This guest post was written by Peak Performance intern Emily Reader, a Senior at Olivet Nazarene University majoring in Exercise Science.
Therapeutic Modalities, Ways to Assist the Healing Process After Injury
Outside of the Physical Therapy and Athletic Training world, therapeutic modalities are not commonly discussed and without gaining the knowledge from a physical therapist people don’t know about modalities and just how beneficial they are. Modalities used in the right situation can benefit a patient receiving treatment from a therapist. Two of the most common modalities, ice and heat, are used often by people to assist in healing. But, do people really know how it is working and progressing the healing process? Modalities generally help to relax muscles, relieve pain, reduce swelling and assist in healing. Knowing how these are used could be helpful for someone trying to get rid of some of these symptoms.
1. Cold packs (cryotherapy)
Cold packs which could simply be a bag of frozen vegetables at home, helps to reduce swelling of the injured area. Reducing swelling allows for more functional movement of the muscles. Being able to use the muscles in the affected area more, we can work with a greater variety of exercises to help rehabilitate the injury. Because of the way cold affects muscles, it is important to ice only after all exercises are finished. Cold muscles are less flexible and have a hard time stretching and therefore are more prone to injury during exercise as opposed to muscles that have been properly warmed up.
Tip: ice within 15-30 minutes after exercise for about 8-10 minutes
Tip: put some sort of cloth layer between the ice pack and skin to avoid damage to skin
2. Heat (thermotherapy)
Applying heat to an injury is another affective way to quicken healing process. Heat is typically applied before exercise. Heat is known to reduce pain, reduce joint stiffness, and prep muscles for exercise. For a home remedy, a heating pad could be used or a sock filled with rice and heated in the microwave works great as well for areas like the neck for example where a heating pad can be hard to use.
Tip: heat just before beginning exercise for about 8-10 minutes.
An ultrasound is performed using a wand with gel in between contact of the skin and wand. Ultrasound uses sound waves that reach deep into tissues. It heats the deeper layers of tissues and therefore increases the blood flow to the area. Ultrasounds are used to reduce pain and muscle spasms, improve the flexibility of soft tissue, and assist in the healing process by bringing more oxygen to the tissues.
An ultrasound will be performed in a small localized area so that the deeper tissues can be properly heated. If the area is too large, the deep tissues won’t get enough sound waves to heat up. This picture following shows how an ultrasound reaches deeper layers off tissue whereas massaging and heat packs only heat top layers of tissue.
The feeling during an ultrasound is mostly just feeling warmth in the area. What you should not feel during an ultrasound is a burning sensation. It should be a relaxing treatment.
Tip: When receiving an ultrasound stay relaxed to allow for the greatest effects.
4. Electrical stimulation
Electrical stimulation is performed using 4 pads, 2 positive and 2 negatives, hooked up to a machine. The pads are put in a cross pattern meaning the negative pads are across from each other and the positive pads are across from each other. This is represented in the picture below where it shows some examples of common places to have electrical stimulation done.
The current that is passed through the pads helps to decrease the perception of pain by stimulating the nerves that carry pain to the brain. The feeling during the therapy is pretty strange. You will feel a tingly feeling in the muscles. During stimulation, you want to set the intensity high enough to feel it but you don’t want the muscles to flex or twitch during it.
Many times multiple modalities will be used together. For example Physical Therapists will add heat to electrical stimulation. The heat helps to reduce pain and also relax muscles. This helps patient to leave the clinic relaxed after working on the injured area. On the other side, ice can be added to electrical stimulation. Ice packs are used to control inflamed areas and avoid swelling as much as possible. Using multiple modalities is a good way to enhance the effects all the more.
5. TENS unit
Electrical stimulation can be performed at home using a TENS unit. TENS stands for transcutaneous electrical nerve stimulation. This device acts very similar to electrical stimulation in reducing pain in a certain area. This is an option for a treatment that someone could do at home easily on themselves. This video helps to understand how a TENS unit would be set up.
Tip: be sure to understand placement of pads before use
Tip: wash any lotions off the area before placing pads down