What does therapeutic ultrasound do?

Therapeutic ultrasound uses sound waves to create mechanical and sometimes gentle thermal effects in soft tissues. It may support circulation, reduce stiffness and assist healing when combined with exercise and other physiotherapy treatments.

Which conditions may benefit from therapeutic ultrasound?

Physiotherapists may consider ultrasound for mastitis and blocked ducts, muscle strain, tendinopathy and some tendon-related elbow conditions. It is usually an adjunct to active rehabilitation rather than the main treatment.

Is therapeutic ultrasound safe?

Yes, when used by a qualified physiotherapist who follows safety guidelines and screens for contraindications. Your physio will adjust the settings and treatment time to suit your condition and comfort.

When should therapeutic ultrasound be avoided?

Ultrasound should not be used over known or suspected malignancy, some metal implants, active infection, the pregnant uterus, or sensitive regions such as eyes and testes. Your physiotherapist will check your medical history before treatment.

Will therapeutic ultrasound fix my injury on its own?

No. Ultrasound is one tool within a broader physiotherapy plan. The most important parts of your recovery are accurate diagnosis, load management, progressive exercise and self-management strategies tailored to your goals.

Therapeutic Ultrasound

Article by John Miller

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What is Therapeutic Ultrasound?

Therapeutic ultrasound is a physiotherapy treatment that uses sound waves to target soft tissues. It has been used in physiotherapy treatments for many decades to assist pain relief, circulation, and tissue healing.

At PhysioWorks, ultrasound is one of several tools your physiotherapist may use. It usually sits alongside exercise, education, and hands-on treatment rather than acting as a stand-alone solution. For a general overview, you can also visit our FAQ page: What is Therapeutic Ultrasound?

How Does Therapeutic Ultrasound Work?

The ultrasound machine sends high-frequency sound waves through a small treatment head into the tissues under the skin. These waves cause tiny vibrations and mechanical effects in muscles, tendons, and other soft tissues.

Depending on the settings, ultrasound can create:

Gentle mechanical effects to support fluid movement and tissue healing
Thermal effects that can increase local blood flow and tissue flexibility

Your physiotherapist adjusts the intensity, frequency, and treatment time to suit your injury, healing stage, and comfort.

When Might Your Physiotherapist Use Ultrasound?

Research suggests that therapeutic ultrasound may offer benefits for some soft tissue conditions when applied correctly and combined with active rehabilitation. It is usually used as an adjunct, not the main treatment.

Your physiotherapist may consider ultrasound as part of your care for conditions such as:

Mastitis and blocked ducts in breastfeeding women
Muscle strains and muscle pain
Tendinopathy (e.g. Achilles or patellar tendinopathy)
Tennis elbow and other elbow tendon conditions

In each case, ultrasound is one part of a broader physiotherapy plan that should include progressive exercise, load management, and self-care advice.

Therapeutic Ultrasound for Mastitis and Blocked Ducts

Therapeutic ultrasound is commonly used to help manage breast pain, blocked ducts, and mastitis in breastfeeding women. It aims to reduce local inflammation, improve circulation, and assist milk flow through affected ducts.

This can provide pain relief and support breastfeeding continuation when combined with correct latch, feeding advice, and follow-up with your health team. Learn more on our Mastitis & Blocked Ducts information page.

Soft Tissue Injury, Muscle Strain, and Tendon Problems

Ultrasound has been investigated for muscle strains, tendinopathy, and other soft tissue injuries. Some studies report improved tissue healing and pain reduction, particularly when low-intensity pulsed ultrasound is combined with structured exercise programs.

Your physiotherapist will decide whether ultrasound adds value to your condition or whether your time is better spent on exercise, education, or other treatments.

A Versatile Modality – But Not a Magic Fix

Physiotherapist applying therapeutic ultrasound to a patient’s shoulder during treatment — Therapeutic Ultrasound Used During Physiotherapy Shoulder Treatment.

Therapeutic ultrasound sessions are usually quick and comfortable. However, research also reminds us that ultrasound is not a cure-all. Many soft tissue conditions respond best to active rehabilitation. Your physiotherapist will weigh up the pros and cons before choosing to include ultrasound in your program.

Is Therapeutic Ultrasound Effective?

Modern research into ultrasound is mixed. Some laboratory and clinical studies suggest that low-intensity pulsed ultrasound can influence cell activity, tendon healing, and pain modulation. Other trials show limited added benefit over placebo or exercise alone.

In simple terms, ultrasound may help in selected situations, but it should not replace good assessment, load management, and progressive exercise. Your physiotherapist will explain where ultrasound fits in your specific plan and will review its value as you progress.

When Should Ultrasound Be Avoided?

Like all treatments, therapeutic ultrasound has clear safety guidelines. Your physiotherapist will screen for the following before treatment:

Known or suspected malignancy in the treatment area
Over the uterus during pregnancy
Areas with active infection or open wounds (unless specifically indicated)
Over some metal implants or electronic devices
Areas with poor sensation or circulation
Over eyes, testes, or directly over the spine after some surgeries

Please tell your physiotherapist about your medical history, medications, and any implants before you start treatment.

What Does a Typical Ultrasound Session Involve?

A therapeutic ultrasound session usually includes:

A physiotherapy assessment to confirm whether ultrasound is appropriate
Application of ultrasound gel to allow the sound waves to pass into the tissues
Slow, continuous movement of the treatment head over the target area
Short treatment times, often between 3 and 10 minutes

You should not feel pain during treatment. You may feel mild warmth or nothing at all, depending on the settings. Your physiotherapist then guides you into exercises or other treatments to build on the effects of the session.

Should You Choose Therapeutic Ultrasound?

Ultrasound is best viewed as one tool in a complete physiotherapy toolkit. For many conditions, especially mastitis, blocked ducts, selected soft tissue injuries, and some tendon problems, it may support your recovery when used appropriately and alongside exercise and self-management strategies.

If you are unsure whether ultrasound is right for you, book a consultation so we can assess your condition and discuss the most effective options for your goals.

References

Qin H, Qin YX. The therapeutic effects of low-intensity pulsed ultrasound in musculoskeletal soft tissue injuries. Front Bioeng Biotechnol. 2022;10:1080430.

Li Y, Li J, Zhang H, et al. Effects of low-intensity pulsed ultrasound in tendon injuries. J Ultrasound Med. 2023;42(2):435-447.

Lin KY, Käkämies U, Gustafsson M, et al. Physical therapy intervention for breast symptoms in lactating women: a randomised trial. BMC Pregnancy Childbirth. 2023;23(1):481.

Liang W, Zhang J, Chen Y, et al. The current status of various preclinical and clinical treatment options for tendon injury. Ann Med. 2024;56(1):2190464.

Muscle & Soft Tissue Products

These muscle and soft tissue products are commonly used by our physiotherapists to relax or loosen muscles, improve strength, comfort, flexibility, and home exercise programs.