WEEKEND LECTURE – ULTRASOUND

OVERVIEW

THERAPEUTIC ULTRASOUND
THERMAL NON-THERMAL
Soft Tissue Shortening Delayed Tissue Healing
(Tightness) Pain Prolonged Inflammation
Muscle Relaxation Jumpstart Healing
Pain Reduction
 Thermal 100% Duty  Non-Thermal 20% Duty
 Superficial: (1-2cm)  Superficial: (1-2cm)
3MHz, 0.5 W/cm2 3MHz, 0.5-1.0 W/cm2
 Deep: (2-5cm)  Deep: (2-5cm)
Freq - 1MHz, Intensity - Freq - 1MHz, Intensity -
1.5-2.0W/cm2 0.5-1.0 W/cm2
5-10 min / 2 x ERA

- Emit ultrasound waves that travel through superficial

tissues of body and causes tissues to vibrate after contact
with tissue causing them to heat up
- Duty Cycle – percentage of time utz is emitting ultrasound
waves
- Superficial = Deltoid, Deep = Rotator Cuff ms
- Typically start at lowest intensity then increase as tolerated
but never over 2.0 (e.g., 0.5 initially)
- Thermal is more often used in the clinics
- Heating may induce more inflammation

TISSUE ATTENUATION COEFFICIENT (1

MHz)
Blood 0.18
Fat 0.6
Liver 0.9
Muscle 1.2-3.3
Bone 20
Lung 40

- Attenuation coefficient: certain tissue types are going to

heat up faster (lower attenuation, slower heating and vice
versa) so be careful in bones and lungs

APPLICATION
1. Apply gel on treatment area and ultrasound head

ERA (Effective Radiating Area)

- Region of ultrasound head emitting ultrasound waves
(Surface area in contact with skin)

2. Put ultrasound on the area and move in continuous circles

(1 small circle every 1s in a big circle axis)

CASE
“Pt. reports painful (4/10) L calf tightness and upon palpation,
there is a know at the site in the picture. What parameters would
you program to use therapeutic ultrasound on the region?”
- Pain with tightness (Thermal)
- Goal = Loosen soft tissue
- Duty Cycle = 100%
- Frequency = 3.0 (3.3) MHz (Palpable often superficial)
- Intensity = 0.5 W/cm2
- Duration = 5 min at start, progressing to 10 min
- Other modalities?
o Heat, if no inflammation
o Cold (addresses only pain, not tightness)
o Manual work + TENS