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Month: October 2016

Indications vs Contraindications of Ultrasound Therapy

Ultrasound therapy is a popular method of treatment for chiropractors, physical therapists, and other medical care providers. It involves transferring sound waves with frequencies greater than the human sound spectrum (above 20 kilohertz) into a patient. The energy that is transferred with the sound waves can be used to treat focused, isolated areas of tissue to help with relieving pain in affected areas of the body and to speed the recovery process for injured muscle or other tissues.

General Indications for Ultrasound Therapy Use

Therapeutic ultrasound can be used to create a deep heat effect for relief of pain, muscle spasms and in cases where joints have been tightened over a prolonged period of time – joint contracture – as in cases such as spastic cerebral palsy or in work-induced environments.

Some of the most common medical problems that warrant the use of ultrasound therapy are adhesive capsulitis (“frozen shoulder”, or pain and stiffness in the shoulder caused by inflammation), calcific bursitis (the calcification of bursa sacs due to prolonged inflammation, usually in the shoulder), inflammation of the skeletal muscles (myositis), and soft tissue injuries from sports or other causes. Ultrasound therapy is also used to treat tendons that have been shortened from untreated scar tissue or past injuries. Ultrasound therapy machines can be used to overcome capsular tightness or scarring, which often result from surgeries such as breast augmentation.

Contraindications of Ultrasound Therapy

There are many situations for which the typical ultrasound therapy treatment is not recommended. Ultrasound should not be used to treat local pain without the patient first receiving a thorough diagnosis, and the cause of the pain has been confidently determined. It should not be used when there are cancerous lesions on or near area to be treated. If a patient shows symptoms of carrying serious infectious diseases or in cases where the patient should be avoiding excess heat or fevers, it is not advised to use therapeutic ultrasound.

Other conditions governing the use of ultrasound therapy include avoiding particular parts of the body that may be susceptible to negative side effects from the treatment. It should not be used in areas where bones are growing. If a patient uses a pacemaker, it is not recommended to use this kind of treatment in the thoracic part of the body, as the pacemaker may be affected in those cases. Ultrasound devices should not be used where a fracture is healing, it should not be applied close to a patient’s eyes, and it should not be used over the uterus region of a pregnant woman. Therapists should be careful not to use ultrasound in patients who suffer from vascular disease and who have ischemic tissue. In this case, cells could die because of the blood supply’s inability to keep pace with the increased metabolic demand from tissues affected by the treatment.

Other situations that prohibit the use of ultrasound therapy include the spine area of patients who have had spinal surgeries, anywhere on a patient where anesthetics are being used, or any kind of disposition to bleeding excessively.

If you have any questions regarding ultrasound, and whether it would be a therapy for you, please call Minnesota Chiropractic and Rehabilitation at 763.390.1323

What does Therapeutic Ultrasound Do?

Many people hear of ultrasound and they think of a device that uses sound waves to construct images inside the human body. But did you know ultrasound has long been used as a therapeutic device to decrease swelling and increase healing for a variety of injuries? Sprained ankles, sore elbows, and achy backs can all be helped from the relatively common therapeutic device. The sound waves produced by an ultrasound machine are absorbed by tissues up to 5 inches below the skin which has a number of positive physiological effects at different stages of healing.

Acute Stage

In acute injuries ultrasound causes a release of histamine which attracts neutrophils and monocytes to the injured area. Together these cells help clear the injured area of foreign substances in the area and promote healing. Overall, the main effect from ultrasound during this stage is a decrease in swelling and pain.

Proliferative StageUltrasound used for shoulder pain

After the acute stage ultrasound helps what we call the proliferative stage by stimulating fibroblast activity. Fibroblasts are stimulated which then secrete collagen. The collagen secretion helps increase the tensile strength and wound contraction of the injured area. This not only helps the injured area heal faster, but makes the area stronger and less susceptible to injuries in the future. Also at this stage of healing the ultrasound machine is used at a different frequency that produces heat in the area it is being used. This heat promotes blood flow to the area which helps deliver nutrients required for healing. The increased blood flow also helps remove toxins and other broken down substances.

How It Can Help You

These physiological changes caused by the ultrasound have many benefits in all types of soft tissue injures. Tennis elbow, heel pain, back sprains, patellar tendonitis, knee pain and shoulder pain are just a few of the common injuries that can be helped with therapeutic ultrasound. If you have any further questions about ultrasound and how it can help you, please give our office a call at 763.390.1323.

Therapeutic Ultrasound

Ultrasound is a therapeutic modality that has been used by health practitioners 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.

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 ptherapeutic ultrasound for shoulder rehabilitationatient 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.

Stretching

Stretching may take a back seat to your exercise routine. You may think that stretching your hamstrings and calves is just something to be done if you have a few extra minutes before or after pounding out some miles on the treadmill. The main concern is exercising, not stretching, right?Not so fast. Although studies about the benefits of stretching are mixed, stretching may help you improve your joint range of motion, which in turn may help improve your athletic performance and decrease your risk of injury. Understand why stretching can help and how to stretch correctly.Stretching can help improve flexibility, and, consequently, range of motion in your joints. Better flexibility may improve your performance in physical activities or decrease your risk of injuries by helping your joints move through their full range of motion and enabling your muscles to work most effectively.

Stretching also increases blood flow to the muscle. And you may come to enjoy the ritual of stretching before or after hitting the trail, ballet floor or soccer field.

Stretching essentials

Before you plunge into stretching, make sure you do it safely and effectively. While you can stretch anytime, anywhere — in your home, at work, in a hotel room or at the park — you want to be sure to use proper technique. Stretching incorrectly can actually do more harm than good.

Use these tips to keep stretching safe:

  • Don’t consider stretching a warm-up. You may hurt yourself if you stretch cold muscles. So before stretching, warm up with light walking, jogging or biking at low intensity for five to 10 minutes. Or better yet, stretch after you exercise when your muscles are warmed up.Also, consider holding off on stretching before an intense activity, such as sprinting or track and field activities. Some research suggests that pre-event stretching before these types of events may actually decrease performance.Strive for symmetry. Everyone’s genetics for flexibility are a bit different, so rather than striving for that gymnast or ballet dancer degree of motion, focus on having equal flexibility side to side (especially if you have a history of a previous injury).
  • Focus on major muscle groups. When you’re stretching, focus on major muscle groups such as your calves, thighs, hips, lower back, neck and shoulders.Also stretch muscles and joints that you routinely use at work or play. Make sure that you stretch both sides. For instance, if you stretch your left hamstring, be sure to stretch your right hamstring, too.
  • Don’t bounce. Stretch in a smooth movement, without bouncing. Bouncing as you stretch can cause injury to your muscle.
  • Hold your stretch. Hold each stretch for about 30 seconds; in problem areas, you may need to hold for around 60 seconds. Breathe normally as you stretch.
  • Don’t aim for pain. Expect to feel tension while you’re stretching, not pain. If it hurts, you’ve pushed too far. Back off to the point where you don’t feel any pain, then hold the stretch.
  • Make stretches sport specific. Some evidence suggests that it’s helpful to do stretches tailored for your sport or activity. If you play soccer, for instance, you’re more vulnerable to hamstring strains. So opt for stretches that help your hamstrings.
  • Keep up with your stretching. Stretching can be time-consuming. But you can achieve the most benefits by stretching regularly, at least two to three times a week.If you don’t stretch regularly, you risk losing any benefits that stretching offered. For instance, if stretching helped you increase your range of motion, and you stop stretching, your range of motion may decrease again.
  • Bring movement into your stretching. Gentle movement can help you be more flexible in specific movements. The gentle movements of tai chi or yoga, for instance, may be a good way to stretch.And if you’re going to perform a specific activity, such as a kick in martial arts or kicking a soccer ball, do the move slowly and at low intensity at first to get your muscles used to it. Then speed up gradually as your muscles become accustomed to the motion.

“Do I have to stretch?” is a very common question, especially when discussing exercise. It’s a good idea, says the American College of Sports Medicine. The ACSM recommends stretching each of the major muscle groups at least two times a week for 60 seconds per stretch. Staying flexible as you age is a priority to help keep your mobility high as discussed in this weeks previous blogs.

If you have problems with posture or activities, make it a habit to stretch those muscles regularly. If you have back pain from sitting at a desk all day, stretches that reverse that posture can help.

Simple Back Stretchstretching2

Exercise physiologist Mike Bracko recommends doing the “Standing Cat-Camel” as a work-related back stretch. Here’s how:

  • Stand with your feet shoulder-width apart and knees bent slightly
  • Lean forward, placing your hands just above your knees.
  • Round your back so that your chest is closed and your shoulders are curved forward.
  • Then arch your back so that your chest opens and your shoulders roll back.
  • Repeat several times.

If your job keeps you in the same position all day, Bracko suggests doing 2-minute stretch breaks to reverse that posture at least every hour.

Strength Training

Whatever your age, strength training is an activity that provides many health benefits for both men and women. Strength training can be done by people who are in good health, as well as by those who have health concerns — such as arthritis or chronic pain.

Combined with regular aerobic exercise, doing an activity like lifting weights two or more times a week can improve your mental, emotional and physical health.

Strength training is known to reduce the symptoms of several health problems and chronic diseases, such as:

  • Arthritis, including osteoarthritis
  • Back pain and other types of pain
  • Depression
  • Diabetes
  • Obesity
  • Osteoporosis

While some of the benefits of strength training are for older men and women, it is never too early to start. The major benefits of strength training include:

  • Increased muscle strength. Without use, our muscles waste away as we age. Regular strength training can keep your muscles strong well into the post-retirement years. This can have a profound impact on your ability to function in your daily life.
  • Improved balance and reduced falls. Simple strength and balance training can improve your balance. This can reduce the risk of falling, which is a common problem for older people. Bone fractures from falls can lead to permanent disability and may even lead to death.
  • Stronger bones. Lifting weights or doing other types of resistance exercises puts stress on the bones. In response, the bones grow stronger (denser). This reduces the risk of bone fractures. Post-menopausal women, in particular, can benefit, because they lose 1 to 2 percent of their bone mass each year.
  • Weight control. Building muscle also increases how many calories you burn, because muscle tissue is very active. For this reason, strength training can boost your metabolism, which can help you lose weight or maintain a healthy weight.
  • Improved glucose control. Millions of Americans have type-2 diabetes, a condition that involves elevated levels of glucose in the blood. Left untreated, this condition can lead to heart or kidney problems, and even blindness. Strength training reduces the risk of these conditions by improving the glucose levels in the blood.
  • Better moods and sleep. Like aerobic exercise, strength training can improve your mood, self-confidence and self-esteem. In addition, regular exercise can help you sleep better. Together, these add up to a better overall quality of life.
  • Stronger heart muscle. The muscles of your arms and legs are not the only ones that benefit from strength training. Your heart will also grow stronger with exercise, which shows up as improved aerobic capacity. Even cardiac patients can benefit from doing this type of physical activity three times a week.

It is never too early or too late to start a strength training program. Adults should aim for doing this as least two days a week. The exercises should work all the major muscle groups of the body.

Strength training often involves lifting weights. But other types of resistance exercises also work well — such as using exercise bands or doing bodyweight exercises, such as push-ups or crunches.

If you are physically inactive, have an existing health condition or have concerns about your health, check with your doctor before starting any exercise program.