infrared modalities

infrared modalities

mechanism of heat transfer

clinical uses and effects of cryo- and thermotherapy

examples of cryotherapy

ice massage

commercial cold packs

ice packs

cold whirlpool

cryo-cuff

examples thermotherapy

warm whirlpool

hydrocollator packs

paraffin baths

fluidotherapy

conduction

heat loss or gain through direct contact (nothing is moving)

convection

heat gain or loss by the movement of air or water molecules across the skin

radiation

the transmission of energy through electromagnetic waves

clinical uses of infrared

thermotherapy and cryotherapy

clinical implications

depth of penetration:

1 cm for heat

up to 3 cm for cold

effects of therapy

why can cold move further than heat

Heat has a high frequency and short wave length

Cold: vasoconstriction so the cold will not be moved out as rapidly

Hot: vasodilation so he heat is moved out fast 

how do cryo and thermo modalities have an effect

superficial circulation

muscle spasm

local metabolism

tissue extensibility and fluid viscosity

effects of cryotherapy

local decrease in temperature

decrease metabolic rate

decrease perception of pain

increase threshold to pain

promote local vasoconstriction

decrease muscle spasm and guarding

**most useful in acute injuries**

how can you tell if an injury is acute

should continue 36-72 hours after injury

frostbite

freezing point of a body part

can occur when the tissue temperature decreases below 0 degrees C

prolonged exposure to cold will cause vasoconstriction that can be damaging

tissue will get white indicating no blood flow

raynaud’s phenomenon

hypersensitivity to cold

tissue ischemia and excessive pain accompany sort exposures to cold

cryotherapy treatment guidelines

usually continued until skin temperature reaches 58 F (tissue is numb)

this is generally acheived after 20 minutes

consider barriers (towels)

educating your patients on cryotherapy

you should feel: cold-stinging-burning-aching-numbness

keeping it on until numbness will maximize the benefit

cryokinetics

combines the application of cold with sub-maximal exercise

the goal of treatment is to get the injured part numb to allow exercising to achieve normal motion

appropriate for patellar tendinitis

contradictions for cryotherapy

impaired circulation, peripheral vascular disease, hypersensitivity to cold, skin anesthesia, open wounds or skin conditions, infection, cold allergy

pain control- cryotherapy

ascending pain control

decrease nerve conduction velocity

decrease sensitivity of pain receptors

decrease compression on pain fibers

thermotherapy local effects

increase in temperature, vasodilation, increase extensibility of soft tissue, decrease viscosity of fluid, decrease pain, increase metabolic rate, decrease muscle spasm and promote relaxation

moderate heating

2-3 degree C increase in tissue temperature

decrease muscle spasm

decrease pain

vigorous heating

3-4 degree C increase in tissue temperature

tissue elongation

thermotherapy treatment guidelines

generally 10-20 minutes is a typical treatment interval (want to maximize heat— deeper tissue more time, superficial tissue less time)

treatment depth

mechanisms of pain control thermotherapy

ascending pain control

decrease compression on pain fibers

flush out pro-inflammatory chemicals

contraindications for thermotherapy

acute musculoskeletal conditions, impaired circulation, peripheral vascular disease, skin anesthesia, open wounds or skin conditions