1. 1 Therapeutic Modalities PE 236 Juan Cuevas, ATC

2. 2 Using Therapeutic Modalities  Incorporated into ______________ program as adjuncts to exercise  ________________ and thermotherapy  Ultrasound and electrical stimulation  ___________ and traction  Require special instruction and supervised clinical experience  In absence of ________ coach may opt for simple modalities within scope of expertise

3. 3 Cryotherapy / Cold Therapy  ________ Relief –A decreased nerve transmission in ___________ –Cold reduces the activity of free ___________ –Cold raises the pain threshold –Cold causes a release of endorphins –Cold sensations over-ride the pain sensation - known as the _______________________  Stops Bleeding and _____________ –By cooling the surface of the skin and underlying tissues, ice causes the narrowing of blood vessels, a process known as ________________

4. 4 Cryotherapy / Cold Therapy  Reduces Muscle ___________ –Muscle spasm is often a response to ______  Decreases Metabolic Rate –By reducing the cells metabolic rate, ice reduces the cells ________ requirements. Thus when blood flow has been limited by vasoconstriction then the risk of cell death due to oxygen demands (secondary ________) will be lessened.

5. 5 Cryotherapy / Cold Therapy  _________-  Ice Cups (7-10 minutes)  Ice bath (__________ degrees F)  GameReady –Recommended 20 minutes every 1-2 hours –For the first 48-72hrs post injury  ___________

6. 6 Thermotherapy  Used post-_______ (after swelling stops) –Increase blood flow (___________________) –Facilitate reabsorption of injury by-products  Useful as analgesic and for relaxation effects  Be careful not to use too soon in healing process –Cold should be used for first _____ hours post injury  Reduces Muscle __________

7. 7 Thermotherapy  Moist heat packs  Hot ___________  Continuous ultrasound

8. 8  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 –Athlete should _______ on top of pack

9. 9 Electrical Stimulation  __________ –Interferential current –Pain control –Over stimulation of ____________ –Gate Mechanism of Pain Control

10. 10 Electrical Stimulation  ___________ –Muscle re-education  Contract / relax –Post __________

11. 11 Massage  Systematic manipulation of ____________ of the body  Involves __________, compressing, stretching, percussing, and vibrating –Produce specific responses in athlete  Causes mechanical, physiological, and psychological _________________

12. 12  Uses: –Encourage _____ drainage –Stretch superficial ______ tissue –Stretch connective tissue (friction massage) –Increase ______ – due to increased metabolism  Helps to remove lactic acid or edema  Assist normal venous blood return to heart –________________

13. 13 Importance of the Healing Process Following Injury  There is a sequence and time frame for various _________ of the healing process  Interference with healing process will delay return to full activity  Work to create optimal healing _________________ –Little can be done to speed the process, while much can be done to ___________

14. 14  ____________________ Response Phase –Begins immediately following injury – critically important  Without the inflammatory phase the other phases will ______________ –Chemical mediators are released to facilitate ______________ –Symptomatically presents with the following  Redness, ____________, warmth, tenderness and loss/disordered ___________ –Stage lasts 2-4 days following injury

15. 15  _________________ Repair Phase –Proliferative and regenerative activity occurs resulting in ________ formation (fibroplasia)  Occurs within initial hours of injury and continues up to _____________ –S&S of inflammatory phase subside  Athlete will _______ experience some tenderness and pain with motion  With increasing development of the scar, complaints of pain and tenderness will _____________

16. 16  __________________-Remodeling Phase –_________--term process –Re-alignment of scar tissue according to tensile forces acting on tissue  Re-align to position of maximum efficiency (parallel to lines of tension) –Tissue gradually resumes normal ____________ and function –After 3 weeks  Firm, strong, contracted, nonvascular scar exists –Maturation may take several ________ to be totally complete