Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |1
Injury Treatment

Therapeutic Modalities
o
o include the use of heat, cold, electrotherapy, mechanical, light treatments
o Indication-
o



Contraindication-
Thermal Modalities
transfer energy ________________________________________________ the tissues
exchange energy based on a __________________________________________________________________
energy transferred through the following ways
o conductionexample:
o
convectionexample:
o
radiationexample:
o
conversionexample:
o
evaporationexample:


Cryotherapy
application of ________________ modalities
effects:
o
o
o
o
o
o
o
o


Thermotherapy
application of superficial or deep ______________
agents
effects:
o
o
o
o
o
o
o
o
Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |
2
Cryotherapy

Types:

Indications:
o Acute injury or inflammation
o Acute or chronic pain
o Small, superficial, first-degree burns
o Postsurgical pain and edema
o Use in conjunction with rehabilitation
exercises
o Acute or chronic muscle spasms
o neuralgia
Contraindications:
o Cardiac or respiratory involvement
o Uncovered open wounds
o Circulatory insufficiency
o Cold allergy/cold-induced urticaria
o Anesthetic skin
o Advanced diabetes
o Peripheral vascular disease
o Raynaud’s phenomenon
o Lupus



Thermotherapy
Effects Continued
o
o
o
o
o
Types:
o superficial:
o
•
•
deep heat:
Indications:
o Subacute or chronic inflammatory
conditions
o Reduction of subacute or chronic pain
o Subacute or chronic muscle spasm
o Decreased range of motion
o Hematoma resolution
o Reduction of joint contractures
Contraindications:
o Acute injuries
o Impaired circulation
o Advanced arthritis (vigorous heating)
o Poor thermal regulation
o Anesthetic areas
o Neoplasms
o thrombophlebitis
Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |
3
Thermotherapy Continued
Deep Heating Agents
• Therapeutic Ultrasound-________________________________________________ modality capable of producing
changes in tissue through both thermal and nonthermal mechanisms
o Uses ________________________________________________________________________________
• Effects
o Deep-heating
o Increase rate of tissue repair
o Wound healing
o Increased blood flow
o Increased tissue extensibility
o Breakdown calcium deposits
o Reduction of pain
o Reduction of muscle spasm
o Deliver medications
o _________________________________________________________________
• Used for heating tissues
o __________________________________________________________________
• Nonthermal effects
o The closer the duty cycle is to 100% the more thermal effects there are. The lower the duty cycle, the less
thermal effects
• Nonthermal Effects
• Thermal Effects
o Increased cell membrane permeability
o Increased sensory nerve conduction velocity
o Altered rates of diffusion across the cell
o Increased motor nerve conduction velocity
membrane
o Increased extensibility of collagen-rich
o Increased vascular permeability
structures
o Secretion of cytokines
o Increased collagen deposition
o Increased blood flow
o Increased blood flow
o Increased fibroblastic activity
o Reduction of muscle spasm
o Stimulation of phagocytosis
o Increased macrophage activity
o Production of healthy granulation tissue
o Enhanced adhesion of leukocytes to damaged
o Synthesis of protein
endothelial cells
o Synthesis of collagen
o Reduction of edema
o Diffusion of ions
o Tissue regeneration
o Formation of stronger, more deformable
connective tissue
Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |
4
•
Indications
o Joint contractures
o Muscle spasms
o Neuroma
o Scar tissue
o Sympathetic nervous system disorders
o Trigger areas
o Warts
o Spasticity
o Postacute reduction of myositis ossificans
o Acute inflammatory conditions (pulsed)
o Chronic inflammatory conditions (pulsed
or continuous)
•
Contraindications
o Acute conditions (continuous)
o Ischemic areas
o Areas of impaired circulation/artery disease
o Over areas of deep vein thrombosis
o Anesthetic areas
o Over cancerous tumors
o Over sites of active infection of sepsis
o Over spinal cord or large nerve plexus (high
doses)
o Exposed metal that penetrates skin
o Areas around eyes, heart, skull, or genitals
o Over the thorax (pacemaker)
o Pregnancy when over pelvic or lumbar areas
o Over fracture site before healing is complete
o Stress fracture sites or sites of osteoporosis
o Over the pelvic of lumbar area in menstruating
patients
Temperature Increases and Their Desired Effect
Classification of
Ultrasound
Temperature
Increase
Used for Thermal Effects
Mild
1ºC
Mild inflammation, accelerating metabolic rate
Moderate
2°-3°C
Decreasing muscle spasm, decreasing pain, increasing
blood flow, reducing chronic inflammation
Vigorous
3°-4°C
Tissue elongation, scar tissue reduction, inhibition of
sympathetic activity
Rate of Ultrasound Heating (temperature increase per
minute)
Intensity
Tissue Depth
1MHz
3MHz
0.5
0.04°C
0.3°C
1.0
0.2°C
0.6°C
1.5
0.3°C
0.9°C
2.0
0.4°C
1.4°C
Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |
5
Thermotherapy Continued
Deep Heating Agents
• Shortwave diathermy-uses _____________________________________________________________________
to produce deep heat within the tissue
o Effects similar to thermal and nonthermal ultrasound
• Effects
o Thermal• Increased microvascular perfusion
• Activation of fibroblast growth factors
• Increased macrophage activity
o Nonthermal• Heating of large area of tissue
• Heat retained 3 times longer than ultrasound
• Indications
• Contraindications
o Acute trauma (nonthermal)
o Ischemia
o Acute inflammation (nonthermal)
o Hemorrhage
o Edema reduction (nonthermal)
o Acute inflammation (thermal)
o Subacute inflammation
o Metal within the output field
o Pain syndromes
o Pacemaker
o Muscle spasms
o Presence of moisture
o Chronic inflammation
o Moist dressing, adhesive tape, skin creams
o Increase blood flow
o Skull (extreme caution)
o Stretching collagen-rich tissues
o Contact lenses must be removed before
application over head
o Pregnancy (over pelvis, abdomen, or lumbar)
o Menstruating females (over pelvis, abdomen,
or lumbar)
o Unfused epiphyseal plates
Precautions Against Metal Within the Field of Shortwave Diathermy
In the Environment
Near or On the Patient
In the Patient
Beds
Treatment tables
Chairs
Wheelchairs
Metal stools
CPM Units
Splints
Braces
Medical instruments
Electrical modalities
Jewelry
Body piercings
Earrings
Watches
Metal in pockets (keys, etc.)
Belt buckles
Zippers
Metal underwire bras
Hearing aids
Orthodontic braces
Dental fillings
Implanted fixation devices
External fixation devices
Metal heart valves
Artificial joints
Metal IUDs
Body piercings
Cardiac pacemakers
Implanted bone growth
generators
Phrenic pacers
Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |
6



Electrical Stimulation
modality that utilizes _______________________ ______________________
electricity- force created by an imbalance in the number of ________________________ at two poles
o Electrons flow in an attempt to equalize difference in charges—this creates an electrical current
o Negative pole-area of high electron concentration
o Positive pole-area of low electron concentration
o Closed circuit-formed when a complete path is formed between the 2 poles
Electrical Currents
o Direct Current-________________________________________________________________ flow of
electrons; square wave
o Alternating Current-direction of flow _______________________________________________________
________________________________________; no true positive or negative poles; electrons go back and
forth between electrodes
o Pulsed Current-one direction of flow that is interrupted by _______________________________________
_________________________________________________
o Vocabulary
 Electrode leads-_______________________ that conduct the current to and from the generator,
electrodes, and patient
 Electrodes-_________________ that introduce the current into the body; point where the electrode
contacts the skin is where the electrons are converted into ions
 When placed __________________________ together, current flows
_________________________________
 When places __________________________ apart, the __________________________
the current flows
Stimulation Levels
Between the point at which the output rises from zero to the point where the patient first receives
an electrical sensation
Stimulation of only sensory nerves
Stimulation that produces a visible muscle contraction
Stimulation of pain fibers
•
Indications
o Controlling acute and chronic pain
o Reducing edema
o Reducing muscle spasm
o Reducing joint contractures
o Inhibiting muscle spasms
o Minimizing disuse atrophy
o Facilitation tissue healing
o Facilitating muscle reeducation
o Facilitating fracture healing
o Strengthening muscle
•
Contraindications
o Cardiac disability
o Pacemakers
o Pregnancy (over abdomen, pelvis, and lumbar
regions)
o Menstruation (over abdomen, pelvis, and
lumbar regions)
o Exposed metal implants
o Areas of nerve sensitivity
• Carotid sinus
• Esophagus
Name ___________________
Sports Medicine II—Injury Treatment Guided Notes
Page |
7
o
o
o
o
Severe obesity
Epilepsy
Electronic monitoring equipment
Cancerous lesions
Sites of infection
•
•
•
•
•
Larynx
Pharynx
Around or on eyes
Upper thorax
Temporal region