MODALITIES
POLICY:
No modality other than the application of ice, compression, and elevation will be applied without
authorization and knowledge of the Head Trainer and/or Team Physician and/or ATC, LAT. All
recommended treatments as per treatment appointment will be disregarded by any trainer who
has not been familiarized and their competence verified for said treatments or modality
utilization by the Head Trainer, Team Physician, or ATC/LAT. All treatments must be recorded
on proper forms immediately before or after treatment is given. EACH TRAINER IS
RESPONSIBLE FOR EQUIPMENT MAINTENANCE. SAFETY IS DIRECTLY RELATED
TO EQUIPMENT MAINTENANCE AND REPAIR.
CRYOTHERAPY
PROCEDURES: Ice
A.
Ice may be used in form of ice bag, ice whirlpool, ice bath or ice massage.
B.
Ice can damage the skin if not used correctly. Skin color is an indication as to the
affect of the ice upon the skin.
a. Red – increased circulation in the area
b. Deep grayish white – frostbite or frozen skin
C.
The uses of spray coolants are not suggested even though in some areas of
practice Ethyl Chloride spray might be indicated.
D.
Solid jells or chemical type ice or coolants are not recommended unless a low
grade cooling is desired.
E.
Ice application should be for a short period of time if vasoconstriction is desired
and should be applied as soon as possible following trauma. Duration should be
less than 20 minutes. For vasodilation the duration of application should be 30 to
45 minutes.
F.
Ice massage should be in a circular motion over the entire injured area. Larger
areas should be divided into 6” square areas.
G.
Explain what sensations the athlete should and should not experience.
a. Cold – initially burning or aching
b. Tingles
c. Numbness – more able to exercise without pain
d. Warming – as area returns to normal temperature
H.
Following all ice treatments, the trainer should put the athlete through stretching
exercises
I.
Following all ice treatments, the trainer will clean up then discard any unusable
supplies that remain.
INTERFERENTIAL STIMULATION
POLICY:
Interferential stimulation can be used to treat pain or re-educate and re-strengthen muscles.
PROCEDURE:
A.
B.
C.
D.
This modality should be used under the supervision of the Head Trainer, Team
Physician and/or certified Trainers
The sponges for this modality should be moist, not wet. If the sponges are too
wet, water gets into the machine through the suction hoses.
Prior to each use, check the hoses to make sure there is no water in the hoses or
the machine.
If pain increases with the treatment, stop immediately.
MUSCLE STIMULATION
GALVANIC
POLICY:
Galvanic muscle stimulation may be used to reduce pain, induce muscle contraction, and reduce
edema. Galvanic Stimulation is direct current (DC) and can be used in combination with ice and
/or heat.
PROCEDURE:
A.
B.
C.
D.
This modality should be used under the supervision of the Head Trainer, team
Physician, and/or Certified Trainers.
Good skin contact with dispersal pad and active pads is necessary for a good
treatment. Sponge pads should be moist and in good contact with the skin.
If pain is increased with treatment, stop treatment immediately.
The Stephen F. Austin State University training rooms utilize the Dynaware and
Richmar Galvanic Stimulation Units. Each trainer should know each machine’s
usages thoroughly before using the modalities.
ULTRASOUND & MUSCLE STIMULATION
RICHMAR
POLICY:
Ultrasound used in combination with muscle stimulation can be used to reduce muscle
spasm, reduce edema, increase blood flow and to reduce adhesions.
PROCEDURE:
A.
B.
C.
D.
E.
This modality should be used under the supervision of the Head Athletic
Trainer, Team Physician, and/or Certified Trainers.
All the rules for ultrasound and galvanic stimulation apply. The
ultrasound head will serve as the active electrode.
If pain or irritation occurs during the treatment, stop pimmediately.
All trainers who operate the Richmar are responsible for:
a. Knowing the differences and indications for pulsed and continuous
ultrasound.
b. Proper clean-up after using the Richmar.
c. Maintenance of the equipment.
Each trainer should know the modality’s use thoroughly before using it.
PENETRATING MODALITIES
POLICY:
Penetrating modalities may be used at various times for the treatment of deep muscle contusions,
muscle spasms, etc. These modalities will be used only by those who have been instructed in
their uses.
PROCEDURES:
A.
B.
For injury evaluation:
a. Place the athlete in a comfortable position with the injury exposed.
b. Palpate the area for local tenderness.
c. Apply ultrasound cream or gel.
d. Adjust the wattage to the highest level and proceed to penetrate the general
area of the injury, observing amperage dial and instructing the athlete to
declare any sensations of pins or hot spots.
e. Any traumatized area should react to ultrasound and the trainer can pinpoint
the area of injury and proceed with normal ultrasound protocols.
f. Traumatized areas should be quite sensitive to ultrasound waves. This will
give an indication of injury severity.
For injury treatment:
a. Injury treatment should be as directed by the Head Trainer, Team Physician or
ATC/LAT.
b. Underwater treatment is occasionally called for and can be quite effective.
Caution should be taken when in combination treatments are employed.
i. All ultrasound cables and transducers must be cleaned and dried
following underwater treatment.
ii. Lime Away should be used to clean the ultrasound periodically.
c. All trainers should be familiar with the operation and maintenance of all
ultrasound equipment in the training room.
d. Athletes being treated should be informed as to what treatments of ultrasound
are and how they affect the injury. There should be no irritation as the
treatment is being administered.
e. Check sound head for vibration periodically.
WHIRLPOOL
(ICE & HEAT)
PROCEDURES:
Ice Whirlpools
A.
Ice whirlpools should be utilized whenever cold tapotement massage is called for.
B.
If no massage is necessary, and ice bath can be used.
C.
Temperature should range from 50-60 degrees.
D.
Time will vary depending on the technique being used.
E.
Sensations should be reviewed with all athletes.
PROCEDURES:
Heat Whirlpools
A.
Hot whirlpools should be utilized whenever heat tapotement massage is called for.
B.
Hot or warm whirlpools should be used only when all chances of edema have
passed.
C.
Whirlpools can be used when a general area is being treated and should be
discontinued when an localized area is to be treated.
D.
WARM OR HOT WHIRLPOOLS SHOULD NOT BE DONE OVER A
GENERAL MUSCLE AREA JUST PRIOR TO PRACTICE. EX: DO NOT
WHIRLPOOL THE WHOLE LEG IN ORDER TO GIVE HEAT TO THE
ANKLE OR KNEE.
E.
ELIMINATE HOW WHIRLPOOL TREATMENTS ONE (1) HOUR
BEFORE PRACTICE BEGINS BECAUSE HOT WHIRLPOOLS WILL
FATIGUE THE MUSCLES.
F.
During whirlpool treatments the water level and agitator should be adjusted to the
correct position in order to maximize effects of the modality.
PROCEDURES:
General
A.
Never operate a whirlpool without water level being at least half way up on the
agitator shaft.
B.
Never treat an athlete in the whirlpool until a disinfectant has been added to the
water.
C.
Insist on all athletes showering before using a whirlpool.
D.
Limit full immersion of any athlete into the whirlpool.
E.
Temperature range for whirlpool uses should be as follows:
a. Contrast – 102 degrees (for warm phase) and 55 degrees (for cold phase)
b. Low range – 90 degrees
c. Mid Range – 102 degrees
d. High Range – 108-110 degrees
F.
Don’t allow athletes to adjust any parts of the whirlpool while being treated.
G.
The trainer is totally responsible for the safe operation of the whirlpools and
should instruct athletes to safe usages thereof.
H.
All whirlpools should be sterilized after the last athlete has been treated or
following any treatment of an athlete with any open wounds and/or infections.
Ex: Athlete’s foot, staff infection, or other skin disorders.
I.
All trainers are expected to read all printed materials pertaining to the whirlpool
operations.
J.
K.
L.
All whirlpools are grounded and breakers should be checked periodically for
working condition.
When cleaning stainless steel, never use any abrasives. (Ex: Steelwool or wire
brush)
Whirlpool baths may be used in combination with other modalities and caution
should be taken.