5. Therapeutic Modalities in Athletic Therapy

Therapeutic Modalities

What are Therapeutic Modalities?

• Definition: Therapeutic modalities refer to the application of various forms of energy to facilitate the treatment of athletes or patients.

  • Modalities include:

  • Thermal energy

  • Mechanical energy

  • Electromagnetic energy

  • Electrical energy

  • Sound energy

• Purpose: Used to achieve therapy goals, such as:

  • Decreasing pain

  • Increasing range of motion

  • Improving tissue healing

  • Enhancing muscle activation

• Usage: Commonly utilized by Athletic Therapists.

Classification of Therapeutic Modalities

• Types of Modalities:

  • Thermal conductive energy

  • Mechanical energy

  • Electrical energy

  • Electromagnetic energy

  • Sound energy

Thermal Conductive Energy

Thermotherapy

• Hydrocollator Packs

  • Physiological Effects:

  • Increases extensibility of collagen tissues

  • Decreases joint stiffness

  • Reduces pain and muscle spasms

  • Increases blood flow

  • Indications:

  • Relaxation

  • Reduction of pain in spasm and hypoxic pain cycles

  • Contraindications:

  • Avoid laying on packs.

• Whirlpool

  • Physiological Effects:

  • Assists in movement through buoyancy.

  • Indications:

  • When assistance in movement is desired.

  • Contraindications:

  • Requires supervision and cleanliness.

Cryotherapy

• Ice Packs

  • Physiological Effects:

  • Reduces muscle temperature (as low as 3.5°C)

  • Causes vasoconstriction which slows cellular metabolic rates

  • Decreases swelling and muscle guarding

  • Sensations progress: cold, burning, aching, numbness.

  • Indications:

  • After acute injuries.

  • Contraindications:

  • Do not apply longer than 20 minutes.

• Ice Massage

  • Physiological Effects:

  • Same as ice packs but focuses on specific areas like tendons and myofascial trigger points.

  • Contraindications:

  • Consider patient comfort; avoid excess cold.

• Water Immersion

  • Physiological Effects:

  • Provides circumferential cooling.

  • Contraindications:

  • Be cautious about returning to movement quickly due to numbness.

Electrical Energy

Electrical Stimulation

• Definition: Applying electrical current to nerve tissue at sufficient intensity to reach excitability threshold.

• Physiological Effects:

  • Results in membrane depolarization or firing of nerve

  • Modulates pain via sensory nerves

  • Elicits muscle contractions via motor nerve fibers

  • Stimulates healing at cellular level through electrical fields.

• Indications:

  • Pain management

  • Tissue healing enhancement

• Contraindications:

  • Cardiac issues (e.g., pacemakers)

  • Arterial disease

  • Infections

  • Uncontrolled hemorrhage

  • Blood clots

  • Pregnancy

  • Cancer

  • Seizures

  • Unstable fractures.

Electromagnetic Energy

Low Level Laser

• Definition: Utilizes photons of red and infrared light.

• Physiological Effects:

  • Stimulates ATP production

  • Enhances cell proliferation of fibroblasts and osteocytes

  • Increases collagen, cartilage, and bone regeneration

  • Decreases inflammation and edema.

• Indications:

  • Accelerates the healing process

  • Reduces pain and inflammation

  • Triggers acupuncture points.

• Contraindications:

  • Avoid in cancerous tissues, eyes, and early pregnancy.

Sound Energy

Ultrasound

• Definition: Utilizes inaudible, high-frequency acoustic vibrations for therapeutic effects.

• Physiological Effects:

  • Stimulates ATP production

  • Affects soft tissue repair

  • Reduces pain

  • Breaks down scar tissue

  • Increases collagen synthesis and tissue regeneration.

• Indications:

  • Chronic inflammation

  • Tissue regeneration

  • Trigger point management.

• Contraindications:

  • Decreased temperature sensation

  • Vascular insufficiency

  • Pregnancy

  • Cancerous tissues

  • Infections.

Mechanical Energy

Traction

• Physiological Effects:

  • Increases separation of tissues to relieve pressure on nerves and nerve roots

  • Changes joint proprioception

  • Relieves compressive effects of poor posture.

• Indications:

  • Spinal nerve root impingement

  • Herniations

  • Muscle guarding.

Massage

• Physiological Effects:

  • Increases cellular exchange and oxygenation.

  • Facilitates lymphatic drainage and waste removal.

  • Promotes capillarization and vasodilation.

• Indications:

  • Venous and lymphatic drainage

  • Muscle relaxation

  • Pain reduction.

• Contraindications:

  • Thrombosis

  • Severe varicose veins

  • Acute phlebitis.

Instrument Assisted Soft Tissue Mobilization (IASTM)

• Physiological Effects:

  • Reduces pain and hypersensitivity

  • Improves motor control and mobility.

• Indications:

  • Muscle atrophy

  • Contractures

  • Edema management.

Therapeutic Exercise

Goals of Therapeutic Exercise

• Restores normal body function post-injury.

Components of a Rehab Program

1. Control Inflammation

2. Restore Motion

3. Develop Muscular Strength, Power, and Endurance

4. Return to Sport/Physical Activity

Case Study: Lateral Ankle Sprain

• Example: A 19-year-old basketball player sustains a grade 2 lateral ankle sprain.

• Findings:

  • Bruising, swelling, inability to weight bear, limited ROM and muscle weakness.

Control Inflammation

• Goals:

  • Minimize scar tissue development with cryotherapy.

  • Maintain movement and strength in unaffected body parts.

  • Preserve cardiovascular endurance.

• Recommended Practice: Apply PRICE (Protection, Rest, Ice, Compression, Elevation).