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LaurenJohnson
Mr.Rudebusch
EnglishComp.IV
22Dec.2015
UltrasoundandTendonitis
Manypeopleeithersufferfromthepainfuldiseaseknownastendonitisorknowsomeone
whodoesstrugglewithitandhastriednumeroustreatmentstonoavail.Mostpeoplewhohave
tendonitistreatitwithbasicremediesliketheRICEtreatment.RICEstandsforrest,ice,
compression,andelevation.Adoctormayalsoprescribeantiinflammatoryandnonsteroidal
drugstoaidwiththeinflammationofthetendons.Thesetreatmentsareok.However,ifthey
weretobepairedwith
therapeuticultrasound,theywouldbemuchmoreeffectiveandthe
healingprocesswouldprogressmorerapidly.
Eventhoughalargenumberofpeoplesufferfromtendonitis,manymaynotknowthe
causes.Tendonitisis
aninflammationorirritationofatendonwhichcausespainandtenderness
justoutsideajoint.
BrettAndresofJohnsHopkinsHospitalexplainsclassifiespaininand
aroundtendonsthatislinkedtoactivityastendonitis.Thisterminologyimpliesthepain
associatedwiththeseconditionsiscausedfrominflammatoryreasons.Hegoesontosaythat
treatmentusuallyconsistsofwaystocontrolthatinflammation.Dr.Andres,alongwithsome
otherprofessionalresearchersfoundthatultrasoundappearedeffectiveforthetreatmentof
calcifictendonitis.Thisgivesaninklingthatultrasoundisinfacteffectiveintreatingtendonitis.
Tendonitisisverypainfulandthebesttreatmentforitisuncertain,buttherearestill
suggestions.
Tendinitiscantypicallyoccurinanyofthehumanbodystendons,butitismost


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commonaroundtheshoulders,elbows,wrists,kneesandheels.Toomuchusageofatendonor
doingarepetitiveactioncancausetendonitis.Athletics,oldage,orotherdiseaseslikediabetes.
arealsocommoncausesoftendonitis.Inveryseverecases,thedamagingactivitiesordiseases
canevencausethetendontorupture.Ifthishappens,therapywillstillbenecessary,butinorder
tousephysicaltherapyandultrasoundsuccessfullyandbeneficially,patientsmustgenerally
addressthesituationsurgicallybeforeattendingaphysicaltherapysession.
Whatistherapeuticultrasound?onemightask.Well,sincethe1940s,therapeutic
ultrasoundhasbeenusedasamodalityinphysicaltherapyinwhichthetherapistappliesa
probethatgivesoffhighfrequencysoundwavestotheareathatultrasoundisbeingappliedto
andthenthetherapistusesconstantcircularmotionsduringtreatment,massagingtheareawhich
isimportantbecauseitrelaxesthetendonsimprovingbloodcirculationandthereforepromoting
moreefficienthealing.Thetherapistalsoappliesultrasoundgelpriortousingtheprobeinorder
toreducethefrictionthattherewouldbebetweenthemodalityandthehumanflesh,andalsoto
helpthesoundwavesthatthemodalityemitsintothebodytogetamoreefficienteffectonthe
injuredarea.
Therapeuticultrasoundismeanttostimulatetissuesbeneaththeskin,andcreatesthe
effectofheatduringtherapywhichcanbeveryhelpful.AsJerroldScottPetrofsky,Professorof
PhysicalTherapyatLomaLindaUniversity,putsit,
Itiscommonlybelievedinmedicinethat
usingheatwillincreasethedistensibilityandflexibilityofsofttissue.Thisincludestendons.If
itistruethatusingheatwilldothesepurportedthings,theprobabilityofsportsinjurieswouldbe
greatlydecreasediftheathleteweretobeusingtherapeuticultrasound.


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TherapeuticUltrasoundisultimatelysafeforanyone.Actually,manyprofessional
athletes
do
useittotheiradvantage.Oftentimestheyevenpurchasetheirownmodalities.They
usethemasapreventiveaidtoprotectagainstinjuries,andtogetbacktotheirgrindandplaying
tothebestoftheirabilitiesafterinjuriesfasterthantheywouldiftheyweretojustusebasic
remediesofhealing.Throughnumeroussurveys,ProfessorandChairintheDepartmentof
PhysicalTherapyatMarymountUniversity,RitaWongandherteamdeterminedthestanceof
physicaltherapistswithexperienceinorthopedicsopinionsaboutclinicalimportanceof
ultrasoundinachievingbeneficialoutcomeswhenmanagingmusculoskeletalimpairments
(tendonitis).Wongsaysthat83.6%ofresponsestothesentoutsurveysaidthattheywere
likelytouseultrasoundforsofttissueinflammation,ortendonitis/bursitis.Overallthe
researchersfoundthatmostPTsperceiveultrasoundasaclinicalimportanceintreating
conditionsliketendonitis.

TheresearchersinthearticlebyProfessorJerroldScottPetrofskyinadditiontotwo
otherprofessorsusedcoldexposureandheattodetermineiftheclaimsaboutheatapplication
beinghelpfulinrecoveryareaccurate.Forheatapplication,theresearchersappliedThermaCare
heatwrapsandforcoolingtheyusedacoldpackapplication.Whentheystudiedtheresults,
theycametotheconclusionthat
coldincreasestheforcenecessarytopassivelymovetheknee
throughrangeofmotion,whereasheathastheoppositeeffect,whichsimplyputjustmeansthat
thecoldpackcreatessortofatensingeffectonthemusclesoitishardertomoveandultimately
morepronetoinjury.Theyalsofoundthatcoldandheatalterboththeelasticityoftheanterior
andposteriorcruciateligaments,aswellastendonandmuscle.So,essentiallytheclaimsabout
heatbeingapositivefactorwerefoundtobetrue.Thatindicatesthatultrasoundwouldbe


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helpful,becauseultrasoundsignificantlyheatsthetissuebeingtreated.Somemayaskifaheat
packwouldbeasimplerandmorecosteffectivetreatmentcomparedtotherapeuticultrasound.
Theanswerisyes,itwouldbesimplerandmorecosteffective,butitwillalsobealesseffective
treatment.
Althoughtherapeuticultrasoundismostcommonlyknownforitsheatingeffect,ithas
otherpositiveeffectsaswell.Itpromotesrelaxationwhenpainispresent,increasesbloodflow
whichspeedshealingprocesses,andreducesswellingwhichreducespain.Italsogetsdeeperinto
thetissuesthanaheatpackwould.C.A.Speed,HonoraryConsultantofRheumatology,Sports
andExerciseMedicine,indicates
thattherapeuticultrasoundisoneofthemostcommon
treatmentsusedinthemanagementofsofttissuelesions(softtissuelesionsincludetendons).He
alsotouchesbaseoninformationaboutultrasoundanditsthermaleffects,whichitisverywell
knownforasonemaynotice.Hetalksabouthowthethermaleffectsofultrasoundupontissue
mayincludeincreasedbloodflow,reductioninmusclespasm,increasedextensibilityofcollagen
fibresandaproinflammatoryresponse.Whythisissoimportantwillbeexplained.
Ultrasoundreducestheinflammationintheaffectedtendonortendonsbydecreasing
whatiscalledahistamineresponseultimatelyreducingtendonitis.Thisparticularchemical,
histamine,iswhatcausesmostofthecommonallergysymptoms.Whenthehumanbodysenses
somethingiswrongorsomethingabnormal,itsignalstheimmunesystemwhentheninturn
releaseshistaminewhichoneofthemaincausesofinflammation.Thinkofitaswar,whenthe
humanbodyisalarmedbyaforeigninvader(orinthiscaseaninjuryoroveruseofatendon)it
sendsinitstroops(histamineandotherchemicals)asanattempttogettheforeigninvaderoutof
thebodyortoessentiallykillit,theresultisinflammation.Itonlymakessensethatreducingthe


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mainsourcethattheinflammationintendonitisderivesitselffromwouldinturnhaveapositive
effectonreductionoftendonitisandthatisonemainreasonwhytheheatingeffectisso
important.
Therapeuticultrasoundalsoisknowntobreakdownscartissue.Itdoesthiswhenit
gentlymassagesthebodysmusclesandtendonsetcandindoingsothescartissueissoftened.It
canalsobeagooddetectorinfindingeventheslightestfracturesofbones.Generallyitisnot
meanttodothis,butifasharppainoccurswhentherapeuticultrasoundbegins,thistypically
meansyouhaveabreakinsomethingaroundthetreatedarea.Thesharppainiscausedbythe
soundwavesgettinginbetweenthebreak.So,itcanbeahelpfuldiagnostictoolaswell.
Mostresearcherswiththeexceptionofveryfew,whohavedoubtsthattherapeutic
ultrasoundiseffectivebecausethereiscurrentlynotenoughevidencegiveconfirmationtothe
notionthattherapeuticultrasoundindeedhasapositiveeffectonthosepatientswithtendonitis.
Inadditiontothat,manyprofessionalresearcherssaythattherapeuticultrasound
speedsthehealingprocessofinjuriesandreducesscartissue(asmultiplequalifieddoctorshave
confirmed).Thisisahugefactorwhendealingwiththesetypesofissuesbecausealmostany
diseaseorinjuryetc.thatdamagesatendon,muscle,ortissueinthatcategoryleadstoavery
extensiveandattentivehealingprocessandtreatment.Thereasonthesetypesoftissuestakeso
longtohealisbecauseligamentsliketendonsarelackinginnerveandbloodsupply.Theyare
veryavascular.Thefactthattherapeuticultrasoundreducesscartissueisgoodaswellbecauseit
givesthepersondealingwithtendonissuesaminimizedchanceoftheinjuryrecurring.
Otherthanthenotionthattherapeuticultrasoundhasextremelikelihoodinbeingvery
helpfulwithtendonitis,italsohelpsinthetreatmentofawidevarietyofmuscularandjoint


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problems.Itmainlyfocusesontendoninjuries,muscleinjuries,andligamentinjuries,but
essentially,anywheresomeonemayhaveswellingorinflammation,ultrasoundwillhelp.
Alotoftimes,thosewhosufferfromchronicdiseasessuchasarthritis,carpaltunnel,
bursitis,etc.willbenefitgreatlyfromtherapeuticultrasoundaswell.Thereasonthattherapeutic
ultrasoundwouldbehelpfulintreatingtheseconditionsisthesamereasonthatitishelpfulin
treatingtendonitis.Theonlydownfallisthattherapeuticultrasoundcannot
cure
thesediseases.
Itjustaidsinhandlingpainandswelling,andwillhelpinjointflexibility,butwhenthosetypes
ofproblemsarediminishedfromthesediseasesitisverybeneficialforthevictim.
Thoughtherapeuticultrasoundisveryhelpfulintreatingdiseasesliketendonitis,itisnot
the
best
treatmentforthesediseases,anditdoesnotcurethem.Yes,itgreatlyaidsinpain
managementandreductionofswellingandinflammation,butithasbeenfoundthatmostpeople
professionalsknowoneofthebesttreatmentsfortendonitistobeantiinflammatoryand
nonsteroidaldrugs.
M.D.JonathanCluettgivessomeinsightonthetypesofmedicationusedtotreatdiseases
liketendonitis.
Nonsteroidalantiinflammatorypainmedications,commonlyreferredto
asNSAIDs(pronouncedensayds),aresomeofthemostcommonly
prescribedmedications,especiallyforpatientswithorthopedicproblems
suchasarthritis,bursitis,andtendonitis.Thesemedicationsareavailable
overthecounter(e.g.Ibuprofen,Motrin,Aleve)orasaprescription(e.g.
Celebrex,DayPro,Relafen).NSAIDsareeffectiveatpainrelief
(analgesia),andtoreduceswelling(antiinflammatory).


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Thepointofthesemedicationsisthattheyaremeanttointerferewiththechemicalsthatcause
swellingandpaininconditionsliketendonitis.Theymayhavemildsideeffectslikestomach
irritation,butseveresideeffectsareveryrare.
Eventhoughithasbeenfoundthattherapeuticultrasoundaloneisnotthemosteffective
treatmentfortendonitis,thereisawaytomakeitthebesttreatment.Itisafactthattherapeutic
ultrasoundisaveryhelpfultreatmentwhendealingwithtendonitisbecauseofitsabilityto
reduceswellingandpromotehealingduetobloodflowincrease.Itisalsoafactthatnonsteroidal
andantiinflammatorydrugsareknownasoneofthebesttreatmentsfortendonitis.Paired
together,thesetwotreatmentswouldbecomeadynamicduoinfightingtendonitis.Soifaperson
iseithersufferingfromtendonitisorknowssomeonewhoisbutanefficienttreatmentislacking,
agreatrecommendationwouldbethecombinationofdrugsandtherapeuticultrasound.


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