Transcript Chapter 15: Therapeutic Modalities

Cryotherapy Principles
– Most common means of cold therapy
• Ice packs
• Ice immersion
– Wet ice is a more effective coolant due to the energy required to
melt ice
– Cold whirlpool
• Ice towel
• Ice massage
• Physiological Principles
– Vasoconstriction
– Decreases extent of secondary tissue death
• Decreases cell metabolic rate
• Decreases the need for oxygen
• Results in less tissue damage
– Decreased swelling from inflammatory response
– Decreases muscle spasm
– Decreases pain
– Cold is more penetrating than heat
– Decreases muscle fatigue
• Special Considerations
– Avoid overcooling
– Some individuals are allergic to cold and react with
• Hives
• Joint pain
– Special medical conditions ice is contraindicated
– Application of ice (very rare) can cause nerve damage
– Be cautious with return to activity following icing
– Stop cryotherapy for any of the above complications or side effects
– Icing through a towel or bandage
• Limits the reduction in temperature
• Could limit effectiveness of treatment
• Cold Response
• Burning
• Aching
• Numbness
• Analgesia (pain is relieved)
– Athlete can engage in rehab activities
• Special considerations
– Keep in mind comfort of the athlete during treatment
Cryotherapy Techniques
• Ice Massage
• Cold or Ice Water Immersion
– Temperature 50º to 60º
• Ice Packs (Bags)
• Chemical Cold packs
• Vasocoolant Sprays
Transmission of Thermal Energy
• Temperatures of
– 116.6o F will cause tissue damage and temperatures
– 113o F should not be on the skin longer than 30 min.
Thermotherapy
• Physiological Effects of Superficial Heat
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Dependent on type of heat energy applied
Intensity of heat energy
Duration of exposure
Desired effects
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Increase soft tissue flexibility
Decreasing joint stiffness
Reducing pain
Relieving muscle spasm
Reduction of edema and swelling
Increasing blood flow
– Pain relief
• Gate control mechanism
• Secretion of endorphins to block pain
• Special considerations
– Never apply heat
• When there is loss of sensation
• Immediately after injury
• When there is decreased arterial circulation
• Directly to eyes or the genitals
• To the abdomen during pregnancy
• When there are signs of acute inflammation
• Dry Heat
• Moist Heat Therapies
– Moist Heat Packs
– Whirlpool
• Ultrasound
• Contrast (Alternating Cold and Heat)
– Equipment
• Hot and cold tubs/whirlpools
• Hot and cold packs
– Indications
• Transition from cold to heat
• Minimal temperature changes occur superficially
– Application
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Treatment ratio used
Move from primarily cold to heat
Water temperature should be kept constant
Athlete should be comfortable