Ch. 12 Therapeutic Modalities

1. Ch. 12 Therapeutic Modalities

2. Objectives • Explain the use and effectiveness of physical modalities. • Describe the various thermal modalities and their applications. • Explain and describe the use of therapeutic ultrasound. • Explain and describe the use of electrical modalities.

3. Modalities • Various heating, cooling, and electrical methods of treatment used to promote healing • In order to be effective, modalities should be applied properly • Helps relieve pain, reduce swelling, decrease spasm, minimize time lost from sports

4. Cryotherapy • Use of cooling agents • Ice packs • Ice massage • Cold whirlpool • Coldwater Compression • Always monitor athlete • Contraindications • Thermoregulatory problems • Sensory deficits • Hypersensitivity • Impaired circulation • Heart disease • Malignant tissue

5. Why ice? • Effects • Vasoconstriction • Reduce tissue metabolism • Decrease nerve conduction velocity • Reduce muscle spasm • Always use ice for acute injuries

6. Ice Bag • Easy to make, readily available, cheap • No air should be in bag • May be wrapped on body • Reusable ice packs are better for clinical setting • Time: 20 minutes • May use thin barrier between ice and skin

7. Ice Massage • Freeze water in a paper cup • Reusable plastic cups • Ideal for tendonitis, shin splints • Time: 5-7 minutes

8. Cold Whirlpool • Immersing body part in cold water (50°F-60°F) • Covers the whole body part • Athlete may move body part while receiving treatment • Time: 10 minutes

9. Cold Compression Unit • Many different units that provide cold and compression to shoulders, knees, and ankles • Some use a pump and some uses gravity • Time: 15-20 minutes

10. Heating Agents • Superficial and deep tissue heating • Effects • Reduce pain • Increase range of motion • Muscle relaxation • Increased vasodilation • Only use with subacute or chronic injuries

11. Heat Packs • Moist heat packs are kept in a hydrocollator • Water temp. 140°F to 194°F • Cover heat pack before placing on body • Should be warm but not burn • Time: 10-20 minutes

12. Warm Whirlpool • Immersing body part in warm water (95°F to 104°F) • Larger part of the body may be treated • Athlete may move during treatment • Time: 10-20 minutes

13. Contrast Therapy • Alternating hot and cold therapy • Used in subacute stage to reduce swelling, reduce pain, and increase range of motion

14. Ultrasound • Deep heating modality • High frequency sound wave • Can affect tissue up to 5 cm • Ideal for tendons, ligaments, and joint capsules • Time: 5-7 minutes

15. Ultrasound • Effects • Increased nerve conduction velocity • Increased extensibility of collagen rich structures • Increased blood flow • Tissue regeneration • Stimulating phagocytosis • Synthesis of collagen • Contraindications • Acute injuries • Ischemic areas • Anesthetic areas • Over cancerous tumors • Over active infections • Over spinal cord • Over fracture sites • Around eyes, heart, skull

16. Ultrasound Set-Up • Transducer head: 1 cm², 5 cm², 10 cm² • Depends on availability and treatment area • Frequency: 1MHz for deep tissue, 3MHz for superficial • Continuous or pulsed setting (Duty Cycle) • Must use coupling agent • Move sound head at 2-4 cm/sec

17. Electrical Stimulation • Use of electrical currents to stimulate the muscle to cause contractions or spasms • Different types of currents • Different set-ups • Interferential • Pre-modulated

18. Electrical Stimulation • Effects • Increase range of motion • Increase muscle strength • Reeducation muscles • Improve muscle tone • Reduces muscle spasm • Control pain

19. Electrical Stimulation • Contraindications • Cardiac disability • Pacemaker • Pregnancy (over abdominal area) • Menstruation • Over cancerous lesions • Over sites of infection • Over exposed metal • Severe obesity • Epilepsy