What is Therapeutic Ultrasound?

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Therapeutic Ultrasound

If you've ever been prescribed physical therapy by your doctor your therapist may have utilized a modality called ultrasound. Most people hear "ultrasound" and think of the black and white images that outline a tiny little human forming in a uterus. Well, it's still the same kind of technology, just utilized differently. 

Therapeutic ultrasound uses in physical therapy:

  • Tendonitis
  • Bursitis
  • Plantar faciitis
  • Small calcifications within tendons
  • Confirming/diagnosing stress fractures
  • Diagnosing fractures

Therapeutic ultrasound consists of a transducer head that contains a crystal that vibrates at different frequencies. Ultrasound is a method of stimulating the tissue beneath the skin's surface using very high frequency sound waves, between 800,000 Hz and 2,000,000 Hz, which cannot be heard by humans. 

"Ultrasound is applied using a transducer or applicator that is in direct contact with the patient's skin. Gel is used on all surfaces of the head to reduce friction and assist transmission of the ultrasonic waves. Therapeutic ultrasound in physical therapy is alternating compression and rarefaction of sound waves with a frequency of 0.7 to 3.3 MHz. Maximum energy absorption in soft tissue occurs from 2 to 5 cm. Intensity decreases as the waves penetrate deeper. They are absorbed primarily by connective tissue: ligaments, tendons, and fascia (and also by scar tissue)." [SOURCE]

These ultrasonic waves that are absorbed by the various tissues allow for a deep heat to occur within these deeper tissues. This method of heating the deeper tissues is more affective than a heating pad since that is a more superficial heat and will not penetrate as deep as the ultrasonic waves.  Heating up these deeper tissues promotes blood flow which promotes healing. Since the ultrasonic waves penetrates to the deeper tissues the heat isn't always felt because the nerve tissues that perceive heat aren't as populated in the deeper tissues. Sometimes you do feel some warmth, but it shouldn't be too hot.

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Treating Calcifications

From our experience with utilizing ultrasound we have found that if a slight calcification is present in a tendon such as a bone spur, discomfort can be felt with treatment. However, we have found that after several sessions of ultrasound this discomfort will decrease which we suspect is helping this calcification be reabsorbed. This is only from our own experience with treating chronic achilles tendonitis with improvement in pain level and increased activity. We have no evidence that the bone was reabsorbed. There is some research to show ultrasound treatment can improve pain from calcific tendonitis in shoulders as well [SOURCE]. 

Are you a Candidate for Ultrasound Treatment?

If you've been diagnosed with any sort of tendonitis, bursitis, or other chronic tendon issues you may benefit from ultrasound intervention. This treatment is non-invasive, painless, and requires no effort on your part. The major contraindication with ultrasound treatment is metal implants (only over the site), pacemaker (only over the site), and metastatic cancer sites/other malignant tumors (only over the site). 

Feel free to contact us about how we can help you find the right intervention for you! 

Boston Strong

Today marks 2 years since the Boston Marathon Bombing in 2013.  It's now one of those dates for me, and everyone from the New England area that everyone will know where and what they were doing that day. I certainly remember the day as I watched all the runners make their way to Boylston Street and it wasn't until about an hour after heading home that I heard the news. We had friends from out of town visiting for the Patriot Holiday weekend. Patriot's Day is probably one of the only holidays that the rest of the country does not observe, which is a shame. I feel the Patriot's Day is even more special than July 4th since it marks the start of the Revolutionary War, April 19, 1775.

My super good friend Anne Schomber, OTR/L is on the left with me on the right. This picture was taken on April 14, 2013 at the Finish line for the Boston Marathon.

My super good friend Anne Schomber, OTR/L is on the left with me on the right. This picture was taken on April 14, 2013 at the Finish line for the Boston Marathon.

The Marathon has so much meaning; people coming together from around the world with one goal, and everyone supporting each other, no matter how fast, slow, big or small, or color of your skin, just to finish those long grueling 26.2 miles. I've been on the sidelines and I've had the opportunity to experience those 26.2 miles first hand. It's hard to describe, but it's amazing the impact that this event has had on my experience of living near Boston, and I highly recommend visiting during this busy and historical time of year.

In 2013 we had friends from out of town and we've started a tradition each year to get up "wicked" early on Patriot's Day/ Marathon Monday to see the Lexington Reenactment then head to Natick, where our friends have a house on the Marathon route. On April 15, 2013 we were all very happy and excited soaking in the meaning of the day, only to suddenly be shocked and confused by the events that followed. I don't need to go into the details of that day, especially with the final sentencing that is still ongoing. I hope that each year the wounds, both physically for those involved, and those emotional for even more, left from that day will continue to heal and we won't forget the values that this country was founded. Especially right now with so much division, labeling, and hatred in the news. We're all here to get through each day, each week, each year and the miles in-between with as little pain as possible. Why not help each other out to make them easier and more enjoyable? It's all about the journey not the destination, which is something I strive to achieve with each individual I treat.

Natasha, DPT


7 Stretches to Help Recover from Shoveling

Boston hit 100 inches of snow! If you live in this area, then you may be like so many who have been dealing with aches and pain from so much shoveling. It gets rigorous when you're trying to throw that snow 7 feet high! Check out my neighbor's backyard, it's insane!

So, what's ailing you, shoulders, back, maybe even elbows? I know those areas were certainly some hot zones for myself. So, how about give them some relief. Below are a few for each area to help with some of the common repetitive injuries that can occur after so much shoveling. (Forgive the awkward photos...)

ELBOW

Common Injuries: Tennis Elbow or Golfer's Elbow (Medial and Lateral Epicondylitis)

Most likely you have heard of these conditions in the sport's world, but basically they occur with repetitive gripping and hand use.  They can especially occur when gripping and then lifting something heavy, and tendonitis can be very painful and take a long time to heal. So, how about cut it off at the pass and do these stretches after you've shoveled.

Tennis Elbow Stretch: Extend elbow and bend palm toward you wrap opp hand over your hand and stretch.

Tennis Elbow Stretch: Extend elbow and bend palm toward you wrap opp hand over your hand and stretch.

Golfer's Elbow Stretch: Extend elbow and bend palm away from you, opp hand pulls fingers toward you to stretch. (No I am not pregnant, awkward stretch of photo...)

Golfer's Elbow Stretch: Extend elbow and bend palm away from you, opp hand pulls fingers toward you to stretch. (No I am not pregnant, awkward stretch of photo...)

 

SHOULDER

Common Injuries: Impingement and Bicep Tendonitis

Pain around the front of the shoulder and difficulty raising your arm over head is common after repetitively lifting heavy weight overhead.  Try some of these stretches to help open up your shoulder, chest, and neck after all that forward movement from shoveling. Sometimes the pain can even radiate down into your arm and hand. If your pain is radiating into your arm, elbow or hand seriously consider seeing your doctor for a referral to a physical therapist to help centralize the pain.

Pec Stretch: Place arms on either side of a door frame or corner and then lean forward to stretch the front of the shoulders and chest.

Pec Stretch: Place arms on either side of a door frame or corner and then lean forward to stretch the front of the shoulders and chest.

 
Upper Trap Stretch: Neck and shoulder stretch (trust me!), place arm behind low back and take other hand on head and pull head to opposite direction.

Upper Trap Stretch: Neck and shoulder stretch (trust me!), place arm behind low back and take other hand on head and pull head to opposite direction.

LOW BACK

Common Injuries: Lumbar Strain and SI joint Dysfunction

Low back pain is a very prevalent condition that occurs in probably almost everyone at some point in their life. Back pain can be complex and I'll talk more about different conditions in later posts, but for now let's focus on just general achiness after a lot of bending from shoveling. Hopefully, when you're shoveling you are lifting with your legs and trying to limit bending forward. But I know it's very difficult not to bend forward at some point with shoveling and throwing all that heavy snow. If you develop back pain that causes radiating pain into your legs at all, please consult your doctor.

The following few stretches are my favorite stretches for low back pain, and I've experienced first hand how beneficial these stretches are. There's even an extra one in there for good measure.

Double Knee to Chest: Pull both knees into your chest for a stretch on your low back.

Double Knee to Chest: Pull both knees into your chest for a stretch on your low back.

Figure 4/Piriformis Stretch: Cross one foot over the opposite knee and pull the knee towards yourself to stretch the opposite hip.

Figure 4/Piriformis Stretch: Cross one foot over the opposite knee and pull the knee towards yourself to stretch the opposite hip.

Runner's Lunge/Hip Flexor Stretch: Half kneel and lean forward, keep pelvis/low back neutral to feel a stretch in the thigh that the knee is on the ground.

Runner's Lunge/Hip Flexor Stretch: Half kneel and lean forward, keep pelvis/low back neutral to feel a stretch in the thigh that the knee is on the ground.

Hamstring Stretch: Lie on your back with a belt/strap on foot straighten your leg keep quad muscle engaged and straight leg, pull leg towards to feel stretch behind your knee/thigh.

Hamstring Stretch: Lie on your back with a belt/strap on foot straighten your leg keep quad muscle engaged and straight leg, pull leg towards to feel stretch behind your knee/thigh.

 

I recommend that you hold these exercises for 30 seconds 1-2 reps as you can tolerate. If any pain persists though please consult your PCP and your own physical therapist. I hope that these stretches help you recover from all the hard work of clearing your driveways, sidewalks, and roofs. Please stay safe, and remember that to always consult your own medical professional if pain persists.

Have fun Stretching,

Natasha, DPT

Introductions...

Welcome to my website and blog. I'm just starting out so bare with me as I keep developing my site. I am currently in the process of creating my business and honing my writing skills. I want to share my vision and purpose as well as some background about myself.

A Little About Me: I like to think of myself as a renaissance woman (I know vain right?). I have a lot of random talents, and I seem to forget about them sometimes. I am a DPT by trade, but I also play violin, viola, and piano. I've even done some teaching on the side for family and friend's kids. I obtained my private's Pilot's license before I went to college, but personally haven't been pilot in command in awhile (I let my husband do that). I completed the 2014 Boston Marathon last year, as well as my first sprint Triathlon. I love my road bike, and hope to do more biking once its not snowing so much. I've recently gotten into a more Paleo lifestyle, though on and off it depending on the week, but baby steps right?

My Vision:  My name is Natasha and I'm passionate about being a physical therapist and the profession.  Unfortunately the way our healthcare system is designed most people come to see me once an ailment has set in for far longer than it should have. I envision that someday people will start seeing their PT as they would their dentist. Come see us for your regular tune-up for your whole body. I've helped people change their environment to prevent further injury, and improve alignment. I hope that with this blog I can help you do the same, and know where to go when things do go wrong.  What I also truly hope I will be able to provide others are the resources to help themselves and inspire people to move. No one's perfect, so don't think  you have to be an athlete to get moving. I love the baby steps approach, we're all a work in progress. I'm not going to be showing you me lifting or doing other crazy athletics, I'm not that kind of person. I want to be realistic, provide the resources that others have found to be helpful, and maybe some of you can teach me as well.

I love teaching others about exercise, health, and recently have been getting more involved with food coaching. I'm hoping that I will be able to be that PT who can treat the entire person, instead of just a single diagnosis.

Going Forward: I hope that I can help you, and that you can help me with any requests, feedback, and recommendations that you may have. I'm hoping to be have things more updated about what I'll be providing, but for now I'm just taking the leap to get things started. Thanks in advance for your feedback and patience.

Best,

Natasha, DPT

 

Shoveling after Blizzard Juno 2015

Shoveling after Blizzard Juno 2015

Boylston Street, finish line 2015 Boston Marathon

Boylston Street, finish line 2015 Boston Marathon