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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.
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
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
Why ice?
EffectsVasoconstrictionReduce tissue metabolismDecrease nerve conduction
velocity Reduce muscle spasm
Always use ice for acute injuries
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
Ice Massage
Freeze water in a paper cup
Reusable plastic cups
Ideal for tendonitis, shin splints
Time: 5-7 minutes
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
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
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
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
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
Contrast Therapy
Alternating hot and cold therapy
Used in subacute stage to reduce swelling, reduce pain, and increase range of motion
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
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
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
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
Electrical Stimulation Effects
Increase range of motion
Increase muscle strength
Reeducation muscles
Improve muscle tone
Reduces muscle spasm
Control pain