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Therapeutic
Ultrasound
Most patients
are familiar with diagnostic ultrasonography
or "ultrasound" which is used to discern
problems deep in the body without breaking
the surface of the skin, by bouncing and
measuring high frequency sound waves to
create audio "images". Less common is the
awareness of this remarkable technology as a
therapeutic tool.
"Therapeutic Ultrasound" is one of the most
common electrophysical modalities used by
physicians in today's technologically
advanced nations, and has been for several
decades. Its effectiveness has been enhanced
over the years by studies which helped
determine optimum techniques and patterns of
application, and a wide range of injuries
have shown to be responsive to this popular,
non-invasive therapy.
A deep tissue heating modality reaching
underlying tissues as deep as 1 to 5
centimeters, it is used to treat musculo-skeletal
injuries, back and joint conditions, limited
range of motion, soft tissue injuries, and
chronic conditions.
Treatment is administered directly which
penetrates the tissues, increases blood
flow, relaxes muscle spasms, repairs damaged
tissue, and dramatically speeds the healing
process. It creates permanent, physical
changes and repairs both hard and soft
tissues problems.
One of the major advantages of ultrasound is
that it is nontoxic and nondestructive. The
healing response is directly proportional to
the input of ultrasonic energy and is
somewhat dependent on ultrasonic frequency,
which are highly variable and, although
proven to be effective in many case studies,
is being continually refined through newer
studies designed to measure the effects of
time, frequency and intensity of
applications on various body structures and
conditions affecting them.
For soft tissue healing, ultrasound uses
high frequency sound waves, well beyond the
range of human hearing, which cause
molecules in the tissues to vibrate,
producing heat and mechanical energy.
The main piece of equipment is a
high-frequency generator, which provides an
electrical current through a coaxial cable
to a transducer contained within an
applicator. The crystal in the ultrasound
head expands and contracts which produces
the necessary sound wave. By adjusting the
frequency of the waves, the therapist can
target tissues for either healing or
destruction, or simply use the device to
reduce pain.
Ultrasound therapy can be applied directly
to the skin or through a water medium. When
applied directly, it must be performed using
a coupling gel. Ultrasound can also be done
in a tub of water or through gel packs.
Ultrasound is commonly used by athletic
trainers. In fact, ultrasound therapy
has become the most commonly used deep
therapeutic heat modality in sports
medicine, valuable for the
rehabilitation of many different
injuries because it stimulates the
repair of soft tissue injuries and also
relieves pain.
Although simple in principle, the use of
ultrasound as a therapeutic modality
requires a comprehensive understanding of
its effects on the body tissues and of the
physical mechanisms by which its effects are
produced. The lower the frequency used, the
deeper is the penetration of the waves into
the body. And by varying the frequency from
continuous to intermittent, the amount of
heat applied can likewise be controlled by
the practitioner.
Early practitioners used continuous or
"thermal mode" ultrasound to treat
contusions and muscle injuries, but it was
quickly determined that pulsed or
intermittent waves were more practical for
most therapeutic applications. While
providing highly effective "micromassage"
which is thought to assist in the reduction
of swelling and edema, pulsed ultrasound is
free of the intense, possibly
tissue-damaging "heating effect" on tissues
when using the non-pulsing thermal mode. The
thermal mode is used primarily where heat is
an essential element of the treatment.
Medical studies have shown therapeutic
ultrasound to be a versatile tool with a
wide range of uses.
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