Ultrasound...& MCL ? ? ?

[tcw]

Anyone know of the benefits of using Ultra Sound on a Tendon Injury?

I have a MCL sprain that i want to heal fast but was told that it might take 6 mths.

Its getting better *(about 60%) but still feel a little pain when i "rotate my foot."

Anyone ever use Ultrasound on a knee Tendon?

[Too Little Muscles]

I have never heard of using ultra sound to repair a torn ligament. A sprain is the same thing as a minor tear. I had a grade 1 tear of my MCL(medial collateral ligament). It is not a tendon. Tendons connect muscle to bone. Ligaments connect bone to bone. I diagnosed it on WebMD. Never went to a doc. Grade 1 is a minor tear. Grade 2 is a more serious tear and grade 3 is a complete tear and requires immediate surgery. There is no surgery for grade 1 and 2. The healing time is the same whether you have surgery or not. You just have to rest it. Mine healed in 2 mo. You can see more of the MCL on You-Tube.

[lovbyts]

Ultrasound therapy is a treatment modality used by physical therapists or occupational therapists to treat pain conditions, and to promote tissue healing.
http://pain.about.com/od/treatment/f...nd_therapy.htm

As yet, there seems to be little evidence to support the use of ultrasound therapy in the treatment of musculoskeletal disorders.
http://www.ncbi.nlm.nih.gov/pubmed/10431713

[tcw]

Conflicting Data from Reliable Sources?

http://ajs.sagepub.com/content/33/7/1048.abstract

I know that when i go the PT, the first thing he's gonna do is some ultra sound. I also know that it has helped me heal deep tissue sprains, spasms related to my back.

What i'm basically concerned about is if US DAMAGES or WEAKENS the bones in any way?

Since the MCL is so close to the knee bone joint...i wonder if there is a danger of it damaging the knee mechanism itself?

Anyone?

[tcw]

More articles point to ultrasound for this injury.

http://www.physioadvisor.com.au/9589...mcl-injury.htm

[Hillary Clinton]

Wow...!

And all this time....we were told that nothing could be done for Ligament injuries/tears. Every time i have a sprain or slight tear in some Tendon or Ligament...the Dr's want an MRI (i'm ok with this) and then a Visit to the Surgeon (who invariably want to operate).

...more B.chit from the "AMA propaganda" machine!

REMEMBER: if Surgeons don't operate...they can't put gas in their Yachts!

Good work "tcw"

Conflicting Data from Reliable Sources?

http://ajs.sagepub.com/content/33/7/1048.abstract

I know that when i go the PT, the first thing he's gonna do is some ultra sound. I also know that it has helped me heal deep tissue sprains, spasms related to my back.

What i'm basically concerned about is if US DAMAGES or WEAKENS the bones in any way?

Since the MCL is so close to the knee bone joint...i wonder if there is a danger of it damaging the knee mechanism itself?

Anyone?

[Builder15]

Ultrasound will not do any damage to the knee itself. It is a deep heat modality with a max penetration depth of 5cm. If left over a bone too long you will feel a sharp pain but that is because bone absorbs the heat at a much faster rate than other tissues in the body, but again will not do any damage.

As for healing the MCL, no it won't necessarily help it heal. It may make it feel a little better as it can help reduce swelling due to some its mechanism of action and this will help reduce the irritation, but overall it will not necessarily help it heal. The majority of musculoskeletal injuries out there, ultrasound has been proven equivocal or not effective and beneficial for very few things.

[tcw]

thanks...

How do you know it won't heal (or help) the MCL?

I know that 99% of the surgeons out there don't want you to heal without Sugery...but do you have any studies to prove that US does little to nothing?

Ultrasound will not do any damage to the knee itself. It is a deep heat modality with a max penetration depth of 5cm. If left over a bone too long you will feel a sharp pain but that is because bone absorbs the heat at a much faster rate than other tissues in the body, but again will not do any damage.

As for healing the MCL, no it won't necessarily help it heal. It may make it feel a little better as it can help reduce swelling due to some its mechanism of action and this will help reduce the irritation, but overall it will not necessarily help it heal. The majority of musculoskeletal injuries out there, ultrasound has been proven equivocal or not effective and beneficial for very few things.

[Builder15]

There are hundreds of studies on the reported effects of ultrasound. The majority of them you will find no benefit on whatever condition they are treating it for. Sure you will find studies that will conclude that ultrasound is beneficial but you need to look at the total response. Usually the change is statistically different but in the real world this means nothing to us clinically. Another huge problem with ultrasound studies is that they are using incorrect parameters when delivering treatment. Either too little energy is being delivered into the tissue, selecting the wrong frequency for penetration depth, or treating greater than 2-3 times the ERA of the sound head. You are fooling yourself if you think that ultrasound alone will help your tendon heal. Yes it will help but if that is all your physical therapist or chiropractor is doing then you are not getting what you deserve. I have read studies that show promising changes in tissue with ultrasound and I have read studies that also show ultrasound can actually do damage to collagen synthesis.

I also think that you are wrong about surgeons. Some of the best surgeons in the US will not even consider operating unless you have failed conservative management including 6 weeks or more of physical therapy. When I see any type of tendon or ligament injury I can tell you that 90% of the time I will never ultrasound it and the majority of them get better. Those that struggle with getting better I will try ultrasound and in my experience its usually a 50/50 chance that it will help. When it helps it is certainly not a miracle cure, but I have had a few instances where people just love it and think its the greatest thing ever, but these are generally the people that come in and say "heal me" not "what can I do to heal better and get back to normal" and generally like the more passive modalities such as ultrasound. If it helps, then wonderful and I don't really care if its all placebo or if we are stimulating a healing response. Hope this helps.

[Builder15]

double post

[tcw]

Thanks builder.

Yeah...dude...i never said it was a "Cure-all"...but certainly a potential Helper in healing an injured Ligament.

Surgeons recommend PT because they have too...Not because they believe in it. Surgeons have found it is a liability issue to operate on someone who has not had PT,...no PT was recommended in their file, and if THE SURGERY fails..BINGO..they get their arses sued and have to pay out immediately (there's no defense).

It sounds like you are against Ultra-Sound...May i ask why?

Why are you against using a Tool that has been proven to help the healing process?

PS
Appreciate the input!

There are hundreds of studies on the reported effects of ultrasound. The majority of them you will find no benefit on whatever condition they are treating it for. Sure you will find studies that will conclude that ultrasound is beneficial but you need to look at the total response. Usually the change is statistically different but in the real world this means nothing to us clinically. Another huge problem with ultrasound studies is that they are using incorrect parameters when delivering treatment. Either too little energy is being delivered into the tissue, selecting the wrong frequency for penetration depth, or treating greater than 2-3 times the ERA of the sound head. You are fooling yourself if you think that ultrasound alone will help your tendon heal. Yes it will help but if that is all your physical therapist or chiropractor is doing then you are not getting what you deserve. I have read studies that show promising changes in tissue with ultrasound and I have read studies that also show ultrasound can actually do damage to collagen synthesis.

I also think that you are wrong about surgeons. Some of the best surgeons in the US will not even consider operating unless you have failed conservative management including 6 weeks or more of physical therapy. When I see any type of tendon or ligament injury I can tell you that 90% of the time I will never ultrasound it and the majority of them get better. Those that struggle with getting better I will try ultrasound and in my experience its usually a 50/50 chance that it will help. When it helps it is certainly not a miracle cure, but I have had a few instances where people just love it and think its the greatest thing ever, but these are generally the people that come in and say "heal me" not "what can I do to heal better and get back to normal" and generally like the more passive modalities such as ultrasound. If it helps, then wonderful and I don't really care if its all placebo or if we are stimulating a healing response. Hope this helps.

[Builder15]

Surgeons do not have to recommend anything. The ones that recommend PT do it because they know it works and have found it helps their patients. For example, spinal surgeries have been shown to be just as effective as physical therapy in patient outcomes. The spine surgeons who are up to date on research know this and if they don't see an immediate need for surgery they will send them to PT. If it doesn't help then they will try surgical intervention but it is their call. They can operate all they want as that is what they are trained to do. They are not held liable if the surgery fails and they did not send them to PT. That is why they explain the risks and benefits of surgery and have you sign papers to say you understand. Surgeries do fail, its not common but it happens and if the surgeon was held liable there would be no surgeons.

I am not against ultrasound, but it sounds like you have made up your mind that it is proven effective when again the majority of the research proves that it is not beneficial. I think we are thinking about this 2 different ways. Yes ultrasound will alter cell properties and promote healing, however, when this is compared against groups in research studies who get no treatment, or a different type of treatment it generally shows that there is no improvement in their outcome for those who received ultrasound. That is why I do not use ultrasound except as a last resort if someone is not showing improvements. I think its perfectly fine if you want to give it try and if you find it beneficial then great at least you are on your way to recovery and whether its placebo effect or truly is a result of the ultrasound treatment it doesn't matter. Most physicians and PT's will tell you that almost 1/3 of their treatment outcome is probably due to placebo but i'll take that anyday! haha.

[tcw]

thanks dude.

Again, i don't know where you get that i feel that US is a cure all for injuries. I'm merely suggesting that it is a TOOL...that has been PROVEN to help (see above notations).

Are you in the Health Field?

You refer to the topic as if you are in the health field...

Surgeons do not have to recommend anything. The ones that recommend PT do it because they know it works and have found it helps their patients. For example, spinal surgeries have been shown to be just as effective as physical therapy in patient outcomes. The spine surgeons who are up to date on research know this and if they don't see an physicians and PT's will tell you that almost 1/3 of their treatment outcome is probably due to placebo but i'll take that anyday! haha.

[Builder15]

thanks dude.

Again, i don't know where you get that i feel that US is a cure all for injuries. I'm merely suggesting that it is a TOOL...that has been PROVEN to help (see above notations).

Are you in the Health Field?

You refer to the topic as if you are in the health field...

I do work in the health field. I am a physical therapist and do use ultrasound occasionally. I agree with you that it is a tool that can be used but what I disagree with is that it has been PROVEN to work. The study you sited performed ultrasound on rabbits which while similar to humans they are in fact not humans. They also did not provide any of the ultrasound parameters in the abstract and I would need to read the whole study. My big issue is that how does that study apply to me in the clinic? It doesn't. While it showed modest and slight improvements in healing of the MCL at 3 and 6 weeks, does that mean that the rabbits had less pain and more function? I can't answer it based on that study. Like I said it does change cell properties and promote healing but does that truely affect the results someone may have (better pain and function, etc) I can't say for certain. I have studied this extensively when I was in school and now that I am a practicing clinician and I have concluded there is no clear evidence that ultrasound is effective for most things. That doesn't mean I won't use it but its certainly not the first tool I reach for. I hope I am not sounding hostile or anything just trying to give you an idea of what I have learned about it. Back to the real issue though, how is your MCL doing?

[lovbyts]

Wow, lots to read on those studies. I to have been looking into the ultrasound for some pain relief in my shoulders due to tendonosis I believe. Lots of good personal reviews on some of the little gadgets on amazon but I know people are easily fooled by placebo and positive thinking.
I still think the studies are interesting and probably true; not saying it CANT help but not like people think.

27 completed the trial (13 active-LIPUS and 14 inactive-LIPUS).
This randomized, double-blind, placebo-controlled study found LIPUS to provide no benefit over and above placebo treatment in the management of pain associated with PT. Average and worst pain in both the active- and inactive-LIPUS-treated groups decreased significantly over the 12-week study period;

[tcw]

Hey Builder,

thanks for your input. I have been doing various things to help heal my MCL. One thing that seems to help is Moist Heat for about 5 mins...followed by deep tissue massage (although painful for about 60 secs).

I have tried 2 US treatments in the MCL area which is quite boney (as you know). Interesting though...is that the following day the area is "Sore" even though i only use it for 3-5 mins...using continuous circular motion.

Hmmm....wonder what that means?

I have been resting the quite a bit and cut back on any unnecessary walking or exertion of any kind (catching up on movies and sedate activities like writing, reading, etc).

Overall the area is improving TO WHICH i am Pleased but i do miss my Lower Body Workouts (sigh)

thanks Very much for your input!

~T

I do work in the health field. I am a physical therapist and do use ultrasound occasionally. I agree with you that it is a tool that can be used but what I disagree with is that it has been PROVEN to work. The study you sited performed ultrasound on rabbits which while similar to humans they are in fact not humans.

[dsupera]

Tell you what, I can't say for sure that ultrasound is a miracle thing but I had a bad fall on may 10th 2009. I broke my ankle in three places and my fibula was snapped along with several ligaments torn. My ortho guy said I should try ultrasound, so I bought the unit myself to keep. After having pins inserted in the ankle and a plate on my fibula, I performed this therapy everday for about 30min at a time twice a day. Three months to the day later on Aug 10, 2009 I squated again with 135lbs. A week after that my physical therapist couldn't believe it when I walked in the office and performed 10 calf raises with the entire stack on his machine. I think ultrasound had a lot to do with it, personally.

[tcw]

...there ya go !

Another testimony.