Literally,
Rehabilitation may mean to restore back to use; or bring back to use’.
Rehabilitation process and period is very crucial and fragile, needs to be
technically and professionally handle so as to achieve the dream of coming back
to top form level.
The
period is a period of proper and complete total healing and restoration. These
therapeutic modalities must carefully be followed. They include:-
(a)
Cryotherapy
(b)
Thermotherapy
(c)
Mechanical Electrical
(d)
Pharmacological Agents
All
these therapeutic Modalities are capable of helping the process of come back
when used appropriately. Only two of these modalities shall be treated in this
work.
In
this post, you will be able to define and correctly explain each of the key
terms, discuss the purpose of Therapeutic Modalities, List the different types
of Modalities and explain how some are used and discuss several safety
considerations involved with the use of Therapeutic Modalities.
Cryotherapy Modalities
This
method of therapy includes several others such as; ice massage, cold water
immersion, ice packs, and vapor-coolant sprays. Due to the cold that is used in
cryotherapy, the athlete or patient may feel uncomfortable when it is first
applied.
As
with all procedure, you should explain the procedure to the patient in advance
so as he or she knows what to expect. In the application of cryotherapy, the
longer the cold treatment, the deeper or depth the cold penetration to the
underlining tissues i.e treatment involving bigger muscles, the. Cooling the
body tissue can decrease blood flow, reducing muscle Spasms, Pain, and Edema.
These
therapeutic effects are achieved when cold is applied tissue to constrict.
Cooling an area for less than 15 mins does not reach a therapeutic depth or
level, and increase blood flow instead.
After
20 mins of cryotherapy, the body defends itself in much the vessels to dilate.
When cryotherapy, the body defends itself in much the vessels to dilate.
When
cryotherapy is used at a therapeutic depth, the person will experience three
phases of sensation: 1. A cold sensation lasting 0-3 mins
2.
Mild burning and acting 2-7 mins
3.
Relative numbness lasting 5-12 mins
Rehabilitation
process and period is very crucial, and fragile that needs to be technically or
professionally handled, to avoid a falling back to same or even a more
divesting condition. The period of come back of an injured athlete is a period
of joy and apprehension which requires some therapeutic modalities or processes
that will manipulate circulation (blood flow) blood in the treatment of muscles
and joints.
The
purpose is to improve or restore the athlete’s range of motion, physical
agility on ability to engage in daily activities and athletic endeavor at his or
her optimal performance level. Several approaches are usedcondition and the
muscles and joints.
It
is important to understand how such therapy can be helpful to the athletes and
most importantly the safety can be classified into five general types, thus;
i)
Cryoptheraphy
ii)
Thermotheraphy
iii)
Electricaltheraphy
iv)
Mechanical modalities
v)
Pharmacologic agents, depending on the mode of stimulation.
Injury Rehabilitation
Rehabilitation
of sports injuries start immediately in the form of First aid, the therapy is
only to determine by the type, extend, or area of injury involve. For proper
understanding of the modalities approaches used in rehabilitating sports
injuries, the modalities can be grouped into
(1)
Exercise (comprising of passive and active exercises)
(2)
Pharmacologic Agents, depending on the mode of stimulation.
Injuries
such as contused wound, (strains and sprains) increase blood flow to the area
tissues involve resulting in inflammation and edema.
Symptoms
of inflamed tissues include, pain, heat and redness. Due to this local trauma,
the vessels does not carry the tissues oxygen to the tissues, and it may cause
muscle spasms and increased edema. The muscle spasm thencausesadditional pain
which can increase the spasm and so on.
This
syndrome is called the ‘Muscle Spasms/Pain Cycle’ and levels to decreased
mobility. Modalitiesare used to stop, slow, or otherwise interrupt the Muscle
Spasms/Pain Cycle.
For
example, method of cryotherapy– can be applied to the inflamed area. The cold
(ice) will course construction in the blood vessels, decreasing local
inflammation and edema, as well as stopping or slowing the muscle spasm/pain
cycle.
As
helpful as this may be, it is important to know that a wrongful use or
misapplication of a modality (method) may only aggravate a condition rather
than providing relief.
Guidelines for Cryotherapy
1.
Except for ice massage, all cold modalities required the use of a barrier, such
as a towel, to prevent the skin from frostbite. This applies to both ice and
reusable packs, which reach temperature below freezing.
2.
Never applied any form of cold on an open wound without a protective covering.
3.
Never apply and form of old to anesthetized skin.
4.
Except for vapo-codant sprays, do not apply cryotherapy to patients with decreased
circulation, diabetes, or Cardiac conditions.
5.
Monitor the patient for signs of cold allergy or Raynaud ’s phenomenon, a
condition in which the arteries and arterioles of an extremity constrict
excessively. 6. To avoid further injuries to the tissues always monitor the
time for which cryotherapy is applied, application should not exceed 30mins.
Guidelines for Applying Ice Pack
1.
Fill a plastic bag with enough crushed ice to model around the injured area. Or
obtain a result able ice pack from the freezer.
2.
Explain the procedural effect to the patient
3.
Expose the area to be trended draping the patience for modesty as appropriate
4.
Wet an elastic wrap or towel and place it between the ice and the patient’s
skin. Especially when using a revisable or chemical ice pack to prevent a
burning effect.
5.
Leave the ice in place for 15-20mins, checking with the patient periodically
for signs of undue discomfort or cold allergy. 6. Leave treatment area clean
and dry when you are done. Wipe up any water drops from the floor to prevent
others from slipping.
Guidelines to Ice Massage
1.
Prepare the ice by freezing a disposable cup ¾ full of water, forming a
cylinder of ice. Massage the ice to the area to be treated. Use materials that
will prevent your fingers to the cooling effect from the ice. 2. Expose the
area to be treated, draping the patient for modesty as appropriate. Use towel
to sock the water drops from the ice.
3.
Explain the procedure to the patient.
4.
Slowly massage the ice over the injured area in overlapping stokes, taking care
not to cause the patient undue discomfort by the pressure of the strokes.
Remove more of the Styrofoam or paper from the ice container as the ice melt.
5.
After 7 to 10mins of treatment dry the patients skin and assist him or her from
the treatment table. 6. Leave the treatment area clean and dry when you are
done. Wipe up any water drops from the floor to prevent others from slipping.
Other cryotherapy modalities
include:
i.
The use of vapo-coolant spray
ii.
Ice water immersion
iii.
Whirlpool baths
iv.
Contrast baths
v.
Thermotherapy e.g moist heat packs/hydro-collator
vi. Fluidotherapy
vii.
Paraffin bath
Electrical Modalities
This
modalities uses electricity to influence healing by stimulating the body
tissues. Like the other therapeutic modalities, electrical modalities are used
to speed up the healing of tissues. Because electrical modalities penetrate
deeper into the tissues than other modalities, they are among the most
effective in terms of decreasing healing time.
In
general, low voltage stimulation is used to help control pain and high voltage
stimulation is used to increase blood flow. General instructions for the
electrical modalities follow, but should not be interested as sufficient
instruction for therapeutic use in a professional environment.
Guidelines for electrical modalities
Administration of electrical modalities requires special training beyond the scope of these instructions.
Furthermore, procedures will vary according to the modality and
equipment used.
The
following guidelines will be helpful.
1.
Follow the physician or therapists orders for all electrical modalities
2.
Make sure the equipment is in proper working condition, is plugged in, and is
powered through a circuit served by a ground fault interrupter.
3.
Explain the procedure to the patient.
4.
Expose the area to be treated
5.
Cleanse the treatment area with soap and water or alcohol. Then, dry it
thoroughly. (cleaning the patients skin of dirt and oils will ensure proper
adhension of the electoe pads).
6.
Place electrode pads according to the manufacturer’s instructions
7.
Avoid prolonged point contact when using ultrasound.
8.
Follow the manufacturer’s instructions for use of all equipment. Improper use
may cause burns or fire.
9.
Turn the treatment channel(s) off before carefully removing the adhesive
electrodes from the patients skin.
10.
Leave the treatment area cleans when you are done
11.
To prevent infection and ensure safe use, follow the manufacturer’s
instructions for cleaning and maintaining the unit.
12.
Never use an electrical modality on an open wound.
13.
Do not use electrical modalities on a patient with a pacemaker without approval
from a physician, as this may interfere with the pace of the heart set by the
pace maker.
14.
Avoid high fluid area of the body when using electrical modalities. The
electrical current may be intertied by high concentration of fluid, causing
burns.
15.
Avoid using electrical modalities over the carotid arteries as this could
change the patient’s blood pressure and cause him or her to faint.
16.
Electrical modalities must never be used on the trunk of a pregnant patient.
Their use on the extremities is permitted upon approval by the physician.
17.
Stop the treatment if the procedure increases the patient’s pain.
The following are some
electrical modalities used in the therapeutic modalities:
i.
Ultrasound therapy
ii.
Electrical muscle stimulation (EMS)
iii.
Galvanic stimulation
iv.
Interferential stimulation
v.
Lontophoresiss
vi.
Transcutaneous electrical nerve stimulation (TENS)
vii.
Diathermy
Mechanical Modalities
This include; intermittent compression, Fraction and massage theropy, assist in healing by exerting pressure to the soft tissues, increasing circulation and/or distraction (pulling) bony structures.
This pressure can be applied manually or with device. Joint mobilization and my of asocial release, performed by seaports, chiropractors, physical therapist and certified athletic trainers are also mechanical modalities, but are beyond the scope of this text due to the amount of training that is required to use them.
General instructions for the
mechanical modalities follow, but should not be interpreted as sufficient
instruction for therapeutic use in a professional environment.
Guidelines for Mechanical Modalities
Guidelines
for electrical modalities, administration of mechanical modalities requires
special training beyond the scope of this module write up.
However,
some general guidelines are as follow;
1.
Follow the manufacturer’s instructions, for use of all equipment.
2.
Frequent circulation cheeks of extremities are important when applying traction
3.
Stop the treatment if the procedure increases the patient pain.
Massage Therapy
Is
the systematic manipulation methodical pressure, friction and kneading of the
soft body tissues. It is used to stimulate muscles, decrease muscle spasms,
increase circulation, decrease edema and promote relaxation.
There are five types of
massage therapy:
i.
Effleurage
ii.
Petrissage
iii.
Deep Friction
iv.
Tapotement
v.
Vibration
Lubricants,
such as oil, lanolin, powder, analgesic balms, or special lotions, may be used
with any of these forms of message to decrease the skin friction.
Effleurage:
Consists of strokes that glide over the skin without attempting to move the
deep muscle group. This form of massage is done with either the palms or the
fingers. Usually effleurage is used to either begin or end a massage treatment;
it may also be used to direct muscles tightness.
Petrissage:
Is done by kneading the soft tissues between the thumb and fore finger or with
the palm of the hand. The rolling and twisting motion of the tissue stimulates
fluid drainage. Fluid drainage is beneficial to the patient because it remove
cellular waste from the body tissues.
Deep Friction: This
massage is performed primarily on joints and areas with little soft tissue. The
thumbs and fingers are rotated on the skin in a circular pattern, applying
enough pressure to contract the underlying tissue. An alternative to the
circular pattern of deep friction message is transverse friction. In transverse
friction massage, the strokes are applied in a transverse pattern over a
tendon. The effects of friction massage are to increase circulation and
decrease scar tissue.
Tapotement: Or percussion
involves “beating” the hands or fingers upon the skin. This form of massage can
be done using clenched hands, the palms of the hand, the ulnar borders of the
palms, or the fingertips. Care is taken to avoid inducing pain by contacting
the person too harshly.
Vibration: Is
a form of massage that makes use of a vibrating machine or quick motions of the
fingers to produce therapecetic benefits. The benefits of vibration are
increased circulation and lymphatic drainage.
Vibration
massage also provides a mild stretch of the superficial tissues, which is
beneficial because it increases the elasticity of those tissues. Massage has
value to self and to others levels and this might require more professional
training and service.
Hints
on Massage Therapy
1.
Expose the area to be massaged and drape the patient to provide warmth and
maintain professional standards of modesty, making sure you have good access to
the area. (never massage an infected area or over a recent injury).
2.
Position the patients as comfortable as possible
3.
Apply a light lubricant to the body area
4.
Begin with light massage strokes (effleurage). Deeper, heavier massage may
follow, depending upon the clients comfort level and therapeutic needs. By
watering the patients face and/or body movements you can monitor the clients
tolerance to different levels of massage pressure. Avoid harsh massage strokes
that cause undue discomfort to the patient.
5.
Be sure to keep one hand on the patient’s body at all times. This will make the
patient to know where you are in relation to his or her body and helps avoid
startling the patient with an unexpected touch.
6.
When reduction of edema is the goal, strokes from below the injury site toward
the heart.
7.
Maintain a steady rhythm during the massage and end the session with light
massage strokes.
The
last step in giving the treatment is to remove the massage lubricant. This is
done with a clean, dry towel.
8.
Leave the treatment area clean when you are done. Discard used towels in the
place designated by the facility.
Other mechanical modalities include:
·
Intermittent compression
·
Traction
The
last modalities in rehabilitating an injured athlete is the use of
‘pharmacologic agents’. This should be prescribed by a qualified medical
professional. They constitute an important aspect of therapy that must not be
over look. A variety of drugs are used in the treatment of pain, edema,
inflammation and muscle spasms resulting from injuries.
Drugs
commonly used to control these symptoms includes; anesthetics, analgesics, no
steroidal anti-inflammatory drugs (NSAIDs), cox-2 inhibitors, corticosteroids,
and muscles relaxants. These drugs are best used in conjunction with the other
therapeutic modalities earlier discussed or mentioned.
Muscle relaxants:
such as cyclobenza prime metaxalone, carisoprodol and dantrolene relieve
muscles spasms resulting from injury or inflammation.
It
is assumed that you have learnt the contents in this post. Therefore,
therapeutic Modalities are methods of applying physical agents to create an
optimal environment for healing and reduce an individual’s pain and discomfort
following of injury or recognition of certain disease processes.
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