Clinical Uses Of Long-Duration Ultrasound And Long-Duration Sonophoresis In Sports Medicine - Minireview

Abstract

Competitive physical sports demand rigorous training, increasing the risk of overuse-associated musculoskeletal traumatic injuries followed by a complex and time-consuming healing process with economic effects and potential disability. Tissue healing involves inflammation, molecular and cellular pathway regulation, proliferation, and tissue regeneration. These responses can significantly vary depending on the location and severity of the injury, affecting recovery time, pain intensity, range of motion, and return to sports activity. Despite medical advancements, healing, pain alleviation, regenerative tissue quality, mobility, and quality of life remain challenging. Current treatments, including nonsteroidal anti-inflammatory drugs and opioid-based treatments, have systemic adverse effects and efficacy limitations. Long-duration ultrasound therapy has emerged as a promising mechanobiological and diathermic treatment, providing critical biomechanical and thermal stimuli. Biomechanical stimuli help regulate acute inflammation, cellular proliferation, and tissue regeneration. Thermal stimuli enhance blood flow, angiogenesis, and nutrient exchange, accelerating healing and improving recovery outcomes. These combined stimuli also increase skin porosity and permeability, facilitating targeted drug delivery through sonoporation and enhancing the efficacy of treatments like platelet-rich plasma therapy. This review examines recent studies exploring the therapeutic effects of long-duration ultrasound as a standalone and adjunctive therapy. It examined its roles in regulating acute inflammation, mitigating chronic inflammation, tissue regeneration, healing, sports-associated pain management, mobility, and overall tissue recovery.

Keywords: Long-Duration Ultrasound; Musculoskeletal pain; Platelet-rich Plasma; Sonoporation; Sports Medicine.

Figure 1:. Synergistic Effects of Long Duration Ultrasound and Sonoporation.

A) Inflammatory response to musculoskeletal injury. Marked muscle tissue damage with an increased level of inflammatory cells. B) LDU regulates the inflammatory response and improves tissue healing. C) The Synergistic effects of LDU/LDS enhance targeted drug delivery with accelerated tissue healing and regulate the inflammatory response.

Figure 1:. Synergistic Effects of Long Duration Ultrasound and Sonoporation.

A) Inflammatory response to musculoskeletal injury. Marked muscle tissue damage with an increased level of inflammatory cells. B) LDU regulates the inflammatory response and improves tissue healing. C) The Synergistic effects of LDU/LDS enhance targeted drug delivery with accelerated tissue healing and regulate the inflammatory response.

Figure 2:

Basic 3 MHz LDU delivery system components for treating soft tissue injuries. A) Ultrasound transducer applicator and coupling patch, B) Ultrasound power controller and treatment timer, and C) Power splitter cable.