Therapeutic ultrasound can be a useful adjunct to hands-on physiotherapy in selected postnatal presentations – including painful, restricted caesarean scars and with some lactation-related breast symptoms.
What is therapeutic ultrasound?
The ultrasound head or transducer, produces high frequency mechanical sound waves that travel through tissue. As these waves interact with cells and extracellular structures that make up soft tissue, they can produce thermal and non-thermal mechanical effects. These effects can influence cell signalling, membrane permeability and local tissue behaviour.
A gel is used on the skin to help the ultrasound energy pass efficiently from the treatment head into the tissues beneath the skin. The gel also reduces friction and skin irritation during treatment
Caesarean scar management
Once the incision is appropriately healed, therapeutic ultrasound may be incorporated alongside scar mobilisation and other soft tissue techniques, to help address scar sensitivity, reduced tissue mobility and discomfort.
The aim is not simply to “break down” scar tissue, but to improve comfort and tissue mobility as part of a broader, individualised rehabilitation program. Evidence for scar- specific ultrasound remains limited, so treatment should be guided by clinical assessment rather than used routinely for every scar.
Instruction from our women’s health physiotherapist will include:
- Soft tissue mobilisation of the scar and surrounding area
- Effective deep abdominal core activation training with graded exercise
Encouraging a postnatal woman to “get to know and love” her tummy again, is an important part of our women’s health physiotherapy.
Breast engorgement & lactation-related breast symptoms
Therapeutic ultrasound has been used by physiotherapists for breast symptoms, such as engorgement, tenderness and ductal narrowing/blocked areas. Small studies suggest that a multimodal physiotherapy approach can reduce symptoms. However, there is a recent randomised controlled trial that found ultrasound itself was not superior to sham ultrasound. This highlights an important point – ultrasound is best considered an adjunct, rather than a stand-alone treatment.
What about mastitis?
It is important to distinguish inflammatory breast symptoms from bacterial mastitis and breast abscess. Current mastitis guidance emphasises reducing inflammation and avoiding overly aggressive breast massage or excessive milk removal. Therapeutic ultrasound should only be considered following appropriate clinical assessment and within an evidence-informed treatment plan.
Our women’s health physios have worked in this area for many years, and understand the importance of clinical effectiveness being demonstrated in their treatment of mastitis and lactation-related breast symptoms.
Women’s health physiotherapy is about more than the scar or breast!
We look at the whole postnatal picture. This may include pain, loss of functional movement (neck, back, wrists, hips), abdominal wall function, pelvic floor health, breastfeeding challenges, scar mobility and your confidence in returning to everyday activities and feeling strong as a mum.
If you are experiencing a painful/tight caesarean scar or persistent breast symptoms after birth, our women’s health physiotherapist can assess whether therapeutic ultrasound is appropriate for you – and, importantly, what other treatment strategies may be more beneficial.
Our well trained, caring physios are only a phone call away.