It is possible that some of your patients have old injuries that keep them from exercising. A recent study found that in a group of people over sixty, injury was a main barrier to exercise for nearly half of them. You may want to ask your patients what they see as a barrier to being more active, and then address each case individually. Also, work closely with other resources in your health care community so you know whom to send patients to for their specific needs. For example, find out which physical therapists will design structured exercise programs for patients who’ve had past injuries. Yoga and Tai Chi classes designed for the elderly can help improve flexibility, balance, and muscle strength if these are causing problems.
FAQ Category: General
In the past two years, I’ve run two half-marathon races. Surprisingly, I trained less for the first race than I did for the second one, yet I did better in the first race. I trained hard to improve my time on second race. Why didn’t my hard work pay off?
Perhaps you trained too hard right up to the time of the race. To improve performance, you should plan to taper off your workout seven to 21 days before the competition. This gives certain muscle fibers a chance to “spring back.” Working too hard up to the time of the race can actually cause important muscle fibers to shrink, leading to a drop in muscle strength and decreased overall performance in the race. Instead, plan to lower your total mileage and focus on interval training prior to the race to improve your “kick” on hills and to give you an edge when you near the finish line.
I’m training for a swim meet at my local YMCA. I’ve read about tapering off my usual training program a week or so before the meet. I don’t have a coach and am not experienced with this. Any suggestions on how to do it?
A recent study of swimmers who tapered down on their training intensity before a major competition did it this way: Twenty one days before the meet, they began to swim shorter overall distances during each session. They kept doing interval sets and pushed themselves to do each one at race speed. But again, their total distance was less during the 21-day period. If you are unclear about how to do these sets or need more help, you may want to talk with a swimming coach or a strength and conditioning specialist. Most pools have swim clubs and a trained coach whose expertise could be tapped for free or a nominal fee at most.
My track coach said that he will shorten our training a week before the upcoming state competition. I’m not complaining, but I am curious how this will help us do better at state.
It’s well known that tapering back from intense training before a major competition can improve muscle strength and overall performance. This relates mainly to a particular muscle fiber, the Type IIa muscle fiber. This is the fiber that gives our muscles short bursts of power for activities like sprinting and lifting. This fiber gets larger and has more power and spring when it has been given a break after a long, intense period of exercise. Significantly, it becomes smaller and less effective after months of heavy and intense training. Your coach is on the right track by having you taper your training before going to the championships.
At what age should a person start using a cane or walker?
Using a walking aid is not always related to a person’s age. Most often, it has to do with the person’s general health, especially as it relates to strong muscles and good balance. The challenge occurs when people think they’re strong and that their balance is not a problem. They often resist using a walking aid and remain at risk of falling. If they do fall down, the results can be devastating
One recent study suggested that earlier use of canes and walkers could benefit elderly patients. In the study, patients who used walking aids fell down significantly less often than their stronger, more quick-moving counterparts who didn’t use walking aids. This led researchers to suggest that earlier use of walking aids might benefit the elderly. If you have questions or concerns about the use of a walking aid, talk with your doctor or physical therapist.
I run on a track team as a sprinter in the spring and cross country in the fall. My friends all drink caffeine pops before running. They say it helps their time. My track coach says caffeine can actually make me more tired. I’m not sure who to believe.
For cross-country running, caffeine could actually help with your endurance. But for sprinters, the verdict is still out. And there’s some evidence that caffeine may lead to more fatigue when sprints are repeated in sequence. The effects vary from person to person. If you try caffeine before a race, pay attention to your individual response. You will be the best judge.
I get ultrasound treatments for chronic pain. Last time I had a burning sensation during the treatment. Could I have been burned from ultrasound?
It is unlikely. The ultrasound machine produces sound waves, not heat. You should only feel the transducer head rubbing on your skin. If you felt the burning sensation as soon as the transducer head was put on your body, it is possible that it was already heated up from an earlier session on another patient.
It is common to feel warmth during therapeutic ultrasound. The sound waves can be turned into heat energy in the tissues of your body. The heat energy then travels to the skin surface, where the heat receptors are located. If the temperature in the tissues ever got too hot, you might feel a painful burning sensation. Your tissues are not actually being burned, but you still need to let your therapist know. This kind of pain isn’t appropriate for ultrasound therapy. That is why therapists don’t do ultrasound treatments in areas that have a loss of sensation for some reason.
I’m training for my first triathlon. I’m a terrible swimmer, so I am looking for anything to help in that event. I have friends who are competitive swimmers who swear that using caffeine before swim meets can help. Is it true?
Caffeine does not seem to help much for untrained swimmers. In trained swimmers, however, it appears to improve speed quite a bit. It might be worth a try.
I’m supposed to start ultrasound treatments for my sore joints. Is this the same kind of ultrasound that doctors use to look at hearts?
Ultrasound can be used both for treatments and for imaging. Diagnostic ultrasound uses higher frequencies that bounce of the underlying structure and can be viewed as an image. Therapeutic ultrasound uses much lower frequencies.
I heard that there was some kind of lung exerciser that was supposed to make your breathing muscles stronger. Is there such a thing?
There is. It is called an inspiratory muscle trainer. You should be able to find one through a local sports medicine clinic. The inspiratory muscle trainer creates resistance when you breathe in. You can control the amount of resistance. This device has been shown to improve athletic performance when people use it for a few minutes each day.
Ultrasound treatments really relieve the pain in my sore neck. Can they help my headaches, too?
Ultrasound can be a good first step in calming muscle spasm. If you are suffering from tension headaches, ultrasound treatments on the back of your neck may help relieve muscle spasm and help alleviate your headaches. Some combination of massage, mobilization, exercise, and ice packs can also calm muscle spasms.
You need to look at possible causes of your tension headaches. You or your therapist should check your work station to see if your postures, lighting, or repetitive tasks could be to blame for your headaches. Stress management might also be in order.
I broke my leg two years ago, and it still hasn’t healed. My orthopedist says it’s because of my age (I’m 77) and the fact that I have to take steroids for my arthritis. I haven’t time to hobble about. Anything new out there?
Yes and no. Low-frequency ultrasound has been around for decades, so it’s not new. However, new evidence shows that treating a problem fracture like yours with ultrasound for 20 minutes a day can improve healing by up to 90%. Talk to your doctor to see whether ultrasound could be used to help your leg.
Why don’t I feel anything when my therapist rubs the ultrasound head on my skin? I thought it was supposed to feel warm.
Ultrasound waves are high-frequency sound waves. These sound waves are too high for you to hear, and they are not hot in themselves. Your therapist can adjust the frequency and intensity of the ultrasound so that the sound waves create heat energy in your body. Ultrasound treatment can cause vibrations in the molecules of your tissues, which creates heat. You cannot feel these vibrations, however. Ultrasound also creates heat in tissues that absorb the sound waves, such as tendons, ligaments, and bone.
Not feeling any heat doesn’t mean that the ultrasound isn’t working. If the ultrasound is targeted to deep tissues, it could be creating heat that you can’t feel. There are no heat sensors below the surface of your skin. That means you only experience heat during an ultrasound if the warmth can travel back to the skin surface.
It is also possible that your therapist is setting the ultrasound so that it doesn’t cause a build-up of heat. Therapists usually try to avoid building up heat in tissues that are swollen or severely inflamed.
How does ultrasound work to heal bone fractures?
No one knows for sure, though there are many theories. Some think ultrasound mimics signals our body sends that triggers bone building. Others believe the sound waves are absorbed by the bone, causing needed chemicals to move across the bone’s surface and help it heal. More time and research will be needed to tell what really happens. The most important thing is that it appears to work, and without the side effects of more aggressive treatments, such as surgery.
Why do I feel heat when my therapist treats my aches and pains with ultrasound?
Therapeutic ultrasound creates high-frequency sound waves. These waves are not sources of heat themselves, but they can cause a heat reaction in your body. At certain settings, ultrasound waves can cause vibrations in the molecules of your body’s tissues. The vibrations cause heat. Also, tissues high in collagen, such as bone, tendons, and ligaments, absorb some of the sound waves. This also creates heat energy.
You can’t feel heat below the surface of your skin. However, if there is enough heat energy, or if the heat is created close enough to travel up to your skin, you will feel warmth within the skin during ultrasound.
My doctor has prescribed ultrasound to heal the broken bone in my arm. I’ve never heard of this. Does ultrasound have any side effects or dangers?
Low-intensity ultrasound has been used for decades to promote bone healing. There are no negative side effects from ultrasound treatments. In fact, its use has been well studied in pregnancy, where it is used routinely without any problems. Ultrasound has also been shown to be very effective in helping heal fractured bones.
What can ultrasound treatments do for my pain?
Ultrasound treatments are used to ease pain, improve circulation, and speed healing. Ultrasound treatments can be manipulated to have different effects. Your therapist can set the frequency and intensity of the sound waves to create heat in the sore area. This thermal effect brings in blood to the sore area. The blood brings in oxygen and nutrients, and it flushes away waste products and chemicals that may be causing pain. Thermal treatments can also stimulate the nerve sensors to start easing pain. As the pain eases, tight muscles can relax, which further relieves the cycle of pain.
The ultrasound machine can also be set in a way that avoids a thermal effect. This is often necessary if the area is swollen or severely inflamed. The non-thermal treatments can help move body chemicals to and from the cells in the sore area. This can help speed the healing process.
How does the ultrasound machine used by my therapist work?
The ultrasound unit gets its power from the electricity in the wall outlet. The electricity enters the unit at the standard 60 cycles per second (60 Hertz). The ultrasound machine ramps the frequency up much higher, generally either to one million (one megahertz, or 1 MHz) or 3.5 million (3.5 MHz) cycles per second. The electricity then travels through an insulated cord to the handle. The electricity is passed through a special crystal inside the transducer, the part placed on your body. The electrical current vibrates the crystal to produce sound waves at the same frequency. These sound waves enter your body through the transducer.
The 1 MHz setting sends waves over a deeper and wider area. It is used to reach tissues up to two inches below the skin surface–deeper tissues of the spine, for example. The 3.5 MHz setting creates waves that are packed more closely together. It is used to treat tissues just under the surface of the skin, such as the jaw, tendons of the hands and feet, or bony areas around the elbow.
I have one sore spot. Why can’t my therapist just hold the ultrasound right on it, instead of rubbing it around?
If the transducer is held in one spot for too long, it can magnify the effect of the ultrasound. Sound waves going in can crash into sound waves that are on their way out, forming a single wave that is twice as large. This increases the intensity of the treatment, creating too much sound and heat in the underlying tissues. Cells can be damaged, slowing down your healing time and causing pain and inflammation.
Is there a home ultrasound unit? Ultrasound really relieves my pain, but I always have to go to my therapist to get treatments.
There are no home ultrasound units. There are two reasons for this. One reason is that only trained personnel should use ultrasound equipment. Used incorrectly, ultrasound could worsen symptoms or even damage the tissues of your body.
The second reason is that ultrasound is not meant to be a long-term fix for your symptoms. It is used early to improve circulation, ease muscle spasm, and speed healing. This helps as you start a therapy program to improve your strength, flexibility, and alignment. The exercises and pain management strategies you learn throughout therapy should be what helps you keep your condition under control.