Modalities
 
Therapeutic Ultrasound
Mobility can be affected by many factors. Our body responds to the forces that are placed upon it. Most tissues require movement to maintain their structural integrity and health.
 
Ultrasound is one of the most widely used modalities in sports medicine. It has been used for therapeutic purposes as a valuable tool in the rehabilitation of many different injuries primarily for the purpose of stimulating the repair of soft-tissue injuries for relief of pain. Although warm whirlpools and hot packs may be used to relieve pain, these methods cannot penetrate the skin. Ultrasound is classified as a “deep heating modality” and can reach muscles that traditional hot packs and whirlpools cannot. The clinical effects of using ultrasound to heat tissues are similar to other forms of heat that may be applied, including
  1. Decrease in joint stiffness
  2. Reduction of muscle spasm
  3. Modulation of pain
  4. Increased blood flow
  5. Mild inflammatory response that may help in the resolution of chronic inflammation
 
 
 
Using ultrasound in combination with other modalities:
  • Ultrasound is frequently used with hot packs, cold packs, and electrical stimulating currents
Ultrasound & hot packs:
  • Heat is effective in reducing muscle spasm and muscle guarding and is useful in pain reduction
Ultrasound & cold packs:
  • When treating acute injuries, the combination of cold to reduce swelling and ultrasound that promote soft-tissue healing, may be the treatment of choice.
 
 
Electrical Stimulation
 
Therapists use electrical stimulation for the following reasons:
  1. To create muscle contraction through nerve or muscle stimulations
  2. To stimulate sensory nerves to help in treating pain
  3. To create an electrical field in biologic tissues to stimulate or alter the healing process
  4. To create an electrical field on the skin surface to drive ions beneficial to the healing process into or through the skin
Therapeutic gains of electrically induced muscle contraction
  1. Muscle reeducation
  2. Muscle pump contractions
  3. Muscle strengthening
  4. Increasing range of motion
 
 
Cryotherapy
 
 
 
Cryotherapy is the use of cold in the treatment of acute trauma and subacute injury and for the decrease of discomfort after reconditioning and rehabilitation.
 
Cold has been demonstrated to be more effective when applied along with compression than using ice alone for reducing metabolism in injured tissue. It is also used immediately after injury to decrease pain and promote local vasoconstriction, thus controlling hemorrhage and edema. Cold is also used in the acute phase of inflammatory conditions such as bursitis, tendinitis, in which heat may cause additional pain and swelling.
Cryotherapy Treatment Techniques
Tools of cryotherapy include ice packs, cold whirlpool, ice whirlpool, ice massage, commercial chemical cold spray, and contrast baths.
 
Physiologic Effects of Tissue Heating
 
Local superficial heating (infrared heat) is recommended in subacute conditions for reducing pain and inflammation through analgesic effects. Heat dilates blood vessels, causing the patent capillaries to open up and increase circulation. Heat is applied in musculoskeletal and neuromuscular disorders, such as sprains, strains, articular (joint-related) problems, and muscle spasms, which all describe various types of muscle pain.
 
Factors that Impede Healing
Extent of injury
The extent of the inflammatory response is determined by the extent of the tissue injury. Microtears of soft tissue involve only minor damage and most often are associated with overuse. Macrotears involve significantly greater destruction of soft tissue and result in clinical symptoms of functional alterations.
 
Edema
The increased pressure caused by swelling retards the healing process, causes separation of tissues, inhibits neuromuscular control, and impedes nutrition in the injured part.
 
Hemorrhage
Bleeding produces the same negative effects on healing as does the accumulation of edema, and its presence produces additional tissue damage and thus exacerbation of the injury.
 
Poor Vascular Supply
Injuries to tissues with a poor vascular supply heal poorly and slowly.
 
Separation of tissue
A wound that has jagged separated edges must heal by second intention with granulation tissue filling that defect and excessive scarring.
 
Muscle spasm
Muscle spasm causes traction on the torn tissue, separates the two ends, and prevents approximation.
 
Atrophy
Wasting away of muscle tissue begins immediately with injury. Strengthening and early mobilization of the injured structure retards atrophy.
 
Corticosteroids
Steroid use is debatable in the later stages of healing and with chronic inflammation.
 
Infection
Presence of bacteria in the wound can delay healing and may cause excessive granulation tissue and large deformed scars.
 
Humidity, Climate, and Oxygen Tension
Health, Age, and Nutrition-The elastic qualities of the skin decrease with aging. Degenerative diseases such as diabetes and arteriosclerosis also become a concern of the older patient and may affect wound healing.
 
 
 
 
Contact us For a free consultation if you are interested in learning more and having a specific customized stretching program made for you.
 
     
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