Echography & Shockwave
Echography
A major change in our approach has been the introduction of ‘Echography’ or ‘Musculo-Skeletal Ultrasound Scan’ this is an area of expertise for me. A very common tool used in ante-natal consultations or internal medicine, but relatively new in physiotherapy.
Echography has the ability to ‘see’ inside your body, and check the affected soft tissues. By doing so, it is much easier to confirm or deny the initial diagnosis. However it is not yet a widespread approach, simply because it is not easy to do and the equipment is expensive.
Nevertheless, in my practice it has changed tremendously the concept of tendon pathology. Just to give you an example: we found that ‘tendinitis’ (inflammation of the tendon) simply does not exist!
Nowadays we name it ‘tendinopathy’ (disease of the tendon). This sounds like a semantic discussion, but it does impact on the treatment.
The tissue is not inflamed; therefore the majority of treatments used in the past are not the most appropriate and may even be harmful!
Another big advantage is the cost of investigation. Echography is a lot cheaper than CT or MRI scans. It can be done during the initial consultation, therefore avoiding wasting time! Diagnostics with echography will determine your problem specifically, and treatment is based on the actual picture we see!
Echography is only suitable for soft tissue, such as tendons, muscles, joint capsules, ligaments etc. The surface of bone can be made visible, but not the inside.
Unfortunately, there are problems that need an alternative approach. For example, a rotator cuff problem can be caused by severe swelling around the tendon causing pressure and entrapment. Here surgery may be the only solution. But let’s be clear on one thing: cortisone injections have now been shown not to give any positive long-term results
Shockwave
A major change in our approach has been the introduction of ‘Echography’ or ‘Musculo-Skeletal Ultrasound Scan’. A very common tool used in ante-natal consultations or internal medicine, but relatively new in physiotherapy.
Echography has the ability to ‘see’ inside your body, and check the affected soft tissues. By doing so, it is much easier to confirm or deny the initial diagnosis. However it is not yet a widespread approach, simply because it is not easy to do and the equipment is expensive.
Nevertheless, in my practice it has changed tremendously the concept of tendon pathology. Just to give you an example: we found that ‘tendinitis’ (inflammation of the tendon) simply does not exist!
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