Edinburgh Osteopath - Helen How

11/04/2026

11/04/2026

Updates on ESWT bibliography include Women’s Health

11/04/2026

📚 Shockwave Therapy — 30 Years of Evidence

This isn’t emerging anymore.
It’s established, expanding, and impossible to ignore.

Across:
Orthopaedics. Tendons. Pain. Regenerative medicine.
Women’s & men’s health.

I update this every single week —
because the volume of new research is relentless.

If you’re not keeping up, you’re already behind.

Bibliography updated — Saturday 11th April

📩 Message me if you want the full bibliography / infographic.

31/03/2026

European Masters Indoors
Jennifer Beattie reports from Poland 🇵🇱

Following on from a busy day yesterday, Day Four Four of the European Masters in Torun was another packed one for our Scottish athletes across sprints, middle distance and field events.
Previously I reported that a number of athletes had qualified for the 60m finals, and indeed four Scots had their championship final moment on the short track Getting us off to a flying start and the first medal of the day was W35 Stacey Downie (Edinburgh) who stormed home to take the silver medal, taking the Scottish W35 60m record down from 7.80s to 7.77s in doing so-huge congratulations Stacey!
The next athlete out was M80 Jim Smith (Motherwell) who was really unlucky to just miss out on the bronze medal in fourth place (9.82s). In the M60 final, Ron Hunter finished a fine 6th (8.06s), and then in the M55 we were back in the medals with Darren Scott delivering the bronze in a time of 7.53s.

On the 200m track it was the turn of the 800m runners to contest their respective heats to try and qualify for the finals on Tuesday night.
First out was M45 athlete Andrew Brown (Lasswade) who made light work of this stage of the competition delivering the fastest qualifying time in the age group (2:02.47).
Next was M50 Allan Cameron (VP-Glasgow) who was second in heat 2 in a time of 2:08.5 to take his place in the final. Ian McPherson (Corstorphine) was 6th in heat 1 of the M55 section, crossing the line in a new PB of 2:23.13 but sadly not progressing to the final, and following Ian was Graeme Gemmell (Bellahouston Harriers) who was 3rd in heat 5 of a huge M60 section of 33 athletes. Sadly 2:19.90 narrowly missed out on a spot in the final, such is the depth and quality in this age group.
Rounding up the 800 heats, W40 Jennifer Beattie (Kilmarnock) was fourth in heat 2 in 2:29.63 which was enough to earn a spot in the final.

In the field events it was a slightly quieter day, but there were still some excellent performances in big and competitive fields. Allan Leiper was first up in the M65 discus where he finished 8th with 38.36m. Meanwhile, Susan Jones (SVHC) had her opportunity at the W60 weight throw where she finished 7th with a 12.01m effort. M55 Darren Kerr was in action in the hammer, with a 49.02m (SB) effort good enough for 7th place, and in the W65 shot Claire Cameron delivered a SB performance of 9.27m for 5th overall. Our sole jumper of the day M60 Andrew Pringle (SVHC) finished 5th in the triple jump with 10.39m in a really tight competition where bronze was only 15cm ahead.

29/03/2026

📚 Tendons Don’t Age Well — The Science by Decade
Tendons are built in adolescence. By age 17, the collagen core of the Achilles tendon has stopped renewing. What follows is a slow, largely irreversible decline.
Teens: Collagen type I peaks. Tendon stem cells (TSPCs) are abundant, proliferating and tenogenic. The ECM is organised, parallel and mechanically robust.
30s: TSPC numbers begin falling. Cell doubling time slows — aged fibroblasts take approximately 3x longer to divide than young ones. Focal adhesion proteins redistribute away from the cell surface, impairing migration to injury sites.
40s–50s: Collagen synthesis drops. MMP-2 and MMP-9 activity rises while their inhibitors (TIMP-1, TIMP-2) fall — the balance tips toward degradation. Advanced glycation end-products (AGEs) accumulate, crosslinking collagen fibrils and increasing rigidity. Cell senescence accelerates via the ROCK and JAK-STAT pathways.
60s+: “Inflammaging” — chronic low-grade inflammation driven by elevated mtDNA, PGE2 and reduced antioxidant defences. TSPCs that remain are senescent, stiff, poorly migratory and produce type III rather than type I collagen. Healing capacity is severely compromised.
Tendinopathy affects 25% of adults. Heavy slow loading over 12+ weeks remains our strongest intervention.
🔵 Kwan et al. 2023 https://doi.org/10.3390/ijms242015183 ✅
🔵 Korcari et al. 2023 https://doi.org/10.1080/03008207.2022.2102004 ✅
🟢 Magnusson & Kjaer 2019 https://doi.org/10.1113/JP275450 ✅

🟡 Millar et al. 2021 https://doi.org/10.1038/s41572-020-00234-1

29/03/2026

EMTT works by stimulating early bone healing at a cellular level, not through mechanical input.
Research shows it enhances calcium signalling, collagen formation, and early mineralisation — particularly in the first 1–2 weeks.
In painful, swollen fracture cases, the focus is on reducing oedema, easing pain, and supporting the biology of healing.

29/03/2026

🦴 EMTT Timeline for Bone Healing (Clinically Relevant)

🔴 Phase 1: Inflammatory / Early Healing (Days 0–7)

What’s happening biologically:
• Haematoma → inflammatory cascade
• Early cell recruitment (MSCs, osteoprogenitors)
• Vascular signalling begins

What EMTT does here:
• ↑ Calcium signalling (cell activation)
• ↑ VEGF → angiogenesis (blood supply)
• ↑ Early gene activation (RUNX2, SP7)

👉 This is the MOST important window

💡 In your case (revision surgery / plating):
• Tissue has been “reset” → this phase is active again
• EMTT here = kick-start biology again

🟠 Phase 2: Soft Callus / Early Matrix (Week 1–3)

Biology:
• Collagen scaffold formation
• Early stability (not mineralised yet)

EMTT effect:
• ↑ Collagen production (COL1A1)
• ↑ Osteoblast activity
• ↑ Early mineralisation signals

👉 Accelerates the scaffold being laid down

💡 Clinically:
• Ideal time to continue EMTT regularly
• You’re influencing structure formation

🟡 Phase 3: Hard Callus / Mineralisation (Week 3–8+)

Biology:
• Calcium + phosphate deposition
• Transition to stronger bone

EMTT effect:
• ↑ Mineralisation early
• But effect starts to plateau

👉 EMTT becomes less dominant driver

💡 Clinically:
• Still useful, but diminishing returns
• Load + mechanical stimulus becomes more important

⚪ Phase 4: Remodelling (Months)

Biology:
• Bone reshaping along load lines

EMTT:
• Minimal additional effect

👉 This phase is load-dependent, not device-dependent

28/03/2026

March 2020

This email changed everything.
“I’m an 800/1500m runner. Right hamstring/glute. Seems more nerve than muscular. Eases on the track but aches on long runs and when sitting. Causing problems accelerating.”
He came in. We treated the hamstring. The gluteal pain disappeared. Nerve symptoms settling. He was returning to run. He had booked a race for the following day.
Mid-treatment session he said casually —
“While I’m here — can you just check my foot?”
I applied focused shockwave to his foot.
Spike pain.
I stopped immediately. That spike was the signal. Something was wrong.
He rushed to the foot surgeon. Rare stress fracture confirmed. Already healing — but racing the next day could have displaced it. Career over. Potentially worse.
Then the radiologist’s email arrived. Just in time.
He did not race.
MRI access was severely restricted. I was a key worker. EMTT + Focused + Radial Shockwave continued throughout the pandemic.
2024 — Haglund’s. Surgery recommended again.
No surgery. Again.
January 2026. Emirates Arena, Glasgow. 800m — 1:59. 1500m — 4:12.
Six years. Two surgeries avoided. Still competing at elite level.
Patient consent obtained. Full case publication 2026.


That is the real story Helen. Raw, clinical, dramatic and completely true. Ready for carousel captions?

03/01/2026

03/01/2026

📍 Ex-Military Knee Case: Patellar Tendinosis Since 2018

This 33-year-old ex-military patient developed chronic patellar tendinosis back in 2018 during field training while carrying heavy backpacks.

He’s now an amateur boxing enthusiast who’s committed years to quality rehab. Despite his excellent compliance and strength, impact activities like running and jumping still cause sharp pain below the kneecap, stopping him from enjoying the sport he loves at full capacity.

We’re supporting his recovery with:
✅ Shockwave therapy (ESWT)
✅ EMTT (Electromagnetic Transduction Therapy)
✅ Slow, heavy isometric loading on the leg extension machine — 70% bodyweight, 45-second holds, spaced every 2–3 days
✅ Respecting collagen timelines and avoiding overload

➡️ He’s now progressing through a structured return to sport — isometric → isotonic → controlled plyometrics.

🔬 The key message? Tendon healing takes structure, timing, and patience — not just “strength”.

📸 Full patient consent given for sharing this journey to help others.
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