In all advanced organisms, blood circulation regulates the nourishment of cells with oxygen and nutrients, the removal of waste products, vital information about hormones and chemical messengers, immune defenses and many other processes. The performance and functionality of every individual body cell and of muscles, joints, organs, glands and the immune system etc. depend on the optimal supply and removal by means of microcirculation.
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Laser therapy was not demonstrated to be superior to placebo for patients with rotator cuff tendinopathy (Green et al 2003). Ultrasound (RR 1.81, 95% CI 1.26–2.60) and pulsed electromagnetic field therapy (RR 19, 95% CI 1.16–12.43) resulted in improvement compared to placebo with regard to pain in patients with calcific tendinopathy. There is no evidence of an effect for ultrasound in patients with other tendinopathy. Ultrasound also provides no additional benefit when used in combination with exercise interventions over exercise alone (Green et al 2003). There is strong evidence that extra-corporeal shock-wave therapy is no more effective than placebo in patients with impingement with regard to functional limitations (Faber et al 2006).