Sports Medicine Thermotherapy

Discussion Scenario A tennis player who has been diagnosed with lateral epicondylitis (tennis elbow) wants to start using heat before his practices and matches. He wants to know what type of heat will be most effective and how long he needs to apply the heat. What would you tell him? Be prepared to share your response with the class.

Objectives Review the physiological effects of heat Explain the indications and contraindications of heat Discuss the advantages and disadvantages of specific heat modalities

Terminology Thermotherapy – using a source of heat for treatment

Physiological Effects of Heat Decreased muscle spasm Decreased pain Increased blood flow (vasodilation) Increased metabolism Increased tissue elasticity Decreased joint stiffness

Indications of Thermotherapy Chronic inflammatory conditions Chronic pain Chronic muscle spasm Muscle contracture

Contraindications of Thermotherapy Sensory loss Acute injury Areas of decreased sensation/circulation Over the abdomen during pregnancy Area over tumor/malignant tissue Peripheral vascular disease

Warm Whirlpool What it is: Basin filled with 100 to 105°F water Heating through conduction & convection When it’s used: Treating an injured extremity Advantages: Effective cooling in 10-20 minutes Treat large areas Disadvantages: Clean after each use to prevent infection Prep time Can’t be transported Constant supervision

Hydrocollator (Heat) Pack What it is: A moist heat pack filled with gel and stored in 160°F water bath Wrapped in towels to prevent burning When it’s used: Applied over large areas Advantages: Superficial heating in 15-20 minutes Reusable Conforms to areas Disadvantages: Hydrocollator requires electricity (not transportable)

Paraffin Bath What it is: Basin filled with paraffin and mineral oil heated to 125- 130°F Extremity is dipped 6 times, then wrapped in plastic bag When it’s used: Chronic pain/swelling in hands/feet Advantages: Treatment time varies from 5- 20 minutes Disadvantages: Messy application Risk of infection (replace wax often) Treatment area limited Supervision required https://www.youtube.com/watch?v=pq5XiODK6bM