Ch. 12 Therapeutic Modalities
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?Effects
VasoconstrictionReduce 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
Electrical Stimulation Contraindications
Cardiac disability Pacemaker Pregnancy (over abdominal area) Menstruation Over cancerous lesions Over sites of infection Over exposed metal Severe obesity Epilepsy