Vale Health Injection Clinic


A non-invasive treatment method clinically proven for tendon, joint, and sports injuries.



Frozen Shoulder




30 minutes


No Downtime


Increases range of motion as well as reducing pain

Minimal side effects

Superior to cortisone alone

Exploring Hydrodistension as a Promising Intervention for Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a debilitating condition characterized by pain, stiffness, and restricted range of motion in the shoulder joint. While conservative treatments such as physical therapy and cortisone injections are often employed to manage symptoms, some cases may require more aggressive interventions. Hydrodistension, also referred to as hydrodilatation, is a minimally invasive procedure that has emerged as a promising therapeutic option for individuals with frozen shoulder.

Hydrodistension TREATMENT
London Bridge Regenerative Clinic

Hydrodistension is a valuable therapeutic option for individuals suffering from frozen shoulder, offering mechanical stretching of the joint capsule, immediate pain relief, and the potential for long-term improvement in range of motion.

By disrupting adhesions and promoting tissue flexibility, hydrodistension addresses the underlying pathology of adhesive capsulitis, making it an effective alternative to standalone cortisone injections.

As part of a comprehensive treatment approach, hydrodistension can help individuals regain shoulder function and improve their quality of life

The underlying pathology of frozen shoulder involves inflammation and fibrosis of the joint capsule, leading to adhesions and contractures that restrict shoulder movement. Hydrodistension aims to address these issues by mechanically stretching the tight capsule and disrupting adhesions, thereby promoting tissue flexibility and restoring range of motion.

During the procedure, a combination of cortisone, a high volume of sterile saline solution and a local anaesthetic (such as lidocaine) is injected into the joint capsule under ultrasound guidance. The pressure generated by the fluid distends or expands the capsule, stretching the surrounding tissues and breaking up adhesions. Additionally, the local anaesthetic provides temporary pain relief, allowing for a more comfortable stretching of the shoulder joint.

The mechanical stretching induced by hydrodistension triggers a cascade of physiological responses within the joint tissues. Firstly, it stimulates the release of cytokines and growth factors, which promote tissue remodelling and repair. Secondly, it increases blood flow to the area, facilitating the delivery of oxygen and nutrients essential for healing. Lastly, it interrupts the pain-spasm cycle, reducing pain perception and improving muscle relaxation.

How does shockwave therapy work

Shockwave therapy, known for its ‘mechanism of action’, involves the use of a specialized device to deliver acoustic energy through the skin to the injured part of the body. The shockwaves, which are mechanical and not electric, consist of audible, low-energy sound waves that increase blood flow to the injured area.

This therapy operates through two primary modes of action to alleviate persistent tendon pain. Firstly, the shockwaves work to desensitize nerve endings, often resulting in an immediate reduction in pain. Secondly, and perhaps most importantly, the shockwaves induce controlled micro-trauma (microscopic damage) to the tissues. This action encourages the body to respond by enhancing blood circulation and metabolism in the affected area, thereby activating and accelerating the body’s natural healing response. Additionally, shockwaves can assist in ‘breaking down’ disorganised tissue and calcifications. For treatment to be optimal we would normally recommend combining this treatment with injection therapy and a rehabilitation programme.  

Extensive testing has shown that Ostenil Plus does not induce any significant adverse reactions. Furthermore, as it lacks animal proteins, the likelihood of triggering an allergic response is minimal. Like with any injections, there exists a slight risk of infection, and occasional post-injection discomfort at the site may persist for a day or two.

Ostenil injections have become increasingly popular among athletes, particularly football players, who seek relief from joint discomfort resulting from intense physical exertion.

Featuring hyaluronic acid as its primary ingredient, these injections offer enhanced joint lubrication and cushioning, thereby reducing friction, easing pain, and improving mobility to enhance performance on the field.

The non-invasive nature and minimal side effects of Ostenil make it an appealing option for athletes aiming to preserve joint health and quickly return to their training and competitive activities.

Implementing injury prevention measures such as warm-up routines, conditioning exercises, and recovery strategies further bolster joint health and overall athletic prowess.

Ostenil is commonly manufactured through a method referred to as bacterial fermentation.

In this process, specific bacterial strains, typically Streptococcus zooepidemicus, are chosen for their capacity to generate hyaluronic acid. These bacteria are cultivated in a suitable growth medium that contains carbohydrates like glucose or corn syrup, serving as a carbon source. Through fermentation, the bacteria produce hyaluronic acid as a byproduct of their metabolic processes.

The resulting sodium hyaluronate can then be utilized in orthopedic applications, such as treating conditions like Osteoarthritis, Knee Meniscus issues, as well as Shoulder or Hip Labral tears.


At London Bridge Regeneration clinic we provide various payment options meaning you can spread the cost and enjoy a confident outlook at a price you can afford this can also include interest free options.

Please book your free initial 10 minute free telephone or face-to-face consultation to ascertain the suitability of the shockwave and the different treatments we offer. 

Procedure Specialists


Hydrodistension injection

Gary Edwards


Procedure Steps

Patient Preparation

The patient is positioned comfortably on an examination table, typically in a supine position. The shoulder area is exposed and sterilised to minimise the risk of infection.

Anaesthesia Administration

Local anaesthesia is administered to numb the skin and underlying tissues, alleviating discomfort during the procedure. This involves the use of a local anaesthetic injection.

Ultrasound guidance

A real-time imaging technique, ultrasound, is utilised to visualise the shoulder joint and guide the placement of the needle for precise injection. This ensures accurate delivery of the saline solution into the joint capsule.

Injection Procedure

A needle is inserted into the shoulder joint space under ultrasound guidance. A mixture of cortisone, local anaesthetic and sterile saline is then injected into the joint capsule, gradually distending it and stretching the surrounding tissues.

Post-Procedure Care

After the hydrodistension procedure, the patient may experience temporary soreness or discomfort in the shoulder area. Ice packs and over-the-counter pain relievers may be recommended to alleviate these symptoms. Patients are typically advised to avoid strenuous activities for a short period following the procedure to allow for adequate recovery.

While cortisone injections are commonly used to manage pain and inflammation associated with frozen shoulder, they primarily provide symptomatic relief and do not address the underlying adhesive capsulitis. In contrast, hydrodistension offers several distinct advantages:

Mechanical Stretching

Hydrodistension mechanically stretches the tight joint capsule and breaks up adhesions, addressing the underlying pathology of frozen shoulder and promoting long-term improvement in range of motion.

Pain Relief

In addition to stretching the capsule, hydrodistension provides immediate pain relief through the administration of a local anesthetic, allowing for more comfortable stretching of the shoulder joint.

Minimal Side Effects

Hydrodistension is a minimally invasive procedure with a low risk of complications.

Potential for Long-Term Improvement

While cortisone injections may provide temporary relief, the benefits are often short-lived, and repeated injections may be necessary. Hydrodistension has the potential to produce more lasting improvements in shoulder function by addressing the underlying adhesive capsulitis.

After the procedure,  typically we dvise refraining from engaging in strenuous physical activities for several days to allow your body to recover optimally. It’s essential to prioritise hydration by drinking plenty of water to help flush out any toxins and aid in the healing process. If you experience any discomfort or pain, Paracetamol can be safely used for pain management as needed.

It is important to follow your clinician post-procedure instructions carefully and perform any rehabilitation exercises advised.


Step 1. Free Intial consultation

London Bridge Regenerative Clinic gives every patient a free consultation with one of our injecting practitioners.

There is no obligation to proceed to treatment. The consultation is an opportunity to discuss your issue in detail and the benefits and risks of the procedure.

Many individuals find significant relief through ultrasound-guided injections when grappling with persistent conditions such as arthritis affecting various joints or soft tissue issues like frozen shoulder, plantar fasciitis, and carpal tunnel syndrome.


We will perform palpation and orthopaedic tests to help confirm your diagnosis.  If required we may also perform a diagnostic ultrasound scan to assist in visualising the issue.  We may also refer you for an X-ray or MRI, depending on the examination findings.  

We will allow time to explain the procedure and answer any questions you may have.  We make sure you understand the advantages and risks with the procedure before going ahead


All hydrodistension injections are delivered with ultrasound guidance.  You’ll be given individual pre-injection advice to reduce your chance of bleeding or infection and support your recovery and aid healing

It’s important to let your practitioner know if you’re on any prescription or over-the-counter medications. You may be asked to stop taking aspirin or anti-inflammatory tablets, which can increase the risk of bruising. It’s also important to stop smoking cigarettes and e-cigarettes before and after the procedure because they can disrupt the healing process.

Local anesthetic is normally used for this procedure so it not advised to drive to your appointment.  


Following the procedure, most individuals can return home and resume their normal activities. Our clinical team will be available to offer water and provide guidance on post-injection care.

For the next twenty-four hours, it’s advisable to refrain from strenuous activities and alcohol consumption. Don’t be alarmed if you don’t notice immediate effects; it typically takes a few days for the injection to take effect.

A follow-up appointment or phone consultation will be scheduled for four weeks after the procedure to review your progress. 



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Gary Edwards

Doctor of Chiropractic and Injection therapy

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