1. Modalities are Fun!
Sports Med 2

2. Therapeutic Modalities Guided notes Cryokinetics.
Modality: a physical technique or substance administered to produce a therapeutic or pain free affect.
Legal concerns
Understand use of specific modalities
Accurate evaluation of injury
Avoid “shotgun” approach
Adhere to the law

3. Cryotherapy
most common forms are; ice massages, cold immersion, and ice packs.
Physiological effects of cryotherapy:
Muscle spasm
pain reception
blood flow up to minutes
metabolic rate
joint stiffness

4. Therapeutic effects of cryotherapy:
pain
or prevent swelling
inflammation
Minimized secondary tissue damage.

5. Skin response to cryotherapy:
Stage 1
Cold Sensation
0 – 3 min
Stage 2
Mild burning, aching
2-7 min
Stage 3
Anesthesia
5-12 min

6. 4. Adverse Conditions to Cryotherapy
hypothermia
frostbite
cold allergies
Raynauds phenomenon

7. Contraindications for Cryotherapy
lack of normal temperature sensibility
cold hypersensitivity
Raynaud’s disease
Coronary artery disease

8. Methods p 445… http://youtu.be/9hQsymsi5xU http://youtu.be/ucFQbSbKNJY
Ice massage
Ice Immersion, CWP
Ice Pack
Equipment
Indications
Application
Considerations

9. Cryokinetics Numb the part to pain free Ice until numb
Work toward regaining ROM
3-7 min.
Ice until numb
Exercise 3-7 min.
Ice 3-5 min
Repeat 5 times

10. Thermotherapy is Hot

11. Thermotherapy: application of heat to treat injuries
Thermotherapy: application of heat to treat injuries. Heat energy increases activity by conduction, convection, and radiation.
Modes are moist, dry, superficial and deep.

12. Physiological Effects of thermotherapy:
muscle spasm
pain perception
blood flow
metabolic rate
collagen elasticity
joint stiffness
Therapeutic effects of thermotherapy
pain
soft tissue extensibility

13. Adverse Conditions to thermotherapy
burns
open wounds
Contraindications of thermotherapy
loss of sensations
immediately after injury
impaired circulation
directly to eyes
during acute inflammation

14. Methods Moist Heat Pack Warm Whirlpool Equipment
Hydrocullator packs, 160 degrees. Retain heat for about 20-30min. Terry cloth or towel
degressF. Heat min
Indication
Warms and relax, reduction for spasm. Superficial only
convection, reduce swelling, spasms, and pain.
Applications
Remove pack from water, cover, treat
Fill tank, put extremity in and heat
Considerations
Never! Let athlete sit or lay on heat pack…burns
Light headedness, electrical outlets, cleanliness

15. Therapeutic Modalities Electrical stimulation (electrotherapy)

16. Electrotherapy: implies a flow of electrons between two points.
Electricity is a form of energy that displays magnetic, chemical, mechanical, and thermal effects on tissue.
Ampere: volume or amount
Ohm: resistance
Voltage: force
Watt: power.
Electrical Stimulating Units: generate 3 different types of currents, which produce specific physiological tissue changes. AC, DC, and pulsed. All 3 send currents through the body. Their purpose is to trigger the peripheral nerves to stop pain.

17. Examples of Electric generators
TENS: transcutaneous nerve stimulators
NMES: neuromuscular electrical stimulators
EMS: electrical muscle stimulator
MENS: micro-current electrical nerve stimulators

18. Every nerve has an excitability threshold
Every nerve has an excitability threshold. This is what we get to play with, with the electrical stem. There are 3 types of nerve fibers: sensory, motor, pain. It is possible to produce different physiologic response by adjusting the treatment parameters.

19. DC (Majority) AC Pulsed Definition uses
Flows in one direction from positive to negative poles
Muscle contraction, movement AC
Current flow reverses once during each cycle
Pain control, muscle contraction
Pulsed
3 or more pulses, interrupted for short periods of time
Pain control, muscle rehab.

20. Waveforms: represents electrical current. DC
+ 0 -

21. Waveforms: represents electrical current. AC
+ 0 -

22. Waveforms: represents electrical current. Pulsed
+ 0 -

23. Electrode Set up Electrode Setup:
Pads: directly to skin, up to 4 in. Set up in an “X” pattern with the desired stimulation area in the center of the “X”.

24. Physiological effects of Electrical Stem.
depolarization of peripheral nerves
Therapeutic effects of Electrical Stem.
stop pain
Contraindication of electrical Stem.
pregnancy
electrical pace devices
cardiac arrhythmia

25. Electrical Stimulation
Equipment
- Electrotherapy generator
Water
Pads
Towel
Indication
Pain perception
Muscle contraction
Strengthening
Stop atrophy
Muscle re-education
Application
Spray pads with water
Place pads securely
Turn on machine
Set parameters
Have them tell you when they feel something
Press start
Considerations
Same as contraindications

26. Therapeutic Modalities Ultrasound

27. Ultrasound: is an inaudible, acoustic sound wave modality used in sport medicine for the purpose of elevating tissue temperature, repairing soft tissues, and relieving pain.
Ultrasound can be used for thermal or non-thermal effects on soft tissue.

28. Physiological Effects of Ultrasound:
Thermal:
elevated tissue temperature
blood flow
tissue extensibility
local metabolism
Non-thermal:
cavitation
fluid movement
cellular permeability

29. Therapeutic Effects of Ultrasound:
collagen tissues extensibility
joint stiffness
muscle spasm
blood flow

30. Equipment descriptions
generator: main piece of equipment for delivering therapeutic ultrasound
applicator/ultrasound head: has crystals the rebound the acoustic waves.
Piezoelectric effect: causes expansion and contraction of the crystals
Effective radiating area: the part where the transducer produces sound waves.

31. Ultrasound has a frequency range from 1 MHz – 3.3 MHz.
1 MHZ: better if there is a layer of fat, or you need to get to deeper tissue.
3MHz: better for superficial thermal/non-thermal effects

32. Ultrasound can be continuous or pulsed
Energy remains constant 100% of the time
Thermal effects
Energy is interrupted
Non-thermal effects

33. Method Equipment Ultrasound machine, coupling agent/method: gel, water
Indications
Soft tissue injury: sprain, strain, contusion.
Decrease pain, increase blood flow for repair
Applications
Put coupling agent on US head
Continuous movement of sound head
Use firm, steady overlapping motion
2-8 min
Considerations
Not over large areas
Impaired circulation
Eyes
Spinal cord
Not over reproductive organs