FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Effect of extracorporeal shock wave therapy on the biochemic...
Equine veterinary journal2007; 39(3); 226-231; doi: 10.2746/042516407x180408

Effect of extracorporeal shock wave therapy on the biochemical composition and metabolic activity of tenocytes in normal tendinous structures in ponies.

Abstract: Extracorporeal shockwave therapy (ESWT) has recently been introduced as a new therapy for tendon injuries in horses, but little is known about the basic mechanism of action of this therapy. Objective: To study the effect of ESWT on biochemical parameters and tenocyte metabolism of normal tendinous structures in ponies. Methods: Six Shetland ponies, free of lameness and with ultrasonographically normal flexor and extensor tendons and suspensory ligaments (SL), were used. ESWT was applied at the origin of the suspensory ligament and the mid-metacarpal region of the superficial digital flexor tendon (SDFT) 6 weeks prior to sample taking, and at the mid-metacarpal region (ET) and the insertion on the extensor process of the distal phalanx (EP) of the common digital extensor tendon 3 h prior to tendon sampling. In all animals one front leg was treated and the other front leg was used as control. After euthanasia, tendon explants were harvested aseptically for in vitro cell culture experiments and additional samples were taken for biochemical analyses. Results: In the explants harvested 3 h after treatment, glycosaminoglycan (GAG) and protein syntheses were increased (P<0.05). The synthesis of all measured parameters was decreased 6 weeks after ESWT treatment. Biochemically, the level of degraded collagen was increased 3 h after treatment (P<0.05). Six weeks after treatment, there was a decrease of degraded collagen and GAG contents. DNA content had not changed in either tendon samples or explants after culturing. Conclusions: ESWT causes a transient stimulation of metabolism in tendinous structures of ponies shortly after treatment. After 6 weeks metabolism has decreased significantly and GAG levels are lower than in untreated control limbs. Conclusions: The stimulating short-term effect of ESWT might accelerate the initiation of the healing process in injured tendons. The long-term effect seems less beneficial. Further research should aim at determining the duration of this effect and at assessing its relevance for end-stage tendon quality.
Get Full Text
Publication Date: 2007-05-25 PubMed ID: 17520973DOI: 10.2746/042516407x180408Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research explores the effects of extracorporeal shockwave therapy (ESWT) on tendon cells in normal ponies, showing that short-term ESWT accelerates metabolic activity, potentially aiding initial healing, but long-term effects may be less beneficial.

Objective and Methods

  • The objective of the study was to understand the impact of extracorporeal shockwave therapy (ESWT) on the biochemical composition and metabolism of tendon cells within normal tendon structures in ponies. This therapy has recently been incorporated for treating tendon injuries in horses, but its underlying mechanism is not fully understood.
  • The subject group comprised six Shetland ponies with normal flexor, extensor tendons, and suspensory ligaments, all free from lameness. ESWT was applied at specific regions of the tendinous structures at different time intervals prior to sample collection. One front leg of each pony was given treatment while the other served as a control.
  • Post euthanasia, tendon samples were gathered aseptically to be used for in vitro cell culture experiments and biochemical analyses.

A short-term increase in biochemical components and metabolic activity

  • The study found that in samples collected 3 hours after treatment, there was an increase in glycosaminoglycan (GAG) and protein syntheses – key biochemical components in maintaining the structure and function of the tendons.
  • Moreover, the level of degraded collagen, another essential component of the extracellular matrix of tendon tissue, also increased 3 hours post-treatment, indicating increased tendon metabolism.

A long-term decrease in metabolism and biochemical components

  • Conversely, six weeks after ESWT treatment, the synthesis of all the measured parameters decreased, and both the degraded collagen and GAG contents also decreased. This suggests a drop in tendon metabolic activity and biochemical composition with long-term ESWT application.
  • The study did not observe any significant change in DNA content in either the tendon samples or the explants post-culturing.

Conclusion and Future Research Direction

  • The study concludes that ESWT leads to a short-term increase in metabolism in the tendinous structures of ponies, which may help spur the initial healing process in injured tendons.
  • However, the long-term effect seems to be less beneficial as metabolism decreases significantly and GAG levels decline compared to untreated limbs.
  • Future research is suggested to pinpoint the duration of this effect and to assess its relevance for end-stage tendon quality.

Cite This Article

APA
Bosch G, Lin YL, van Schie HT, van De Lest CH, Barneveld A, van Weeren PR. (2007). Effect of extracorporeal shock wave therapy on the biochemical composition and metabolic activity of tenocytes in normal tendinous structures in ponies. Equine Vet J, 39(3), 226-231. https://doi.org/10.2746/042516407x180408

Publication

Equine veterinary journal
ISSN: 0425-1644
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 39
Issue: 3
Pages: 226-231

Researcher Affiliations

Bosch, G
  • Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht.
Lin, Y L
    van Schie, H T M
      van De Lest, C H A
        Barneveld, A
          van Weeren, P R

            MeSH Terms

            • Animals
            • Collagen / analysis
            • Collagen / metabolism
            • DNA / analysis
            • DNA / metabolism
            • Glycosaminoglycans / analysis
            • Glycosaminoglycans / metabolism
            • High-Energy Shock Waves / therapeutic use
            • Horse Diseases / therapy
            • Horses / metabolism
            • Ligaments / metabolism
            • Ligaments / radiation effects
            • Male
            • Organ Culture Techniques
            • Tendon Injuries / therapy
            • Tendon Injuries / veterinary
            • Tendons / metabolism
            • Tendons / radiation effects
            • Time Factors

            Citations

            This article has been cited 23 times.
            1. Saxena A, Bondi E, Gerdesmeyer L, Tenforde AS. Extracorporeal shock wave therapy (ESWT) and radial pressure waves (RPW) May improve post-operative recovery following insertional Achilles tendon surgeries: a case-control pilot study. J Orthop Surg Res 2025 Aug 9;20(1):751.
              doi: 10.1186/s13018-025-06165-5pubmed: 40783538google scholar: lookup
            2. Fulceri F, Ryskalin L, Morucci G, Busoni F, Soldani P, Gesi M. Long-Term Efficacy of Combined Focused and Radial Extracorporeal Shockwave Therapy for Gluteus Medius Tendon Pathology: A Pilot Study. Life (Basel) 2024 Dec 21;14(12).
              doi: 10.3390/life14121698pubmed: 39768404google scholar: lookup
            3. Guest DJ, Birch HL, Thorpe CT. A review of the equine suspensory ligament: Injury prone yet understudied. Equine Vet J 2025 Sep;57(5):1167-1182.
              doi: 10.1111/evj.14447pubmed: 39604165google scholar: lookup
            4. Sudhakar S, Kirthika S V, J C, M SK. Enhancing Skeletal Muscle Rehabilitation: The Effects of Diclofenac Phonophoresis and Shock Wave Therapy on Serum Creatine Kinase in Athletes With Delayed-Onset Muscle Soreness. Cureus 2023 Sep;15(9):e46267.
              doi: 10.7759/cureus.46267pubmed: 37908915google scholar: lookup
            5. Rhim HC, Borg-Stein J, Sampson S, Tenforde AS. Utilizing Extracorporeal Shockwave Therapy for in-Season Athletes. Healthcare (Basel) 2023 Apr 1;11(7).
              doi: 10.3390/healthcare11071006pubmed: 37046934google scholar: lookup
            6. Poenaru D, Sandulescu MI, Cinteza D. Biological effects of extracorporeal shockwave therapy in tendons: A systematic review. Biomed Rep 2023 Feb;18(2):15.
              doi: 10.3892/br.2022.1597pubmed: 36684664google scholar: lookup
            7. Boström A, Bergh A, Hyytiäinen H, Asplund K. Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Extracorporeal Shockwave Therapy. Animals (Basel) 2022 Nov 12;12(22).
              doi: 10.3390/ani12223124pubmed: 36428352google scholar: lookup
            8. Chen Y, Lyu K, Lu J, Jiang L, Zhu B, Liu X, Li Y, Liu X, Long L, Wang X, Xu H, Wang D, Li S. Biological response of extracorporeal shock wave therapy to tendinopathy in vivo (review). Front Vet Sci 2022;9:851894.
              doi: 10.3389/fvets.2022.851894pubmed: 35942112google scholar: lookup
            9. Wuerfel T, Schmitz C, Jokinen LLJ. The Effects of the Exposure of Musculoskeletal Tissue to Extracorporeal Shock Waves. Biomedicines 2022 May 6;10(5).
              doi: 10.3390/biomedicines10051084pubmed: 35625821google scholar: lookup
            10. Lo WS, Sheen JM, Chen YC, Wu KT, Wang LY, Lau YC, Hsiao CC, Ko JY. The Application of Focused Medium-Energy Extracorporeal Shockwave Therapy in Hemophilic A Arthropathy. Healthcare (Basel) 2022 Feb 11;10(2).
              doi: 10.3390/healthcare10020352pubmed: 35206968google scholar: lookup
            11. Gatz M, Schweda S, Betsch M, Dirrichs T, de la Fuente M, Reinhardt N, Quack V. Line- and Point-Focused Extracorporeal Shock Wave Therapy for Achilles Tendinopathy: A Placebo-Controlled RCT Study. Sports Health 2021 Sep-Oct;13(5):511-518.
              doi: 10.1177/1941738121991791pubmed: 33586526google scholar: lookup
            12. Chen K, Yin S, Wang X, Lin Q, Duan H, Zhang Z, Chang Y, Gu Y, Wu M, Wu N, Liu C. Effect of extracorporeal shock wave therapy for rotator cuff tendonitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020 Nov 25;99(48):e22661.
              doi: 10.1097/MD.0000000000022661pubmed: 33235062google scholar: lookup
            13. Simplicio CL, Purita J, Murrell W, Santos GS, Dos Santos RG, Lana JFSD. Extracorporeal shock wave therapy mechanisms in musculoskeletal regenerative medicine. J Clin Orthop Trauma 2020 May;11(Suppl 3):S309-S318.
              doi: 10.1016/j.jcot.2020.02.004pubmed: 32523286google scholar: lookup
            14. Cullen TE, Semevolos SA, Stieger-Vanegas SM, Duesterdieck-Zellmer K. Muscle tears as a primary cause of lameness in horses: 14 cases (2009-2016). Can Vet J 2020 Apr;61(4):389-395.
              pubmed: 32255824
            15. Ikeda Y, Ishihara A, Nakajima M, Yamada K. Risk factors for superficial digital flexor tendinopathy in Thoroughbred racing horses in Japan. J Equine Sci 2019;30(4):93-98.
              doi: 10.1294/jes.30.93pubmed: 31871411google scholar: lookup
            16. Lipman K, Wang C, Ting K, Soo C, Zheng Z. Tendinopathy: injury, repair, and current exploration. Drug Des Devel Ther 2018;12:591-603.
              doi: 10.2147/DDDT.S154660pubmed: 29593382google scholar: lookup
            17. Zhang H, Li ZL, Yang F, Zhang Q, Su XZ, Li J, Zhang N, Liu CH, Mao N, Zhu H. Radial shockwave treatment promotes human mesenchymal stem cell self-renewal and enhances cartilage healing. Stem Cell Res Ther 2018 Mar 9;9(1):54.
              doi: 10.1186/s13287-018-0805-5pubmed: 29523197google scholar: lookup
            18. Acar N. Low-energy versus middle-energy extracorporeal shockwave therapy for the treatment of snapping scapula bursitis. Pak J Med Sci 2017 Mar-Apr;33(2):335-340.
              doi: 10.12669/pjms.332.12262pubmed: 28523033google scholar: lookup
            19. Notarnicola A, Maccagnano G, Tafuri S, Fiore A, Margiotta C, Pesce V, Moretti B. Prognostic factors of extracorporeal shock wave therapy for tendinopathies. Musculoskelet Surg 2016 Apr;100(1):53-61.
              doi: 10.1007/s12306-015-0375-ypubmed: 25982090google scholar: lookup
            20. Visco V, Vulpiani MC, Torrisi MR, Ferretti A, Pavan A, Vetrano M. Experimental studies on the biological effects of extracorporeal shock wave therapy on tendon models. A review of the literature. Muscles Ligaments Tendons J 2014 Jul;4(3):357-61.
              pubmed: 25489555
            21. Notarnicola A, Moretti B. The biological effects of extracorporeal shock wave therapy (eswt) on tendon tissue. Muscles Ligaments Tendons J 2012 Jan;2(1):33-7.
              pubmed: 23738271
            22. van der Worp H, van den Akker-Scheek I, van Schie H, Zwerver J. ESWT for tendinopathy: technology and clinical implications. Knee Surg Sports Traumatol Arthrosc 2013 Jun;21(6):1451-8.
              doi: 10.1007/s00167-012-2009-3pubmed: 22547246google scholar: lookup
            23. Penteado FT, Faloppa F, Giusti G, Moraes VY, Belloti JC, Santos JB. High-energy extracorporeal shockwave therapy in a patellar tendon animal model: a vascularization focused study. Clinics (Sao Paulo) 2011;66(9):1611-4.
              doi: 10.1590/s1807-59322011000900018pubmed: 22179168google scholar: lookup
            Subscribe to our newsletter
            Join 99,308 horse owners like you who receive our email updates on horse health and nutrition.