Chapter 15: Therapeutic
Modalities
Therapeutic modalities can be
an effective adjunct to various techniques of therapeutic exercise
A variety of modalities can
be utilized by athletic trainers including cryotherapy,electrical stimulation,
ultrasound, massage, traction, diathermy, lasers and magnets
Legal Concerns
How are Modalities Related?
Electromagnetic energy
modalities
Acoustic energy modalities
Characteristics of
Electromagnetic Modalities
Transmission of Thermal Energy
Conduction
Convection
Radiation
Conversion
Cryotherapy
Used in first aid treatment
of trauma to the musculoskeletal system
Physical Principles
Physiological Principles
–Vasoconstriction
–Increase
in blood viscosity and decrease in vasodilator metabolites
–Decreases
extent of hypoxic injury to cells--
–Decreased
metabolic rate and vasoconstriction decreases swelling associated w/
inflammatory response
–Decreases
muscle spasm
–Decreases
free nerve ending and peripheral nerve excitability
–Cold
is more penetrating than heat
–Ability
to decrease muscle fatigue and increase and maintain muscular contraction
Special Considerations
Cryotherapy Techniques
Ice Massage
Cold or Ice Water Immersion
–Equipment
–Indications
Cold or Ice Water Immersion
(continued)
–Special
Considerations
Ice packs can be another way
to apply cryotherapy.
Ice Packs (Bags)
–Equipment
–Indications
–Special
Considerations
Vasocoolant Sprays
–Equipment
–Indications
–Application
Vasocoolant Spray (continued)
–Application
For trigger points
Cryokinetics
Thermotherapy
Physiological Effects of Heat
–Extensibility
of collagen
–Pain
relief
–Assistance
w/ inflammation
Superficial Heat
Special Consideration w/
Superficial Heat
–Important
contraindications
–Moist
Heat Therapies
At least two protective
layers of toweling must be applied between the skin and a moist heat pack.
Moist Heat Packs
–Equipment
–Indications
–Application
Whirlpool Bath
–Equipment
–Indications
–Application
Special Considerations
Paraffin Bath
–Equipment
–Indications
–Application
Contrast Bath
–Equipment
–Indications
–Application
Fluidotherapy
–Equipment
–Indications
–Application
Ultrasound
Modality which stimulates
repair of soft tissue and pain relief
Form of acoustic energy used
for deep tissue heating
Equipment
–Frequency
range between .75 and 3.0 MHz
–Area
of transducer that produces sound is the effective radiating area
–Intensity
is determined by amount of energy delivered to the sound head (W/cm2)
–Can
be delivered as either pulsed or continuous ultrasound
Indications
–Produces
thermal and non-thermal effects
–Acute conditions require more treatments over a
shorter period and chronic conditions require fewer treatments over a longer
period
Application
–Direct
skin application
–Underwater
application
–Bladder
technique
–Moving
the transducer
–Dosage
and Time
–Special
Considerations
Ultrasound in Combination w/
Other Modalities
Ultrasound can be used w/ a
variety of modalities to accomplish a series of treatment goals
Phonophoresis
Method of driving molecules
through the skin using mechanical vibration
Electrotherapy
Physical Principles
–Electricity
is applied to nerve tissue at certain intensities and duration to reach tissue
excitability thresholds resulting in membrane depolarization
Electrical Stimulating Units
–Three
types of units
–Generate
3 types of current
Current Parameters
–Waveforms
–Modulation
–Intensity
–Duration(pulse
width or pulse duration)
–Frequency
–Polarity
–Electrode
Set-up
Indications
–Pain
Modulation
–Muscle
Contraction
Muscle pump
Muscle strengthening
Retardation of atrophy
Muscle re-education
Ionotophoresis
Interferential Currents
Low Intensity Stimulators
Biofeedback
Massage
Systematic manipulation of
soft tissue
Therapeutic Effects
–Psychological
Responses
Massage Strokes
Effleurage
Stroking Variations
Petrissage
Friction
–Tapotement
–Vibration
Guidelines for an Effective
Massage
Sports Massage
Deep Transverse Friction
Massage
Acupressure Massage
Traction
Indications
Application
–Mechanical
Traction
–Positional
Traction
–Wall-Mounted
Traction
–Inverted
Traction