Edinburgh Osteopath - Helen How

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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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.

03/01/2026

New evidence challenges the inevitability of hip surgery

A newly published 2025 retrospective cohort study with 4–10 year follow-up (119 hips) reports that non-surgical hip preservation can deliver durable pain relief and functional improvement in patients with osteonecrosis of the femoral head (ONFH) — even when radiological progression occurs.

🔹 Key findings
• ~91% hip survival (avoidance of THA or hip-preservation surgery)
• Significant improvements in pain and function (VAS, Harris Hip Score, iHOT-12, WOMAC)
• Clinical outcomes frequently outperformed imaging findings
• Best results in ARCO stages I–IIIa, with selected IIIb patients also maintaining acceptable long-term function

🔹 How conservative hip preservation was delivered
• Immediate load reduction with protective or partial weight-bearing
→ Crutches routinely used for several months
• Activity modification, avoiding early impact and high mechanical load
• Progressive, symptom-guided rehabilitation, focused on hip mobility and functional exercise
• Non-surgical management only
→ No surgery, injections, shockwave therapy, bisphosphonates, or vitamin D protocols reported

🔹 Why this matters
At a time when hip arthroplasty volumes continue to rise and younger patients face the prospect of multiple revisions over a lifetime, this study reinforces an important principle:

Symptoms and function — not imaging alone — should guide decision-making.

Conservative hip preservation should be considered a legitimate first-line or delay strategy for selected patients seeking to postpone arthroplasty.

🔗 Open-access article (published December 2025):
https://doi.org/10.5312/wjo.v16.i12.110291

03/01/2026

Achilles Tendonitis from Pain to Performing
It’s always word-of-mouth from fellow athletes and runners.
Over the past two years, I’ve treated at least ten endurance athletes with a similar, highly effective formula — combining Focused Shockwave Therapy (FSWT), EMTT, and Radial Shockwave to the calf complex, alongside structured isometric loading using the Smith machine.

This most recent case was referred by another athlete I follow on Instagram — a runner who previously overcame chronic Haglund’s insertional Achilles pain with the same approach and is now back competing at a high level.

The new referral, a dedicated ultra and marathon runner, began treatment on 15th August with a moderate, persistent mid-portion Achilles tendinopathy.
His rehab included:
🏋️‍♂️ 5 × 45-second Smith machine isometric holds at half bodyweight
⏱ 2-minute rest between sets, twice weekly
🗓 Always with a rest day between loading sessions

After just two sessions of Focused Shockwave, Radial Shockwave, and EMTT, he’s already shown:
✅ Dramatic reduction in swelling
✅ No tenderness on palpation
✅ Strong, pain-free loading tolerance

He’s now seven days out from his ultramarathon, running comfortably and symptom-free, with a fast marathon lined up for January.

⸻

💡 Why the Combination Works

Focused Shockwave and EMTT complement each other beautifully in tendon rehab.
• FSWT delivers targeted acoustic energy that stimulates collagen regeneration, angiogenesis, and tendon remodeling.
• EMTT enhances cellular metabolism, vascular repair, and anti-inflammatory activity through pulsed magnetic energy.
• Adding Radial Shockwave over the calf muscles optimises blood flow and muscle-tendon interaction, helping reduce overload through the kinetic chain.

When combined with structured isometric loading, the results speak for themselves — faster recovery, stronger tissue, and confident return to performance.

03/01/2026

2026 Clinical Perspective: Why Regenerative Medicine Matters More Than Ever

As we move into 2026, regenerative medicine has become increasingly important in musculoskeletal practice — not as a replacement for surgery, but as a necessary part of informed, proportionate clinical decision-making, particularly in elite and high-demand populations.

This feels especially timely following recent high-profile scrutiny within the Premier League, which has brought renewed attention to the irreversible nature of surgical intervention and the long-term consequences that can follow when timing, indication, or proportionality are misjudged.

The key lesson is not that surgery is wrong. Rather, it reinforces a core clinical principle:
when an intervention is irreversible, all credible non-operative and biological options should be meaningfully considered and discussed first.

Within this context, regenerative medicine pathways — including regulated MSC-based clinical trials — represent the careful translation of decades of research into patient-centred options. Grounded in long-term science and delivered within structured frameworks, these approaches sit alongside orthodox care, supporting shared decision-making and appropriate timing of intervention.

As clinicians move forward in 2026, the emphasis is clear:
better questions, better timing, and better choices — always in the service of patient welfare and long-term outcomes.

19/12/2025

19/12/2025

19/12/2025

https://www.instagram.com/p/DSc4ilODBfw/?igsh=MXc2eXd3emcyeTVwaw== Rejuvenation by Dr Morag

11/11/2025

https://www.dropbox.com/s/s3enz18eexz6916/AATD%20Sampson%20Lecture%205.21.mp4.mp4?dl=0

Shared with Dropbox

08/11/2025

🇸🇪 From 25 Years of Stem Cell Research in Sweden… to Clinical Trials in the Bahamas 🇧🇸

Did you know that the stem cells being used in new clinical trials in the Bahamas actually come from over 25 years of research in Sweden?

These mesenchymal stem cells (MSCs) are produced in a GMP – Good Manufacturing Practice – certified laboratory, which means they’re made to the same kind of standards used for medicines:
• Strict quality control at every step
• Careful checking of cell identity, purity and viability
• Continuous monitoring by the Swedish authorities

Once the cells are prepared under these pharmaceutical-grade conditions in Sweden, they’re cryo-shipped in liquid nitrogen all the way to the Bahamas, with GPS temperature tracking to make sure they stay at exactly the right conditions during the journey.

In the Bahamas, the cells are being used in regulated clinical trials looking at:
• Cardiovascular disease (CVD) prevention
• Musculoskeletal degeneration and injuries

The trials have been approved by The Bahamas National Stem Cell Ethics Committee and the Ministry of Health (October 2023). In Nassau, the cells are:
• Reconstituted in a dedicated laboratory under strict protocols
• Checked again for cell viability and cell counts
• Injected within a 2-hour window, to keep them as fresh and effective as possible for the study

It’s important to say that these are clinical trials, not routine treatments – the aim is to carefully test safety and potential benefits under controlled conditions.

But it’s exciting to see long-term Swedish stem cell science and high-level manufacturing standards now being applied in real-world trials that could shape future care for heart and musculoskeletal health.

As always, this is information, not personal medical advice – but I thought some of you would be interested in what’s happening behind the scenes in regenerative medicine. 💙

https://www.cellcolabsclinical.com/cellcolabs-clinical-webinar/