One of the most widely used therapeutic modalities among physiotherapists is ultrasound. This type of ultrasound uses mechanical sound waves to vibrate the tissues. It is different from a diagnostic ultrasound in that it does not produce an image, but rather produces a vibration that is transmitted to the tissues. Audible sound waves operate at a frequency of 20 Hz to 20KHz, while ultrasound sound waves have a vibrational frequency of 1-3 MHz.
Primarily the ultrasound acts as a heating agent, where the vibration creates energy that is turned into heat. By applying heat to the affected tissue, blood flow, elasticity and metabolic processes are increased. For example, a stiff joint may benefit from the thermal effects of ultrasound by allowing more blood flow to reach the area and increasing its flexibility or range of motion.
When ultrasound is used on the pulsed setting it prevents the heating effect and instead the vibration from the mechanical sound wave acts like a massage, especially useful for scar tight tissue.
Ultrasound should not be applied to the following: localized cancer or malignancy, metal implants (such as total hip or knee replacements), acute infections, pregnancy, implanted pacemakers for the heart, or over blood clots.
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