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Sydney Borden

on 12 December 2013

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Transcript of Ultrasound

The Equipment of an Ultrasound
A deep-heating modality that is used primarily for elevating tissue temperatures using sound waves.
The Ultrasound machine uses inaudible vibrations of high frequency that may produce thermal or nonthermal effects.
Almost all ultrasound generators can emit either continuous or pulsed waves.
The percentage of time that ultrasound is being generated is called a
duty cycle
What occurs during an Ultrasound Examination?
The main piece used in delivering ultrasound therapy is a high-frequency generator. This piece provides an electrical current through a transducer.
Inside of the transducer there are disks of synthetic crystals that receive energy from the generator in order to produce sound waves to penetrate tissues.
The number of movements, or oscillations, in one second is referred to as the frequency of a sound wave. This is measured in hertz (Hz).
Ultrasound has a frequency range between .75 and 3.0 MHz (megahertz). Most ultrasound generators are set at a frequency between 1 and 3 MHz.
The intensity of an ultrasound beam is determined by the amount of energy being delivered by the applicator.
In sports medicine, the intensity used ranges from .1 to 3 W/cm^2 (Watts per centimeters squared).
If continuous waves are produced the intensity remains constant and the energy produced is being generated 100% of the time which results in thermal effects.
If pulsed waves are used, the intensity is being interrupted and no ultrasound energy is produced during these off periods which produces nonthermal effects.
The 1 MHz setting is used for areas that require deep ultrasound therapy due to the bone not being superficial.

Ex. 1 MHz would be used on larger muscle tissues such as the quadriceps to remove calcium deposits caused by Myositis Ossificans
The 3MHz setting is used on areas that need a superficial treatment due to the short distance that sound waves need to travel to the bone.

Ex. 3 MHz would be used on the the patellar tendon for tendonitis in order to break up the inflammation.
As already mentioned, Ultrasound can produce both thermal and non thermal effects.
Why do you think acute injuries need a non-thermal type of ultrasound therapy?
Ultrasound therapy should be started as soon as possible after the injury.
In Acute conditions, they need to be treated with low intensity once or twice daily until the acute symptoms have gone away.
In Chronic conditions, treatment should be done on alternating days for a total of about 10-12 treatments.
For an acute injury, the athletic trainer should not use thermal ultrasound therapy using continuous sound waves because the heating effects on acute injuries may make the swelling and pain worse.

For Chronic injuries, the athletic trainer should not perform ultrasound therapy every day because you need to give the body enough time to recuperate and allow swelling to enter the area so you can work on it the next day.
There are many options for using ultrasound therapy in Sports Medicine.
Direct Skin Application
- In order to perform this type of Ultrasound, the ATC needs a coupling medium.
Coupling mediums
include gels and mineral oils that provide airtight contact with the skin and a low friction surface.
Underwater Application
- This method should be used for irregular body parts such as the hand, foot, wrist, ankle, elbow , and knee.

Step 1
: The part should be fully submerged in the water.
Step 2:
The ultrasound head should be submerged as well and positioned one inch from the body part. The water provides an airtight medium just as a coupling medium does.
Step 3:
The transducer should be slowly moved in either a circular or longitudinal pattern. If air bubbles form on the surface of the skin, then they should be wiped away. This type of application should be done in a plastic or rubber non-mental container to avoid reflection of energy.
Ultrasound should not be used on the eyes, ears, testes, brain, spinal cord, and heart. Reproductive organs of women that are pregnant should not receive ultrasound.
Ultrasound in addition to other modalities
Ultrasound is often used with hot packs, cold packs, and electrical stimulation. Hot packs are useful because of the relaxing effects in muscle spasms and muscle guarding. Hot Packs produce more superficial heating while the Ultrasound heats deeper into the tissues.

Cold Packs are often used with Ultrasound as well. However, if the goal of the treatment is to heat tissues than the Cold Packs would interfere with heating.

Ultrasound is also used with E-Stim to treat trigger points. Ultrasound increases the blood to the area while the E-Stim does its job.
Review Time!
High-Frequency Generator
There should be careful usage over areas with poor blood circulation
The duration of treatment time should range from 5-10 minutes.
The Epiphyseal areas in children should have limited ultrasound exposure.
Phonophoresis is a method of transporting molecules through the skin using the mechanical vibration of the ultrasound.
Phonophoresis and Iontophoresis are often confused.
Both techniques are used to deliver medication to tissues in the body.
It involves the use of ultrasound to transport whole molecules across the skin into the tissues
Uses an electical current to transport ions into the tissues
Some Medical personnel have stated that it is less hazardous to the skin and gets deeper into the tissues.
Used to introduce hydrocortisone and anesthetic into tissues
Treats bursitis, tendinitis, and painful trigger points
Need further research!
Chemopads are pads that are impregnated with the medication necessary that can be used instead of the traditional medicated ointment application.
The medication is massaged into the skin before the normal ultrasound process is carried out.
Drives charged particles into the tissues with the use of knowledge of polarity and charges.
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