Today, I did yet another ultrasound. Basically, when using an ultrasound on a patient, you are creating a deep heating affect in the soft tissue of the body. The waves from the ultrasound cause cells to vibrate faster on a cellular level creating that heat. The heat ultimately promotes blood flow and helps to break up knots, thus loosening and promoting healing in the targeted tissue. When performing an ultrasound, you can (and should) adjust many this according to the patient. You can first change the time, though typically we use eight minutes at Response Therapy, then you choose which sized head you will use. There is a 2 cm head for targeting smaller areas (things like tendons or ligaments) and a 5 cm head for targeting larger areas (like entire parts of a muscle). After that you choose the “duty cycle” percentage which basically controls what percent of the time the ultrasound will actually be sending waves into the body; there is 100%, 50%, 20%, and 10%. Next, you choose the frequency – either 1 MHz or 3 MHz – which determines how deep the ultrasound waves will penetrate into the soft tissue (1 MHz goes about twice as deep as 3 MHz). Finally, you adjust intensity of the waves; we typically use 1.2 or 1.5 W/cm2.
Later in the day, I saw an ultrasound being performed along with e-stim. Another intern asked what that did and I realized that Dan’s response was very similar to what he had said needling with e-stim did. This prompted me to ask him about the difference between the two and when you would choose one over the other. He explained that the two processes are extremely similar in helping to break up knots and loosen the muscle, how needling is an “irritation” as he called it that also helps to reteach muscles to fire, whereas, while e-stim can help to reteach muscles to fire, it is less of an “irritant” and promotes more healing aspects. Dan explained that, in therapy, the way they help people is actually through micro-irritation. He explained that micro-irritation, like needling and other things they do at Response Therapy, helps the body. Macro-irritation is what injures the body in the first place, for example: surgery, tearing something, etc. The easiest way to think about it is which exercise. When you exercise you create micro-tears in your muscles, a form of micro-irritation, which then heal and actually promote growth of new muscles which is how working out and exercising works. However, if you push too hard you may go beyond micro-irritation into macro-irritation such as tearing a muscle which would now be an injury.
