How Is ESWT Integrated into a Training Programme?

ESWT often comes up for persistent complaints in the Achilles, patellar tendon and heel area in athletes. But what actually decides the outcome isn't the application itself — it's how it's fitted into the training plan.

Which tendon complaints is it used for?

Achilles tendinopathy, patellar tendinopathy and heel pain that persist for weeks despite exercise and manual treatment are the areas where ESWT is used most. The common point is that the tissue's capacity to carry load has dropped.

How does it fit into the training week?

ESWT is scheduled on a relatively light day, not a high-intensity training day. Since there can be temporary tenderness in the area afterward, high-level jumping or speed work isn't recommended on the same day.

Why is strength work essential?

ESWT opens a window by reducing pain; if that window isn't filled with graded loading, the gain doesn't last. That's why the application is always planned alongside that week's strength and loading programme, not in place of it.

How many sessions, and when do results show?

Usually applied once a week, for 3-5 sessions; the effect doesn't appear immediately, it emerges gradually over the following weeks. Impatiently returning to high load early can undo the progress gained.

Who isn't it applied to?

It isn't applied, or the approach is changed, in young athletes with open growth plates, and in cases with active infection or a bleeding disorder; this history is asked about at the first assessment.

Fzt. Bilal Kara always runs ESWT treatment as part of the weekly training and strength plan, not as a standalone solution.