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Therapeutic Ultrasound

I am fully certified and insured to use therapeutic ultrasound, and therefore able to offer it as part of my massage services.

Therapeutic ultrasound is a treatment used within physiotherapy which uses high frequency soundwaves to produce thermal and non thermal effects in mainly soft tissue structures such as muscles, tendons and ligaments with a view to assist with the healing and remodeling of injuries.

Ultrasound can be used for many different ailments as follows;

​Joint Mobility - With the use of ultrasound, it is possible to improve the range of motion within a joint which may have been compromised by scar tissue, muscle spasm, tendonitis and bursitis.  By elevating tissue temperatures, a level of comfort will be provided to the horse when stretching exercises are used to increase the joint's range of motion.

​Tendon Extension - When a tendon is injured, it will shorten or contract.  Therapeutic ultrasound can aid in the healing of a tendon injury by heating the affected tendon to 37-40C.  Static and repeated steady stretches can then be applied manually to help increase tendon length.

​Scar Tissue - It has been found that ultrasound can soften scar tissue, which as well as being cosmetically unattractive, can inhibit the horses ability to perform by affecting the normal range of motion.  As the scar tissue will absorb more of the soundwave activity used within ultrasound, it can be selectively heated as it is more dense than the surrounding tissue.

​Bony Growths - Ultrasound can, on occasion, be used to treat the pain and inflammation associated with splints and exostosis of the interosseous ligament between the metacarpal bones.  The condition occurs as a response to trauma from a blow or from weight bearing on poorly positioned bones.  It is unlikely that ultrasound can assist with the reabsorption of calcium deposits once they have been established.  The most affective way to prevent a bony growth is by starting the treatment process at the first sign of inflammation.

​Pain Relief - It is uncertain how ultrasound works when it alleviates pain, and more studies in to this are to take place.  It is known that ultrasound can stimulate acupuncture points and trigger points for pain relief.

​Reduction of Edema - As ultrasound promotes an increase in the quantity of blood flowing through the capillaries and increases the cell membrane and vascular wall permeability, it will aid with the reduction of edema.  This is essential for the rapid recovery from soft tissue injuries.

​Wound Healing - Observations have taken place and have found that wounds heal significantly faster with the aid of ultrasound.  Ultrasound can increase the rate of protein synthesis in fibroblasts, which are responsible for the repair of the injured tissue.  The stage of the healing process of the wound when the ultrasound is applied is very important - if the ultrasound treatment is applied too early, then it could actually slow the healing process down.  If ultrasound is applied at lower intensities two weeks after the injury occurred when collagen begins to form and fibroblastic infiltrations have begun, it can be highly beneficial.

​Contraindications of Ultrasound

  • Ultrasound should not be applied to the eyes.  The lens of the eye has poor vascularization and therefore cannot conduct the heat caused by ultrasound away.  This could lead to irreversible damage.

  • Exposing a mare's uterus to therapeutic ultrasound during pregnancy could lead to the possibility of cavitation in the amniotic fluid.

  • The heart should not be directly sonated at therapeutic levels due to the possibility that it may change the action potentials and contractile properties of the heart tissue.

  • Ultrasound cannot be used over or near growth plates until the growth is complete.  It could cause a change in the epiphysal area and disrupt normal growth of the bone.

  • Fractures should not be exposed to ultrasound when they are healing, as it could cause a delay in the calcification of the bone and slow down the healing process.

  • Ultrasound must not be applied to anesthetized areas or areas which have diminished sensation.

  • Areas of vascular insufficiency should be avoided as the blood supply is not able to adjust to meet the needs of the metabolic demand.

  • An embolus could be created if ultrasound is applied to inflamed blood vessels or vessels with known clots, and therefore should be avoided.

  • Tumours must be avoided at all costs.  The vibrations caused by ultrasonography could stimulate tissues to grow and encourage the migration of cancerous cells to other organs.

  • Ultrasound shouldn't be used over areas of celluitis or other infections as it will result in dissemination of the infection process.

  • Ultrasound musn't be used on an injured area straight after exercise.  Irritation from the exercise will increase with the use of ultrasound.


Therapeutic Ultrasound can be highly beneficial when it is used by the right hands.  If the correct level of ultrasound is administered, it can be utilized to aid healing a number of maladies and ailments swiftly and more efficiently.  Worryingly, ultrasound devices can be bought on the open market, meaning that there is a good chance they will eventually end up in the wrong hands, and cause more harm than good.  Overdosing with ultrasound repeatedly either in terms of a too high an intensity or too frequent use could result in permanent deep tissue damage. 


The Veterinary Permissions Act (1966) states that veterinary permission must be sought by an animal therapist (Chiropractor/Osteopath/Physiotherapist) prior to any treatment taking place.  I will make it clear when obtaining veterinary permission that ultrasound may be used during the massage treatment.  If the animal's vet objects, it shall not be used.  After the treatment has taken place, I will advise on when the next treatment should be, and will update the animal's vet with my findings.  This is very important, to ensure that the animal is treated professionally, effectively, and to prevent further injury.

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