Full Disclosure

We do not currently offer shockwave therapy for Achilles tendinopathy as after continuing to monitor the research, we believe exercise-based rehabilitation remains the treatment with the strongest evidence of benefit. However, we support informed, person-centred decision-making and can discuss the evidence and provide referrals if someone wishes to explore shockwave therapy as part of their overall rehabilitation plan.

What Is Achilles Tendinopathy?

Your Achilles tendon is the strong band of tissue that connects your calf muscles to your heel bone.

It helps you walk, run, jump, climb stairs, and push off the ground when moving.

When the tendon becomes irritated and struggles to cope with load, it can become painful and common symptoms include:

• Pain at the back of the heel or ankle
• Morning stiffness
• Pain during or after activity
• Tenderness when touching the tendon
• Difficulty running, jumping, or walking long distances

What Is Shockwave Therapy?

Shockwave therapy uses sound waves delivered into painful tissue through a handheld device.

Researchers have proposed several ways shockwave therapy might help, including stimulating tissue repair, increasing blood flow, or changing how pain is processed by the nervous system. However, many of these theories come from animal or laboratory studies, and researchers still do not fully understand whether these mechanisms explain improvements seen in people with Achilles tendinopathy.

Does Shockwave Therapy Work for Achilles Tendinopathy?

• A large 2026 review examined nine clinical trials involving 557 people with Achilles tendinopathy
• Researchers compared shockwave therapy to sham (fake) treatments or other comparison groups.

Are We Over diagnosing Attention-deficit/Hyperactivity Disorder (ADHD) in Women?!

As a psychologist with ADHD, I’ve seen firsthand how ADHD remains largely misunderstood, especially in women. Traditionally, ADHD has been associated with hyperactive young boys, leading to a gender gap in diagnosis and treatment. In fact, the average age of ADHD diagnosis in Australia for women is 36, compared to just 12 for boys! This delayed recognition often results in untreated symptoms, increasing the likelihood of comorbid conditions such as anxiety, depression, and eating disorders. Understanding how ADHD presents in women is crucial for accurate diagnosis and effective intervention.

Common Presentations of ADHD in Women

While ADHD is the same neurological condition across genders, its manifestation in women often differs. Here are some ways it may present:

Inattention:

• Difficulty initiating or completing difficult or boring tasks
• Task paralysis (feeling stuck despite knowing what needs to be done)
• Chronic forgetfulness and losing belongings
• Messy or disorganised personal spaces (doom piles!)
• Poor time management and frequent lateness
• Tasks (work or assignments) taking longer to complete than peers/colleagues

Hyperactivity/Impulsivity:

• Excessive talking and interrupting others
• Internal restlessness (fidgeting, nail-biting, hair-twirling)
• Acting without thinking (impulse purchases, risky decisions)
• Struggling to wait for turns in conversations

Emotional Dysregulation:

• Overwhelm from routine tasks or excessive workload
• Heightened emotional sensitivity and mood swings
• Intense reactions to stress or perceived rejection

Perfectionism and Overcompensation:

• Overworking to mask difficulties with focus and organisation
• Striving for perfection to counteract perceived shortcomings

Women often go undiagnosed or misdiagnosed due to a range of factors:

Many women with ADHD receive diagnoses for anxiety, depression, or eating disorders before ADHD is even considered. These conditions can overshadow ADHD symptoms, leading professionals to treat surface-level issues without recognising the underlying neurodevelopmental disorder

• Anxiety Disorders: Persistent worry and perfectionism often stem from the effort to compensate for ADHD-related challenges.
• Depressive Disorders: Chronic stress, repeated failures, and feelings of inadequacy can contribute to depression.
• Eating Disorders: Impulsivity and a desire for control may lead to disordered eating behaviours

Gender Bias:

Girls are generally perceived to be less hyperactive than their male peers, causing those with ADHD to subconsciously internalise their restlessness. This often presents as racing thoughts, mental overload (like having multiple tabs open in the brain), and subtler physical signs such as hair twirling, nail picking, or restless legs. Similarly, women are often expected to be quieter, organised, attentive, and emotionally composed, leading many to develop masking strategies that make their ADHD symptoms less noticeable (think lists, double/triple checking, multiple alarms!)

Overdiagnosis:

But are we overdiagnosing?

When left-handedness was stigmatised, its recorded prevalence was quite low because many people (my grandmother!) were forced to use their right hand. Once societal acceptance grew, the number of reported left-handers spiked! Not because more people became left-handed, but because they were finally able to be themselves.

Similarly, the rise in ADHD diagnoses isn’t due to overdiagnosis but rather increased awareness and recognition of those who have always had it. Over time, like left-handedness, ADHD diagnoses will likely plateau at their true prevalence.

Receiving an accurate ADHD diagnosis is life changing. It provides clarity, validation, and access to the right support. As I often tell my clients, “You’re just a Zebra! Not a broken horse.” Representation and proper labelling matter in helping women understanding themselves and their needs.

Underrepresentation:

The criteria for ADHD in the diagnostic manual (DSM) are primarily based on research conducted on males, leading to a gender bias in research on ADHD. There is actually no single definitive number of studies solely focused on women with ADHD! As a result, the way ADHD manifests in women (often more inattentive than hyperactive) can be overlooked or misinterpreted because the (DSM) is yet to capture and include the typical female presentation.

How can we at TLC help?

If you resonate with this information, I encourage you to come see us for a chat!

• Speak with myself (Allie, Psychologist) to discuss an ADHD assessment
• Client often have an improved self-understanding through diagnosis to provide context for past struggles, reducing self-blame.

• Referral to a psychiatrist for medical and medication review can be discussed for treatment options.

• Therapy, which includes individualised treatment plans and proper support often leads to better emotional regulation, relationships, improved daily functioning  and professional success.

Recognising ADHD in women is essential to provide validation, strategies, and a sense of community/belonging. Learning about ADHD empowers you to understand yourself, normalise your struggles and advocate for your needs! If any of this sounds familiar, don’t hesitate to seek the support you deserve.

Article written by,

Allie McGrath
Registered Psychologist