Ultrasound Physical Therapy Services
Ultrasound Physical Therapy
Have You Heard About Ultrasound?
Most people have heard the word ultrasound used to describe the process of viewing a fetus throughout pregnancy, but did you know that ultrasound has many other diagnostic and therapeutic uses? It’s true. Ultrasound is a tool used both to help diagnose injuries or disease and to provide a therapeutic and healing benefit. Physical therapists are professionals trained in the therapeutic use of ultrasound and more recently, many have begun to incorporate it as a diagnostic tool as well. In this article we will explore both uses of ultrasound in the world of physical therapy.
ULTRASOUND IN PHYSICAL THERAPY
Ultrasound is performed using a transducer that moves along the skin over an ultrasound gel or lotion and that connects to a machine that produces the ultrasound waves. The therapist adjusts the settings in order to treat or visualize tissues at different depths. The use of ultrasound in medicine began during and shortly after World War II. It was initially used as a diagnostic tool and by the mid sixties and onward, the invention of commercially available ultrasound units allowed for much wider dissemination and use. When ultrasound first made its way into the profession of physical therapy it was mostly as a therapeutic treatment. Over time, some physical therapists have received training in how to utilize ultrasound as a diagnostic tool thus expanding the role of ultrasound within the profession. Let’s take a deeper look at both of these applications.
Most individuals are probably familiar with ultrasound as a diagnostic tool wherein an image of the underlying tissue is projected onto a screen. If you have ever watched an ultrasound, especially one performed on a shoulder or ankle, for example, you will realize quickly how much expertise it takes to perform the ultrasound and evaluate the findings. To most people, the ultrasound is simply a grainy black and white image with little discernible anatomy. This is why a physical therapist who utilizes diagnostic ultrasound will have undergone extensive training to use the modality correctly.
Physical therapists use diagnostic ultrasound to evaluate musculoskeletal injuries. For example, they may use it to identify an injury. Physical therapists are commonly looking for conditions like joint effusion, tendon or ligament injury, inflammation or bone fractures. It can also be utilized to grade the severity of an injury or to evaluate how well it is healing. The information gleaned from an ultrasound can also help a therapist determine the best course of action in treating the injury.
Therapeutic ultrasound is another application of ultrasound in physical therapy and one that all physical therapists are trained to use during their schooling. This type of ultrasound uses the properties of mechanical energy to affect the tissues below the transducer. Ultrasound waves can promote healing of local tissues when placed over inflamed, injured or scarred tissues. It can also help resolve an ongoing inflammatory process and facilitate good tissue recovery. Ultrasound is used to treat many different types of musculoskeletal conditions. A physical therapist may choose to use ultrasound to treat conditions like bursitis, tendonitis, ligament sprains or injuries, muscle strains or muscle tears and even frozen shoulder.
THE SCIENCE BEHIND ULTRASOUND
Now that we have reviewed the uses of ultrasound, let’s talk about how therapeutic ultrasound is able to have a healing effect on some tissues. Ultrasound uses mechanical energy in the form of sound waves which are conducted through a hand-held transducer head and then passed through the body tissues. Different frequencies of ultrasound penetrate tissue layers at different depths. In physical therapy, we typically use 1MHz and 3Mhz frequencies to reach deeper and more shallow structures.
When these ultrasound waves enter the body, they are absorbed and attenuated by the tissue layers. Ultrasound creams and gels are used on the surface of the skin to minimize the amount of waves that are lost to the air and maximize the waves that pass through the skin. Different tissue types absorb the ultrasound waves better or worse. Tissues like blood or fat, for example, have worse ultrasound wave absorption capabilities than ligaments, tendons, joint capsules, fascia or scar tissue. Because of this, ultrasound is a great tool to image and treat musculoskeletal conditions.
The effect that ultrasound has on the tissues it penetrates are caused by either thermal or nonthermal effects. Though it is likely impossible to deliver only one of these effects, physical therapists use the settings on their ultrasound machine to maximize one effect over the other. The word thermal is associated with heat. Thermal effects of ultrasound are caused by a warming of the tissues under the transducer head. This warming causes increased blood flow to the local area which can help resolve chronic states of inflammation. Nonthermal effects of ultrasound are attributed to two unique effects caused by the passage of the ultrasound waves through the targeted tissues. These effects are called stable cavitation and acoustic streaming. While your physical therapist will have studied how these processes work, the most important thing for you to know is that these effects are thought to excite the cell membranes in the target tissue and upregulate the cell activities that are involved in tissue healing.
A RELAXING WAY TO HEAL
Ultrasound, whether used diagnostically or therapeutically, is painless and comfortable. The worst part about it is the ultrasound gel squeezed onto your bare skin. After that, the therapist will move the transducer head around to either visualize a structure or treat the tissue below. Therapeutic ultrasound usually lasts several minutes and often is applied over several treatment sessions. You get to relax during this process but don’t get too comfy. Ultrasound can be a helpful modality for the right patient but it is rarely, if ever used in isolation. You can expect ultrasound to be just one part of a comprehensive treatment plan that may include manual therapy techniques, other modalities or therapeutic exercises. Now that you know the uses and benefits of ultrasound, you can ask your physical therapist if this treatment is right for you. To learn more about how we use ultrasound as part of our treatment plans, call Evolve Physical Therapy today.
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