Ultrasound Therapy & Physiotherapy

What is ultrasound?

Ultrasound treatment is the use of high frequency sound waves directed into a specific area of the body. Sound waves are mechanical energy. In other words, they are capable of moving and vibrating soft tissues like muscle, tendon and ligament. The frequency is usually between one million and three million cycles per second. Ultrasound waves also penetrate the body safely up to several centimeters usually one to five cm and up to ten cm. Sound waves travel much better in water than in air. That is one of the reasons that marine mammals can hear each other from several kilometers. The human body is approximately 70%-80% water and therefore allows for very good sound wave absorption.

Many people ask if treatment ultrasound is similar to a pregnancy or imaging ultrasound. The answer is yes and no. Ultrasound used to produce images of a fetus are high frequency sound waves but at different frequencies and strengths than what physiotherapists use. The machine design is also different in that it is only designed to produce high quality moving pictures of the fetus and many internal organs but it not used for the treatment of injury. Imaging ultrasound is extremely valuable in this regard because it allows physicians a window into living and moving organs such as the heart with no risk. This use of imaging ultrasound also highlights the fact that ultrasound waves can penetrate deep into the body.

The properties of treatment ultrasound allow for some very beneficial effects namely heating and vibration:

• As the sound waves pass into the soft tissue like a ligament, they micromassage and vibrate the tissue. The micromassage causes a heating of the tissue due to mechanical friction and small movements in the tissue. Heated soft tissue:
  •  Stretches and moves easier
  •  Allows nutrients to be absorbed better
  •  Creates improved blood circulation which flushes  inflammatory chemicals out of the area
• Ultrasound micromassage of soft tissue also causes:
  • A breakdown of scar tissue and adhesions (layers of tissue stuck together)
  • Softening of scar and new tissue
  • A much improved weave and lying down of new fibers of ligament, tendon or muscle tissue. This is the difference between having a ball of badly tangled fishing net or having it neatly strung out long lengthened lines. Ultrasound helps the healing tissue to be strong and flexible.
  • The breakdown of calcium deposits or old blood deposits from trauma (haematoma)
• Ultrasound also causes swelling to become less thick and glue-ish (liquefaction). This will allow for the body to reduce swelling easier.
• Ultrasound also helps with the release of helpful natural chemicals in and around cells.

How does this benefit a person with an injury or condition?

• Overstretched or torn muscle, tendon or ligament (strain or sprain) will heal faster and with a better final result
• Swelling and inflammation is reduced faster
• Stretching and exercising of tight muscles and joints becomes easier
• Scar tissue either internal or external will be less painful, more flexible and strong.

Ultrasound helps lead to less pain, a faster recovery, and quicker return to your pursuits.

How effective and safe is ultrasound?

Ultrasound has been used extensively by physiotherapists since the 1940’s. It has been studied more than any other physical treatment modality used in physiotherapy. The effects of ultrasound have been extremely well documented and proven. There is no debate as to the beneficial results of ultrasound. It is very effective in achieving the above benefits especially when it is part of an overall physiotherapy treatment program.

In terms of safety, it is extremely safe when used appropriately by a physiotherapist. There are no side effects or long term risks. It is comfortable and often you will feel a gentle warming as it is used and only gentle pressure is used with the probe and gel. It is safe to use near metal implants like a joint replacement and is safe near pacemakers. Treatments last five to ten minutes.

 Ultrasound treatment is very effective and proven for the following:

• Joint, muscle, tendon, and ligament injuries
• Pain control
• Reducing inflammation and swelling
• Breaking down scar tissue and deposits
• Overall speeding of the healing process

When ultrasound is used, however, there are two very important facts that should be understood and are supported by the best reviews of all the available research:

Ultrasound treatment should be part of an overall treatment program or the outcomes will be disappointing. The treatment program should include some or all of the following:

1. Specific exercises that are tailored to the individual. They may include flexibility, strengthening and postural exercises to mechanically improve how an injured area is working.
2.  Education on proper body mechanics and posture.
3. Hands on therapy (manual therapy) aimed at improving the mechanics of an injured area and reducing pain.
4. Other treatment modalities such as heat, acupuncture, and electrical therapy used to also decrease pain and inflammation.

The patient needs to be thoroughly evaluated first by their healthcare team including licensed healthcare professionals such as a physiotherapist and a medical doctor (family physician or specialist) to carefully plan a treatment program that best suits a patient’s needs.