Therapeutic Ultrasound

Ultrasound therapy can be an ideal way to effectively treat musculoskeletal injuries, joint pains, soft tissue injuries and restricted range of movements. Injuries and health disorders can be quite painful. High frequency ultrasound waves penetrate deep inside the skin and target the affected area that cannot be reached by other methods such massage, stretching or active release.

Method of Application

Ultrasound is applied using a round-headed wand or probe that is put in direct contact with the patient’s skin. Ultrasound gel is used on all surfaces of the head of the probe in order to reduce friction and assist in the transmission of ultrasonic waves. These ultrasonic sound waves pass through the skin causing a vibration of the local tissues. This vibration or cavitation can cause a deep heating locally though sometimes no sensation of heat is felt by the patient.


Ultrasound produces many positive effects other than just the heating effect. It has been shown to cause increases in tissue relaxation, increased blood flow and breaks down undesirable scar tissue and adhesions that cause pain, limit performance and more. Ultrasound has been proven to be an excellent treatment for fibromyalgia, myofascitis, bursitis, tendinitis, muscle spasms, trigger points, joint fixations, scar tissue breakdown and more.

A typical session of ultrasound will take only 3-5 minutes, depending on the size of the area being treated. For scar tissue breakdown this treatment can last much longer.

Interferential Stimulation Therapy

Have you long been struggling with the pain from an injured joints and muscles? Then it will definitely ease you to know of an advanced treatment we will use for it. Interferential stimulation (IFS), is one of the breakthroughs in clinical research and technology development. Modern electrotherapy was especially designed as treatment for hurt joints and muscles.

Interferential stimulation is a ground-breaking treatment procedure of using electrical current specifically to stimulate selected nerve fibers, muscle fibers and joints, therefore promoting faster repair and healing.

Interferential stimulation is believed to reduce pain, decrease swelling or edema, and increase blood circulation in damaged tissues, thus stimulating faster repair and a quicker return to normal health.

As previously mentioned, Interferential stimulation has been established as a medical technique in reducing pain, promoting repair and healing among various harmed tissues, and improve the range of movement of joints. IFS therapy is used for its analgesic effect and in restoring damaged muscle and joint tissues.

IFS therapy is now commonly used for joint injury syndrome, pre- and post-orthopedic surgery, cumulative trauma disorders, increasing blood circulation, and managing pain. Great success has been utilized with the treatment of whiplash, back pain, carpal tunnel syndrome, sciatica, arm pain, joint pains, fibromyalgia and other musculoskeletal problems.

Intersegmental Traction

Intersegmental Traction is a particularly useful and effective therapy to treat and help prevent painful muscle spasms and muscle guarding specifically in spinal muscles.

Back Muscles

The back is a marvelous wonder. There are many muscles in your back used singly or in combination to achieve a tremendous range of motion (forward flexion, lateral flexion, rotation, and extension). In your core muscles there are small muscles connecting one vertebrae to the next and there are the muscles of the Erector Spinae which are longer and connect different sections together. When fatigued, or affected by accident, injury, or repetitive stress, these muscles can spasm and can lead to chronic muscle guarding and pain.

Vetebral Discs

In between the vertebrae there are shock absorbing structures called vertebral discs. The outer layer of a vertebral disc (like the dough of a jelly donut) is comprised of multiple layers of annulus fibrosus which is a very tough fiber. The inside of the disc contains nucleous pulposus (the jelly) which is really very jelly-like and contains about 90% water.

Intersegmnetal traction is a great intervention. Intersegmental traction is delivered through the use of a traction table.

The vertebral discs cushion the vertebrae from movement and act as a shock absorber during more strenuous movements like walking or running. When Back muscles are tight and spasming they can pull vertebrae out of alignment (because the muscles are attached to the vertebrae and they shorten during a spasm). When vertebrae are out of alignment they may cause the vertebral disc to be displaced or in severe cases rupture which may lead to mild to severe pain.

It is a table that you lay down on your back and there are special rollers just underneath the surface of the table. These rollers are adjusted for your condition and weight to gently and specifically elongate and stretch your spinal joints and muscles. This benefits in reduction and prevention of muscle spasm and begins to re-establish normal range of motion for your spinal joints (each vertebrae). When your muscles become more relaxed and vertebrae begin to move normally your vertebral discs now have their normal space and can return to their normal position and functioning. This also helps to prevent abnormal wear and tear on the vertebral discs and vertebrae which in turn prevent further injury and reduce the arthritis process.

Proprioceptive Neuromuscular Facilitation

How Does Proprioceptive Neuromuscluar Facilitation Work?
Your muscles are made up of fibers that stretch and contract in order to do something mechanical, like lift and lower your leg.  Like many components of the body, your muscles have a built in safe-guard called a myotatic stretch reflex that will signal your muscle to contract if it senses that it is being overstretched.

There is another safe guard in your tendons called a golgi tendon organ which signals the muscles to relax when your tendons are stretched too far. Proprioceptive Neuromuscular Facilitation (PNF) utilizes both of these sensory responses in it’s approach to improving flexibility, range of motion, even strength and athletic performance.

How is Proprioceptive Neuromuscular Facilitation Performed?
This advanced therapy technique utilizes a series of exercises that combine alternating isometric (static contraction against resistance provided by your therapist) and isotonic  (passive) stretching techniques in a way that allows you to achieve maximum flexibility and improvement in range of motion. There are several different exercises and types of stretches that are utilized depending on your condition.

This is one of the best ways to improve flexibility, range of motion, and everyday movements to increase efficiency and prevent muscle spasms and injury.

Moist Heat Therapy

For centuries, the ability of heat to increase blood flow and ease the sensation of pain has had an important role in managing pain and supporting the healing process.

How does it work?
When warm moist heat is applied to an injury, it dilates the capillaries (tiny blood vessels) in the affected area thus increasing blood flow which in turn nourishes the tissues with essential nutrients and oxygen to accelerate the healing process. Heat also temporarily reduces pain in an injured area and helps reduce muscle spasm.

The therapeutic moist heat pack is stored in water at 155 degrees Fahrenheit. When applied to the treatment area, it is wrapped in towels and is at that point approximately 115 degrees Fahrenheit. Moist heat is adjusted according to the patient’s tolerance and sensitivity to heat. The skin on the affected area should turn a bright pink when the proper level of circulation has been reached. Moist heat is beneficial in that it increases circulation and nutrients, facilitates the removal of cellular by-products and relieves tight muscles.

Ice for Injury and Inflammation

Injury caused by a trauma, such as a bruise or a sprain, or a repetitive strain, such as carpal tunnel, will cause inflammation. When a cell membrane is damaged, it releases chemicals (prostaglandins) around the cell which causes the capillaries (tiny blood vessels) around the affected area to swell. Inflammation is a good thing because your tissues need it to heal. Inflammation acts to isolate the injured area and initiates the repair process.  However, if proper care of the injury is not taken, inflammation can hinder the healing process. If inflammation is left uncontrolled, nutrition flow to the injury will decrease, which may lead to scarring and dysfunctional muscle groups, which may ultimately lead to improper motion and on-going pain.

The following instructions describe what to do during the first 24 to 48 hours after receiving an injury. They are meant as a general guideline only and posted here for our patient’s reference. It is always best to call us, your doctor, or other qualified healthcare provider for advice specific to your situation if you are injured. (Individuals suffering from Raynaud’s phenomenon, peripheral vascular disease, or susceptibility to frostbite should be cautious when utilizing ice therapy).

A helpful aid in remembering what to do in case of an injury is the acronym PRICES.
P = protect   R = rest   I = ice   C = compress   E = elevate   S = stabilize

Immediately after sustaining an injury PROTECT it, REST it and ICE it.

Ice will cause the capillaries to shrink back to normal and naturally decrease pain. (NEVER put an ice pack directly on your skin. Place a cloth towel or t-shirt between the injury and the ice pack. Frozen peas work great as an impromptu ice pack, or get a towel wet and put it in a Ziploc bag and freeze it!)

Combining ICE and COMPRESSION aid in the resorption of excess intracellular fluids produced as a result of the injury.  Studies have demonstrated that ice combined with compression is more effective than ice therapy alone. (Try securing the ice pack with an ace bandage).

ELEVATE the injury. This helps drain excess fluids away from the affected area.
STABILIZE the injury as soon as possible.

These methods will control the negative aspects of inflammation and create the optimum environment for your body to heal itself.
How long should I apply ice for?

The amount of time and frequency that ice should be applied to an injury varies with the degree of injury and place of injury. A good rule of thumb is to remember the acronym CBAN. CBAN is what you feel when you apply ice to the injury.

First it feels COOL; then it BURNs; then it feels ACHY; finally it feels NUMB. CBAN.

When the area feels numb, due to decreased nerve conduction, it is time to remove the ice. This usually varies from a few minutes to 20 minutes. The ice can be reapplied when the area warms up to normal temperature (after about 60 minutes). This can be done several times a day.

Ice packs are a natural, drug free way to reduce inflammation and swelling with none of the adverse side effects that may be experienced with the use of costly medication.

Therapeutic Exercises

Therapeutic exercise is a therapy intervention encompassing a broad range of activities designed to restore or improve musculoskeletal, cardiopulmonary and/or neurologic function.

Some form of therapeutic exercise is indicated in almost every therapy case. We often assist clients in designing therapeutic exercise programs to prevent injury or secondary impairments. In addition, we use therapeutic exercise as one component of patient care to improve functional ability and general well-being in those who are experiencing limitations or disability due to a disease, disorder, trauma, or surgery.

Therapeutic exercise includes a broad spectrum of activities, from passive range of motion and breathing exercises to high-speed agility drills. Precautions, therefore, are specific to each individual depending upon his or her condition. We use our specialized knowledge to determine exercises that are appropriate for a patient level of ability, age, endurance, severity of injury and/or stage of recovery. Outlined below, however, are a few examples of situations in which general precautions should be observed.

A progression of therapeutic exercise is usually more gradual in a patient recovering from severe trauma than in one who did not suffer a severe trauma or have surgery, especially in order to allow inflamed tissues to heal. In general, specific joint motions and weight bearing positions are often restricted. High-intensity stretching and resistance exercise is usually limited in the beginning for at least six weeks, to allow adequate healing time for muscles or tendons that have been repaired.

Our team of doctors and staff have extensive experience in administering and designing individualized therapeutic exercises programs for our patients. Dr. Fife has personally trained professional and amateur athletes. He has designed both therapeutic exercises programs and strength and conditioning programs for thousands of patients and athletes. In addition to being a chiropractic physician, Dr. Fife is Certified Personal Fitness Trainer and a competitive athlete. This knowledge and experience allows him to truly understand what will work and what will not work for any given health condition or exercise goal.