Ultrasound Therapy at Home in Shankar Sheth Road, Pune

Two complaints come up again and again among people who stand and serve along a commercial road. One is pain under the heel, sharpest with the first steps in the morning or after sitting, which is typical of plantar heel pain. The other is pain on the outer side of the elbow when gripping, lifting a carton with the palm facing down, or even holding a cup, which is typical of tennis elbow. Hours on a hard shop or showroom floor feed the first; repeated gripping, lifting and writing bills feed the second.

Therapeutic ultrasound is one of the treatments sometimes used for these and other soft-tissue problems. Our ultrasound therapy page describes the technique; here we explain how a physiotherapist decides whether to use it for people on Shankar Sheth Road.

Heels and elbows from a shop-floor day

• Standing on hard floors. Tiled or stone floors behind a counter give the foot little cushioning over a long day.
• Flat or worn footwear. Chappals or tired shoes give the arch very little support.
• Sudden increases. A festival rush, a new job on the shop floor or a week of stock-taking can overload the heel or the elbow tendons quickly.
• Repeated gripping. Lifting cartons, using tools and writing bills by hand all load the tendons that extend the wrist, which attach at the outer elbow.

For more on the conditions themselves, see plantar fasciitis physiotherapy and tennis elbow treatment.

What the evidence says

Therapeutic ultrasound has been part of physiotherapy for decades, but good-quality trials have generally found that it adds little to exercise for most musculoskeletal pain. Some people report short-term comfort, and it may have a place in particular situations, but it is not a treatment to rely on. A careful physiotherapist will say this plainly, use it selectively if at all, and spend most of the session on exercise, load management and advice.

Safety checks for ultrasound

Ultrasound is not used over a pregnant abdomen, the eyes, a known or suspected tumour, a blood clot or an infected area, over the spinal cord after spinal surgery, or over the growth plates of children's bones. Areas with poor sensation or circulation, freshly injured tissue that may still bleed, and the region of an implanted device such as a pacemaker need particular care. The physiotherapist asks about all of these before starting.

How it fits into a home session

If ultrasound is used during a visit, gel is spread on the skin and the treatment head is moved slowly and continuously over the sore area for a few minutes. Most people feel nothing, or a mild warmth; any ache or heat is a signal to stop. It is usually done before or after the main work of the session: hands-on treatment, stretching and strengthening. For tight calves and forearms, myofascial release may be used as well.

Loading exercises do the main work

For heel pain, calf and foot strengthening, a calf stretch, supportive footwear and a cushioned mat behind the counter usually help more than any machine. For tennis elbow, gradually loaded wrist exercises and changes to how you grip and lift are central. Expect progress to be gradual, because tendons and the plantar fascia adapt slowly.

Heel or elbow pain with swelling and redness, numbness or tingling, or pain that began with a fall needs a doctor's assessment first. Book through the booking page, or see how home physiotherapy along Shankar Sheth Road works.