Scott,
Good point and something I thought about after I posted the previous
message. What about the coldness (or warmth if you have time to warm it up)
of the U/S gel?? Perhaps all we need is the U/S gel and not the actual
machine :D Also, does U/S really target the tissue that is damaged, or does
it just target everything??
I feel that I too am slowly discarding U/S and even the interferential. I
think I am just still at a loss to think why it was so emphasized in my
undergraduate course not that long ago!
Thanks for bringing this point up.
Henry***
>From: Scott Epsley <[log in to unmask]>
>Reply-To: - for physiotherapists in education and practice
><[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: ultrasound
>Date: Wed, 22 Aug 2001 13:43:25 +1000
>
>Henry,
>Just curious mate - ever tried an ice pack for 20 mins on subacute tennis
>elbow (whatever that is) and retested grip strength? What about a hot
>pack? Dencorub?
>Or a 5 minute massage?
>
>I'm curious as to what the ultrasound is doing here. It could be
>stimulation of sensory receptors (thermal and pressure) that creates a pain
>gate. Certainly our best physiological understanding of "tennis elbow" (I
>hate that Dx)is one of tendinosis in ECRB with associated neural irritation
>and local muscular trigger points, +/- radioulnar joint, or cervical
>referral. None of these I can see would be significantly effected by US.
>Now a muscle tear with scar contracture maybe - even a ligament as you
>suggest I suppose (I too have use US on subacute ligs in the past but only
>in high doses - incedentally I don't have one in my practice now and don't
>feel it affects my treatment), but not tennis elbow.
>
>Just my opinion.
>---
>Scott Epsley
>BPhty., MAPA, SPG.
>PRINCIPAL PHYSIOTHERAPIST
>Clifford Chambers Sports Medicine
>Suite 4, 120 Russell Street
>Toowoomba QLD 4350
>Australia
>
>e-mail: [log in to unmask]
>
>
>On Tue, 21 Aug 2001 23:49:06
> Henry Tsao wrote:
> >Frank,
> >
> >I understand your point, but I guess where I am coming from is that the
> >majority of RCT's on U/S show significantly no effect. However, we have
>to
> >ask ourselves the question, why are there a small proportion of RCT's
>that
> >do show some significant effect if it doesn't work?? Is there something
>that
> >we have forgotten to take into account between these studies?? I think
>this
> >is an important question to ask ourselves, and not just take the article
>for
> >what it has to say.
> >
> >>There is a big difference between matters not having been proven to
>work,
> >>and matters having been proven to not work. The first we can still use
> >>(things do not have to be proven to work, for them to work), but the
>second
> >>is not exactly a credit to our profession, in my opinion.
> >
> >***I sort of agree with you. But I think there is also a difference
>between
> >proof and effectiveness. U/S has been proven not to have an true effect
>in
> >human subjects according to this study, but some time it does seem to
>have
> >an effect. Best example is subacute tennis elbow - U/S 1.5 W/cm2 and
>retest
> >their grip strength - it is amazing the improvement(this and subacute
>ankle
> >sprains are about the only time I use the U/S). I would be cautious in
> >saying that something that has not been proven to work we can still use -
> >things such as Bowen Therapy and reiki have not undergone strict RCT
> >studies, but should we still use this?? (Now I will probably have these
> >therapists lash out something at me :o
> >
> >As I said, I am not tending towards or against U/S. I went through a uni
> >where a whole year was devoted to electrotherapy (and I hated it!). I
>just
> >think we have to be selective, like all techniques, in their application.
> >
> >Very winding but sunny day 15 degrees in early morning Brisbane,
> >
> >Henry***
> >
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