How does Ultrasound help injuries & explain to me how muscles benefit from Massage?
Ultrasound is probably the most commonly used electrotherapy equipment, but what does it do?
Ultrasound is a form of mechanical energy, it is not electrical energy, so strictly speaking, it isn’t electrotherapy.
Ultrasound works in a manual way. The mechanical vibration produces sound energy and this produces high frequency sound waves. These sound waves agitate and ‘excite’ cells in a mechanical way, in a similar way that the wind would agitate leaves on a tree. The effect of this on cells though, is to make the cells work harder and more efficiently to stimulate and enhance healing. By ‘exciting’ the cell, it increases the activity levels within it and promotes healing.
Tissues will naturally have resistance to the passage of sound waves so we use a special type of gel that conducts the sound waves between the ultrasound head and the skin to allow the sound waves to pass through to reach the deeper tissues.
Most of us have experienced the effect of very loud music beating against our chest. Turn the volume down and the sound waves cannot be felt. Opera singers are able to break a glass by reaching certain notes.
Altering the intensity of the sound waves allows the ultrasound waves to reach different areas. So, for example, we would use different intensity on a large muscle compared to an elbow joint. Depending on which tissues are being targeted will depend on the intensity of the sound waves.
It is believed that ultrasound can enhance the quality of repair to tissue and the normal physiological processes as well as speeding up the rate of healing by 10-15%.
When can Ultrasound be used on an injury?
Ultrasound can be used once the injury has stopped bleeding so within about 12 hours of the injury.
The first phase of healing causes an inflammatory response and this phase is essential for the effective repair to the tissue. The more efficiently this process happens the sooner the next phase of healing can begin.
In this phase ultrasound can be used at a low intensity to enhance the inflammatory response.
The next phase of healing is called proliferation. This happens when the site of the injury has been ‘cleaned’ by specialist cells and allows scar tissue to build.
For instance, if you cut yourself, the injury forms a scab firstly to seal the injury and prevent infection. The scab falls off once the new tissue has formed.
Again, ultrasound is used to enhance this process as the scar tissue develops.
The final phase is referred to as the remodelling phase. This is one of the wonders of nature and our body as the scar tissue takes on the characteristics of the parent tissue. This phase can last months or even years.
Again, ultrasound can greatly enhance this process, so even old injuries respond positively to ultrasound.
Ultrasound is not a treatment that replaces other types of therapeutic intervention, and deep tissue or other forms of massage are highly beneficial to the process of healing and remodelling tissue.
I started my career in alternative therapy studying massage and then went on to study various other forms of massage, and other treatments, before discovering colonic hydrotherapy/irrigation.
I have been a massage therapist for many years and still enjoy it immensely, but many people do not know me to be a massage therapist, I am more widely known for colonics.
As a small child I used to spend hours drawing patterns on my mother’s back and found I had a special way of making people relax by massage. My friend’s mum, who had kidney disease used to tell me I was the only person who could get rid of the awful cramp she used to suffer with in her feet.
Eventually, I decided to do a formal course and along with anatomy and physiology was thrilled to qualify as a massage therapist.
Most of my clients come to me by recommendation so I have never really advertised the fact that I practice massage. Over the years I have become more known for dealing with deep tissue and injury work and having now studied ultrasound I am able to offer a bespoke service for clients old and new.
I have realised over the years the truly marvellous effects and benefits of massage therapy and the profound efficacy it has.
Following massage, it is said tissue has around 3 times as much blood flow as prior to treatment.
In order for cells to function they need to feed on nutrients and excrete waste products in the same way as we do. Massage therapy stimulates blood flow which delivers nutrients and consequently stimulates the removal of the waste products from the cells, mainly in the form of lactic acid and carbon dioxide. Although this process applies to all of us, sports people will especially recognise the need to deliver nutrient rich blood and remove waste products effectively in order to perform on top form.
This doesn’t mean that massage therapy is only for active and sporty people.
Massage is practiced by most people on a daily basis subliminally..
How often do you touch someone, stroke the cheek of a loved one, rub a baby on the back, or simple touch someone. We do it naturally as humans and it provides comfort, security and relaxation.
Professional massage is simply an extension of this process and refined to provide effective relaxation of muscle tissue and promote healing and better function.
Damaged tissue will influence the whole dynamic of the body as it loses elasticity and mobility which then impacts on other muscles.
How many of us have hurt our foot and end up with back ache, shoulder pain and a stiff neck!
How do muscles work?
Bones give strength and stability as well as providing protection for organs. Muscles provide movement to bones and muscles work in pairs. In order to bend your elbow, the top muscle, the bicep, needs to contract and shorten, and the lower muscle, the triceps, needs to stretch/relax and lengthen. The contraction of the biceps muscle pulls your lower arm up and bends at the elbow. During this process, the muscle cells use energy using mainly oxygen and glucose. Once this process has been completed the cell is devoid of energy and needs to excrete the waste products before working again. These waste products contain lactic acid and carbon dioxide.
A muscle cell always contracts to its full potential or not at all. The strength of contraction depends on the amount of muscle cells that contract at any one time.
For example let’s imagine lifting a cup of water and for the sake of demonstration, imagine your bicep and triceps each have 100 muscle cells.
Since the cup of water is a very light weight, in order to lift it you only require 10 muscle cells to contract and 10 to stretch.
Each of these 10 cells contract and stretch to their full extent using glucose and oxygen for energy. Once this process has happened they need time to recover and remove the waste products of lactic acid and carbon dioxide.
If you repeat this again, another set of 10 cells each contract and stretch to allow this action, and if you repeat this action over and over, another set of cells will contract and stretch.
By the time all 100 cells have performed this action the first 10 have excreted the waste products, have been replenished with nutrients and are ready to perform again.
If you lift something really heavy, it may be that all 100 cells need to contract and stretch at the same time in order to have the strength to lift the object. The problem is that because they need time to recover, you will be unable to lift a second heavy object immediately as the cells haven’t excreted the waste products and been replenished.
This is easily demonstrated by watching bodybuilders. They lift one weight and the take time to recover before attempting a second lift, whereas lifting light weights doesn’t need recovery time.
So, how does this relate to massage?
Even though you may not be undertaking lots of dynamic exercise, just sitting down involves lots of adjustments for your muscles to enable your body to stay upright. Sitting in one position for too long causes muscles to become tired and creates stiffness, and sometimes it becomes impossible to find a way of relaxing the muscles and relieving stiffness.
A massage therapist is able to perform this action for you by promoting and increasing blood flow and by gently stretching the muscle fibres. Muscle fibres all lie in the same direction and massage enables the muscle fibres to be stretched in different directions which is not possible when you are doing warm-up or cool-down exercise.
Is ‘ripping’ muscles beneficial?
I thought it made my muscles stronger, so why are people encouraged to do it?
Read on to see why…
Once you reach adult-hood, you have got your finite number of muscle cells. If they are damaged, you do not replace them with more muscle cells and muscle tissue, they are repaired with a substance called collagen which acts like glue, sticking the damages tissue back together.
Imagine a piece of wood that is split in half, you put glue between the two pieces and glue it back together. After this process the glued joint is stronger than the two pieces of wood. Under strain the wood would break before the joint. The glue therefore also reinforces the wood.
The same thing happens with muscle tissue. If you tear a muscle it is repaired with a glue-like substance called collagen. Collagen is stronger than muscle tissue and therefore acts as reinforcement for the muscle tissue to prevent it from tearing again.
So whilst you can argue that the muscle overall is then stronger than before, collagen is very inflexible and is certainly not the same as muscle tissue. Tissue damage that creates collagen formation needs a lot of attention to ensure the collagen is stretched regularly to allow the muscle contraction and stretching ability to function effectively. Therefore repeated tearing or ‘ripping’ of muscle tissue creates lots of collagen scar tissue and inhibits mobility. Collagen will never be as flexible and mobile as muscle tissue.
Muscles can only function when they are in a relaxed state.
What does that mean?
Imagine a spring. If something has acted upon it and it is squashed (contracted) to its full potential, it cannot contract any further. In order for it to have any effect on movement, it has to be relaxed back to its original position.
Muscles act in a similar way. They are relaxed when there is nothing acting upon them to cause any contraction. The difference is that the build-up of lactic acid and waste products in muscles has the effect of preventing the muscle cell fibres from returning to their relaxed state.
Massage helps remove these waste products and allows the muscle to function normally again.
What happens to the waste products following massage?
Good question! I remember when I first trained as a massage therapist the aftercare advice was to ‘drink plenty of fluid to flush out the toxins’.
It took me a while to understand what this process really meant.
The waste products of digestion are excreted by various means including, bladder, bowel and sweating. We eat food, absorb the nutrients and excrete waste products.
Cells do the same thing, but on a much smaller scale. Once they have used the energy to function they also excrete the waste products. These waste products are transferred via our venous system and our lymphatic system.
Blood is delivered to organs, tissues and cells, via our blood circulatory system. It returns some waste products via our veins which is also part of our blood system. The veins carry carbon dioxide back to the heart and then passed to the lungs where it is breathed out.
Our lymphatic system is our body’s defence system. The special cells within it fight infection and the lymphatic system also deals with waste products. It carries things like lactic acid away from the muscle cells and is excreted via organs such as the bladder etc.
So, massage stimulates the excretion of waste products and the delivery of fresh nutrients to the cells and muscle tissue. Blood is around 80% water, so clean clear water helps stimulate this process.
Offering a bespoke massage means we allocate the time to you depending on your particular needs. Typically 30-40 minutes.
Ultrasound treatment can be administered as necessary during massage, or can be administered as a stand-alone treatment.
As a stand-alone treatment, following an initial consultation and first treatment time of around 30 minutes, subsequent treatments take only a few minutes to administer.
If you require and advice please feel free to call.