Introduction to

Therapeutic Modalities

April 18, 2023 1

Today’s Topic

Introduce the inflammatory response (the physiological effect of injury)

The role of therapeutic modalities in the treatment of athletic injuries

April 18, 2023 2

Inflammatory Response

Definition:

- protective response of tissues of body to irritation or injury

Causes of inflammation:

- foreign body, physical trauma, electrical energy, temperature extremes

April 18, 2023 3

Process of Inflammation

Transient vasoconstriction then tissue bleedingRelease of chemical mediators (bind to plug)

- histamines & bradykinins

- causes swelling and isolates the area

- pressure on nerve endingsClot formed WBC activate endothelial cells -

phagocytosis (destroy bacteria and engulf dead cells)

April 18, 2023 4

Inflammatory response

Phagocytes die Collection of dead tissue forms

April 18, 2023 5

Inflammation

April 18, 2023 6

PAIN

SPASM

Treatment Goals

Break the P-S cycleControl pain!!!Minimize extent (edema/effusion)Minimize secondary tissue damage

April 18, 2023 7

Tissue Healing

Removal/minimize wasteO2 and nutrients to tissues

April 18, 2023 8

Initial Treatment

Cold…..

Effects of cold

April 18, 2023 9

Txt - 1st 24 - 72 hours

Use of cold (cryotherapy)

1. Decreases bleeding in tissues

2. Slows/decreases nerve impulses

3. Decreases mm spindle action

4. Decreases demand for O2

5. Decreases 2° tissue damage

April 18, 2023 10

Properties of Cold

April 18, 2023 11

ANALGESIC&

ANESTHETIC

Principles of Treatment & Rehabilitation

1st 72 hours: follow basic protocols

P: protect

R: rest injured tissue/modify activity

I: apply ice to area 20-30 min/hr

C: compression wraps

E: elevationencourage active, pain free ROM

April 18, 2023 12

Principles of Treatment & Rehabilitation

Beginning on day 3???

1. Other modalities

2. Exercise programs

3. Manual therapy

April 18, 2023 13

Objectives of Treatment & Rehabilitation

Assist healingRegain length & strength of injured tissueRegain function:

1. CV fitness

2. Endurance

3. Speed

4. Psychomotor skills

April 18, 2023 14

Healing & Recovery Times

Muscle: 6 weeksTendon & ligaments: 12 weeks

- some (ACL) 8-12 monthsBone & joints: 6-12 weeks

April 18, 2023 15

Modality Intervention

Limit pain-spasm cycleMinimize inflammatory responseEnhance healingAllows better tolerance to rehabilitation

April 18, 2023 16

Categories of Modalities

CryotherapySuperficial thermotherapyPenetrating thermotherapyLight therapyElectrotherapyMechanical therapy

April 18, 2023 17

Other Modalities

Contrast therapyPhonophoresis Iontophoresis BiofeedbackHyperbaric O2 therapy

Therapeutic magnets

April 18, 2023 18

Review

Transmission of thermal energy

• Conduction• Convection• Radiation• Conversion

April 18, 2023 19

Cryotherapy

Forms of cryotherapyIndicationsContraindications

April 18, 2023 20

Physiological Effects of Cryotherapy

Decreases nerve impulses & conduction velocityDecreases muscle spindle activityDecreases tissue bleedingDecreases demand for O2 fewer cells damaged

Lowers tissue temperatureReduces pain & spasm

April 18, 2023 21

Cold Sensations

ColdBurningAchingNumbness

April 18, 2023 22

Techniques of Application

Ice bags 20-30 minutesIce massage 10 - 15 minutesImmersion 5-12 minutes

April 18, 2023 23

Considerations

Frostbite????Cold allergiesApply through a towel?Raynaud’s phenomenomParoxysmal cold hemoglobinuriaNerve palsy

April 18, 2023 24

Next time…..

ThermotherapyElectrotherapy

April 18, 2023 25