Therapeutic ultrasound for rehabilitation of soft tissue has become a physical therapy protocol. All physical therapy offices have ultrasound equipment and licensed ultrasound technicians who are on staff or on call. Many physical therapists themselves are certified ultrasound technicians. New ultrasound machines are small, inexpensive, and can reach even small targets.
Ultrasound Frequencies
Ultrasound for physical therapy uses frequencies of 0.8 to 1.0 MHz to warm the muscle fibers as well as stimulate capillaries to expand and deliver more blood to the target area. These frequencies are generally thought to be benign for repeat exposures and effective in helping speed soft tissue repair.
Machines for Physical Therapy
Ultrasound machines used to treat tissue sprains, strains and inflammation are different from the imaging ultrasound machines used for fetal obstetrics or cardiac imaging. Those machines operate at higher frequencies. Therapeutic ultrasound uses a lower frequency and can pulse the vibrations to minimize collateral stimulation in neighboring tissue. Most physical therapy offices have the machines set up next to a chair or bed so the patient can lie down and receive treatment.
Indications
Sprains, bursa, fractures and separated tendons respond well to a course of ultrasound treatment. Ultrasound treatment is by prescription from a physician or surgeon. The physical therapist needs to be a licensed to use ultrasound or will direct an ultrasound technician to deliver the treatment. Like physical therapy muscle strengthening programs, it takes weeks or months to complete the treatments.
Contraindications
Ultrasound should not be used on areas of the body where acute infections are present nor should it be used on brand-new sprains, as cold, elevations, compression and rest are the gold standard in the first 48 hours of a sprain. Tumors, blood clots, diabetic ulcers and certain skin rashes should not be in the area where ultrasound is applied.
