problems — we screen for all of this at assessment.

assessment and non-invasive treatment. Treatment is recognised by Vitality and AXA health insurance (check your policy terms).

Frequently asked questions

Is shockwave therapy better than a steroid injection?

Neither is “better” for everyone — they do different jobs. An injection usually relieves pain faster, but in chronic tendon problems the benefit often fades and long-term results can be worse than other treatments. Shockwave works more slowly but aims to stimulate tendon repair, with benefits that commonly last 6–12 months in people who respond. For persistent tendinopathy, many clinicians now consider a repair-focused approach before repeated injections.

Can I have shockwave therapy after a steroid injection?

Usually yes — many of our patients come to us after injections have stopped helping. Most clinicians advise leaving a gap of several weeks after a steroid injection before starting shockwave, because a recent injection can dampen the healing response shockwave is designed to trigger. We confirm the right timing at your assessment.

Does shockwave therapy hurt more than an injection?

Shockwave can feel uncomfortable during the few minutes of treatment — most people describe a strong tapping over the sore spot — but no numbing is needed and the intensity is adjusted to you. There are no needles, and any soreness afterwards usually settles within a day or two.

How many shockwave sessions will I need?

A typical course is three to six sessions, usually one week apart, combined with a progressive loading programme. Some improvement is often noticed during the course, but because shockwave stimulates a biological repair process, results commonly continue to build in the weeks after the final session.

How long do the results of each treatment last?

Steroid injections often help for weeks to a few months in tendon problems, with recurrence common. In appropriate candidates who respond to shockwave therapy, improvement commonly lasts 6–12 months and often longer, particularly when the treated tendon is also strengthened through rehabilitation.

Is shockwave therapy available on the NHS, and does insurance cover it?

Shockwave therapy is available in some NHS services, but access and waiting times vary widely by area and condition. Privately, a course at our Hove clinic can usually begin within days. Treatment is recognised by insurers including Vitality and AXA — check your individual policy for cover and any excess.

Ready to find out which approach is right for you?

If tendon pain is limiting your running, work or sleep — or a steroid injection has worn off — book an assessment at Hove Shockwave, 82 Goldstone Villas, Hove. Book online at hovershockwave.janeapp.co.uk

or call 01273 324466 .

This article is for general information only and is not a substitute for individual medical advice, diagnosis or treatment. Treatment outcomes vary between individuals and no specific result can be guaranteed. Always seek advice from an appropriately qualified healthcare professional about your own circumstances. Dr Lewis Kingsnorth DC MChiro is registered with the General Chiropractic Council (registration 3359).

Greater Trochanteric Pain Syndrome: How Shockwave Therapy Can Help With Lateral Hip Pain in Brighton & Hove

Wed, 24 Jun 2026 14:54:01 GMT

Greater Trochanteric Pain Syndrome: How Shockwave

Therapy Can Help With Lateral Hip Pain

 in Brighton &

Hove

By Dr Lewis Kingsnorth DC MChiro · Hove Shockwave, 82 Goldstone Villas, Hove · GCC Reg. 3359

If you have a deep, nagging ache on the outside of your hip — the kind that flares when you climb stairs, get up from a chair, or try to sleep on that side — you may be dealing with greater trochanteric pain syndrome (GTPS). It is one of the most common causes of hip pain we see, yet it is often mislabelled and under-treated. The good news is that it usually responds well to non-surgical care, and shockwave therapy is one of the better-evidenced options for the tendon problem that drives it.

What is greater trochanteric pain syndrome?

GTPS is the medical term for pain and tenderness over the greater trochanter — the bony point you can feel on the outer side of your hip. For years it was called “trochanteric bursitis,” on the assumption that the problem was an inflamed bursa (a small fluid-filled cushion). We now know that in the large majority of cases the main driver is gluteal tendinopathy : irritation, overload or degeneration of the gluteus medius and minimus tendons where they attach to the hip. Any bursal irritation tends to be secondary.

Common symptoms

Pain and tenderness over the outer hip, sometimes spreading down the outside of the thigh.
Pain when lying on the affected side — disturbed sleep is a classic complaint.
Discomfort climbing stairs, standing on one leg, or after prolonged sitting.
Aching that builds during or after walking, running or a busy day on your feet.
Why “bursitis” is usually the wrong label
This distinction matters because it changes the treatment. A true inflammatory bursitis might quieten with rest or a steroid injection — but a tendinopathy behaves differently. Tendons need appropriate, graded load to recover, and repeated steroid injections may give short-term relief while doing little for the

underlying tendon over time. Recognising GTPS as a tendon problem is the first step toward a plan that actually addresses the cause.

Who tends to develop it?

GTPS is most common in women between roughly 40 and 60, but it affects active people of all kinds. Frequent triggers include a sudden increase in walking or running, weakness in the gluteal muscles, and postures that compress the tendon — such as sitting cross-legged or “hanging” on one hip when standing. Lower back, hip or knee problems that alter your gait can contribute too. In a city like Brighton & Hove, with its hills, seafront runs and long walks, an unaccustomed spike in activity is a familiar starting point.

Why GTPS can be slow to settle

Tendons have a relatively poor blood supply and the gluteal tendons are compressed against the greater trochanter with certain movements, so the area can stay irritable for months. Complete rest rarely resolves it and can leave the tendon less tolerant of load. That is why a structured, active approach usually works better than waiting it out.

How shockwave therapy helps gluteal tendinopathy

Extracorporeal shockwave therapy (ESWT) delivers controlled acoustic energy pulses into the affected tendon. This is thought to stimulate local blood flow, prompt a natural healing response in the tissue, and reduce pain signalling — without injections, medication or downtime. For chronic gluteal tendinopathy, ESWT is supported by clinical research, particularly when it is combined with a targeted strengthening programme . Studies have reported good improvement rates over the medium to longer term, and shockwave has compared favourably with corticosteroid injection over time. It is not an instant fix — results build gradually over several weeks — and individual responses vary, but for the right patient it is a well-tolerated, non-surgical option.

At Hove Shockwave we offer radial, focused and EMTT (Magnetolith) technology, allowing treatment to be matched to the depth and nature of the problem — useful for a deeper structure like the gluteal tendons.

What to expect at Hove Shockwave

Treatment always starts with a thorough assessment by Dr Lewis Kingsnorth DC MChiro (GCC Reg. 3359) to confirm the diagnosis and rule out other causes of lateral hip pain, such as referred pain from the lower back or hip joint. If shockwave is appropriate, a typical course is a small number of weekly sessions — commonly three to five — each lasting around 10–15 minutes. You will feel a strong tapping sensation and some discomfort over the tender area, but it is brief and the intensity is adjusted to your tolerance. Crucially, shockwave is delivered alongside a tailored loading and strengthening plan and simple advice on managing your activity, so the tendon is rebuilt as well as stimulated.

What you can do alongside treatment

Ease off compression positions: avoid crossing your legs or “hanging” on one hip, and place a pillow between your knees when lying on your side.
Modify rather than stop: reduce painful spikes in activity instead of resting completely.
Build gluteal strength with a clinician-guided programme — this is central to lasting recovery.
Manage sudden increases in walking, running or training load.
When to seek help — and red flags
It is worth getting outer hip pain assessed if it is not improving, is interfering with sleep, or is limiting your activity. Seek prompt medical advice if you have night pain unrelieved by changing position, fever,

unexplained weight loss, a history of cancer, an inability to bear weight after a fall or injury, or numbness, pins and needles, or weakness spreading down the leg. Any changes to bladder or bowel control should be treated as urgent. These features point to causes that need separate assessment.

Book a hip pain assessment in Hove

Hove Shockwave is based at 82 Goldstone Villas, Hove, BN3 3RU — a short walk from Hove station and easy to reach from across Brighton & Hove and the surrounding area. We accept Vitality and AXA . To arrange an assessment for lateral hip pain, book online at [BOOKING LINK] or call [01273 324466 – confirm] .

Frequently asked questions

What is greater trochanteric pain syndrome (GTPS)?

GTPS is the medical term for pain and tenderness over the bony point on the outside of the hip (the greater trochanter). It was once called trochanteric bursitis, but research now shows the most common cause is gluteal tendinopathy — irritation or degeneration of the gluteal tendons that attach there. It often causes pain when lying on that side, climbing stairs or walking.

Does shockwave therapy work for GTPS?

Shockwave therapy (ESWT) is a recognised, non-surgical option for chronic gluteal tendinopathy and is supported by clinical research, particularly when combined with a targeted strengthening programme. Studies have reported good improvement rates over the medium to longer term, and it has compared favourably with steroid injection over time. Results build gradually over several weeks and individual responses vary.

Is shockwave therapy for the hip painful?

Most people find it manageable. You will feel a strong tapping sensation and some discomfort over the tender area during treatment, but it is brief — each session usually lasts around 10–15 minutes — and any soreness afterwards normally settles within a day or two. The intensity is adjusted to your tolerance.

How many sessions will I need?

A typical course is a small number of weekly sessions — commonly three to five — though this depends on how long you have had the problem and how you respond. Your clinician will agree a plan with you after assessment. Shockwave works best alongside a tailored loading and strengthening programme.

Is my hip pain bursitis or gluteal tendinopathy?

They overlap, which is why the umbrella term GTPS is now preferred. While a bursa can become irritated, research shows the main driver in most cases is gluteal tendinopathy. This matters because tendon problems respond best to graded loading and treatments like shockwave, rather than rest or repeated steroid injections alone.

Can I keep walking or running with GTPS?

Often yes, in a modified way. Complete rest rarely helps tendons and can make them more sensitive to load. The usual approach is to manage your activity — reducing painful spikes rather than stopping altogether — while building strength. Your clinician can guide how much is right for you.

Disclaimer: This article is for general information and education only and is not a substitute for individual medical advice, diagnosis or treatment. Shockwave therapy is not suitable for everyone, and individual results vary. Please book an assessment with a qualified clinician to discuss whether it is appropriate for you. Hove Shockwave · Dr Lewis Kingsnorth DC MChiro · GCC Reg. 3359.

Shoulder Pain and Rotator Cuff Problems in Hove: What’s Causing It and How Shockwave Therapy Can Help

Sat, 06 Jun 2026 20:50:11 GMT

Shoulder Pain and Rotator Cuff Problems in Hove: What’s Causing It and How Shockwave Therapy Can Help

By Dr. Lewis Kingsnorth DC MChiro — Certified Shockwave Specialist at Hove Shockwave | Published June 2026 | 8 minute read

Shoulder pain is one of the most common musculoskeletal complaints we see at Hove Shockwave — and one of the most undertreated. People put up with it for months, sometimes years, managing with painkillers and rest, having steroid injections that wear off, or being told their only option is surgery.

The reality is that many cases of chronic shoulder pain — particularly those involving the rotator cuff — respond very well to shockwave therapy. For one specific condition, calcific tendinitis, focused shockwave therapy can achieve something no other non-surgical treatment can: it physically breaks down the calcium deposits that are causing the pain.

This article explains the most common causes of shoulder pain, how the rotator cuff works, why problems develop, and why shockwave therapy at Hove Shockwave is one of the most effective routes to lasting relief for patients across Brighton, Hove, and East Sussex.

Understanding the Rotator Cuff

The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, connecting the upper arm bone (humerus) to the shoulder blade (scapula). Together, they stabilise the shoulder and control the wide range of arm movements we take for granted — reaching overhead, rotating the arm, lifting, throwing.

Because the shoulder is the most mobile joint in the body, it is also one of the most vulnerable. The tendons of the rotator cuff pass through a narrow space beneath the top of the shoulder blade (the acromion), and any swelling, structural change, or degeneration in that space can quickly create pain and restricted movement.

The four rotator cuff muscles are:

• Supraspinatus — runs across the top of the shoulder; most commonly involved in pain and tears

• Infraspinatus — at the back of the shoulder; involved in external rotation

• Teres minor — assists infraspinatus in rotating the arm outward

• Subscapularis — at the front of the shoulder; controls internal rotation

Rotator cuff problems are not one single condition — they are a spectrum, from mild tendon irritation through to full thickness tears. Understanding which part of the spectrum you are on determines the most appropriate treatment.

Common Causes of Rotator Cuff and Shoulder Pain

At Hove Shockwave, we see patients with shoulder pain from a wide range of backgrounds — tradespeople, office workers, gym users, swimmers, and people whose shoulders have simply worn down over time. The most common presentations we treat include:

Rotator Cuff Tendinopathy

Tendinopathy refers to degeneration and chronic irritation of the tendon, typically caused by repetitive loading or overuse. The supraspinatus tendon is most commonly affected. Pain is felt at the outer shoulder and often radiates into the upper arm, typically worsening with overhead activity, reaching behind the back, or sleeping on the affected side.

When tendinopathy is left unaddressed for months or years, the tendon enters a state of chronic failed healing — it is no longer actively repairing itself, and conventional anti-inflammatory treatments become progressively less effective. Shockwave therapy is specifically designed to break this cycle.

Calcific Tendinitis

Calcific tendinitis is a distinct and often particularly painful condition in which calcium deposits form within one or more of the rotator cuff tendons — most commonly the supraspinatus. The deposits can range from chalky paste to hard, stone-like material, and at certain stages of their development they cause severe, often debilitating pain that comes on quickly and can be intense enough to prevent sleep or any arm movement.

This is where shockwave therapy, and in particular focused shockwave, has its most remarkable results. Focused shockwave generates precise, high-energy acoustic pulses that physically fragment and dissolve calcium deposits within the tendon — achieving without surgery what no injection or exercise programme can do. Once the calcium is broken down, the body can resorb it naturally, the tendon heals, and the pain resolves.

A 2024 systematic review and meta-analysis of 21 randomised controlled trials confirmed that ESWT produces clinically significant improvements in pain and function in patients with calcific tendinitis, with focused high-energy shockwave producing the strongest results.

Subacromial Impingement

Impingement occurs when the soft tissue structures within the subacromial space — the tendons and bursa — are compressed between the humeral head and the acromion, typically during overhead movement. It is a common cause of the painful arc — pain that occurs between roughly 60 and 120 degrees of arm elevation. Shockwave therapy can effectively reduce the tendon and bursal inflammation driving this problem.

Partial Rotator Cuff Tears

Partial thickness tears — where the tendon is damaged but not completely severed — are common, particularly in people over 40, and can cause significant pain and weakness. Many partial tears are suitable for conservative management including shockwave therapy, which promotes tissue repair and can meaningfully improve symptoms in patients who are not surgical candidates or who wish to exhaust non-invasive options first.

Post-Injection or Post-Physiotherapy Plateau

Many patients arrive at Hove Shockwave having already had one or more steroid injections and a course of physiotherapy. They may have improved temporarily but hit a plateau — the pain has returned, the shoulder is still restricting their life, and they have been told surgery is the next step. For many of these patients, shockwave therapy achieves what previous treatments could not.

How Shockwave Therapy Treats Shoulder and Rotator Cuff Pain

Shockwave therapy uses focused or radial acoustic energy delivered through the skin to the affected tendon and surrounding tissue. There are no injections, no incisions, and no general anaesthetic. At Hove Shockwave we offer all three types of shockwave technology — focused, radial, and EMTT — and we match the right technology to your specific diagnosis.

Focused shockwave for calcific tendinitis:

This is where focused shockwave is at its most powerful. The high-energy pulses are directed precisely at the calcium deposit, fragmenting and dissolving it over the course of three to five sessions. For patients who have been told surgery is the only option for their calcification, this is often a genuine game-changer. We have on-site digital X-ray to confirm the presence, size, and location of calcium deposits before treatment begins.

For tendinopathy and impingement:

Shockwave therapy triggers the biological processes needed to restart stalled tendon healing: collagen synthesis, neovascularisation (new blood vessel formation), stem cell activation, and the dissolution of scar tissue and micro-calcifications. It also has a direct pain-relieving effect through modulation of nerve fibres in the treated area. The result is tissue that moves from a chronic, non-healing state back into active repair.

EMTT for deeper structures:

For patients with shoulder problems involving deeper structures — or for those who find conventional shockwave uncomfortable around the shoulder — we also offer EMTT (Extracorporeal Magnetotransduction Therapy). EMTT uses high-intensity magnetic pulses that penetrate significantly deeper than radial shockwave and is completely touch-free and painless. We are one of fewer than 30 clinics in the UK offering this technology, and it is particularly effective for inflammatory conditions, arthritis, and cases where precise shockwave targeting is challenging.

What Does the Evidence Say?

The research on shockwave therapy for shoulder and rotator cuff conditions is substantial and broadly positive, particularly for calcific tendinitis.

A 2024 meta-analysis reviewing 21 randomised controlled trials found that ESWT produces clinically significant improvements in both pain and shoulder function compared to sham treatment at 24 weeks, with high-energy focused shockwave producing the strongest results for calcific disease.

A separate 2024 systematic review and meta-analysis found that ESWT significantly reduces pain in rotator cuff tendinopathy — both calcific and non-calcific — with meaningful functional improvements across outcome measures.

For patients with calcific tendinitis in particular, focused shockwave therapy is now widely regarded by musculoskeletal specialists as the treatment of choice before surgical intervention is considered. The evidence consistently shows high rates of calcium resorption and sustained pain relief at 12-month follow-up.

Why Has My Shoulder Pain Become Chronic?

A question we hear often. The honest answer is that tendons heal slowly and poorly. They have a limited blood supply, and when they are repeatedly loaded without adequate recovery time, they enter a state of failed healing — a condition called tendinopathy — where the tissue is disorganised and not actively repairing.

Standard advice — rest, ice, anti-inflammatories — is most appropriate in the acute phase of injury. Once a tendon has become chronically symptomatic, these approaches are often insufficient because inflammation is no longer the primary driver of pain. What the tissue needs is a stimulus to restart the repair process. That is precisely what shockwave therapy provides.

Steroid injections can provide useful short-term pain relief, but they do not address the underlying tissue pathology and carry risks with repeated use, including tendon weakening. Many patients find that each injection provides a shorter period of relief than the last. Shockwave therapy addresses the structural problem rather than suppressing symptoms.

Who Gets Rotator Cuff Problems?

We see shoulder pain in patients of all ages and backgrounds. Common presentations include:

Overhead athletes and gym users: Swimmers, tennis players, weightlifters, and CrossFit enthusiasts place high repetitive loads through the shoulder. Rotator cuff tendinopathy is an occupational hazard of high-volume overhead training.

Tradespeople: Painters, plasterers, electricians, and carpenters who work with their arms overhead or in sustained overhead positions for hours at a time are disproportionately affected.

Office workers: Poor desk posture and prolonged sitting can contribute to shoulder and neck muscle imbalances that increase load on the rotator cuff.

Adults over 40: The risk of both tendinopathy and calcific tendinitis increases significantly with age, as tissue repair capacity declines and cumulative wear accumulates.

Those with previous shoulder injuries: Prior injuries, including dislocations or partial tears, alter shoulder mechanics and increase the risk of secondary tendon problems.

Treatment at Hove Shockwave: What to Expect

Every patient at Hove Shockwave begins with a thorough clinical assessment. Dr. Lewis Kingsnorth DC MChiro will take a detailed history, examine your shoulder, and — where indicated — use our on-site digital X-ray to assess for calcification, structural changes, and other pathology. We also have access to MRI for cases that require it.

This assessment is not a box-ticking exercise. It determines exactly what is driving your shoulder pain and whether shockwave therapy — and which type — is the most appropriate approach for your specific presentation. Not all shoulder pain is the same, and treatment should reflect that.

A typical course of treatment for shoulder and rotator cuff pain:

• Thorough initial assessment including clinical examination and X-ray where appropriate

• Three to five shockwave sessions for most presentations, spaced approximately one week apart

• Focused shockwave for calcific tendinitis; radial or focused for tendinopathy and impingement

• EMTT available as an adjunct or standalone for appropriate cases

• Each session lasts approximately 15 to 20 minutes

• No injections, no surgery, no downtime — most patients can continue normal daily activities throughout

• Rehabilitation guidance and exercises prescribed alongside treatment

Results vary by presentation, but many patients with shoulder tendinopathy notice meaningful improvement within two to three sessions. Calcific tendinitis — particularly in the later stages of calcium development — can respond even faster, with dramatic pain reduction sometimes occurring after the first or second treatment as the calcium begins to fragment.

Frequently Asked Questions

Can shockwave therapy treat a rotator cuff tear?

It depends on the nature and severity of the tear. Partial thickness tears can respond well to shockwave therapy, which promotes tendon repair and reduces associated pain and inflammation. Full thickness tears — where the tendon is completely severed — typically require surgical repair, though shockwave may have a role in prehabilitation or post-surgical recovery. We will assess your shoulder thoroughly and give you an honest picture of what is likely to be achievable.

Is shockwave therapy painful on the shoulder?

The shoulder can be a sensitive area, and some patients find the treatment more uncomfortable than in other body regions, particularly around the front of the shoulder. We adjust the treatment parameters to your tolerance, and any discomfort during the session settles quickly afterwards. For patients who find conventional shockwave too uncomfortable, EMTT — which is completely painless and touch-free — is an excellent alternative.

I’ve been told I need shoulder surgery. Should I try shockwave first?

For many shoulder conditions — particularly calcific tendinitis and tendinopathy — yes, it is well worth trying shockwave therapy before committing to surgery. The evidence supports shockwave as a genuine first-line intervention for these conditions, and many patients who come to us having been listed for surgery find that they no longer need it after a course of treatment. We will always be honest about whether your presentation is likely to respond to shockwave or whether surgical referral is genuinely the more appropriate route.

How long will results last?

For calcific tendinitis, once the calcium has been resorbed, the results are typically permanent — the deposits do not regrow. For tendinopathy, the durability of results depends partly on addressing the underlying load and lifestyle factors driving the condition. We provide rehabilitation guidance alongside treatment to help you maintain your improvement long term.

Do I need a referral?

No GP referral is needed. You can book directly with Hove Shockwave for an initial assessment.

Why Choose Hove Shockwave for Shoulder Pain?

Shoulder pain is one of the more technically demanding presentations in shockwave therapy. Getting the right diagnosis, matching the right technology to the pathology, and delivering treatment accurately requires both expertise and the right equipment.

At Hove Shockwave, Dr. Lewis Kingsnorth is a certified shockwave specialist with nearly 20 years of clinical experience. We have on-site digital X-ray to confirm calcific deposits and assess shoulder pathology before treatment begins. We offer all three shockwave modalities — focused, radial, and EMTT — which means we can genuinely match the most appropriate technology to your diagnosis rather than applying a one-size approach.

We are one of fewer than 30 clinics in the UK offering EMTT, and Brighton and Hove’s most advanced shockwave clinic. Patients come to us from across Hove, Brighton, Worthing, Lewes, and the wider East and West Sussex area — many having already tried other routes without lasting success.

Suffering from Shoulder Pain? Let’s Talk.

If your shoulder has been holding you back — whether it’s a dull ache that won’t shift, a sharp pain with overhead movement, or a calcific tendinitis that has made life miserable — there is a very good chance shockwave therapy can help.

Book your initial assessment at Hove Shockwave today. No referral needed.

01273 324466 — hove-shockwave.co.uk]

Hove Shockwave is a specialist shockwave therapy clinic in Hove, East Sussex. Dr. Lewis Kingsnorth DC MChiro is registered with the General Chiropractic Council (GCC) and is a certified shockwave specialist. This article is for informational purposes only and does not constitute medical advice. Please consult a registered healthcare professional if you have concerns about your symptoms.

Jumper's Knee: How Shockwave Therapy Treats Patellar Tendinopathy in Brighton & Hove

Tue, 02 Jun 2026 21:54:38 GMT

Jumper's Knee: How Shockwave Therapy Treats Patellar Tendinopathy in Brighton & Hove

By Dr Lewis Kingsnorth DC MChiro — Certified Shockwave Specialist at Hove Shockwave
Published: June 2026 | 7 minute read

Pain directly below your kneecap — sharp during a squat, nagging after a run, or aching the morning after football training — is one of the most common complaints I see at the clinic. In most cases, it turns out to be patellar tendinopathy: a degenerative condition of the patellar tendon that connects the kneecap to the shinbone.

Colloquially known as jumper's knee, it's not just a problem for basketball players and volleyball athletes. Runners, cyclists, gym-goers, and anyone who spends long hours on their feet can develop it. And once it sets in, it has a frustrating habit of lingering — sometimes for months or years — because the tendon's poor blood supply makes it slow to heal on its own.

The good news is that shockwave therapy is now one of the most evidence-backed treatments for stubborn patellar tendinopathy. At Hove Shockwave, it's one of the conditions we treat regularly, and the results — particularly when combined with a proper loading programme — are consistently strong.

What Is Patellar Tendinopathy?

The patellar tendon runs from the bottom of the patella (kneecap) to the tibial tuberosity — the bony bump at the top of the shinbone. Every time you jump, squat, run, or climb stairs, this tendon absorbs enormous forces. When those forces repeatedly exceed the tendon's capacity to recover, microscopic tears accumulate faster than the body can repair them.

Over time, this cumulative microtrauma leads to a degenerative process within the tendon: the normal, organised collagen structure breaks down and is replaced with disorganised, pain-sensitive tissue. This is tendinopathy, and it's distinct from acute tendinitis (which involves active inflammation) — a distinction that matters a great deal for treatment, as we'll come to shortly.

The classic presentation is a sharp or burning pain at the lower pole of the kneecap, reproduced by loading the knee — particularly during activities like jumping, landing, running downhill, or performing a squat. Pain is often worse after exercise rather than during it, and many patients notice stiffness first thing in the morning or after prolonged sitting.

Key point: Patellar tendinopathy is a degenerative condition, not simply inflammation. This is why anti-inflammatory medications and corticosteroid injections often provide only short-term relief — and why treatments that actively stimulate healing, like shockwave therapy, tend to produce more durable outcomes.

Who Gets Jumper's Knee?

Despite the name, jumper's knee is by no means confined to jumping athletes. Research puts the prevalence among elite volleyball players as high as 40 to 45%, and among basketball players at around 30% — but the condition also affects a much broader population. Runners, particularly those who have recently increased their mileage or started incorporating hill work, are a common presentation. So too are CrossFit athletes, cyclists, and people returning to exercise after a period of relative inactivity.

Non-athletic risk factors include occupations that involve prolonged standing or kneeling, and a rapid increase in any repetitive knee-loading activity. Age plays a role as well — tendons become less resilient with age, which is why patellar tendinopathy becomes more common from the mid-thirties onwards even without elite sporting involvement.

Why Other Treatments Sometimes Fall Short

The majority of patients who arrive at Hove Shockwave for patellar tendinopathy have already tried a combination of rest, physiotherapy, anti-inflammatories, and possibly a corticosteroid injection. Some will have seen partial improvement; many will have seen none at all.

The reason is largely biological. Chronic tendinopathy isn't an inflammatory condition in the classic sense — the tissue has entered a degenerative state where it simply isn't healing, regardless of how much rest you give it. Rest reduces pain temporarily, but it doesn't address the underlying structural problem. Anti-inflammatory medications have limited benefit for the same reason. Corticosteroid injections can reduce pain in the short term but have been shown in multiple studies to worsen tendon structure over time and increase the risk of rupture with repeated use.

What the patellar tendon actually needs — once it has become chronically degenerated — is a stimulus strong enough to restart the healing cascade: new blood vessel formation, growth factor release, and fresh collagen synthesis. This is precisely what shockwave therapy delivers.

How Shockwave Therapy Works for the Patellar Tendon

Extracorporeal shockwave therapy (ESWT) uses a handheld device to transmit focused acoustic waves through the skin into the damaged tendon. The energy from these waves creates a controlled mechanical stimulus within the tissue, triggering a cascade of biological repair responses.

At the cellular level, shockwave therapy increases local blood flow and promotes the release of growth factors including VEGF (vascular endothelial growth factor) and TGF-β1 (transforming growth factor beta-1), both of which are critical to tendon remodelling. It stimulates tenocyte activity — tenocytes are the cells responsible for producing collagen — and promotes the formation of new, organised collagen fibres to replace the disorganised degenerative tissue. It also temporarily desensitises the C-fibre nociceptors in the tendon, providing meaningful pain relief from the early stages of treatment.

What makes shockwave particularly well-suited to chronic tendinopathy is that it works by provoking healing rather than suppressing symptoms. The treatment essentially restarts a biological process that has stalled — which is why the results tend to be durable rather than temporary.

What the Evidence Shows

The evidence base for shockwave therapy in patellar tendinopathy has grown steadily over the past decade. A 2024 randomised controlled trial published in Knee Surgery, Sports Traumatology, Arthroscopy confirmed that shockwave therapy — particularly when combined with heavy slow resistance training — produces significant, sustained improvements in pain and function in athletes with chronic patellar tendinopathy. The combination approach consistently outperforms either treatment alone.

Current clinical guidelines, including those reviewed in a 2026 update in StatPearls, now recognise shockwave as a first-line non-surgical treatment for patellar tendinopathy that has failed to respond to conservative management over six months, alongside eccentric loading programmes and PRP. For patients who have already tried physiotherapy without resolution, the evidence strongly supports moving to shockwave rather than waiting further or proceeding directly to surgical intervention.

Evidence summary: Multiple randomised controlled trials support shockwave therapy as an effective, safe, non-surgical treatment for chronic patellar tendinopathy. It is most effective when delivered alongside a structured rehabilitation programme — which is why our treatment approach at Hove Shockwave always combines the two.

What to Expect at Hove Shockwave

Before any treatment begins, I carry out a thorough clinical assessment to confirm the diagnosis and rule out other causes of anterior knee pain — including patellofemoral syndrome, fat pad impingement, quadriceps tendinopathy, and referred pain from the hip or lumbar spine. We also have on-site X-ray facilities, which allows us to assess for any structural bony abnormality that might influence the treatment plan.

Once patellar tendinopathy is confirmed, treatment typically involves three to five shockwave sessions spaced approximately one week apart. Each session takes around fifteen to twenty minutes. Ultrasound gel is applied to the skin over the patellar tendon, and the shockwave handpiece is moved systematically over the tender area at the lower pole of the patella. Most patients describe the sensation as a deep tapping or pressure — it can be mildly uncomfortable, but the intensity is always adjusted to stay within a tolerable range.

Alongside the shockwave sessions, I provide a structured tendon loading programme. The research is clear that mechanical loading — done correctly — is essential to drive collagen synthesis and tendon remodelling. The programme is graduated and designed to keep you active during the treatment course, rather than requiring complete rest.

How Long Until I See Results?

Many patients notice a reduction in pain and improved function within two to three sessions. The full benefit of shockwave therapy continues to develop for several weeks after the final treatment, as the tissue remodelling process completes — so it's worth completing the full course even if improvement feels gradual early on.

Mild post-treatment soreness for 24 to 48 hours after each session is normal and expected. This is a sign that the tissue is responding. You can continue normal daily activities throughout the treatment course; we may ask you to reduce high-impact loading temporarily in the 24 hours immediately after each session.

Jumper's Knee vs Runner's Knee: Getting the Right Diagnosis

A number of patients come to the clinic having self-diagnosed from online research, and it's worth clarifying the distinction between the two most commonly confused knee conditions. Patellar tendinopathy (jumper's knee) causes pain at the lower pole of the kneecap — directly on the tendon itself — reproduced most strongly by activities like jumping and squatting. Patellofemoral pain syndrome (runner's knee) causes pain behind or around the kneecap, often worsened by running, stairs, and prolonged sitting with the knee bent.

Both conditions can benefit from shockwave therapy, but the treatment protocol differs. An accurate diagnosis at the outset ensures you receive the right treatment in the right location — which is why a clinical assessment always precedes treatment at Hove Shockwave.

Ready to get your knee assessed?

If you've had knee pain for more than three months and previous treatments haven't resolved it, shockwave therapy may be the answer. We can typically see you within a few days of booking.

Book an appointment online

Frequently Asked Questions

What is jumper's knee?

Jumper's knee is the common name for patellar tendinopathy — a degenerative condition of the patellar tendon, which runs from the bottom of the kneecap to the top of the shinbone. It causes pain directly below the kneecap, particularly during or after activity. Despite the name, it affects runners, cyclists, and gym-goers as well as jumping athletes.

How does shockwave therapy treat patellar tendinopathy?

Shockwave therapy delivers focused acoustic waves into the degenerated tendon tissue. This stimulates blood flow, activates growth factors, and prompts the body to lay down healthy new collagen — essentially restarting a healing process that has stalled. It also provides pain relief by temporarily desensitising the nerve endings within the tendon.

How many shockwave sessions will I need for jumper's knee?

Most patients see significant improvement over three to five sessions, spaced approximately one week apart. We combine shockwave with a structured loading programme to maximise tendon remodelling and reduce the risk of the problem returning.

Can I keep training during shockwave treatment?

In most cases, yes — with modification. One of the practical advantages of shockwave therapy is that it doesn't require complete rest. We provide load management guidance during the treatment course so you can stay active while the tendon heals.

Is jumper's knee the same as runner's knee?

No — these are different conditions. Jumper's knee (patellar tendinopathy) involves the patellar tendon below the kneecap. Runner's knee (patellofemoral pain syndrome) refers to pain around or behind the kneecap itself. Both can respond well to shockwave therapy; a clinical assessment will confirm the correct diagnosis and the appropriate treatment approach.

How quickly can I book an appointment at Hove Shockwave?

We typically have appointments available within a few days. You can book online through our Jane App booking system or call the clinic directly on 01273 324466.

Achilles Tendinopathy Treatment in Brighton & Hove: How Shockwave Therapy Can Help

Sat, 23 May 2026 14:51:32 GMT

Achilles Tendinopathy Treatment in Brighton & Hove: How Shockwave Therapy Can Help

Why your Achilles tendon isn't getting better — and what the latest evidence says about shockwave therapy

By Dr Lewis Kingsnorth DC MChiro | Hove Shockwave | May 2026

Shockwave therapy for Achilles tendinopathy at Hove Shockwave clinic, Brighton & Hove. A non-invasive, evidence-based treatment for chronic Achilles tendon pain.

If you've been limping through your first steps in the morning, wincing when you push off to walk upstairs, or watching your running mileage drop week after week because of a nagging pain at the back of your heel, there's a good chance you're dealing with Achilles tendinopathy.

It's one of the most common overuse injuries we see at our Brighton and Hove clinic — and one of the most frustrating. The Achilles tendon is the largest and strongest tendon in the body, connecting your calf muscles to your heel bone and handling forces of up to eight times your bodyweight during running. When it starts to break down, it rarely fixes itself with rest alone.

That's where shockwave therapy comes in. At Hove Shockwave, we use extracorporeal shockwave therapy (ESWT) to treat Achilles tendinopathy without injections, without surgery, and without long periods away from the activities you enjoy.

What Is Achilles Tendinopathy?

Achilles tendinopathy is a condition where the Achilles tendon degenerates over time, usually as a result of repeated overloading. The collagen fibres that make up the tendon become disorganised and the tendon often thickens, becoming painful under load.

It's different from a sudden Achilles tear or rupture. Tendinopathy develops gradually — often over weeks or months — and tends to get worse if you try to push through it without addressing the underlying problem.

There are two main types, and the distinction matters because treatment can differ between them:

Mid-portion Achilles tendinopathy affects the middle section of the tendon, typically 2 to 6 centimetres above the heel bone. This is the most common form and is frequently seen in runners, particularly those who have recently increased their training volume or intensity.

Insertional Achilles tendinopathy occurs where the tendon attaches to the heel bone itself. This type can affect both active and less active people and is often associated with a bony prominence at the back of the heel (known as a Haglund's deformity). It can be more stubborn to treat and doesn't always respond to the same rehabilitation exercises that work for mid-portion problems.

Who Gets Achilles Tendinopathy in Brighton & Hove?

Living on the south coast, we have a huge community of runners, from parkrunners at Hove Park and Preston Park to marathon trainers running along the seafront. Add in the popularity of CrossFit, Hyrox, football, and weekend hiking on the South Downs, and it's no surprise that Achilles tendon injuries are one of the most common reasons people walk through our door.

The typical risk factors include a sudden increase in training load (the "too much, too soon" pattern), a switch from supportive trainers to minimal or flat shoes, tight or weak calf muscles, returning to exercise after a long break, and spending long hours on your feet at work. Age is also a factor — the tendon's ability to cope with load naturally declines from your mid-thirties onwards, which is why Achilles tendinopathy peaks in people aged 35 to 55.

Why Rest Alone Doesn't Work

One of the most important things to understand about Achilles tendinopathy is that rest alone is rarely the answer. Unlike a muscle strain, where time off allows the tissue to repair and return to normal, a degenerative tendon doesn't simply heal when you stop using it.

In fact, prolonged rest can make things worse. Tendons need mechanical load to maintain their structure and strength. When you stop loading the Achilles completely, the tendon can weaken further, making it even more vulnerable when you try to return to activity.

This is why so many people with Achilles tendinopathy find themselves stuck in a frustrating cycle: they rest until the pain subsides, return to running or sport, and the pain comes back within days or weeks — often worse than before.

How Shockwave Therapy Treats Achilles Tendinopathy

Shockwave therapy (ESWT) works by delivering controlled pulses of acoustic energy directly into the affected area of the tendon. These high-energy sound waves trigger a cascade of biological responses that promote healing from within.

The key mechanisms include stimulation of blood flow and new blood vessel formation (neovascularisation) in the tendon, which is significant because tendons have a naturally poor blood supply; activation of growth factors and stem cells that drive tissue repair and collagen remodelling; reduction of substance P, a neurotransmitter involved in pain signalling, which provides both immediate and longer-term pain relief; and breakdown of disorganised scar tissue and calcifications that may have formed within the tendon.

In practical terms, shockwave therapy kickstarts the healing process in a tendon that has stalled. It essentially converts a chronic, non-healing injury into an active repair process.

What the research says: A 2026 randomised controlled trial published in the Journal of Orthopaedic & Sports Physical Therapy examined shockwave therapy for both mid-portion and insertional Achilles tendinopathy, adding to a growing body of evidence supporting ESWT as an effective treatment option. A 2024 randomised clinical trial published in Frontiers in Neurology found that radial shockwave therapy produced significant improvements in pain and function in patients with non-insertional Achilles tendinopathy compared to both ultrasound therapy and placebo groups.

What to Expect During Treatment at Hove Shockwave

When you come in for your first appointment, Dr Kingsnorth will carry out a thorough assessment of your Achilles tendon and the surrounding structures — your calf strength, ankle mobility, foot biomechanics, and how the tendon responds to loading. This assessment is essential because it determines exactly where the shockwave needs to be targeted and what supporting rehabilitation you'll need alongside it.

The shockwave treatment itself takes around 5 to 10 minutes. A handheld applicator is pressed against the skin over the affected area of the tendon, delivering rapid pulses of pressure. You'll feel a firm tapping sensation that can be uncomfortable over the most tender spot, but the intensity is always adjusted to your tolerance. No anaesthetic is needed and there's no downtime — most patients walk straight out and return to their normal day.

A typical course of treatment involves three to six sessions, spaced one week apart. Many patients begin to notice improvement after two or three sessions, though the tendon continues to heal and strengthen for several weeks after the final session.

Shockwave Plus Rehabilitation: The Strongest Combination

At Hove Shockwave, we don't just apply shockwave and send you on your way. Evidence consistently shows that the best outcomes for Achilles tendinopathy come from combining shockwave therapy with a structured loading programme.

This typically includes eccentric calf exercises (where the muscle lengthens under load), progressive heavy resistance training, and a gradual return-to-running plan tailored to your goals. Shockwave therapy reduces pain and stimulates healing, while the exercise programme rebuilds the tendon's capacity to handle the loads you want to put through it — whether that's running a 10k along Brighton seafront, playing five-a-side football, or simply walking to work without pain.

This combined approach reflects current best practice and gives you the strongest chance of a lasting recovery rather than a short-term fix.

Why Cortisone Injections Are Not Recommended for the Achilles

If you've been offered a cortisone injection for your Achilles tendon pain, it's worth knowing that most sports medicine specialists now advise against this. While corticosteroids can temporarily reduce pain, they are associated with tendon weakening and an increased risk of Achilles rupture — a far more serious injury that often requires surgery and months of rehabilitation.

Shockwave therapy offers a fundamentally different approach. Rather than suppressing the body's inflammatory response, it actively stimulates tissue repair. There is no risk of tendon rupture, no need for rest afterwards, and the effects are cumulative rather than temporary.

How Long Does Recovery Take?

This depends on how long you've had the problem, how severe the tendon degeneration is, and how consistently you follow the rehabilitation programme. As a general guide, most patients begin to feel meaningful improvement within three to four weeks of starting shockwave treatment. Full recovery — meaning a return to your previous activity level without pain — typically takes between six and twelve weeks, though some stubborn cases may take longer.

The key is catching it early. An Achilles tendon that has been painful for a few weeks will almost always respond faster than one that has been grumbling for a year or more. If you're noticing the early signs — morning stiffness, tenderness when you pinch the tendon, pain at the start of a run that eases as you warm up — that's the ideal time to get it assessed.

Don't let Achilles tendon pain stop you from doing what you love. Book an assessment at Hove Shockwave and find out whether shockwave therapy is right for you.

Frequently Asked Questions

How many shockwave sessions do I need for Achilles tendinopathy?

Most patients require three to six sessions, spaced one week apart. Many people notice improvement after just two or three sessions, though the full benefit typically develops over the following weeks as the tendon continues to heal and remodel.

Is shockwave therapy painful on the Achilles tendon?

You'll feel a tapping or pulsing sensation during treatment, and some discomfort is normal — particularly over the most tender area of the tendon. However, the intensity is always adjusted to your tolerance. Most patients describe it as uncomfortable rather than painful, and each session lasts only around 5 to 10 minutes.

Can I still run while having shockwave treatment for my Achilles?

In most cases you can continue running at a reduced level during treatment, depending on the severity of your tendinopathy. Dr Kingsnorth will assess your specific situation and advise on activity modification. Many runners are able to maintain some training while gradually increasing load as the tendon responds to treatment.

What is the difference between Achilles tendonitis and Achilles tendinopathy?

Achilles tendonitis refers to acute inflammation of the tendon and is more common in the early stages of injury. Achilles tendinopathy is the broader term used when the tendon has undergone degenerative changes over time — the collagen fibres become disorganised and the tendon thickens. Most chronic Achilles tendon problems are classified as tendinopathy rather than tendonitis, and shockwave therapy is particularly effective for this degenerative stage.

How much does shockwave therapy for the Achilles tendon cost in Brighton?

At Hove Shockwave, an initial consultation and treatment session costs from £90, with follow-up sessions from £90. Contact the clinic directly for the most up-to-date pricing and any package options available.

Is shockwave therapy better than cortisone injections for Achilles tendinopathy?

Cortisone injections into or around the Achilles tendon carry a significant risk of tendon rupture, which is why most specialists now avoid them for this condition. Shockwave therapy offers a safer alternative that works with the body's own healing mechanisms rather than simply suppressing inflammation. Current clinical guidance increasingly favours shockwave therapy and structured rehabilitation over corticosteroid injections for Achilles tendinopathy.

Tennis Elbow Treatment in Brighton & Hove: Why Shockwave Therapy Works When Nothing Else Has

Tue, 14 Apr 2026 20:04:20 GMT

Tennis Elbow Treatment in Brighton & Hove: Why Shockwave Therapy Works When Nothing Else Has

Tennis elbow is one of those injuries that sounds minor but can completely disrupt your daily life. Gripping a coffee mug, turning a door handle, shaking someone's hand — when your elbow is affected, even the simplest tasks become painful. And despite its name, you certainly don't need to play tennis to develop it.

If you're in Brighton or Hove and dealing with persistent elbow pain that hasn't responded to rest, ice, or physiotherapy exercises, shockwave therapy may be the treatment that finally makes the difference. Here's what you need to know.

What Is Tennis Elbow?

Tennis elbow — medically known as lateral epicondylitis — is a condition affecting the tendons that attach to the outer (lateral) side of the elbow. These tendons connect the forearm muscles used for gripping, twisting, and lifting to the bone at the elbow joint.

When these tendons are repeatedly strained through overuse, micro-tears develop in the tissue. Over time, the body's attempt to repair these tears leads to a build-up of disorganised scar tissue and a breakdown of the normal tendon structure. This is why doctors increasingly refer to the condition as a "tendinopathy" (a degenerative tendon problem) rather than a "tendinitis" (which implies active inflammation).

The related condition on the inner side of the elbow, known as golfer's elbow (medial epicondylitis), follows the same pattern and responds equally well to shockwave therapy.

Who Gets Tennis Elbow?

Tennis elbow is extremely common, particularly among adults aged 35 to 55. Despite the name, most cases have nothing to do with racquet sports. The most frequent causes we see at our Hove clinic include repetitive computer mouse and keyboard use, manual work involving gripping tools (plumbing, carpentry, gardening), carrying heavy bags or children, gym exercises such as pull-ups and deadlifts, and cooking and food preparation involving repetitive chopping or stirring.

Essentially, any activity that involves repetitive gripping or wrist extension can overload these tendons. Many of our patients are office workers, tradespeople, or keen home gardeners who have gradually developed the condition over weeks or months.

Why Tennis Elbow Becomes a Stubborn Problem

One of the most frustrating aspects of tennis elbow is how long it can linger. The NHS advises that it can take anywhere from six months to two years to fully resolve on its own — and some people find that it never fully settles without intervention.

The reason is the same as with plantar fasciitis and other chronic tendon conditions: the tendon tissue has a limited blood supply, and once damage becomes chronic, the body's natural repair mechanisms stall. The tissue enters a cycle of degeneration where it's no longer actively trying to heal. Rest alone won't fix tissue that has stopped healing.

This is precisely why shockwave therapy is so effective for this condition. Rather than masking the pain, it restarts the biological repair process at the cellular level.

How Shockwave Therapy Treats Tennis Elbow

Extracorporeal shockwave therapy (ESWT) delivers focused acoustic waves into the damaged tendon tissue at the elbow. These mechanical pulses create several therapeutic effects that work together to promote healing.

The acoustic waves stimulate increased blood flow to the poorly vascularised tendon, providing the building blocks for tissue repair. They trigger the release of growth factors that promote collagen production and the formation of healthy new tendon fibres. They also help to break down calcified deposits and disorganised scar tissue, allowing the tendon to remodel with a more functional structure. Additionally, the treatment provides direct pain relief through neuromodulation — effectively dampening the overactive pain signalling that develops in chronic conditions.

Evidence: Shockwave therapy has been extensively studied for tennis elbow, with multiple randomised controlled trials demonstrating significant improvements in pain and grip strength compared to placebo. It is now widely recommended when conservative measures have failed, as a non-surgical alternative that can prevent the need for injections or surgery.

What Happens During Your Treatment

At Hove Shockwave, your first appointment begins with a comprehensive assessment by Dr Lewis Kingsnorth. This includes a detailed history of your symptoms, a physical examination of the elbow and forearm, and specific tests to confirm the diagnosis and assess the severity of the tendon damage.

Treatment itself involves applying a small amount of coupling gel to the outer elbow and using a handheld shockwave device to deliver precisely targeted acoustic waves to the affected tendon. A typical session lasts 10 to 15 minutes. You'll feel a rhythmic tapping sensation, which can range from mild to moderately uncomfortable depending on the severity of the condition. The intensity is always adjusted to what you can comfortably tolerate.

Most patients need four to six sessions spaced one week apart. Improvement is usually gradual — many people notice that their grip strength starts returning and that daily activities become less painful within the first two to three weeks of starting treatment.

What About Injections?

Injections have traditionally been a go-to treatment for tennis elbow, but the evidence for their long-term effectiveness is increasingly poor. While an injection can provide rapid pain relief in the short term (typically two to six weeks), research consistently shows that outcomes at six and twelve months are no better — and often worse — than doing nothing at all.

This is because injections can suppress the body's natural healing response, and repeated injections can weaken the tendon tissue further. For this reason, many orthopaedic specialists now advise caution with repeated injections for tendon conditions and increasingly recommend shockwave therapy as a more effective long-term solution.

Combining Shockwave with EMTT

At Hove Shockwave, we also offer Extracorporeal Magnetotransduction Therapy (EMTT) — a complementary technology that uses high-intensity magnetic pulses to stimulate cellular repair. When combined with shockwave therapy, EMTT can enhance treatment outcomes, particularly for stubborn or severe cases of tennis elbow.

EMTT is completely painless and "touch-free," making it an excellent option for patients whose elbow is too tender for direct contact during the early stages of treatment. Dr Kingsnorth will advise whether combined treatment would be beneficial for your specific case.

Self-Care Tips Alongside Treatment

While shockwave therapy addresses the damaged tissue directly, there are practical steps you can take to support your recovery and prevent recurrence.

Avoid activities that aggravate the pain where possible — this doesn't mean complete rest, but rather modifying how you grip and lift. Using the palm of your hand rather than gripping with fingers can reduce tendon load significantly. When lifting objects, try to keep your palm facing upwards rather than downwards.

Eccentric strengthening exercises — where you slowly lower a light weight with your wrist — are well supported by research for tendon rehabilitation and can be started once your pain begins to settle. Dr Kingsnorth will provide specific exercise guidance as part of your treatment plan.

If your tennis elbow is work-related, consider ergonomic adjustments to your desk setup. A vertical mouse, a wrist rest, and regular breaks from repetitive tasks can all make a meaningful difference.

Frequently Asked Questions

How long does it take for shockwave to work on tennis elbow? Most patients notice gradual improvement over two to four weeks, with continued healing for up to three months after completing the course of treatment. Four to six sessions are typically recommended.

Should I stop using my arm during treatment? Complete rest isn't usually necessary or advisable. We recommend modifying activities to reduce strain on the tendon while continuing to use the arm normally for day-to-day tasks.

Can shockwave therapy treat golfer's elbow as well? Yes. Golfer's elbow (medial epicondylitis) affects the tendons on the inner side of the elbow and responds very well to the same shockwave treatment protocol.

Is shockwave therapy better than physiotherapy for tennis elbow? They work well together. Physiotherapy exercises support tendon remodelling and strengthening, while shockwave therapy directly stimulates the biological healing process. We often recommend combining both approaches for the best outcomes.

Struggling With Elbow Pain? If tennis or golfer's elbow has been affecting your daily life, book a shockwave assessment with Dr Kingsnorth at our Hove clinic.

Book Your Assessment — or call 01273 324466 | We accept Vitality and AXA insurance

Plantar Fasciitis Treatment in Brighton & Hove: How Shockwave Therapy Can End Your Heel Pain

Sat, 04 Apr 2026 15:50:30 GMT

Plantar Fasciitis Treatment in Brighton & Hove: How Shockwave Therapy Can End Your Heel Pain

By Dr Lewis Kingsnorth DC MChiro — Certified Shockwave Specialist at Hove Shockwave
Published: April 2026 | 7 minute read

If you've ever experienced that sharp, stabbing pain under your heel when you take your first steps in the morning, you're likely dealing with plantar fasciitis. It's one of the most common causes of heel pain, affecting roughly 1 in 10 people at some point in their lives, and it can turn simple activities like walking to the shops or taking the dog out along Hove seafront into a painful ordeal.

The good news is that plantar fasciitis doesn't have to be something you just "live with." At Hove Shockwave, we use extracorporeal shockwave therapy (ESWT) — a clinically proven, non-invasive treatment that's recommended by NICE and used across the NHS — to help patients in Brighton and Hove get back on their feet, often after other treatments have failed.

What Exactly Is Plantar Fasciitis?

The plantar fascia is a thick band of connective tissue running along the underside of your foot, connecting your heel bone to your toes. It acts as a natural shock absorber and supports the arch of your foot every time you take a step.

When this tissue becomes overloaded — through repetitive strain, prolonged standing, changes in activity, or simply wear and tear — it can develop micro-tears and become inflamed. This is plantar fasciitis, and it typically presents as pain concentrated around the inner edge of the heel, worst first thing in the morning and after periods of rest.

Common risk factors include spending long hours on your feet at work, wearing unsupportive footwear, recent increases in exercise (particularly running), carrying excess body weight, and reduced ankle flexibility. It's seen frequently in both active individuals and those with more sedentary lifestyles.

Why Does Plantar Fasciitis Become Chronic?

Many people find that their heel pain persists for months, sometimes years, despite trying rest, stretching, insoles, and anti-inflammatory medication. This happens because the plantar fascia has a relatively poor blood supply, which means the body's natural healing process can stall. Over time, the condition shifts from acute inflammation to a chronic degenerative state — the tissue isn't actively inflamed so much as it has simply stopped healing properly.

This is precisely where shockwave therapy excels. It's most effective when pain has become chronic — typically lasting three months or longer — and other conservative treatments have not resolved the problem.

How Shockwave Therapy Treats Plantar Fasciitis

Shockwave therapy works by delivering focused acoustic (sound) waves into the damaged tissue. These waves create controlled micro-trauma at the cellular level, which triggers several important healing responses in the body.

First, it stimulates increased blood flow to the affected area, bringing the oxygen and nutrients needed for tissue repair. Second, it promotes the release of growth factors and activates stem cells, encouraging the formation of healthy new tissue. Third, it helps to break down calcified deposits and scar tissue that may have built up around the plantar fascia. Finally, it provides a direct analgesic (pain-relieving) effect by overstimulating nerve endings and reducing the transmission of pain signals.

Put simply, shockwave therapy takes a tissue that has become "stuck" in a chronic state and restarts the healing process, moving it back into an active repair phase.

Key point: A 2024 meta-analysis published in Foot and Ankle Surgery reviewed 15 randomised controlled trials involving over 1,100 patients and found that shockwave therapy performed significantly better than placebo for plantar fasciitis pain, and showed comparable or superior results to other conservative treatments including injections.

What to Expect During Treatment at Hove Shockwave

Your first appointment at our Hove clinic lasts approximately 30 minutes. Dr Lewis Kingsnorth will begin with a thorough assessment of your foot, including a review of your medical history, a physical examination of the affected area, and, where appropriate, an X-ray using our on-site digital imaging facilities to rule out structural issues such as fractures or significant heel spurs.

Once we've confirmed that shockwave therapy is appropriate for you, treatment can begin the same day. A coupling gel is applied to the heel and a handheld device delivers precise shockwaves to the target area. Each session lasts around 15 to 20 minutes. You may feel some discomfort during the procedure — most patients describe it as a tapping or pulsing sensation — but the intensity is adjusted throughout to ensure it remains tolerable.

Most patients require between four and six sessions, typically spaced one week apart, to achieve lasting improvement. Many people notice a reduction in their morning heel pain within the first two to three sessions, with continued improvement over the following weeks as the tissue repairs itself.

Shockwave vs. Other Treatments for Plantar Fasciitis

You may be wondering how shockwave compares to the other options available. Here's a practical overview based on current clinical evidence and our experience treating patients here in Brighton and Hove.

Injections

Injections can provide rapid short-term relief, but the effect often wears off within a few weeks to months, and repeated injections carry a risk of weakening or rupturing the plantar fascia. Recent research has shown that shockwave therapy tends to provide superior long-term outcomes compared to injections, with a lower risk of recurrence.

Orthotics and Insoles

Custom orthotics can be helpful for managing biomechanical contributors to plantar fasciitis, and we often recommend them as part of a comprehensive treatment plan. However, on their own, they address the symptom rather than the underlying tissue damage.

Surgery

Surgical release of the plantar fascia is typically only considered after 6 to 12 months of failed conservative treatment. It carries risks including infection, nerve damage, and changes to foot biomechanics. Shockwave therapy offers an effective non-surgical alternative that should be tried before considering an operation.

Rest And Stretching Alone

While stretching the calf and plantar fascia is beneficial and we encourage it alongside shockwave treatment, rest and stretching alone are often insufficient for chronic cases where the tissue has entered a degenerative cycle.

Who Is Shockwave Suitable For?

Shockwave therapy is suitable for most adults experiencing plantar fasciitis that hasn't responded adequately to first-line treatments such as rest, stretching, ice, and appropriate footwear. It's particularly effective for patients who have had symptoms for three months or more.

There are a small number of contraindications. We would not recommend shockwave therapy if you are pregnant, if you have a blood clotting disorder or are taking anticoagulant medication (other than aspirin), or if there is a tumour or active infection in the treatment area. Dr Kingsnorth will discuss your suitability during your initial consultation.

Why Choose Hove Shockwave for Your Plantar Fasciitis Treatment?

At Hove Shockwave, we're not a general physiotherapy practice that happens to have a shockwave machine. Shockwave therapy is our specialism. Dr Lewis Kingsnorth is a certified shockwave therapist with years of experience treating musculoskeletal conditions, and we use professional-grade focused and radial shockwave equipment — the same technology used in leading NHS hospitals and professional sports medicine.

We also have digital X-ray facilities on site, which means we can carry out imaging as part of your assessment without referring you elsewhere. This allows for a faster, more accurate diagnosis and means your treatment can often begin on the same day as your first visit.

Our clinic is conveniently located at 82 Goldstone Villas in Hove, easily accessible from Brighton, Portslade, Shoreham, and across East and West Sussex. We accept Vitality and AXA health insurance.

Frequently Asked Questions

How many shockwave sessions do I need for plantar fasciitis?

Most patients require four to six weekly sessions. Some people experience significant improvement after just two or three treatments, while more longstanding cases may need additional sessions.

Does shockwave therapy for plantar fasciitis hurt?

You'll feel a tapping or pulsing sensation during treatment. It can be mildly uncomfortable but is well tolerated by the vast majority of patients. The intensity is always adjusted to your comfort level.

How quickly will I see results?

Many patients notice improvement in their morning heel pain within the first two to three weeks. Full results continue to develop over six to twelve weeks as the tissue heals and strengthens.

Is shockwave therapy available on the NHS?

Shockwave therapy is recommended in NICE guidelines and used in some NHS settings, but waiting times can be lengthy. At Hove Shockwave, you can typically be seen within a few days of booking.

Can I walk after shockwave treatment?

Yes, you can walk immediately after treatment and return to normal activities. We may advise avoiding high-impact exercise for 24 to 48 hours after each session.

Ready to Fix Your Heel Pain?

Don't let plantar fasciitis hold you back any longer. Book your initial assessment with Dr Kingsnorth today.

Or call us on 01273 324466

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