Therapeutic Ultrasound In Physical Therapy

THERAPEUTIC ULTRASOUND IN PHYSICAL THERAPY

Ultrasound is a therapeutic modality that has been used by physical therapists since the 1940s. Ultrasound is applied using a round-headed wand or probe that is put in direct contact with the patient's skin. Ultrasound gel is used on all surfaces of the head in order to reduce friction and assist in the transmission of the ultrasonic waves. Therapeutic ultrasound is in the frequency range of about 0.8-3.0 MHz.

The waves are generated by a piezoelectric effect caused by the vibration of crystals within the head of the wand/probe. The sound waves that pass through the skin cause a vibration of the local tissues. This vibration or cavitation can cause a deep heating locally though usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, such as a fresh injury with acute inflammation, the ultrasound can be pulsed rather than continuously transmitted.

Ultrasound can produce many effects other than just the potential heating effect. It has been shown to cause increases in tissue relaxation, local blood flow, and scar tissue breakdown. The effect of the increase in local blood flow can be used to help reduce local swelling and chronic inflammation, and, according to some studies, promote bone fracture healing. The intensity or power density of the ultrasound can be adjusted depending on the desired effect. A greater power density (measured in watt/cm² is often used in cases where scar tissue breakdown is the goal.

Ultrasound can also be used to achieve phonophoresis. This is a non-invasive way of administering medications to tissues below the skin; perfect for patients who are uncomfortable with injections. With this technique, the ultrasonic energy forces the medication through the skin. Cortisone, used to reduce inflammation, is one of the more commonly used substances delivered in this way.

A typical ultrasound treatment will take from 3-5 minutes depending on the size of the area being treated. In cases where scar tissue breakdown is the goal, this treatment time can be much longer. During the treatment the head of the ultrasound probe is kept in constant motion. If kept in constant motion, the patient should feel no discomfort at all. If the probe is held in one place for more than just a few seconds, a build up of the sound energy can result which can become uncomfortable. Interestingly, if there is even a very minor break in a bone in the area that is close to the surface, a sharp pain may be felt. This occurs as the sound waves get trapped between the two parts of the break and build up until becoming painful. In this way ultrasound can often be used as a fairly accurate tool for diagnosing minor fractures that may not be obvious on x-ray.

Some conditions treated with ultrasound include tendonitis (or tendinitis if you prefer), non-acute joint swelling, muscle spasm, and even Peyronie's Disease (to break down the scar tissue). Contraindications of ultrasound include local malignancy, metal implants below the area being treated, local acute infection, vascular abnormalities, and directly on the abdomen of pregnant women. It is also contraindicated to apply ultrasound directly over active epiphyseal regions (growth plates) in children, over the spinal cord in the area of a laminectomy, or over the eyes, skull, or testes. 

We're Now On Tumblr!

Good Morning Fellow Bloggers,

We're now on another blogging site called Tumblr. Come and check us out on

Our Tumbrl

Or pay our Facebook a visit on

Our Facebook

DIY Physiotherapy For Minor Sprains

DIY PHYSIOTHERAPY

Some minor aches and pains aren't serious enough for a trip to the doctors.

Below are five top tips which will nurse your body back to fitness in no time.

But if aches or pains persist, consult medical advice immediately.

RACQUET STRETCH

After a long hard game of tennis or squash, your hands and forearms may be a bit stiff.

An easy stretch is to clasp your hands together interlocking your fingers and pushing them away from you leading with your palms.

This will stretch the forearm muscles bringing blood flow to the area to ease the tension.

EASY P-EASY

The peas can come in real handy

A simple tip for a ready-made ice bag for those untimely knocks and sprains.

The next time you go grocery shopping, put your own order in for a 2kg bag of frozen peas.

When you need some ice just place the bag of frozen peas in a hand towel and voila....your own ready-made ice pack.

TENNIS BALL MASSAGE

For tired or achy feet after a long day in the field, grab a tennis ball, take off your socks and take a well-earned seat.

Place the ball under your foot and gently roll it back and forth from your heel to your toes.

To finish the foot massage off, put your feet in a tub of warm water for about five minutes to boost the blood flow.

TOWEL WORKOUT

Ever woken up with a stiff back that has come from nowhere?

The towel has plenty of good uses

An easy self-help treatment is to lie on the floor on your back with that trusty tennis ball again or rolled-up towel placed under the stiff area.

Now take 10 deep, slow breaths.

This will mobilise your chest cage and vertebrae helping to loosen up the stiff joint in your back.

If your pain gets worse or does not go away after a few days, consult your doctor or physio.

If you have suffered from a sprained ankle you can often get swelling for weeks later.

An easy way to get rid of this is to dunk your ankle in hot and cold baths.

Place ice water in one tub and bearable hot water in another and alternate between the two every two minutes.

Do this five times, making sure that you start and end with the cold bath.

The hot and cold treatment opens and closes your vessels helping to generate circulation and flush out the ankle of any excess fluid and swelling

NB, please note these are not long term injuries, if symptoms persist seek medical advice or go and see your physiotherapist for advice.

Pregnancy & Low Back Pain: They Go Together Like Pickles & Ice Cream

Ask any pregnant woman if her back hurts and the majority of them will scream “YES!!!!!”  Especially those who are further along in their pregnancy.  Pregnancy and low back pain seem to go together like pickles and ice cream.

So, what causes back pain during pregnancy?

It is usually caused by strain on the back muscles.  In mid-pregnancy, an expectant mom’s center of gravity changes.  In response to that, her posture changes.  Most women begin to lean backward in the later months of pregnancy, which makes their back muscles work harder.

Pregnancy hormones may contribute to back pain as well.  A hormone relaxes the ligaments in the strong, weight-bearing joints in the pelvis.  This loosening makes the joints more flexible, but it can cause back pain if the joints become too mobile.

What can a pregnant woman do to prevent back pain during pregnancy?

To help prevent or ease back pain, be aware of how you stand, sit, and move.  Here are some tips that may help:

▪   Wear low-heeled (but not flat) shoes with good arch support

▪   Ask for help when lifting heavy objects

▪   When standing for long periods, place one foot on a stool or box

▪   If your bed is too soft, have someone help you place a board between the mattress and box spring

▪   Do not bend over from the waist to pick things up – squat down, bend your knees, and keep your back straight

▪   Sit in chairs with good back support, or use a small pillow behind the low part of your back

▪   Try to sleep on your side with one or two pillows between your legs for support

▪   Exercise – walking, light weight-lifting, and water aerobics are safe to do for most pregnant women

What can a pregnant woman do to ease back pain?

Apply heat or cold to the painful area or massage it*.  If that doesn’t work, ask your OB/GYN to refer you to a Licensed Physical Therapist who has experience with pregnant women.   An experienced Physical Therapist can help an expectant mother do exercises that can help lessen backache.  Such exercises strengthen and stretch muscles that support the back and legs and promote good posture – keeping the muscles of the back, abdomen, hips, and upper body strong.

When should a pregnant woman contact her healthcare provider about back pain?

If you have severe pain, or if pain persists for more than 2 weeks, you should contact your healthcare provider.

*Massage Therapy should NOT be performed during the first trimester.

Sources:

August 2011: American College of Obstetricians & Gynecologists

Journal of Physical Activity and Health, 2011, 8 309-320.

Pregnancy and Back Pain

PREGNANT WOMAN WITH BACK PAINS: CAN YOU AVOID IT?

Many factors predispose the pregnant woman to back pains.  In fact, we know that 70% of the population will come across back pains in their life.  However, even with the predisposing factors, it is possible to go through a pregnancy with a healthy back.  

Some good and practical advice from your physiotherapist can help prevent this problem.

Many changes disrupt a woman during pregnancy.  

For example, the weight of the stomach shifts the gravity centre of the body towards the front, creating the abdominal muscles to release and  the pelvis to tilt provoking a larger lumbar curve (lower back).  This makes the back rounder at the thorax level as well as the chin point towards the front.



On top of all the biomechanical and postural changes, the pregnant woman’s ligaments release with the secretion of a particular pregnancy hormone called relaxin.  The secretion of this hormone increases during the first two trimesters of the pregnancy only to slowly die down until the end.

The releasing of the ligaments is at its peak during the 7th month.  

Result?

The joints of the pelvis and spine become slightly hypermobile and therefore more vulnerable to trauma and pain.

If the woman is not careful, she could suffer from articular pain towards the 6th month of her pregnancy.  

The pain will be more apparent if she is sitting or standing too long, if she is forcing to lift something while turning or simply walking.  

We will observe a waddle in the walk of the pregnant woman.  We must also mention the fact that women with pre-existing back problems should be twice as careful.



What should you do? 

Prevention



Here are some tips from your physiotherapist:

            

            Avoid staying seated or standing too long;

            Avoid wearing high heels (they increase the lumbar curve);

            Adopt a good posture.


To check or correct the posture, do the following exercise:



Standing, back against the wall, feet 5 to 8 cm from the wall, squeeze your stomach, tighten your buttock, slightly bend the knees, shoulders straight and hold your chin in.  While doing this exercise, the back must stay glued to the wall.

            While you are sitting, put a telephone book under your feet so that your knees are slightly more elevated than your hips.  This position reduces tension in your lower back;

            When picking up a child or object, always bend your knees to lower yourself to the child’s level.  When you are holding the child, hold him in the centre.  This will prevent tensions on the articulations of the back.

            Always work facing to what you are doing.  Avoid creating torsions of your trunk when picking up an object.

            If you must stay standing for a long period of time, avoid putting all the weight on one leg.  Balance the weight to both your legs.  There are now anti-fatigue carpets on the market.  Why not try one!

            When you sleep, if you sleep on your side, place a pillow between your legs, and if you sleep on your back, put a pillow under your knees.  This will remove the tension on the articulations of the lower back area.


These are simple tips you can follow.  They are useful to all but the application of these tips is most important while a pregnancy.  


Unfortunately, a woman is predisposed to articular problems which develop back pain.  It is preferable to consult a physiotherapist for an evaluation.  Solutions to this problem exist but we must first determine the cause of the problem

A Helping Hand

Good Morning Everyone,

i've got a few links here for you all to take a browse at, They're helping us out by giving us a few likes on our Facebook so in return here a link to theirs!

For CraftyJewels for funky jewellery and shoes check out the link below

http://www.facebook.com/pages/craftyjewelscouk/252966334724973

For Bright and White a teeth whitening technician, for those who want bright white teeth check the link below

http://www.facebook.com/profile.php?id=100003312821528

And Vicky's Barbers the idea place to go for a brilliant hair cut with some funky colours! 

http://www.facebook.com/profile.php?id=1738282952

Thanks again for your help guys!!

Facebook

Hi everyone

Can you please check out our Facebook and give us a view likes.

We'd really appreciate it and then you'd know every time we'd post a new blog article. You'd also know about up and coming events to do with Physiotherapy and any other interesting local events going on in the community.

Thanks

All at Therapyworks