Therapeutic ModalitiesTherapeutic ModalitiesModalities-treatment of injuries, Modalities-treatment of injuries, including heating, cooling, and including heating, cooling, and mechanical/electrical methods.mechanical/electrical methods.

What modalities do we use in our What modalities do we use in our Training Room?Training Room?

Therapeutic ModalitiesTherapeutic Modalities

Modalities are used to relive pain, Modalities are used to relive pain, reduce or retard swelling, decrease reduce or retard swelling, decrease spasm, and promote healing.spasm, and promote healing.

When used properly they can When used properly they can minimize time lost, and shorten minimize time lost, and shorten recovery time.recovery time.

Therapeutic ModalitiesTherapeutic Modalities

Important to remember, all Important to remember, all modalities have indications (why you modalities have indications (why you should use) and condraindications should use) and condraindications (why you should not use). Know (why you should not use). Know these before you use any modality.these before you use any modality.

Thermal ModalitiesThermal Modalities

Thermal Modalities use Thermal Modalities use thermal agents-heat and thermal agents-heat and cold.cold.

Thermal ModalitiesThermal Modalities

Cryotherapy-Cryotherapy-therapeutic use of therapeutic use of cooling agents. cooling agents. Most often used Most often used modality in sports modality in sports medicine.medicine.

Includes- cold Includes- cold pack, cold bucket pack, cold bucket bath, ice massagebath, ice massage

Cryotherapy (COLD)Cryotherapy (COLD)

Helps to manage pain and swelling.Helps to manage pain and swelling. vasoconstriction of blood vesselsvasoconstriction of blood vessels Decrease in nerve conduction to brainDecrease in nerve conduction to brain Reduce muscle spasmReduce muscle spasm

Then:Then: Vasodialation occursVasodialation occurs Increase in muscle strength after Increase in muscle strength after

treatmenttreatment

CryotherapyCryotherapy

Best choice of Best choice of acute injuriesacute injuries

Soon after an Soon after an injury the betterinjury the better

Application no Application no longer than 20 longer than 20 minutes at one minutes at one timetime

3-4x a day 3-4x a day following injuryfollowing injury

CryotherapyCryotherapy

Ice Packs-effective for local area Ice Packs-effective for local area injury. injury.

Cubes in a plastic bag.Cubes in a plastic bag. Commercial Gel PacksCommercial Gel Packs Chemical-activated cold packChemical-activated cold pack Bag of vegetables/frozen riceBag of vegetables/frozen rice

CryotherapyCryotherapy

Ice Massage-technique of rubbing ice Ice Massage-technique of rubbing ice over injured area.over injured area.• Local area icingLocal area icing• Need to make sure area is draped for Need to make sure area is draped for

collection of watercollection of water• Treatment time only 5 minutesTreatment time only 5 minutes

CryotherapyCryotherapy

Cold Water Compression-systems Cold Water Compression-systems designed to combine compression designed to combine compression with cold simultaneously. with cold simultaneously. • Several shapes to accommodate Several shapes to accommodate

different body parts.different body parts.• Some use gravity, some use a pump.Some use gravity, some use a pump.

CryotherapyCryotherapy

Ice Baths-immersion of a part in ice Ice Baths-immersion of a part in ice water. It provides uniform coverage.water. It provides uniform coverage.

The part can be moved around The part can be moved around during treatment.during treatment.• 55 degrees F55 degrees F• 10 minute treatment10 minute treatment• Cold-burning-aching-numbCold-burning-aching-numb

CryotherapyCryotherapy

Contraindications-Contraindications-• Sensory deficits (the elderly)Sensory deficits (the elderly)• Hyersensitive to coldHyersensitive to cold• Impaired circulationImpaired circulation• Heart diseaseHeart disease• Malignant tissueMalignant tissue

Heating Agents (HOT)Heating Agents (HOT)

Can be skin deep Can be skin deep of up to a few of up to a few inches deep, inches deep, depending upon depending upon modalitymodality

Reduce painReduce pain Promote healingPromote healing Increase ROMIncrease ROM Muscle relaxationMuscle relaxation

Heating Agents (HOT)Heating Agents (HOT)

Increase vasodialation-blood flowIncrease vasodialation-blood flow Increase metabolic rateIncrease metabolic rate Increase oxygenation of tissueIncrease oxygenation of tissue

Use for chronic or subacute injuries, Use for chronic or subacute injuries, not acute.not acute.

Heating Agents Heating Agents

Hydrocollator Packs- moist heat packs Hydrocollator Packs- moist heat packs used for superficial heat.used for superficial heat.• Water is at 60-90 degrees CWater is at 60-90 degrees C• Used for 10-20 minutesUsed for 10-20 minutes• Put in covers for insulation and safetyPut in covers for insulation and safety

Heating Agents Heating Agents

Heating Pads- Electrical pad or Heating Pads- Electrical pad or microwaveable pad used to get microwaveable pad used to get physiological response of heat. Be physiological response of heat. Be aware of time and temperature.aware of time and temperature.• Make sure there is enough insulation of Make sure there is enough insulation of

pad.pad.

Heating AgentsHeating Agents

ContraindicationsContraindications Not used in first 24-48 hours of Not used in first 24-48 hours of

injury-heat dialates vessels and could injury-heat dialates vessels and could cause increase bleeding of injurycause increase bleeding of injury

If it burns take it offIf it burns take it off Do not use with impaired circulationDo not use with impaired circulation do not use with diminished sensationdo not use with diminished sensation

HydrotherapyHydrotherapy

AdvantagesAdvantages• It can allow the It can allow the

patient to work patient to work ROMROM

• A larger area of the A larger area of the body can be treatedbody can be treated

• 10-20 min is 10-20 min is treatment time.treatment time.

DisadvantagesDisadvantages• Extra time and Extra time and

effort to prepare effort to prepare and cleanand clean

• SpaceSpace• ExpensiveExpensive• No elevationNo elevation

A form of superficial heating using agitated, heated water in a whirlpool.A form of superficial heating using agitated, heated water in a whirlpool.

Contrast TherapyContrast Therapy

Alternating hot and cold baths used Alternating hot and cold baths used during the subacute phase (48-72 during the subacute phase (48-72 hours) to help reduce swelling, pain hours) to help reduce swelling, pain and increase ROM.and increase ROM.• 50-66 degrees F cold bath50-66 degrees F cold bath• 102-110 degrees F hot bath102-110 degrees F hot bath• Always end with COLDAlways end with COLD• 3H-1C-3H-1C-3H-1C about 20 minutes3H-1C-3H-1C-3H-1C about 20 minutes

That’s it FolksThat’s it Folks

Well not really we are only half way there Well not really we are only half way there just be happy this is the end of the first just be happy this is the end of the first power point.power point.