Ultrasound in physical therapyUltrasound was invented… well actually discovered… by the US Navy – they were trying to find better ways to kill people at sea and wanted to know how dolphins communicated with each other underwater. It turns out that dolphins communicate by using high pitch sound around 40 Khz. The navy copied the idea and called it sonar. Some bright spark thought, “well the human body is mainly sea water, I wonder what would happen if… “, tried it on a human – and ultrasound therapy was born.

Most standard ultrasound machines on the market really are ultra – they are so high you can’t hear them. I use such a machine on these settings:

50% pulsed, 3Mhz , 2.5 Watts per square centimetre for 8 to 10 minutes on each side of the spine, where the patient is of a light frail build.

For very heavy patients, I use:

50% pulsed, 1Mhz , 2.5 Watts per square centimetre for 8 to 10 minutes on each side of the spine. The 1Mhz has deeper penetration than the 3MHz.

Most Ultrasound machines only go up to 2.5 Watts of power per square centimetre, but where 3 Watts is available, when you are using the 3MHz, you’ll notice the 3 Watts is more effective than 2.5 Watts. So it can usually be used in the Lumbar region.

When using the 1MHz, the 3 Watts might be a bit too strong so only use 2.5 Watts per square centimetre.

Please buy the correct unit. You’ll need to pay new £300 to £1,000 to get a proper Ultrasound machine. The cheaper ones might say “3 Watts” , but it needs to be Watts per square centimetre, not total Watts.

Both 1Mhz & 3Mhz can cause bone cavitation – mini holes in the bone, so you don’t use it in children and you don’t use it over or too close to the spine.

“Pulsed” means it goes on and off. The idea of the “50% pulsing” setting, is to have a cool ultrasound session – non heating – which happens without pulsing on .  The aim of the treatment is to gently reduce the spam, drain the area so that the white blood cells can get their work done and clear the debris and do the repair work needed. To get the patient better, the area needs to be free from obstructions that might have been congested for decades since the accident. A setting that causes heating will work in the opposite direction from what we are trying to achieve – as do most therapies like deep tissue massage etc – “lets get some blood in there !” ends up meaning “let’s increase the congestion !”. The frequency of this pulsing 20HZ, 100HZ, 200Hz is irrelevant so any setting offered by your machine will be fine.

The original ultrasound – the one Dolphins use – is at the 40 Khz level (this is called Longwave Ultrasound) and this has most of the advantages of the Mhz ones without the cavitation problems, so this can be used closer to the spine. It is best used on continuous mode rather than pulsed mode as it has little heating effect. Where you have herniated discs and you can see the redness in the area that as been there for years, using the long wave Ultrasound over this area for 15 to 30 seconds can often reduce the inflammation down so much that the redness goes. In the UK, you can buy such a unit here and also here, where it is called the Phys-Assist.

Don’t use ultrasound over an area where the patient has had cement put in – kyphoplasty – as the ultrasound might breakdown the cement. Pacemakers are another thing to avoid going near. Pregnancy is again a bad idea as it might damage the child’s hearing and do not use it over tumours or directly over metal work,

The ultrasound handpiece is not a massage tool so to not “dig in” use just light surface touch.

All types of ultrasound need a water based ultrasound gel to be placed on the skin for the ultrasound waves to penetrate into the body and the crystals in the head of the Ultrasound unit will

overheat and be damaged if they have nowhere for the heat sound to go so always place the hand unit on the gel on the patient’s skin, then switch on, likewise switch off, or wait till the timer has ended the session before removing the unit from the skin, keep the hand piece moving at all times so as not to cause heating in anyone area, continual motion during the entire session.

I generally use just the Longwave ultrasound – the Dolphin 40Hz one – unless it is a particularly bad back with a very heavy spasm, in which case I use both types as they do slightly different things. It is thought that a lot of the benefit of the “swimming with dolphins” therapy comes from being bathed in 40Khz ultrasound by the dolphins when they assess you – but who knows ?

So how do you get a bad back ? – an accident. The back is very electrical and after a trauma injury the whole back lights up with all sorts of errant nerve signals causing muscles spasms. These spasms – a state of constant flexion – mean the muscle pump is not working, it also means a constant and very powerful pressure on the vertebrae & discs. Overall this is not very helpful to the process of healing as you need the muscle pump to work to clear the tissues of old gunk allowing new fresh white blood cells to do repair work. The discs absorb nutrients by the rise and fall of their height during the day – but if they are continually squashed – this starves and so weakens them.

Ultrasound helps reduce these spasms, the long wave Ultrasound is also particularly soothing to the damaged sensitive tissues around the spine. You can feel the tight knotted fascia smooth out during a treatment session.

Used in conjunctions with EMS & the ASMI, it is very effective at fixing even very seriously damaged bad backs. Even where this problem has persisted for decades.

This is the Ultrasound Machine I use: https://astar.eu/products/sonaris-s