Shockwave therapy for patellar tendinopathy in London

The main symptom is pain at the front of the knee, in the tendon just below the kneecap. The NHS describes it as pain between your kneecap and shin, often caused by repetitive running or jumping. It is usually felt when the tendon takes load: jumping, landing, running, squatting, kneeling or walking down stairs.

Many people find the pain eases once they are warmed up and comes back after the session, and over time it can start earlier and linger longer. Tendonitis and tendinopathy are both used for this problem. Tendinopathy is the more accurate word, because long-running tendon pain of this kind is mainly a loss of capacity in the tendon, which is why extracorporeal shockwave therapy is only ever an addition to rebuilding that capacity.

The tendon has been asked to absorb more load than it has adapted to, usually through repeated jumping and landing. The NHS links pain below the kneecap to repetitive running or jumping, and most of the shockwave trials for this condition were run in sporting groups for that reason. The usual contributors are:

• a rise in training volume or intensity the tendon had not adapted to
• a return to jumping, sprinting or court sport after a long break
• reduced strength in the thigh and hip muscles that share the load of landing
• a training week with more jumping than the tendon can recover from

What matters for treatment is that rest on its own rarely rebuilds a tendon. That is why a progressive loading programme is the first treatment, and why any shockwave course runs alongside one.

The NHS advises seeing a GP if knee pain does not improve within a few weeks. It advises contacting NHS 111 if the knee is very painful, if you cannot move it or put weight on it, if it is badly swollen or has changed shape, if it locks, gives way or painfully clicks, or if you have a very high temperature with redness or heat around the knee.

None of those signs is a reason to try shockwave. A knee that locks or gives way needs examining for a structural injury first, and pain below the kneecap has other sources, including the fat pad and the joint behind the kneecap, which a clinician separates by examination before any treatment is chosen.

No UK guideline sets a recovery time for patellar tendinopathy, so anyone quoting you an exact number is guessing. Tendon capacity is rebuilt through progressive loading, which is slow work measured over weeks and months of training, and a flare after a heavy week of jumping is common along the way.

Shockwave does not shorten that timeline in any proven way. Where it is used, the review point sits 6 to 12 weeks after the last session, as it does for every condition on this site, because the treatment is meant to provoke a slow repair response and very little changes during the course itself. The Achilles tendinopathy page explains the same pattern in the other big lower-limb tendon.

The trials say it adds very little. A 2023 systematic review and meta-analysis in Frontiers in Immunology pooled 10 studies of shockwave for patellar tendinopathy and concluded that there is "low-moderate evidence that ESWT has a negligible effect on pain and function". Against a placebo, on its own or alongside eccentric exercise, shockwave made little difference in the short term.

NICE has published no guidance on shockwave for the knee. Its shockwave assessments cover the heel, the Achilles, the outer elbow, the hip and calcific shoulder pain, set out on plantar fasciitis, tennis elbow and the other condition pages. That is worth knowing before you pay for a course aimed at a knee.

The first treatment is a progressive loading programme for the tendon, supervised by a physiotherapist, with the aggravating jumping or sprinting reduced while strength builds. Shockwave, if it is used at all, is an adjunct for knee pain that has not settled after a proper programme, and the clinician should tell you plainly that the trials found little extra benefit.

London Shockwave Therapy arranges an assessment first, at one of four UNTIL clubs, where a registered clinician examines the knee and discusses whether a course makes sense for you. London Shockwave Therapy sets no fees of its own, and published London prices checked on 29 September 2026 ran from £85 to £150 a session and £348 to £400 for a course of three, set out on the shockwave therapy prices page. To start, ask about your case.

The NHS self-care advice for knee pain is to take weight off the knee where you can, use an ice pack wrapped in a tea towel for up to 20 minutes every 2 to 3 hours, and use painkillers such as paracetamol or ibuprofen gel if you need them. That calms a tendon down, and it does not rebuild it.

Rebuilding usually starts with holds, where the thigh muscles work against a load without the knee moving, then moves to slow, heavy squat and leg-press work, and only later back to jumping and landing. The pace is set by how the tendon responds the next day. A physiotherapist can set the starting load and the steps, which is the part most home programmes get wrong.

If your knee pain has not settled and you are in central London, an assessment is the next step. London Shockwave Therapy arranges assessments at four UNTIL clubs, with walking times from the TfL journey planner: 280 Bishopsgate, about 7 minutes from Liverpool Street station; 111 Charing Cross Road, about 5 minutes from Leicester Square; 1 Orchard Street, about 8 minutes from Marble Arch; and 30 South Colonnade, about 2 minutes from Canary Wharf.

Every club has a gym floor, which matters more for a knee tendon than for most conditions on this site: the squat and leg-press work that rebuilds the tendon can happen in the same building as the assessment. Every club also opens at 06:00 on weekdays, so a session can fit before training or work.