LIPUS

(Low-intensity Pulsed Ultrasonic Bone Stimulation)

WHAT IS IT?

Ultrasonic waves activate cells near a fracture in order to stimulate the healing process, says sports podiatrist Stephen Pribut, a clinical assistant professor of surgery at George Washington University School of Medicine and Health Sciences in the US. Patients are given a small ultrasound kit to use at home. It straps onto the fracture site, so patients can sit while undergoing treatment.

WHAT DOES IT TREAT?

Bone stimulation is generally used if a shin or foot bone fails to heal after four to six months of traditional treatment. It’s sometimes used as an immediate treatment of fifth-metatarsal fractures, since this bone tends not to heal without stimulation or surgery. ‘If you’ve reached the point where you need to use a bone stimulator, this probably means that you’ll also be in a soft cast or on crutches,’ says Pribut.

HOW EFFECTIVE?

A number of studies support it as an effective treatment. Reviewing 17 clinical studies, The National Institute for Health and Care Clinical Excellence concluded that low-intensity pulsed ultrasound treatment showed high rates of fracture healing, judging results sufficient to support the efficacy of treatment. Pribut has found this to be true in his clinic, too.

WHO’S HAD IT?

Former 800m Olympian Rich Kenah used a bone stimulator to help heal a navicular (a bone on the top of the foot) stress fracture. ‘The fracture healed, I returned to make the US Olympic team and I run pain-free today,’ says Kenah.

DOES IT HURT?

Some people report a slight warmth, but most patients feel nothing. ‘All the vibration is deep and internal,’ says Pribut.

WHO OFFERS IT?

Treatment via the Exogen ultrasound bone-healing system is available on prescription, while a device that’s produced by Osteotron can be purchased directly and is widely available. Most sports medicine physicians should be aware of – and have access to – the technology, adds Pribut.

WHAT’S THE COST?

The Osteotron IV LIPUS Ultrasound Bone Growth Stimulator costs £1,700 from emsphysio.co.uk

TREATMENT PLAN?

Pribut suggests runners use the stimulator for 20 minutes per day over three to four months. Since the process takes so long, Pribut says, ‘many elites elect to have surgery instead’.