A field report by the physiotherapists of HSG Konstanz (German 2nd Bundesliga for handball)

As a country, Germany loves sport. Whether it’s handball, football or tennis, millions enjoy playing sports every day.

The handball branch of the TV Konstanz sports association founded in 1923, »HSG Konstanz«, continually offers thrilling matches in the German 2nd Bundesliga for handball. On average, 1,000 fans attend the games at the Schänzle-Sporthalle Konstanz arena.

But where there is competitive sport, injuries are usually not too far behind. Cleo Oexle, physiotherapist for HSG Konstanz, and her colleagues Heike Gaisser, Felix Semler and Tobias Eblen can tell us a thing or two about that.

»The strain on the myotendinous junctions and the tendon tissues is very high in handball due to the many changes of direction, jumps and throws,« Cleo Oexle reports.

This particularly affects areas such as the rotator cuff around the shoulder joint, the patellar ligament and the Achilles tendon.

As physiotherapists, she and her colleagues are very familiar with all of the potential injuries affecting handball players.

Due to the wide variety of injuries, a wide range of treatments is also required. Globally, Extracorporeal Shock Wave Therapy has become established as a therapy option for sports injuries. Thousands of physiotherapists around the world are glad to rely on STORZ MEDICAL products from Switzerland.

For the athletes from HSG Konstanz cared for by Cleo Oexle and her team, the radial shock wave device MASTERPULS® ONE, for example, is a popular choice for sports injuries.

Currently, one handball player is suffering from patellar tendonitis, which is the irritation or inflammation of the patellar ligament. It’s a classic sports injury. During his intensive preparation for the next game, the athlete complained of pain around the patellar ligament insertion. It is an area frequently treated by physiotherapists. It also includes a stage-by-stage action plan helping the person to cope with sports injuries.

• In the case of the HSG handball player, the irritation was initially treated with standard physiotherapy measures. These include, for example, muscle relaxation, cross-friction massage and cryotherapy. Because the symptoms did not significantly improve with these measures after a period of two weeks, the sports physiotherapists decided to prescribe therapy with the MASTERPULS® ONE radial shock wave device. At the same time, the athlete underwent a gait analysis in order to provide him with suitable insoles.

Extracorporeal Shock Wave Therapy
To start the radial shock wave therapy, the physiotherapists initially focused on the quadriceps muscle, which is the four-headed muscle in the thigh.

To do this, they connected the shock wave device with the STORZ MEDICAL D20-T transmitter.

As the physiotherapists report: »The aim of shock wave therapy was to release trigger points and thus reduce the tension exerted by the quadriceps on the patellar ligament. At the same time, boosting the metabolism and stimulating the nervous system also aim to have a positive effect on the patellar tendonitis.«

Based on the long-term experience with the athlete, the physios »selected the frequency on the shock wave device that corresponded to the player selecting a pain intensity of 6/10 on the visual analogue scale.«

The visual analogue scale, or VAS for short, uses information from patients regarding their subjective pain perception. The scale ranges from 0 = no pain to 10 = unbearable pain.

In addition to the D20-T transmitter, the physiotherapists also used the R15 transmitter for the MASTERPULS® ONE. This transmitter is very well suited to shock wave therapy right above the insertion of the patellar ligament.

The treatments were carried out by the physiotherapists two to three times a week over a period of four weeks. After just one and a half weeks, »the athlete stated that his symptoms had significantly improved. After four weeks, he said he had hardly any pain around his patellar ligament.«

In addition, the athlete »completed the exercises in his individual training plan during the whole treatment.« This included applications such as icing the affected area, which the athlete had already discussed with his physio team when the symptoms first arose.

The athlete also changed his nutrition in accordance with the physiotherapists’ recommendations to ensure that his diet had an anti-inflammatory effect.

The shock wave therapy, integrated into the treatment plan, was »a complete success« according to the physiotherapists.

Summary by the player’s physiotherapists
»The ease of use and simple transportation make the MASTERPULS® ONE the perfect companion for us sports physiotherapists. For us, there’s no better alternative.«

Good to know
The STORZ MEDICAL R15 transmitter used gets its name from the fact that the metal tip of the transmitter has a diameter of 15 mm. It is a standard transmitter and is perfect for a broader transmission of shock waves in the body. It is used for treating enthesopathy, for example, which is a disorder involving the attachment of a tendon or ligament usually near a joint.