Physiotherapy ultrasound: how our body reacts
Ultrasound is one of the most used machines at the physiotherapist clinic. It is used to treat several pathologies, since it has been available for several decades. Therefore, the effectiveness of its applications has been demonstrated in numerous studies over the years. On the one hand, ultrasound is used as a diagnostic technique. But in this article we are going to leave that field aside to focus on ultrasound applications in physiotherapy.
How ultrasound works
Ultrasound machines send small vibrations or mechanical waves into the body. The human being is only able to perceive frequencies of up to 20,000Hz. On the other hand, the frequencies that fisios through ultrasound machines are therapeutic way are between 1 and 3MHz. That is, between 1 and 3 million cycles per second.
This means that we, as patients, are not going to notice any effect. But the tissues underlying the area in which they apply, they will vibrate very quickly. In addition to the movement, this will also produce heat (with the consequent increase in blood flow to the area). And these two physical processes are those that produce the beneficial effects.
Finally, it has been shown that ultrasound especially stimulates collagen tissues. Therefore, tissues such as tendons, ligaments, fascia or scar tissue, will be the most receptive to this therapy.
How does it apply?
Physiotherapy ultrasound applications are made with gel and constantly moving the head. This is because ultrasound need a driver to penetrate the skin and reach deep tissues. The gel performs this function. And we must move the head for the simple reason of not being ‘hammering’ the same fabrics for a long time. Drawing small circles will make vibrations distribute and do not cause damage.
In general, ultrasound can be applied continuously or pulsatile. They will continuously produce greater thermal effect, and in its pulsatile mode the mechanical effect is more reinforced.
Ultrasound in physiotherapy
In what situations we can use vibrations and heat in our favor in clinical practice? Let’s look at the most common cases when applying ultrasound:
- Inflammations. Ultrasound are effective in treating pathologies that are in inflammation. Its effect makes more blood repair agents arrive. And if inflammation is no longer acute, increasing blood supply will make the body replace old or damaged cells by new ones. Ultrasound will then be used to treat all kinds of tendonitis, bursitis, capsulitis ..
- Sprains. As we have seen, tendons absorb ultrasound effectively. Therefore, an injury in which the tendon has lengthened more and is damaged, will be a good goal for this treatment.
- Cicatrization. The healing process is also expedited with ultrasound treatment. Ultrasound accelerate cell metabolism, which favors their recovery.
On its effectiveness in the musculoskeletal system there is not enough scientific evidence. Recommendations can be found to apply them to treat muscle contractures, for example. But its effectiveness is not demonstrated and the physiotherapist has at its disposal other more effective alternatives.
Istoforesis
Istoforesis consists of introducing medications into the patient’s subcutaneous tissue through ultrasound. In this modality, instead of applying a gel that acts as a driver, we directly apply the medication in gel format. This makes it better absorb, and the effects we will achieve will depend on the medication used.
Contraindications and precautions
Given its high vibration frequency, we must have certain precautions when using ultrasound in physiotherapy. We must not apply them on tumors or tissues that may bleed. Neither is its use if the patient has an infectious process. Or if the patient suffers from deep vein thrombosis, arteriosclerosis or similar circulatory pathologies. Finally, we must be careful to apply it to metal implants or pacemaker. And you have to remember to move it frequently, taking special care with bone projections.
Seen all of the above, we can say that ultrasound fulfills an important function. Its effect on inflamed tissues and chronic pathologies is remarkable. But we must also know and avoid its risks, since it can be an aggressive therapy in some cases.
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