Ultrasound, which is typically associated with diagnostic imaging, such as during pregnancy, is also commonly used to treat many different types of musculoskeletal injuries. It can be used in physical therapy clinics, athletic training rooms and some medical offices. The key to ultrasound being effective is a knowledgeable practitioner who understands the correct indications and settings that should be used for each type of injury.
Theory
Ultrasound uses ultrasonic energy, which is acoustical. Acoustical energy is transmitted by mechanical waves, also referred to as vibration. Acoustical energy has to have a medium through which it travels. Since ultrasound waves cannot travel through air, a coupling agent, usually a water-based gel, has to be used in order for the waves to penetrate body tissue. Ultrasound can be used in different ways depending on the frequency of the waves.
Benefits
The benefits of ultrasound for injury treatment are a deep heating effect, increased rate of tissue repair and reduced pain and muscle tightness. Ultrasound is commonly used to treat injuries of the tendons, ligaments and muscles. Ultrasound is a non-invasive, pain-free modality with little or no sensation felt while receiving treatment. In the September 2008 issue of "American Journal of Sports Medicine," a study conducted by the American Orthopaedic Society for Sports Medicine found that ultrasound on a low-intensity pulsed setting significantly accelerated the healing times of ligament and tendon injuries if used within two weeks of the occurrence of the injury.
Phonophoresis
Phonophoresis is when the coupling agent for the ultrasound is replaced with a gel or cream containing a medication. The medication is usually a type of anti-inflammatory medication. Because of ultrasound's ability to penetrate deeper into the tissue, it is able to push the medication deeper into the tissue to elicit a greater therapeutic response.
Considerations
Ultrasound is an effective modality for treating musculoskeletal injuries. Ultrasound can be particularly useful when combined with other treatment methods such as electrical stimulation, laser treatment, massage therapy and different stretching techniques. Oftentimes the ultrasound can make the tissue more pliable so a better stretch or manipulation is easier to accomplish than without the ultrasound treatment. Ultrasound is generally safe when used by an experienced practitioner. Contraindications for the treatment include pregnancy, cancer, areas of impaired circulation, fracture sites, active infection or injury to some parts of the body, such as the skull and spinal cord.
Expert Insight
According to Holly Boersma, certified athletic trainer, the best response with ultrasound occurs when using it to treat muscle strains, particularly those that occur over a smaller area of the body. In her 10 years of clinical experience treating musculoskeletal injuries, she relies on ultrasound to be a useful tool in her injury treatment protocol.
References
- "Therapeutic Modalities for Athletic Trainers"; Chad Starkey; 1993
- Holly Boersma, ATC; Action Therapy Services; Shorewood, IL
- "American Journal of Sports Medicine"; Low-Intensity Pulsed Ultrasound on Tendon Healing; Sai-Chuen Fu, et al; July 2008
- "Advance for Physical Therapists and PT Assistants"; Making Waves; Beth Puliti; August 2008
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