http-equiv='refresh'/> Global Therapies: A couple of thoughts on electrotherapeutic modalities

Friday, 20 May 2011

A couple of thoughts on electrotherapeutic modalities

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Having been to a couple of physios in the past for various soft tissue issues- namely tenosynovitis in one of the tendons in my thumb, and once for a knee issue from fencing, the main treatment that was given to me was Ultrasound. The physios veered very much away from massage as a modality, and used a lot of the electric stuff.

There was also a lot of movement therapy, which was great, but only about 10 mins of actual manual therapy. This is fine as it is, but from a little research into clinical sports medicine I came across an interesting study on electrotheraputic modalities.
It would seem that electrotheraputic modalities have been tested on a clinic scale rather than a scientific scale. The study I was looking at specifically mentioned Ultrasound, which is marketed as reducing inflammation and promoting healing- of which apparently there is only limited evidence. Indeed, if ultrasound is being used as a modality, it should not be relied upon as the SOLE treatment, but should be used as part of a collection of treatments on the injury.
In my experience, this has not been the case, and has been relied upon as pretty much the only thing, apart from remedial exercises, to heal the injury.

Another thing thrown up by this study is that there is little evidence to suggest that ultrasound is of any use on Soft-Tissue injury (specifically overuse injuries)- BUT, it has been shown to work on non-union fractures - helping bone to regrow back together. There is a condition to this though - and that is that the Ultrasound used is LIPUS (Low Intensity Pulsed Ultrasound)- and that it is used for 20 mins a day on a daily basis.

Traditional ultrasound, by contrast can only be used for no more than 5 mins at a time, 3 times a week, which doesn't give enough time for it to actually work on soft tissue.

Now, I'm not saying that Ultrasound is useless for long term overuse soft tissue injury. From the reading I have done, it seems that it is good in accompaniment to other theraputic modalities. Obviously I'm a bit biased in saying that massage is one of the better ways in which to get that healing, but there are any number of modalities. Don't rely on just one of them though.

As a note, the information in this post has come from Clinical Sports Medicine, P140-142.
If there are any studies that dispute this, or you are coming at the Ultrasound thing from another angle, I'd be glad to read them and have my perspective changed. Please do point them out.

As they say, don't use science to prove you're right, use science to become right.

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