Transcript Sports Medicine 15

Sports Medicine 15
Using Therapeutic Modalities
Thermotherapy
Sports Massage
By Andrew Morgan BPE/BEd
Using Therapeutic Modalities
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Must take care when you use
Thermotherapy (applying heat) and
Massage – legal ramifications.
Assess athlete first, then decide which
modality to use, based on which
modality can most effectively reach the
desired target tissue to achieve specific
results.
Thermotherapy
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We looked at Cryotherapy (the application
of ice) to treat injuries.
Now we look at Thermotherapy (the
application of heat).
It has been used for centuries to treat
traumatic injuries. However, in the treatment
of musculoskeletal injuries thermotherapy has
been replaced by cryotherapy.
Thermotherapy
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Heat is an energy form that
increases molecular activity by
conduction, convection,
conversion and radiation.
The body’s response to heat
depends on the type of heat
energy applied, the intensity of the
heat energy, the duration of
application, and the unique tissue
response to heat.
Correct amount heat must be
applied…too little and there will be
no effect…too much will result in
further tissue damage.
Thermotherapy
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Many questions still remain
unanswered when deciding
what types of thermotherapy
are appropriate for a given
condition.
Therapeutic effects of
thermotherapy: decreases
muscular spasms and joint
stiffness, reduces pain,
edema and inflammation,
and increases blood flow
and extensibility of
collagen tissues.
Thermotherapy
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Heating contracted
connective tissue
permits an increase
in extensibility
through
stretching….
Application of heat
must be in
association with a
flexibility session.
Ischemia: lack of
blood supply to a
body part
Thermotherapy
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Both heat and cold relieve
pain, stimulating free
nerve endings and
peripheral nerves by the
secretion of endorphins.
Muscle spasms caused by
ischemia can be relieved
by heat which increases
blood flow to the area of
injury.
Heat allows vasodilation
to occur.
Thermotherapy
Special considerations in the use of superficial
heat (Arnheim):
 Never apply heat when there is a loss of sensation.
 Never apply heat immediately after an injury.
 Never apply heat when there is decreased arterial
circulation.
 Never apply heat directly to the eyes.
 Never heat the abdomen during pregnancy.
 Never apply heat to a body part that exhibits signs of
acute inflammation.
Thermatherapy
Moist Heat Therapies
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Heated water is one of the most
widely used therapeutic
modalities in sports medicine.
However, it is always difficult to
control a constant temperature
because of the rapid dissipation
of heat.
Water packs can be usually
heated up to a higher
temperature more than dry
packs can.
Sports Massage
Massage is defined as the systematic
manipulation of the soft tissues of the
body (Arnheim)
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Causes a great deal of physiological and
psychological responses.
Becoming more and more popular in the area
of athletics.
Movements used: gliding, stretching,
percussing and vibrating. These produce
specific responses in the athlete.
Sports Massage
Massage is separated into 5 categories:
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Effluerage
Petrissage
Friction
Tapotement
Vibration
Sports Massage
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Mechanical responses: helps
veins and lymph tissue drain,
stretches superficial and scar
tissue, connective tissue can
also by stretched by friction
massage.
Physiological responses:
Increases circulation, helps in
removal of lactic acid, promotes
the relaxation and stimulation of
musculoskeletal tissue and
organs.
Psychological responses: the
human response to touch is well
documented.
Sports Massage
Massage Strokes
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Effleurage or stroking
is divided into light and
deep methods.
Light effleurage is
sedative.
Deep is the therapeutic
compression of soft
tissue, which encourages
lymphatic and venous
drainage.
Sports Massage – Effleurage
a. effleurage b. hand over hand c. cross-body
Sports Massage
Petrissage
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Petrissage or kneading is used
primarily to loosen heavy tissue
areas such as the trapezius, the
‘lats’ and the triceps muscles.
Procedure consists of picking up
skin between the thumb and the
forefinger of each hand and
rolling and twisting it in opposite
directions.
Whenever possible, deep muscle
tissue should be gathered and
lifted.
Sports Massage
Friction
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Often used around the
joints or other areas
where the tissue is thin,
or areas such as scar
tissue, adhesions, muscle
spasms and fascia.
Action is the bracing of the
hand using either the thumbs
or the fingers and moving them
in a circular motion – hands
move in opposite directions.
Sports Massage
Tapotement , or
Percussion
 Cupping, hacking
and pincerlike or
pincing movements.
 Encourages blood
flow in the area.
Sports Massage - Tapotement
Sports Massage
Vibration
 Rapid movement that
produces a quivering
or trembling effect.
 It is used in sports
because of its ability to
relax and soothe.
 Manual or machine.
Sports Massage
Deep Transverse Friction
Massage or Cyriax Massage
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Specifically treats muscles,
tendons, ligaments, and joint
capsules.
Move transversely across a
ligament or tendon to
mobilize it as much as
possible – restoring muscle
mobility.
Sports Massage – Cyriax massage
a. index crossed over middle, b. Middle crossed over index c. two fingers side by
side d. Opposed finger and thumb
Sports Massage
Guidelines for Effective
Massage
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Make athlete feel comfortable.
Develop gentle approach.
Stroke towards the heart
whenever possible –
encouraging venous and
lymphatic drainage.
Know when to massage.
Never massage when athlete
has local or general infection.
Never apply massage over
recent injury.