1. 1 Therapeutic Modalities PE 236 Amber Giacomazzi MS, ATC

2. 2 Using Therapeutic Modalities  Incorporated into rehabilitation program as adjuncts to __________  Cryotherapy and thermotherapy  Ultrasound and electrical stimulation  Massage and traction  _______________________________ _______________________________  In absence of ATC coach may opt for simple modalities within scope of expertise

3. 3 Cryotherapy  Pain Relief –A decreased nerve transmission in pain fibers –Cold reduces _______________________________ –Cold raises the _____________________ –Cold causes a release of ______________ –Cold sensations over-ride the pain sensation - known as the _________________  Reduces Bleeding and Swelling –By cooling the surface of the skin and underlying tissues, ice causes the narrowing of blood vessels, a process known as ___________________

4. 4 Cryotherapy  ______________________ –Muscle spasm is often a response to pain  ______________________ –By reducing the cells metabolic rate, ice reduces the cells oxygen requirements. Thus when blood flow has been limited by vasoconstriction then the risk of cell death due to oxygen demands (secondary hypoxia) will be lessened.

5. Cold Response  Stage 1- ________________ –0-3 minutes  Stage 2- _________________ –2-7 minutes  Stage 3- _________________ –5-15 minutes 5

6. 6 Cryotherapy  Ice bags  Ice Cups (___________)  Ice bath (_______________)  GameReady –Recommended 20 minutes every 1-2 hours –For the first 48-72hrs post injury  RICE

7. Special Considerations  Over superficial nerves never apply __________________  Ice can cause _____________  Cold urticaria- _____________________ _____________  Chemical packs can cause _________ and ________________ 7

8. 8 Thermotherapy  ______________ (after swelling stops) –Increase blood flow (Vasodialation) –Facilitate reabsorption of injury by-products  Useful as _______ and for ________________  Be careful not to use too soon in healing process –___________________________________________ _____________________  Reduces Muscle Spasm

9. 9 Thermotherapy  Moist heat packs  Hot Whirlpool  Continuous ultrasound  Paraffin bath

10. 10  Moist heat packs (hydrocollator packs) –Silicate gel in cotton pads –Maintained in thermostatically controlled hot water (_____) –Retain water and relatively constant heat for 20-30 minutes –Requires the use of 6 layers of toweling to avoid burning patient –_________________________________ Thermotherapy

11. Special Considerations  Never apply when there is _________ ______________  Never apply immediately after injury or when signs of an acute injury are present  Never heat the abdomen during _______________ 11

12. 12 Electrical Stimulation  IFC –Interferential current –Pain control –Over stimulation of Skin nerves –__________________________

13. 13 Electrical Stimulation  ___________ –_________________  Contract / relax –Post surgery

14. 14 Massage  Systematic manipulation of soft tissues of the body  Involves ________, _____________, __________, _________, and ___________ –Produce specific responses in athlete  Causes mechanical, physiological, and psychological responses

15. 15  Uses: –Encourage ________________ –Stretch superficial _____________ –Stretch connective tissue (_______ massage) –Increase circulation – due to increased metabolism  Helps to remove lactic acid or edema  Assist normal venous blood return to heart –_______________ Massage

16. 16 Importance of the Healing Process Following Injury  There is a sequence and time frame for various phases of the healing process  ______________________________________ __________________________  Work to create optimal healing environment –Little can be done to __________________, while much can be done to ____________

17. 17  _______________________________ –Begins immediately following injury – critically important  Without the inflammatory phase the other phases ___________________ –____________________________________ _________________________ –Symptomatically presents with the following  Redness, swelling, warmth, tenderness and loss/disordered function –Stage lasts _________ following injury

18. 18  ___________________________ –Proliferative and regenerative activity occurs resulting in _______________ (____________)  Occurs within initial hours of injury and continues up to __________ –S&S of inflammatory phase subside  Athlete will still experience some tenderness and pain with motion  With increasing development of the scar, complaints of _________________________ ____________________

19. 19  ______________________________ –________________________ –Re-alignment of scar tissue according to tensile forces acting on tissue  Re-align to position of maximum efficiency (_________ ____________________) –Tissue gradually resumes normal appearance and function –After 3 weeks  Firm, strong, contracted, nonvascular scar exists –_______________________________________________ ___________________