Chapter 2. General Application Procedures

What Is the Shotgun Approach?

What Is the Rifle Approach?

Use modalities that target the specific needs of the patients.

Be a Critical Thinker

Modality Application

Why a General Approach? Easier to learn multiple modalities One system fits all Not as likely to forget something during application

Five Components Background information Preapplication parameters Application procedures Postapplication parameters Maintenance

Background Information

Define the Modality Explain briefly: What the modality is How it operates

Know the modality’s Effects Advantages Disadvantages Indications Contraindications Precautions

Effects What physiological and/or pathological changes does it evoke in the body (both locally and systemically) as it its applied (Reprinted with permission from Castel D. International Academy of Physio Therapeutics. Clip art.)

Advantages What does this modality do that makes it effective in treating injuries?

Disadvantages What are possible negative effects of using this modality to treat sports injuries?

Situations in which this modality should be used Indications Situations in which this modality should be used

Contraindications Situations in which this modality should not be used Situations in which it may do more harm than good

Situations that could cause harm if you are not careful Precautions Situations that could cause harm if you are not careful

NOTE: Alternative terminology Absolute contraindications = contraindications Relative contraindications = precautions

However If contraindication means “don’t use,” how can you relatively not use something?

Preapplication Parameters

Four Aspects Select the proper modality Prepare the patient physically Prepare the patient mentally Prepare the equipment

Select the Proper Modality Determine the anatomical, pathological and physiological changes associated with the injury by (Re)evaluating the injury or problem Reviewing the response to previous treatment Establish objectives (goals) of therapy

Select the Proper Modality (cont.) Match your therapeutic goal with a modality that will help you achieve that goal. Consider Effects, advantages, disadvantages, indications, and contraindications of possible modalities Check for contraindications.

Prepare the Patient Physically Remove clothing as necessary. Remove bandages, braces, etc., as necessary. Position the patient in a manner that will be comfortable, yet allow accessibility to the modality. (Used with permission from Castel D. International Academy of Physio Therapeutics. Clip art.)

Prepare the Patient Psychologically Explain the procedure. Briefly review the physiology, if interested. Tell the patient what to expect, what to feel. Demonstrate the procedure on self, if the patient is apprehensive. Warn about precautions.

Prepare the Equipment Setup Check equipment operation Safety check

Application Procedures

Procedures Turn on Dosage Duration Frequency of application Adjustment sequence Check the patient response Dosage Duration Frequency of application

Postapplication Parameters

Postapplication Remove the equipment/clean up the patient Replace the equipment/clean up the area Instructions to the patient Arrange next treatment

Instructions to the Patient Instruct the athlete concerning what he or she should feel after treatment. Record the treatment and any unique patient responses to the treatment. Instruct the athlete concerning the level of activity and/or self-treatment before the next formal treatment.

Maintenance

Maintenance Clean equipment regularly Routine maintenance Simple repairs