*Therapeutic Ultrsound* 1. Waves 2. Wave characteristics 3. Ultrasound 4. Ultrasound Unit 5. US Transducer 6. US Control Unit 7. Production od US 8. US Modes 9. US Parameters 10. US Treatment Time 11. Coupling medium 12. Physiological effects 13. Acoustic Streaming 14. Method of Application 15. Indications 16. Contraindications 17. Precaution 18. Technique of application

1. THERAPEUTI
C ULTRASOUN
D
A PRESENTATION BY:
S. SRIYA
BPT, 4TH SEMESTER.

2. WAVE
S o A wave is defined as a repeating disturbance that
travels through space and/or matter that transfers
energy from one place to another.
o Waves come in two types:
• Longitudinal
• Transverse
o There are characteristics that are common to all waves
such as frequency, wavelength and amplitude.
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3. WAVE
CHARACTERISTI
CS
o One Cycle: The distance from one point on a wave to
the same point again on the next wave
o Frequency: It is defined as the number of cycles per
second (Hertz)
• 1Hz = 1 cycle per sec.
• Here frequency is 2Hz.
o Amplitude: It is the height of the wave (measured of
intensity)
o Wavelength: It is the distance over which the wave’s
shape repeats (meters)
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4. A
SOUND
…
THERAPEUTIC
ULTRASOUND
o ULTRA – Beyond
o SOUND – A longitudinal wave that travels
through a conduction medium (Air,
Water, Solid materials)
o Ultrasound creates a wave that is beyond
our range for hearing (above 20KHz)
o Ultrasound Therapy – Where ultrasound
energy is used to treat human tissues.
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5. WHAT IS AN ULTRASOUND UNIT?
THERAPEUTIC
ULTRASOUND
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o An ultrasound uses sound waves to create
vibrations to physically effect it’s target tissue.
o The ultrasound machine consist of a control
unit and the transducer.
o The sound waves are created by a vibrating
crystal inside of the ultrasound transducer.
o The control unit manages the various US
settings and controls the energy that is sent
through the transducer.

6. THE ULTRASOUND
TRANSDUCER
THERAPEUTIC
ULTRASOUND
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o The ultrasound head contains a crystal that
expands and contracts.
o The size of that crystal determines the effective
radiating area (ERA) of the ultrasound
transducer.
o When the crystal expands it compresses the
material in front of it.
o When the crystal contracts it rarefies the
material in front of it.
o This creates a wave in the material that
penetrates the body.

7. THERAPEUTIC
ULTRASOUND
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8. THERAPEUTIC
ULTRASOUND
8
THE CONTROL UNIT

9. THERAPEUTIC
ULTRASOUND
9
PRODUCTIO
N
o Piezoelectric effect is the ability of certain
materials to generate an electric charge in
response to applied mechanical stress.
o It converts kinetic energy or mechanical
energy due to crystal deformation, into
electrical energy
PIEZOELECTRIC
EFFECT:
INVERSE-
PIEZOELECTRIC:
o When an electric current is applied to a
piezoelectric crystal, it starts to vibrate.
These vibrations generate sound waves
with frequency between 1.5 – 8 MHz.
(Ultrasound)

10. THERAPEUTIC
ULTRASOUND
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ULTRASOUND MODES
CONTINUOUS MODE: PULSED MODE:
o In Continuous mode, the transducer head
continuously produces the ultrasonic
energy.
o It is primarily used when the therapeutic
goal is to induce thermal effects in the
target tissues.
o Continuous ultrasound is effective for
increasing tissue temperature, promoting
vasodilation, improving blood flow, and
facilitating tissue relaxation.
o Chronic muscle stiffness and limited ROM,
Scar tissue remodeling, tissue healing in
chronic injuries
o In Pulsed mode, the period of ultrasound
are separated by period of silence.
o It is used when the therapeutic goal is to
achieve non-thermal effects or to reduce
the risk of excessive heating.
o It is effective for promoting mechanical
effects such as cavitation, microstreaming,
and acoustic streaming.
o It is often utilized in acute or subacute
conditions like acute soft tissue injuries
and inflammation.

11. CONTINUOUS WAVE
THERAPEUTIC
ULTRASOUND
PULSED WAVE 11

12. THERAPEUTIC
ULTRASOUND
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TREATMENT TIME
ACUTE CONDITIONS: 4 TO 6
MINUTES
CHRONIC CONDITIONS: 6 TO 8
MINUTES

13. THERAPEUTIC
ULTRASOUND
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COUPLING MEDIUM
o To make a firm contact between skin of patient and transducer, jelly or olive oil,
or liquid paraffin is used.
o These are called coupling medium or coupling agents.
o Properties of coupling medium:
• Gel like viscosity
• Non-allergic
• Chemically inert
• Transparent
• Inexpensive

14. THERAPEUTIC
ULTRASOUND
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PHYSIOLOGICAL
EFFECTS
THERMALEFFECTS NON - THERMAL
EFFECTS
o Ultrasound therapy leads to the
absorption of ultrasound energy by
tissues, resulting in an increase in tissue
temperature.
o Heating fibrous tissue structures such as
joint capsules, ligaments, tendons, and
scar tissue may cause a temporary
increase in their extensibility, and
hence a decrease in joint stiffness.
o Mild heating can also have the effect of
reducing pain and muscle spasm and
promoting healing processes
o Cavitation refers to the formation, growth,
and collapse of gas-filled bubbles within
tissues exposed to ultrasound waves.
o This phenomenon generates micro-currents
and mechanical forces, which can enhance
cellular activity, promote tissue
regeneration, and facilitate the breakdown
of cellular debris.
o Stable cavitation involves the oscillation of
bubbles, while Unstable cavitation leads to
bubble collapse, generating microjets that
further stimulate tissue responses.

15. THERAPEUTIC
ULTRASOUND
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16. THERAPEUTIC
ULTRASOUND
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17. THERAPEUTIC
ULTRASOUND
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ACOUSTIC STREAMING
o As a result of either type of cavitation there is a localized, unidirectional fluid
movement around the vibrating bubble.
o These very small fluid movements also occur around cells, tissue fibers, and
other boundaries, which is known as microstreaming.
o Microstreaming exerts stress on the cell membrane and thus may increase
membrane permeability
o This may alter the rate of ion diffusion causing therapeutically useful changes,
which includes increased secretion from mast cells, increased calcium uptake,
and production of macrophages.
o All these effects could account for the acceleration of repair following
ultrasound therapy.

18. THERAPEUTIC
ULTRASOUND
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19. METHOD OFAPPLICATION
THERAPEUTIC
ULTRASOUND
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20. THERAPEUTIC
ULTRASOUND
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INDICATIONS
o Most acute and chronic
musculoskeletal conditions like,
o Myositis,
o Fibrositis,
o Capsulitis,
o Bursitis,
o Tendinitis,
o Tenosynovitis,
o Sprain and Strains
o Myofascial trigger points
o Muscle spasms
o Capel tunnel syndrome
o Neuralgia
o Neuromas
o Calcific deposits
o Scar tissue
o Chronic indurated oedema
o Osteoarthritis
o Radiculitis
o Joint contractures

21. THERAPEUTIC
ULTRASOUND
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CONTRA - INDICATIONS
o Cancerous tumours
o Pregnancy uterus
o Cardiac pacemakers
o Epiphyseal plates
o Infected area
o Tuberculosis
o Haemorrhage
o Haemarthosis
o Over recent grafts
o After radiotherapy
o Over anaesthetic areas
o Areas over nerve plexus
o Over the eye, gonads
o Haemophilia
o Hematoma
o Venous thrombosis
o Atherosclerosis

22. THERAPEUTIC
ULTRASOUND
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PRECAUTION
o The transducer should be perpendicular to the skin and should be moved in
circular motions continuously throughout the treatment
o There must be no gap between the transducer and the skin, good amount of
coupling medium should be used.
o Contraindicate the use of ultrasound on shoulder of the patient with pacemakers,
over the carotid bodies, directly on the abdomen of pregnant women and women
with contraceptive devices implanted like the copper T, over the nerve plexus or
superficial nerves.

23. TECHNIQUE OFAPPLICATION
THERAPEUTIC
ULTRASOUND
ULTRASOUND CAN BE APPLIED USING DIFFERENT TECHNIQUES SUCH AS-
Direct Contact Underwater bath Water bag
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24. THANK
YOU…
THERAPEUTIC
ULTRASOUND
FOR YOUR
TIME!
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