What are ultrasound and shock waves? ｜Are device treatments really ineffective?

I believe it's not just Baker, all physical therapists know that the " device therapy " we use the most is a relatively " negative " therapy in physical therapy

There is only "relief" for the patient's symptoms, and even "deceiving the brain" to achieve an effect similar to painkillers

No active therapeutic implications

These are the well-known electrotherapy, heat compress, waist and neck

But what is the use of a type of instrument that Baker does not have in electrotherapy and hot compress? ｜ What do physiotherapists do under the health care system? mentioned in this article

It's those "waves" that you've seen but can't see

Ultrasound

What's the first image that pops into the minds of residents who haven't had a chance at physical therapy when they hear the word?

I think there is a high probability that animals such as bats and dolphins rely on " ultrasound echolocation "!

That's right! Ultrasound was indeed first used for positioning, that is, to imitate the "sonar" made by these two animals

The "reflection" of sound waves with a frequency exceeding 20,000 Hz, the highest frequency visible to the human ear, hits different media

Can be used to detect enemy troops, locate fish, etc.

In fact, the application of ultrasound has a very long history in human history.

Therefore, there are many applications according to the strength of the energy.

For example: sonar, medical examination, ultrasonic side distance, ultrasonic flaw detection...etc. Weak energy, non-destructive ultrasonic waves

But once the ultrasonic energy is intensified to a certain range, it can produce " destructive "

For example: ultrasonic cleaning, ultrasonic welding, ultrasonic cleaning, extracorporeal lithotripsy, physiotherapy ultrasound, extracorporeal shock wave...

Wait, physiotherapy ultrasound is destructive?

Yes, ultrasound is a relatively "risky" treatment in physical therapy.

On ice or heat? Rest or exercise? ｜ If you have soft tissue injuries, you should do this! This article mentions

Soft tissue injuries can cause "stickiness"

If it is left untreated, it will "reduce the repair speed", and eventually it will even "calcify" and "break" after being pulled.

Because the cross-section when the soft tissue is pulled to the tear is "untidy"

It's like two pieces of cloth are surrounded by raw edges and twisted

If you want to sew two pieces of cloth into a flat piece of cloth, you can imagine how difficult it is

Therefore, in order to allow the tissue to be repaired smoothly, we have to "stick removal"

Not only that, but also to remove "very neat"

In the end how to do it?

In fact, high-energy ultrasound is used to "break" the sticky protein

Because the sticky material structure is not strong enough to withstand such energy, these "wastes" will be "shattered"

Finally, it is metabolized and absorbed by the body...

This treatment is theoretically because you don't want to hurt normal tissue

Therefore, the operation is usually "no feeling"

After all, it's hitting a sticky substance that doesn't have innervated nerves.

But it is a kind of " micro-injury " to the body

cause mild inflammation

As we mentioned before, the inflammatory response is to bring in repairing substances

Therefore, such micro-injury can stimulate the tissue to repair again.

It can also take away metabolic waste and debris of sticky substances!

shock wave

In fact, this is a medical device originally used for patients with "internal stones"

"Smashing Stones" with Stronger Ultrasound

Removal of gravel by other means

The extracorporeal shock wave commonly used in physical therapy is actually a weakened version of the extracorporeal lithotripsy machine;

Generally used in soft tissue that has begun to calcify

This is actually an ultrasound, but with more energy

Even general tissue may be damaged, but at the same time it is accompanied by a stronger repairing effect

Generally divided into:

" Diverging " for large fascia muscles; and " focusing " for a single pain point

Different from ultrasound

It only works if it hurts!

After all, even calcified tissue can be shattered for the body to absorb

Although this is also ultrasound therapy

But shock waves are usually " at their own expense "

There are counts and times.

Usually a treatment of 1000~3000 can't run away

Ultrasound and shock waves actually exploit the body's 'inflammatory response' to injured tissue

Promotes repair while breaking up sticky, calcified tissue

This also means that if your own repair ability is not enough, the treatment will not only be ineffective but may also cause damage

Especially after a destructive treatment like Shockwave

Usually the therapist will ask the patient to add more protein and water

Are physical therapy instruments effective?

Instrument therapy is to add more ink to the principle of " make yourself better "

Electrotherapy , so that you will not be so painful, so you will not reduce the limbs that should be more active because of the pain

Instead, cause sticking, weakness, and poor circulation

Traction , help you loosen the muscles, and if possible, pull the spine slightly apart to create a pressure difference so that the intervertebral disc can easily go back on its own

But for degeneration and bone spurs, it can only be avoided by pulling away from the present.

The ultrasound and shock waves introduced this time are actually instruments that maximize the true meaning of instrument therapy.

Even at the risk of letting the body "injury again"

But usually the effect is significant

It is a relatively active treatment in the instrument treatment

However, both treatments are for " soft tissue injuries "

Soft tissue injuries are handled well in the early stages, and even adhesions can be easily removed

When serious sticking or even calcification occurs, it is usually accompanied by joint skewness and even nerve compression .

These are simply repairing the injured soft tissue and cannot heal by itself.

Relying on manual therapy can solve these problems well

So you will find: early soft tissue injury depends on yourself; long-term adhesion and sequelae rely on physical therapist; already calcified rely on shock wave plus physical therapist

No treatment requires "Healthcare" physiotherapy

So Baker is still the old saying:

Learn to protect yourself and prevent injury; if you really want to do treatment, it is recommended to pay for physical therapy at your own expense, which is definitely more expensive for a single session; but it must be more effective and cost-effective in the long run



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I'm Baker, I'm a physical therapist, welcome to my country

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Under the current health care system in Taiwan, no matter what the zodiac sign, the therapist will definitely write the word "world-weary" in the personality column.

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Over time, the burning dream fire in my heart gradually went out, and "doing the 'teacher' and walking the meat" became a buff at the meeting before going to work every day . . .

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But in my country, I hope my residents can see the true face of physical therapy and then understand, understand, and even like this profession that is "no less than any other medical technology" and "not just mindless operation" . . .

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