918 - A Leap Forward: Extracorporeal Shockwave Therapy for Chronic Ankle Pain in a Young Dancer

A 22-year-old female professional dancer presented with a 9-month history of progressive right ankle pain, localized posteriorly and exacerbated by dance and weight-bearing. Prior first-line conservative management—rest, NSAIDs, bracing, and eccentric and concentric exercises—failed to provide relief. Imaging excluded acute fracture, instability, or significant intra-articular pathology, consistent with chronic tendinopathy. At the patient’s request, standard extracorporeal shockwave therapy (ESWT) protocol was initiated (5 weekly sessions, 2000 impulses/session, energy flux density 0.12–0.25 mJ/mm², no local anesthetic) alongside a home-based eccentric loading program. At 3 months post-treatment, pain scores improved (VAS 7/10 to 2/10), with return to full dance activity. No adverse events occurred.

Discussions: This case is unique for several reasons. First, there are no published reports describing ESWT for chronic ankle pain in young, professional dancers despite the growing use of ESWT. Second, the patient’s proactive request for ESWT reflects increasing public awareness and demand for evidence-based, noninvasive therapies among athletes. Third, the positive outcome aligns with growing evidence supporting ESWT for chronic foot and ankle conditions, particularly plantar fasciitis and Achilles tendinopathy. This underscores the need for research in dancer-specific populations due to their high functional demands, rapid performance requirements, and unique lower-extremity biomechanics. These factors may influence injury patterns, response, and compliance to treatment. Overall, the results of this case are consistent with existing evidence supporting ESWT for chronic foot and ankle disorders, yet highlight the absence of literature addressing elite dancers and the importance of individualized, patient-centered approaches in high-performance populations.

Conclusions: This case underscores a critical gap in the literature regarding ESWT for ankle pain among dancers. It suggests ESWT may be a safe, effective adjunct for refractory cases in this population and highlights the importance of patient-centered care. Further research is warranted to guide clinical practice for high-performance athletes.