2 ATRAD

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SHOCK WAVE THERAPY

WORLD CONGRESS RADIAL

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B O CTO ER 30

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ATRAD Berlin 2010

WELCOmE

DEAR fRIENDS, COLLEAGuES, AND ALL THOSE INTERESTED IN RADIAL SHOCK WAVE THERAPY,
it is our privilege and pleasure to welcome you to the 2nd ATRAD World Congress on Radial Shock Wave Therapy (RSWT) in the sophisticated city of Berlin. With the help of Dr. John P. Furia (President of this congress), Marie-Christine Collet and Susan Wodtke (members of the organizing committee), we have assembled a meeting that will give you access to an internationally recognized group of practitioners, individuals who are among the brightest and most experienced in the field of RSWT. We invite you to this venue, and promise that you wont be disappointed! The 2nd ATRAD World Congress on RSWT will be dynamic, engaging, and interactive. Information will be provided through presentations, discussion of hot topics, updates, and poster presentations. We will encourage questions, discussion, and active participation from both lecturers and attendants. The one-day format of our congress is specifically designed to allow attendees the opportunity to discover the beauty of Berlin. Our pre and post meeting receptions will be less formal venues in which we can exchange ideas, socialize, and get to know one another. On behalf of our generous sponsors, existing ATRAD members, and my talented team, We wish you a successful congress.

Dr. Max Henzen, President of ATRAD

Felix Egloff, General Secretary of ATRAD

ATRAD Berlin 2010

OVERVIEW
Dr. Christoph Schmitz (Nyon, Switzerland; Munich, Germany) > Molecular and cellular mechanisms of radial shock wave therapy Dr. Ludger Gerdesmeyer (Kiel, Germany) > Radial shock wave therapy to treat plantar fasciopathy Dr. Nicola Maffulli (London, United Kingdom) > Radial shock wave therapy to treat Achilles tendinopathy Dr. John P. Furia (Lewisburg, PA, USA) > Radial shock wave therapy to treat greater trochanteric pain syndrome Dr. Markus Maier (Munich, Germany) > Radial shock wave therapy to treat calcifying tendonitis of the shoulder and tennis elbow Dr. Nick Boden (Kuala Lumpur, Malaysia) > Radial shock wave therapy to treat medial unilateral compartment osteoarthritis of the knee Dr. Paco Biosca (Donetsk, Ukraine) > Radial shock wave therapy for sport injuries of professional soccer players Dr. Kai-Uwe Schlaudraff (Geneva, Switzerland) > Radial shock wave therapy to treat cellulite Dr. Simon Locke (Brisbane, Australia) > Why do many patients benefit from radial shock wave therapy, but others do not? Dr. Herv de Labareyre (Paris, France) > Similarity between results of prospective, randomized controlled clinical trials using radial shock wave therapy and in day-to-day clinical use Dr. Bent Brask (Oslo, Norway) > Use of radial shock waves for improved diagnosis and treatment of lateral epicondyalgia Dr. Jan-Dirk Rompe (Mainz, Germany) > Study design: Treatment of idiopathic cervical pain with shock waves or a multimodal therapy approach

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SWISS DOLORCLAST mETHOD

lat. Capsicum annuum

RED CHILI PEPPERS OR THE SECRET Of THE SOOTHING EffECT Of mODERN SHOCK WAVE THERAPY WITH THE ORIGINAL SWISS DOLORCLAST mETHOD }
> Red chili peppers contain capsaicin. At first this substance overwhelms the so-called C nerve fibers responsible for transmitting pain but then disables them for an extended period of time. Everybody knows the feeling first, the mouth is on fire, then it feels completely numb > Research has indicated that shock wave therapy works the same way. When activated, the C nerve fibers release a specific substance (substance P) in the tissue as well as in the spinal cord. This substance is responsible for causing slight discomfort during and after shock wave treatment. However, with prolonged activation, C nerve fibers become incapable for some time of releasing substance P and causing pain > Less substance P in the tissue leads to reduced pain. But there is more: less substance P also causes so-called neurogenic inflammation to decline > A decline in neurogenic inflammation may in turn smooth the way to healing together with the release of growth factors and the activation of stem cells in the treated tissue

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ABSTRACTS

ATRAD Berlin 2010

PACO BIOSCA, SHARKHTAR DONETSK, uKRAINE

RADIAL SHOCK WAVE THERAPY fOR SPORT INjuRIES Of PROfESSIONAL SOCCER PLAYERS
TAKE-HOmE mESSAGE > Injuries of professional soccer players have their own special characteristics. There is more complexity around the injury than in the injury itself. Radial shock waves can play an important role in an integrated treatment concept in cases of tendon pathology. SPORT INjuRIES Of PROfESSIONAL SOCCER PLAYERS > The UEFA performed an injury study, starting in the season 2001/02, that included 17 European soccer clubs who participated in the season 2009/10, with eight of them participating in the quarter finals of the Champions League. Half of the training months had 21.4 days and 6.1 matches per month, without taking into account selections. Among all injuries that were reported, 32.7% were due to overuse. 18.5% of those injuries that prevented players from training for more than four weeks were related to tendons (adductor tendon pain: 9.5%, pubalgy: 3.0%, peroneal tendinopathy: 2.4%, Achilles tendinopathy: 1.8%, and patella tendinopathy: 1.8%). These (and other cases) are potential indications for radial shock wave therapy. VALuE PROPOSITION Of RSWT fOR SPORT INjuRIES Of PROfESSIONAL SOCCER PLAYERS > Because of the lack of universally applied standards in medical services of professional soccer teams, there are only a few publications on the results of injury treatment in professional soccer. In general, the evaluation of treatment success is pretty straightforward: the treatment was good if the player returns to his maximum performance level without missing competitions (or missing only a small number of them; and the treatment was bad if the player cannot play or needs more time to recover than established on average. We have used RSWT for several years to treat tendinoses and insertion pathologies, especially pathologies of the insertion of the adductor muscles which is our principle indication. In addition, we used RSWT for many years during the last phase of rehabilitation for proximal insertion pathologies of the medial knee ligament, but now we apply another method (PRGF). We have used this technique also with good results to treat lumbar vertebrae in posterior joints. Finally, we had good results in treating plantar fasciitis, where we treated about 73 cases.

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NICK BODEN, KuALA LumPuR, mALAYSIA

RADIAL SHOCK WAVE THERAPY TO TREAT PAIN ASSOCIATED WITH uNILATERAL COmPARTmENTAL OSTEOARTHRITIS Of THE KNEE
TAKE-HOmE mESSAGE > Radial shock wave therapy (RSWT) is a safe and efficient adjunct treatment for pain associated with unilateral osteoarthritis of the knee, when applied as part of a biomechanical bracing protocol using the Unloader knee brace. uNILATERAL COmPARTmENTAL OSTEOARTHRITIS Of THE KNEE > A recent study in Malaysia (called Community Oriented Program for the Control of Rheumatic Diseases; COPCORD) revealed that knee pain is the most common joint complaint (64%), while half of these patients showed clinical signs of knee osteoarthritis. The same study showed that 9.3% of adult Malaysians complained of knee pain, with a sharp increase in pain rate to 23% in those over 55 years of age, and 39% in those over 65 years. This may be due to various reasons including, but not limited to, lifestyle factors, foot biomechanics, BMI, injury, dietary deficiencies, excessive loading of the knee joint in a flexed position due to prayer position (Muslims), and excessive squatting (cultural habits). Existing primary care approaches involving NSAIDs and physiotherapy do not appear to significantly alter the course of the osteoarthritis, or have any significant impact on function and quality of life of these patients. EVIDENCE Of EffICACY AND SAfETY Of RADIAL SHOCK WAVE THERAPY (RSWT) TO TREAT PAIN RELATED TO uNILATERAL OSTEOARTHRITIS Of THE KNEE > Our own clinical experience showed no serious adverse incidents related to the treatment of knee pain with RSWT. A 2010 study showed that application of extracorporeal shock waves to the subchondral bone of the medial tibia condyle results in regression of osteoarthritis of the knees in rats. Furthermore, by unloading the knee and allowing normal biomechanics, the joint surfaces are able to heal, while RSWT may accelerate this healing process through previously demonstrated effects on bone morphological proteins and other molecular effects. VALuE PROPOSITION Of RSWT fOR KNEE PAIN RELATED TO uNILATERAL OSTEOARTHRITIS AS PART Of A BIOmECHANICAL uNLOADING PROTOCOL > We describe a protocol of intervention in these cases by providing a mechanical unloading of the knee using an Ossur Unloader knee brace, coupled with (i) RSWT treatment of the painful areas of the knee and (ii) muscular strengthening and rehabilitation through relevant physiotherapy exercises, to augment the effects of the brace. Clinical data from our centres show promise with this approach, compared to more traditional approaches. Early intervention seem to be beneficial.

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BENT BRASK, OSLO, NORWAY

uSE Of RADIAL SHOCK WAVES fOR ImPROVED DIAGNOSIS AND TREATmENT Of LATERAL EPICONDYALGIA
TAKE-HOmE mESSAGE > This clinical experience presentation shows how the use of radial shock waves at low energy levels can (i) help the clinician to identify pain producing areas around the elbow, and (ii) become an advanced palpation technique. BACKGROuND > In clinical studies and textbooks about evaluation and treatment of lateral epicondyalgia, the main focus has been the tissue on the epicondyle itself with the attachment of the extensor carpi radialis brevis muscle. Several ways of evaluation were described, where palpation of the most tender point is central. In my own clinical practice, I experienced that this approach gave good results in about 50% of all patients, which the research also supports. The remaining 50% needed a differential diagnosis, which included for example referred pain from the neck, trigger points in the shoulder, reduced neurodynamics, and other distant pain referring parts. It also became apparent that there are many structures locally around the epicondyle, other than the extensor carpi radialis brevis muscle, that could be pain producing and therefore needed to be part of a differential diagnosis. mATERIALS AND mETHODS > In this content it became apparent that the exploratory use of radial shock waves at low energy levels identified tissues that were tender, and that not necessarily could be identified easily by regular palpation. In this way, the clinician can identify primary locations and secondary contributing pain areas in a new and better way. RESuLTS > In our internal patient satisfaction review, 90% were completely free of symptoms after adequate treatment based on this novel diagnosis technique, and 100% of the patients were back at work.

ATRAD Berlin 2010

jOHN P. fuRIA LEWISBuRG, PA, uSA

RADIAL SHOCK WAVE THERAPY TO TREAT GREATER TROCHANTERIC PAIN SYNDROmE

TAKE-HOmE mESSAGE > Radial shock wave therapy is a safe and effective treatment for chronic greater trochanteric pain syndrome (GTPS); satisfactory improvement is maintained for at least one year. GREATER TROCHANTERIC PAIN SYNDROmE > GTPS is often a manifestation of underlying gluteal tendinopathy. GTPS afflicts both sedentary and athletic individuals, particularly runners and jumping athletes, and has a prevalence of approximately 19%. Risk factors include advanced age, excessive pronation, and training errors. Traditional treatment of GTPS is generally lengthy, associated with frequent recurrences, and in many cases, an unacceptable degree of improvement. Surgical results are mixed. Recovery from surgery is often lengthy and associated with incomplete symptom resolution. EVIDENCE Of EffICACY AND SAfETY Of RADIAL SHOCK WAVE THERAPY (RSWT) fOR GREATER TROCHANTERIC PAIN SYNDROmE > Meyer et al. (unpublished data, ISMST congress 2002) reported satisfactory results and improved VAS scores in 15 of 18 women with a one year history of chronic trochanteric bursitis treated with 1500 to 3000 shocks at various energy levels ranging from 0.03mJ/mm 2 to 0.2mJ/mm 2 . In two other uncontrolled pilot studies, Souza et al. (unplublished data, ISMST congress 2006) and Morrel et al. (unpublished data, ISMST congress 2008) reported good or excellent results (91% and 72%) in a similar cohort of patients. In a controlled trial with 12 month follow-up, Furia et al. (Am J Sports Med 2009;37:1806-1813) reported significant improvement in VAS, Harris Hip, and Roles and Maudsley scores in 33 patients treated with RSWT (2000 impulses; 4 bars of pressure, total energy flux density = 360 mJ/mm 2 ). Rompe et al. (Am J Sports Med 2009;37:1981-1990) compared corticosteroid injection, home stretching, and RSWT. At four month follow-up, RSWT yielded significantly better results than home stretching and injection. At 15 month follow-up, RSWT and home stretching yielded similar results, both better than corticosteroid injection. VALuE PROPOSITION Of RSWT fOR GREATER TROCHANTERIC PAIN SYNDROmE > RSWT is a safe and effective treatment for chronic GTPS. RSWT yields better results than corticosteroid injection, and better short-term results and equivalent long-term results than home stretching. Increased utilization of RSWT for chronic GTPS is justified and supported by the latest evidence.

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LuDGER GERDESmEYER, KIEL, GERmANY

RADIAL SHOCK WAVE THERAPY TO TREAT PLANTAR fASCIOPATHY

TAKE-HOmE mESSAGE
>

To determine the effectiveness of RSWT for chronic plantar heel pain.

mATERIALS AND mETHODS

254 patients were enrolled and assigned to RSWT or placebo. 2000 treatmentimpulses were applied at 0.4 Mpa without local anesthesia. 3 RSWT sessions were done with 2 weeks in between. The primary criteria were: heel pain when taking the
>

first steps and during daily activities. Second criteria were local pain on pressure, Roles and Maudsley-Score and SF-36. The primary point was 3 months after last RSWT, second endpoint at 12 months. The study was performed in accordance to GCP guidelines. RESuLTS 3 months after RSWT success was observed in all criteria. The rate difference in all items at 3 and 12 months after RSWT were statistically significant better in favour of the RSWT treatment. Regarding the percent change of VAS pain reduction on composite score 12 month after RSWT the reduction after RSWT was -84.8%, whereas the placebo group showed a 43.2%. The difference after 1 year was 41.6% percentage points. The group difference in favour of ESWT was further enlarged up to 12 month. The same outcome was found at secondary criteria as well. The a priori ordered hypotheses of the final statistical analysis plan were statistically significant (P < 0.025 one-sided). Only minor side effects as petecheal bleeding, swelling and discomfort during treatment were detected.
>

CONCLuSION > The radial shockwave therapy is effective, save and cost effective in treatment of chronic heel pain.

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HERV DE LABAREYRE, PARIS, fRANCE

SImILARITY BETWEEN RESuLTS Of PROSPECTIVE, RANDOmIzED CONTROLLED CLINICAL TRIALS uSING RADIAL SHOCK WAVE THERAPY AND IN DAY-TO-DAY CLINICAL uSE
TAKE-HOmE mESSAGE > Radial shock wave therapy (RSWT) has given us a real satisfaction in the treatment of various tendinopathies. However, based on relatively poor results obtained with RSWT for lateral and medial epicondylitis, we have started to treat tendinopathies of the elbow with focused shock waves using the Swiss PiezoClast . BACKGROuND > We began to use the Swiss Dolorclast method 11 years ago. Since then, we treated about 1,800 patients mainly for tendinopathies of the upper and lower limbs, but also for muscular strain seque laes. mATERIALS AND mETHODS > We realized a maximum of 6 sessions, once or twice a week according to the will of the patients. The results were always evaluated at least 6 weeks after the last treatment session, irrespective of preliminary results during the treatment. Treatments of plantar fasciopathies were evaluated two months after the last treatment session. We always gave advice to go on with sports practice in athletes, to the condition it was painless and avoiding explosive sports. Our usual treatment paradigm consisted of 2,000 impulses per treatment session, applied at 9 Hz, with pressure from 2 bars to higher values according to the toleration of the patients. We always tried to be as strong as possible, without any anesthesia. RESuLTS > We obtained the following relative numbers of patients with good results: calcaneal tendon pathology: 75%; calcaneal enthesopathy: 65%; plantar fasciopathy: 67%; hamstring pain: 76%; patella tendinopathy: 63%; rotator cuff pathology of the shoulder: 70%; and medial and lateral epicondylitis: 54% and 59%, respectively. Side effects were always minor. Only six patients declared to be worse after the treatment (0.3%). Only 30 patients were treated for muscular residual pain, and 80% of them were improved after an average of 3.75 treatment sessions. In general, the number of treatment sessions per week had no influence on the treatment outcome. Thus, the total number of treatment sessions could decrease when only one treatment per week was given. Importantly, the results of this open study are very similar to results reported about the use of radial shock wave therapy in the scientific literature.

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SImON LOCKE, mICHAEL HuO, BRISBANE, AuSTRALIA

WHY DO mANY PATIENTS BENEfIT fROm RADIAL SHOCK WAVE THERAPY, BuT OTHERS DO NOT?
TAKE-HOmE mESSAGE > As a clinician, I want to know which patients will and who will not benefit from RSWT treatment; analyzing responses to treatment indicates who improves with treatment and what their risk of improvement is. BACKGROuND > The benefits of RSWT in various tendinopathies and fasciopathies are well documented. However, there are still a number of patients who do not benefit from treatment. Identifying those patients who do not improve is still difficult for a clinician. How do patients get better? Are successive treatments associated with continuous decreases in pain? Is it possible to identify non responders using demographic data and response rates to treatment? mATERIALS AND mETHODS > This was a clinical audit of 62 patients, treated by the same clinician. We used a pain intensity measure (Numerical Rating System NRS) for pain when patients first rose in the morning and for the previous day. Clinical diagnoses included mid Achilles tendinopathy (n=13), insertional achilles tendinopathy (n=17), and plantar fasciopathy (n=28). Four patients had incomplete data at follow-up, and n=58 complete sets were available for analysis. Outcome measures included substantial response (>50% reduction NRS), moderate response (30-49%), and no response. For patients with plantar fasciopathy, a patient reported outcome (PRO) was also analyzed. RESuLTS > The average age was 54 years, and 62% were female. Symptom duration averaged 9 months, and follow-up duration 8 months. Initial pain first thing in the morning was 6.2 (95% confidence interval [CI] 5.7-6.8). Collectively, 65.5% (95% CI 52.7-76.4) achieved a substantial reduction in NRS, and 6.9% (95% CI 2.7-16.4) a moderate reduction. Non-responders accounted for 27.6% (95% CI 17.7-40.2) of all patients. This equates to a treatment effect size of 2.56 in patients with a substantial response, and 0.03 in non-responders. Demographically, there was no difference between substantial responders and non-responders. The pattern of NRS score reduction during treatment discriminated between substantial responders and non-responders. All and much better in the PRO analysis also corresponded to a pain reduction of 50%.

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NICOLA mAffuLLI, LONDON, uNITED KINGDOm

RADIAL SHOCK WAVE THERAPY TO TREAT ACHILLES TENDINOPATHY

TAKE-HOmE mESSAGE > Radial shock wave treatment for chronic non-insertional Achilles tendinopathy is safe and effective, but should be combined with eccentric loading. ACHILLES TENDINOPATHY > Excessive repetitive overload of tendons is regarded as the main pathological stimulus which leads to tendinopathy. The tendon may respond to repetitive overload beyond physiological threshold by either inflammation of its sheath, or degeneration of its body, or by a combination of both. Tendinopathy has been attributed to a variety of intrinsic and extrinsic factors. Vascularity, dysfunction of the gastrocnemius -soleus muscle, age, gender, body-weight and height, are considered to be common intrinsic factors. Changes in training pattern, poor technique, and previous injuries are common extrinsic factors which may predispose the athlete to tendinopathy. The management of Achilles tendinopathy is primarily conservative. Although many non-operative options are available, few have been tested under controlled conditions. EVIDENCE Of EffICACY AND SAfETY Of RADIAL SHOCK WAVE THERAPY (RSWT) fOR ACHILLES TENDINOPATHY > We enrolled sixty-eight patients with chronic recalcitrant (>6 months) non-insertional Achilles tendinopathy in a randomized controlled study. All patients had received unsuccessful management for >3 months, including at least peritendinous local injections, nonsteroidal anti-inflammatory drugs, and physiotherapy. Analysis was on an intention-to-treat basis. At 4 months from baseline, the VISA-A score increased in both groups, from 50 to 73 points in group 1 (eccentric loading) and from 51 to 87 points in group 2 (eccentric loading plus RSWT). Pain rating decreased in both groups, from 7 to 4 points in group 1 and from 7 to 2 points in group 2. Nineteen of 34 patients in group 1 (56%) and 28 of 34 patients in group 2 (82%) reported a Likert scale of 1 or 2 points (completely recovered or much improved). For all outcome measures, groups 1 and 2 differed significantly in favor of the combined approach at the 4-month follow-up. At one year from baseline, there was no difference any longer, with 15 failed patients of group 1 opting for having the combined therapy as cross-over, and with 6 failed patients of group 2 having undergone surgery. At 4-month follow-up, eccentric loading alone was less effective when compared with a combination of eccentric loading and repetitive RSWT.

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mARKuS mAIER, muNICH, GERmANY

RADIAL SHOCK WAVE THERAPY TO TREAT CALCIfYING TENDONITIS Of THE SHOuLDER AND TENNIS ELBOW
TAKE-HOmE mESSAGE > RSWT is an established, safe and efficent method in the treatment of chronic courses of calcifying tendonitis of the shoulder and tennis elbow. CALCIfYING TENDONITIS Of THE SHOuLDER AND TENNIS ELBOW > The exact etiology of calcifying tendonitis of the shoulder is still unknown. The disease might be based on a disturbed blood supply of the rotator cuff tendons. The pathogenesis is in context with an inflammation. Calcifying tendonitis of the shoulder is found in approximately 2% of an asymptomatic population; however, it is a common cause for shoulder pain and dysfunction in patients aged between 30 to 50 years. Tennis elbow as a clinical syndrome has a huge number of etiologies and pathogeneses, sharing the characteristic of pain on the radial epicondyle of the distal humerus. Pain can be provoked by various manoevers, all stressing the common extensor tendon. Tennis elbow is a very common syndrome, mainly found in people doing monotonic movements, such as screwing. EVIDENCE Of EffICACY AND SAfETY Of RADIAL SHOCK WAVE THERAPY (RSWT) fOR CALCIfYING TENDONITIS Of THE SHOuLDER AND TENNIS ELBOW > The typical RSWT for the treatment of calcifying tendonitis of the shoulder and tennis elbow uses energy-flux-densities (EFD) between 0.05 and 0.35 mJ/mm 2 , with almost no unwanted side effects. In general, if a calcific deposit is aimed to be cracked, higher EFD levels (approximately 0.35 mJ/mm 2 ) should be used. Our own treatment protocol in calcifying tendonitis of the shoulder is as follows: localize the deposit by ultrasouund, and apply RSWT in 3 to 5 sessions (one session per week), with 3,000 pulses per session, 8 to 10 Hz, 2.5 3.5 bar, Swiss DolorClast Power + handpiece. RSWT for tennis elbow is in compare to the treatments of the shoulder signed by a diminished effect of pain relief. This is due to the very different etiologies of this syndrome. Our own treatment protocol in tennis elbow is asl follows: 3 to 5 sessions (one session per week), 3,000 pulses, 8 to 10 Hz, 2.0 3.0 bar, Swiss DolorClast Radial handpiece. VALuE PROPOSITION Of RSWT fOR CALCIfYING TENDONITIS Of THE SHOuLDER AND TENNIS ELBOW > Today, RSWT is the best evaluated conservative (and surgical) treatment modality in chronic courses of calcifying tendonitis of the shoulder and tennis elbow.

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jAN-DIRK ROmPE, mAINz, GERmANY

STuDY DESIGN: TREATmENT Of IDIOPATHIC CERVICAL PAIN WITH SHOCK WAVES OR A muLTImODAL THERAPY APPROACH
TAKE-HOmE mESSAGE > Prospective randomized action needs to be taken to assess the potential benefit of shock wave therapy for chronic nonspecific muscle pain in the neck region. IDIOPATHIC CERVICAL PAIN > Non-specific neck pain is a common musculoskeletal problem, and most people suffer from it at some point in their lives. Precise diagnosis by clinical examination is problematic, because signs and symptoms are frequently non-specific, with poor reproducibility. EVIDENCE Of EffICACY AND SAfETY Of RADIAL SHOCK WAVE THERAPY (RSWT) AND OTHER THERAPY APPROACHES fOR IDIOPATHIC CERVICAL PAIN > In a systematic search for relevant literature published from 1980 through 2006 on the use, effectiveness, and safety of non-invasive interventions for neck pain, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (Hurwitz et al., Spine 2008;33:S123-S152). The evidence suggests that manual therapy, supervised exercise interventions (Griffiths et al., J Rheumatol 2009;36:390-397), low-level laser therapy, and acupuncture (Fu et al., J Altern Complement Med 2009;15:133-145) are more effective than no treatment, sham, or alternative interventions. However, none of the active treatments was clearly superior to any other in either the short- or long-term. There are only anecdotal reports on the use of focused or radial shock waves for muscle-related pain syndromes. Nevertheless, current guidelines of the German-speaking International Society for Extracorporeal Shock Wave Therapy (Deutschsprachige Internationale Gesellschaft fr Extrakorporale Stowellentherapie; DIGEST) give precise instructions on the use of shock waves in the management of muscle-related pain syndromes (see also Gleitz, Abstracts 10 th International Congress of the International Society for Musculoskeletal Shock wave Therapy, Vancouver, Canada, 2007, p. 48.). According to these guidelines, points of maximum tenderness (PMT) are identified using application of focused low-energy shock waves, then 400 impulses per PMT are applied (energy flux density ~0.15 mJ/mm, repetition frequency 4 Hz). Afterwards, the muscles are treated as a whole, smoothing them out using radial shock waves (500 impulses per muscle, energy flux density ~0.15 mJ/mm, repetition frequency 10 Hz). Eight 15-minute treatment sessions shall be given (two sessions per week, over four weeks) No local anaesthesia is applied to allow patient-guided application. VALuE PROPOSITION Of SHOCK WAVE THERAPY OR A muLTImODAL THERAPY APPROACH fOR IDIOPATHIC CERVICAL PAIN > Our null hypothesis is that shock wave therapy, supervised exercise therapy, and acupuncture will do comparably at four months from baseline.

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KAI-uWE SCHLAuDRAff, CONCEPT-CLINIC, GENEVA, SWITzERLAND

RADIAL SHOCK WAVE THERAPY TO TREAT CELLuLITE

TAKE-HOmE mESSAGE > Radial shock wave therapy (RSWT) has shown promising early results in treating cellulite as a multifactorial pathology. CELLuLITE > Gynoid lipodystrophy - better known as cellulite - is the most common lipodystrophic disease, and is found in 85-90% of post-adolescent women. It develops in the thigh area, buttocks, abdomen, and upper arms, and becomes visible through its orange peel appearance an irregular, dimpled skin surface with thinning of the epidermis/dermis and nodular clusters of fat cells. Cellulite represents not only a cosmetic concern for millions of women, but often becomes a major psychological problem impairing sports activities, clothing, and social interaction. The pathophysiology of cellulite is related to various predisposing factors like biotype, heredity, race, body weight, and age, as well as hormonal changes. Four principal factors have emerged: (i) a different anatomy of the subcutaneous tissue in women compared to men; (ii) changes of the biomechanical properties of epidermal/dermal tissues; (iii) excessive hydrophilia of the extracellular matrix, increasing interstitious pressure and causing edema; and (iv) alterations of both microvascular and lymphatic circulation, resulting in the protrusion of subcutaneous adipose tissue into the lower reticular dermis, as well as in the distinctive mattress-like surface irregularities. EVIDENCE Of EffICACY AND SAfETY Of RSWT TO TREAT CELLuLITE > RSWT has been successfully used in plastic surgery for chronic diabetic foot ulcers, and in an experimental setting to improve skin flap survival. The present pilot study on n=30 women suffering from cellulite showed a beneficial treatment effect for RSWT with regard to blood perfusion, edema, and cellulite stage, as well as a decrease of surface irregularities. An ongoing study will show the impact of RSWT for cellulite on skin elasticity and the duration of its positive effects.

ATRAD Berlin 2010

CHRISTOPH SCHmITz, NYON, SWITzERLAND

mOLECuLAR AND CELLuLAR mECHANISmS Of RADIAL SHOCK WAVE THERAPY

TAKE-HOmE mESSAGE > The current knowledge about the molecular and cellular mechanisms of action of radial and focused shock waves can serve as basis to develop innovative treatment strategies for various diseases of the musculoskeletal system, the skin, and other organs in the near future. CuRRENT KNOWLEDGE ABOuT mOLECuLAR AND CELLuLAR mECHANISmS Of RADIAL SHOCK WAVE THERAPY (RSWT) > The molecular and cellular mechanisms of RSWT are still largely unknown. However, a recent study on transgenic mice showed that RSWT can induce the formation of new capillaries and increase the functional vessel density in injured tissue. These effects are known to be mediated by (focused) extracorporeal shock wave therapy (ESWT) as well. It is therefore hypothesized that RSWT and ESWT share key molecular and cellular mechanisms of action in tissue. This is most probably due to the fact that both radial and focused shock waves can produce (inertial) cavitation (at least in experimental settings in water). CuRRENT KNOWLEDGE ABOuT mOLECuLAR AND CELLuLAR mECHANISmS Of ExTRACORPOREAL SHOCK WAVE THERAPY IN GENERAL > For ESWT, several molecular and cellular mechanisms of action were reported in the international peer-reviewed literature. Among them, the most important are (i) depletion of substance P from free nerve endings, (ii) increased production and release of growth factors such as bone morphogenetic protein (BMP), vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA), (iii) stimulation of angiogenesis and promotion of capillarization, (iv) proliferation of adult stem cells, (v) new bone formation, and (vi) tissue regeneration. Very recently, ESWT-induced expression of lubricin in tendons and septa was reported. VALuE PROPOSITION Of ImPROVED KNOWLEDGE ABOuT mOLECuLAR AND CELLuLAR mECHANISmS Of RSWT > Detailed knowledge about the molecular and cellular mechanisms of action of RSWT in tissue can serve as the basis to develop innovative treatment strategies for various diseases of the musculoskeletal system, the skin, and other organs. For example, the treatment of insertion tendinopathies with both platelet-rich plasma injections and RSWT appears promising from a theoretical point of view, and first clinical trials have been started in this regard.

WAVE fRONT }

HYDROPHONE }

SECONDARY SHOCK WAVES }

CAVITATION BuBBLES } DOLORCLAST APPLICATOR }

RADIAL SHOCK WAVE

SHOCK WAVE fOCuS }

CAVITATION BuBBLES } SECONDARY SHOCK WAVES }

PIEzOCLAST APPLICATOR }

fOCuSED SHOCK WAVE

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fACuLTY

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fACuLTY

PACO BIOSCA
CuRRENT POSITION > Director of the Department of Medicine and Sport Adaptation, FC Shakhtar Donetsk, Donetsk, Ukraine (since 2005) EmPLOYmENT HISTORY (KEY POSITIONS) > President of EFOST (European Federation of Orthopedic and Sports Traumatology) > President of SETRADE (Spanish Society of Sports Traumatology) > President of the Biomedical Society of Iberia EDuCATION > Professor Titular of Anatomy (INEFLleida) > Director/Master of Medical Science in Sports (19982005) AWARDS > Best Spanish Doctor of Sport Medicine KEY PuBLICATIONS > Head Doctor - tennis competitions Olympic Games (Barcelona, Spain, 1992)

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fACuLTY

NICK BODEN
CuRRENT POSITION > Director of the ATRAD Malaysia Office based in Kuala Lumpur, Malaysia (since 2010) > COO of TONIK ASIA (Integrated Healthcare) Group, Kuala Lumpur, Malaysia (since 2009) EmPLOYmENT HISTORY (KEY POSITIONS) > 2008 Beijing Olympic Committee trainer of athletes village polyclinic doctors and physiotherapists with the use of the Swiss Dolorclast Radial Extracoporeal Shock wave therapy > 2003-2005 Chiropractic Consultant, Twin Towers Medical Centre, Kuala Lumpur > 2002 Media Officer: South African Mens Hockey Team - Hockey World Cup > 2004 Athens Olympic Games, Greece > 2004 Athens Olympic Qualifying tournament, Greece > 2003 Afro-Asian games, Hyderabad, India > 2003 World Student Games, South Korea > 2003 Hockey Champions Challenge Johannesburg, South Africa > 2002 Manchester Commonwealth Games, UK > 2002 Hockey World Cup Kuala Lumpur, Malaysia > 2001 Hockey Champions Challenge, Kuala Lumpur, Malaysia > 2001 Junior Mens World Cup, Hobart, Australia > 2001 World Student Games, Beijing, China > 2000 4 Nations Championship, Australia EDuCATION > Masters Degree in Chiropractic (Durban University of Technology) 2002 > South African Matric > GCSE OLevels

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BENT BRASK
CuRRENT POSITION > Owner and daily leader of the Manuell Terapi Klinikken stfold A/S, Oslo, since 1994 EmPLOYmENT HISTORY (KEY POSITIONS) > 2004-2009 Clinical supervisor Norwegian Manual Therapy Education > 1990-1994 Leirvik fysikalske institutt, Dokka, Norway > 1983-1989 Athlete in Action sports medicine, California, USA EDuCATION > 2004 Certified clinical supervisor for Norwegian Manual Therapy Education > 1994 Certified Norwegian Manual Therapist, Oslo, Norway > 1983 Certficate of Physical Therapy, University of Iowa, USA KEY PuBLICATIONS > Brask B, et.al (1984) An electromygrapic evaluation of selected muscles during the lateral step up test. Pys Ther 64:324

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jOHN P. fuRIA
CuRRENT POSITION > Partner, SUN Orthopedics and Sports Medicine, Lewisburg, PA, USA (since 1995) > Managing Partner, SUN Surgical Center, LLC, Lewisburg, PA, USA (since 2007) > CEO, Evangelical Ambulatory Surgical Center, Lewisburg, PA, USA (since 2007) > Chairman of Board of Directors, Evangelical Ambulatory Surgical Center, Lewisburg, PA, USA (since 2003) EmPLOYmENT HISTORY (KEY POSITIONS) > 2003-2008 President, Susquehanna Valley Medical and Surgical Park, LLC, Lewisburg, PA, USA > 2003-2008 President, Old Trail Imaging, LLC, Lewisburg, PA, USA > 1996-2002 Director, Sports Medicine, Evangelical Community Hospital, Lewisburg, PA, USA EDuCATION > 1994-1995 Sports Medicine Fellowship, Baylor College of Medicine, Houston, TX, USA > 1990-1994 Orthopedic Residency, University of Rochester Medical Center, Rochester, NY, USA > 1989-1990 General Surgical Internship, St. Lukes/Roosevelt Hospital/Columbia University, New York, NY, USA > 1985-1989 MD/Ciba-Geigy Distinction in Community Service,Vanderbilt University School of Medicine, Nashville, TE, USA AWARDS > 2009 Achilles Orthopedic Sports Medicine Research Award, 7th Biennial ISAKOS Congress, Osaka, Japan KEY PuBLICATIONS > Furia JP, Juliano PJ, Wade A, Schaden W, Mitterymayer R (2010) Shock wave therapy as a treatment for non-union of the proximal fifth metatarsal metaphyseal (Jones) fracture. J Bone Joint Surg Am 92:846-854 > Furia JP, Rompe JD, Maffulli N (2009). Low energy extracorporeal shock wave therapy as a treatment for greater trochanteric pain syndrome. Am J Sports Med 37:1806-1813 > Furia JP (2008) High-energy extracorporeal shock wave therapy as a treatment for chronic noninsertional Achilles tendinopathy. Am J Sports Med 36:502-508

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LuDGER GERDESmEYER
CuRRENT POSITION > Chairman: Dept. Orthopedic Surgery and Traumatology, University of Kiel, Kiel, Germany (since 2010) > President of the ISMST International Society of Medical Shock Wave Therapy (since 2010) > Chairman: Dept. Joint Replacement, Tumor Surgery and Spine surgery, MARE Clinic Kiel, Kiel, Germany (since 2006) EmPLOYmENT HISTORY (KEY POSITIONS) > Since 2006 Chairman Dept. clinical research, MARE Clinic, Kiel, Germany > Since 2004 Faculty member of ISMST > Since 2003 Faculty member of DIGEST (DIGEST President in 2007) and Faculty of Kyphoplasty > Since 2003 Fellow of the interventional Pain Practice (FIPP) Texas Tech University, Lubbock, Texas, USA and international fellow of the AAOS > Since 2002 Chairman Konsensus group Evidence based medicine and Vice Chairman Working group shock wave therapy of the DGOOC > 1997-2006 Vice Chairman and Associated Professor of the Technical University in Munich, Germany, Dept. Orthopedic Surgery and Traumatology > 1995-1997 Consultant Orthopedic Surgery and Traumatology, University of Lbeck, Germany > 1994-1995 Fellow Sportstraumatology Sportsmedical Center, Kiel, Germany > 1993-1994 Fellow General Surgery, Burg, Germany > 1991-1992 Fellow Orthopedic Surgery and Traumatology Lubinus Klinik , Kiel, Germany AWARDS > SICOT Award in 2002 and 2003 > DIGEST Award in 2003 and 2007 KEY PuBLICATIONS > Gerdesmeyer L, Frey C,Vester J, Maier M, Weil L Jr, Weil L Sr, Russlies M, Stienstra J, Scurran B, Fedder K, Diehl P, Lohrer H, Henne M, Gollwitzer H. (2008) Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med 2008;36:2100-2109 > Principal investigator of two FDA studies proving the efficacy of extracorporeal shock wave therapy on painful heel > Review editor of several national and international medical journals

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HERV DE LABAREYRE
CuRRENT POSITION > Sports Traumatologist, Orthopedic Surgery Service, Piti-Salptrire Hospital, Paris, France (since 1985) EmPLOYmENT HISTORY (KEY POSITIONS) > 1985-1999 Medical supervisor of the French National Track and Fields Team KEY PuBLICATIONS > de Labareyre H, Saillant G (2001) Tendinopathies calcanennes: formes cliniques et valuation de lefficacit du traitement par ondes de choc radiales [Achilles tendinopathies: clinical cases and evaluation on the efficiency of radial shock wave therapy]. J Traumatol Sport 18:59-69 > de Labareyre H, Grun-Rehomme M, Saillant G (2002) A propos du traitement par ondes de choc radiales sur les tendinopathies calcanennes: actualisation des rsultats [Status of radial shock wave therapy on Achilles tendinopathies: update of results]. J Traumatol Sport 19:244-246 > de Labareyre H, Saillant G: Traitement des tendinopathies calcanennes par ondes de choc [Treatment of Achilles tendinopathies with radial shock waves]: ondes de choc extra-corporelles en mdecine orthopdique, Sauramps Mdical, Montpellier, 2004, pp. 48-54

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SImON LOCKE
CuRRENT POSITION > Sport and exercise Physician, Queensland Centre of Sport and movement, Brisbane, Qld, Australia > Senior Lecturer, School of Human Movement Studies, University of Queensland > Honorary Research Fellow, Centre of Excellence, Queensland Academy of Sport, Brisbane, Qld, > Medical consultant, Queensland Academy of Sport EmPLOYmENT HISTORY (KEY POSITIONS) > 1990-2010 Sports and Exercise Physician > 1991-2004 Medical coordinator Queensland Academy of Sport > 1991-2004 Medical coordinator Australian Institute of Sport, Queensland > 1999-2003 Vice President Australasian College of Sports Physicians > 1995-2000 Olympic Athlete Program, National medical committee EDuCATION > 1972-75 B Med Sci, MBBS, University of Tasmania > 1982 Fellow Royal Australian College of General Practitioners > 1990 Fellow Australian Sports Medicine > 1991 Fellowship Australasian College of Sports Physicians > 2006 Foundation Fellow Faculty Sport and Exercise Medicine (UK), College of Surgeons, Physicians AWARDS > 1999 Sports Medicine Australia State Conference Queensland Best Paper > 2006 Kevin Hobbs memorial lecture, Sports Medicine Australia Queensland conference KEY PuBLICATIONS > Locke S, Marks G (2007) Are the prevalence and treatment of asthma similar in elite athletes and the aged matched non-athlete population Scand J Med Sci Sports 17:623627 > Dutoit N, Locke S (2007) An audit of clinically relevant abnormal laboratory parameters investigating athletes with prolonged symptoms of fatigue. J Sci Med Sport 10:351-355 > Locke S, Osborne M, ORourke P (2009) Persistent fatigue in young athletes: Measurement of recovery and identification of variables that affect recovery or prognosis Scand J Med Sci Sports: Epub ahead of print 5 Nov 2009

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NICOLA mAffuLLI
CuRRENT POSITION > Centre Lead and Professor of Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, London, UK (since 2008) EmPLOYmENT HISTORY (KEY POSITIONS) > 2001-2008 Professor of Trauma and Orthopedic Surgery, University of Keele Medical School, Keele, UK > 1996-2001 Senior Lecturer in Orthopedics, University of Aberdeen Medical School, Aberdeen, UK > 1995-1996 Lecturer in Orthopedics and Associate Professor in Orthopedics and Traumatology, Chinese University of Hong Kong, Hong Kong EDuCATION > 1983-1986 Residency in Orthopedics, Ospedale Cardarelli, Napoli, Italy; Ospedale C.T.O., Napoli, Italy; and First Institute of Orthopedics, Napoli, Italy EDITORIAL BOARD mEmBERSHIPS > 2000- Clinical Journal of Sport Medicine since 2000 > 2000- Knee Surgery, Arthroscopy and Sports Traumatology > 2001- British Journal of Sports Medicine > 2005- The Knee > 2006- Surgeon > 2006- Journal of Bone and Joint Surgery (British Volume) KEY PuBLICATIONS > Rompe JD, Furia J, Maffulli N (2009) Eccentric loading versus eccentric loading plus shock-wave treatment for midportion achilles tendinopathy: a randomized controlled trial. Am J Sports Med 37:463-470 > Rompe JD, Furia J, Maffulli N (2008) Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy. A randomized controlled trial. J Bone Joint Surg (Am) 90:52-61 > Rompe JD, Nafe B, Furia J, Maffulli N (2007) Eccentric loading, shock wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achillis: a randomized controlled trial. Am J Sports Med 35:374-383 > Rompe JD, Furia J, Weil L, Maffulli N (2007) Shock wave therapy for chronic plantar fasciopathy. Br Med Bull 81-82:183-208

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mARKuS mAIER
CuRRENT POSITION > Orthopedic Ambulatory Center Starnberg, Germany (since 2005) > Associated Professor of Orthopedics, Ludwig-MaximiliansUniversity, Munich, Germany (since 2008) > Founding member and member of the executive board of DGWT (German Spine Society) (since 2005) EmPLOYmENT HISTORY (KEY POSITIONS) > 2004-2005 Member of the medical board of managers, Rheumazentrum Oberammergau, Germany > 1996-2004 Dept. of Orthopedic Surgery, Ludwig-Maximilians-University, Munich, Germany > 1994-1996 Dept. of Common Surgery, Johannes-Gutenberg University Mainz, Germany EDuCATION > 1989-1994 Orthopdische Klinik Wiesbaden, Germany > 1993 Bundeswehrzentralkrankenhaus, Koblenz, Germany > 1986-1993 Johannes-Gutenberg University Mainz, Germany AWARDS > 2004 Innovation award of the Deutschsprachige Internationale Gesellschaft fr Extrakorporale Stowellentherapie (DIGEST) KEY PuBLICATIONS > Hausdorf J, Lutz A, Mayer-Wagner S, Birkenmaier C, Jansson V, Maier M. Shock wave therapy for femoral head necrosis - pressure measurements inside the femoral head. J Biomech 2010;43:2065-2069 > Hausdorf J, Lemmens MA, Heck KD, Grolms N, Korr H, Kertschanska S, Steinbusch HW, Schmitz C, Maier M. Selective loss of unmyelinated nerve fibers after extracorporeal shock wave application to the musculoskeletal system. Neuroscience 2008 ;155:138-144 > Hausdorf J, Lemmens MA, Kaplan S, Marangoz C, Milz S, Odaci E, Korr H, Schmitz C, Maier M. Extracorporeal shock wave application to the distal femur of rabbits diminishes the number of neurons immunoreactive for substance P in dorsal root ganglia L5. Brain Res 2008;1207:96-101 > Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C. Substance P and prostaglandin E2 release after shock wave application to the rabbit femur. Clin Orthop Relat Res 2003;(406):237-245 > Maier M, Milz S, Tischer T, Mnzing W, Manthey N, Stbler A, Holzknecht N, Weiler C, Nerlich A, Refior HJ, Schmitz C. Influence of extracorporeal shock-wave application on normal bone in an animal model in vivo. Scintigraphy, MRI and histopathology. J Bone Joint Surg Br 2002,4:592-599

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jAN-DIRK ROmPE
CuRRENT POSITION > Orthopedic Surgeon OrthoTrauma Evaluation Center, Mainz, Germany Orthopdie im Centrum, Alzey, Germany Department of Surgery, Red Cross Hospital, Alzey, Germany EmPLOYmENT HISTORY (KEY POSITIONS) > 2005-2007 OrthoTrauma Clinic, Grnstadt, Germany > 2003 Adjunct Professor, Johannes Gutenberg University School of Medicine, Mainz, Germany > 1990-2005 Dept. of Orthopedic Surgery, Johannes Gutenberg University School of Medicine, Mainz, Germany (head: Prof. Dr. J. Heine) > 1988-1990 Dept. of Surgery, Bad Mergentheim, Germany (head: Prof. Dr. W. Schaudig) > 1987-1988 Military physician EDuCATION > 1997 Venia legendi for Orthopedic Surgery, Johannes Gutenberg University School of Medicine, Mainz, Germany > 1980-1986 Study of Medicine, Ruprecht-Karls-University, Heidelberg, Germany KEY PuBLICATIONS > Rompe JD (2009) Plantar fasciopathy. Sports Med Arthrosc 17:100-104 > Rompe JD, Furia J, Maffulli N (2009) Eccentric loading versus eccentric loading plus shock wave treatment for midportion achilles tendinopathy: a randomized controlled trial. Am J Sports Med 37:463-470 > Rompe JD, Furia J, Maffulli N (2008) Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy. A randomized controlled trial. J Bone Joint Surg (Am) 90:52-61 > Rompe JD, Nafe B, Furia J, Maffulli N (2007) Eccentric loading, shock wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achillis: a randomized controlled trial. Am J Sports Med 35:374-383 > Rompe JD, Furia J, Weil L, Maffulli N (2007) Shock wave therapy for chronic plantar fasciopathy. Br Med Bull 81-82:183-208

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KAI-uWE SCHLAuDRAff
CuRRENT POSITION > Private plastic surgery practice Concept-Clinic, Geneva, Switzerland (since 2008) > Scientific advisor for adipose derived stem cell therapy at Cytori Therapeutics, San Diego, CA, USA > Scientific advisor for soft tissue therapy at EMS Electro Medical Systems, Nyon, Switzerland > Member of ISAPS - International Society of Aesthetic Plastic Surgery > Fellow of the European Board of Plastic, Reconstructive and Aesthetic Surgery (EBOPRAS) > Swiss Diploma (FMH) for Plastic, Reconstructive, Aesthetic Surgery EmPLOYmENT HISTORY (KEY POSITIONS) > 2006-2007 Associate plastic surgeon, Crossklinik, Basel, Switzerland > 2006 Specialization in Aesthetic Surgery Chicago (IL), New York (NY) and Marina del Rey(CA), USA > 2004-2005 Registrar Plastic and Reconstructive Surgery, University Hospital Geneva, Geneva, Switzerland (head: Prof. B Pittet) > 2000-2004 Resident Plastic and Reconstructive Surgery, University Hospital Geneva, Geneva, Switzerland (head: Prof. D. Montandon) EDuCATION > 1998 MD thesis: Induction of a local in situ-neoangiogenesis by the use of human growth factor HBGF-I in patients with coronary heart disease > 1990-1997 Study of Medicine, Albert-Ludwigs-University School of Medicine, Freiburg, Germany AWARDS > 2005 Best scientific paper at the 38th Annual Meeting of the British Burns Association (BBA) > 2003 Best scientific lecture at the 7th European Conference of Scientists and Plastic Surgeons (ECSAPS) KEY PuBLICATIONS > Schlaudraff K, von Specht BU, Kolvenbach H, Stegmann Th, Schumacher B (1994) Induktion neuer funktioneller Blutgefsse beim Menschen durch den ersten klinischen Einsatz des humanen Wachstumsfaktor HBGF-I. Langenbecks Archiv fr Chirurgie 167-172 (1994)

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CHRISTOPH SCHmITz
CuRRENT POSITION > Full Professor and Head, Department of Neuroanatomy, Ludwig-Maximilians-University, Munich, Germany (since 2010) > Medical Scientific Officer, EMS Electro Medical Systems, Nyon, Switzerland (since 2010) > Member of the Board of ATRAD (since 2008) > Adjunct Professor, Department of Neuroscience, Mount Sinai School of Medicine, New York, NY, USA (since 2009)

EmPLOYmENT HISTORY (KEY POSITIONS) > 2008-2009 Vice President/International Business Development Manager Orthopedics EMS S.A. (Electro Medical Systems), Nyon, Switzerland > 2003-2008 Assistant Professor (Tenured), Department of Psychiatry and Neuropsychology, University of Maastricht, Netherlands > 2002-2003 Assistant Professor, Department of Anatomy, University of Rostock, Germany EDuCATION > 2001 Venia legendi for Anatomy, RWTH Aachen University, Aachen, Germany > 1986-1993 Study of Medicine, RWTH Aachen University, Aachen, Germany AWARDS > 1996 Best Thesis Award, RWTH Aachen University School of Medicine, Aachen, Germany KEY PuBLICATIONS > Ibrahim MI, Donatelli RA, Schmitz C, Hellman M, Buxbaum F (2010) Successful treatment of chronic plantar fasciitis with two sessions of radial extracorporeal shock wave therapy. Foot Ankle Int 31:391-397 > Hausdorf J, Lemmens MAM, Heck KDW, Grolms N, Korr H, Kertschanska S, Steinbusch HWM, Schmitz C, Maier M (2008) Selective loss of unmyelinated nerve fibers after extracorporeal shock wave application to the musculoskeletal system. Neuroscience 155:138-144 > Maier M, Averbeck B, Milz S, Refior HJ, Schmitz C (2003) Substance P and prostaglandin E2 release after shock wave application to the rabbit femur. Clin Orthop (406):237-245

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ATRAD IS THE ASSOCIATION fOR RADIAL PAIN THERAPY PROmOTING RESEARCH IN AND APPLICATION Of RADIAL ExTRACORPOREAL SHOCK WAVE THERAPY (RSWT) uSING THE SWISS DOLORCLAST mETHOD WITH A fOCuS ON PATIENT-fRIENDLY PAIN THERAPY } PAIN mANAGEmENT COmPETENCY fOR PRACTITIONERS AND PATIENTS
ATRAD ORGANIzING COmmITTEE AND BOARD > Marie-Christine Collet, Coordinator of ATRAD Headquarter Switzerland and International > Susan Wodtke, Coordinator of ATRAD Germany and Austria
> > > > > Dr. Max Henzen, President of ATRAD, founder and member of the Board Dr. Grald Gremion,Vice-President of ATRAD, founder and member of the Board Felix Egloff, General Secretary of ATRAD, founder and member of the Board Dr. Christoph Schmitz, member of the Board Dr. Nick Boden, Director of ATRAD Asia, pre-elected member of the Board

ATRAD-SWISSCOmPETENCY.ORG
ATRAD ASSOCIATION fOR RADIAL PAIN THERAPY Limmattalstrasse 206 CH-8049 zrich Tel. +41 44 340 06 32 fax +41 44 340 06 34 info@atrad.ch www.atrad.ch

EmS SA fA-386 / EN Edition 10 / 2010