What different applications are available to you as a physical therapist? There are
so many different pieces of machines and different applications that can be used to treat
patients. New applications come out every year, trying to find the best and most perfect
one yet. If you walk into many different physical therapy offices, most of them have the
same equipment with the exception of a couple different things. Throughout my research
I have found that all physical therapy offices use three applications all the time. Hot/cold
packs, ultrasound, and EMS (electrical muscle stimulation) are used widely throughout
this profession.
It seems like hot/cold packs have been around forever. An “ice pack” used to
literally be just ice in a bag and a “hot pack” used to be a wet rag heated in some kind of
stove or microwave. Nowadays technology has improved and scientist have made it so
when certain chemicals are mixed the pack will turn hot or cold. These packs decrease
pain and swelling while helping the muscles to relax. Heat cause vasodilatation of the
vessels to increase circulation. A cold pack does the opposite and cause vasoconstriction
to reduce the swelling of the area. Vasodilatation is when the vessels become larger and
vasoconstriction is when the vessels become smaller. Both of these mechanisms bring
blood and nutrients to the infected/swollen area to help heal the pain. Hot and cold packs
are used the same as they always have been. Wrapped in a towel and placed on the
injured area. The entire area should be covered with the ice or the heat.
Another frequently used application is called ultrasound. This is a machine that
sends high or low frequency sound waves to the patient’s injury. Sound waves penetrate
the muscle to cause deep tissue/muscle warming. This helps relax the area of injury.
Ultrasound is mostly used after a major surgery to break up the scar tissue around the
infected area. The sound waves are impossible to hear by the human ear. This can also
treat injuries such as a sprain, tendonitis, or even open wounds. Ultrasound can treat these
injuries by relieving the pressure and relaxing the joint or muscle. This machine is used
with a jelly like substance and a probe that is connected to a machine. The jelly like
substance is placed on the person’s injured area and on the probe. The settings for this are
very low because it is very easy to form a bone bruise with this machine. Usually the
settings are set between .2 and 1.0. The higher the intensity the more heat is being pushed
into the injury. The probe is placed onto the area and moved in a circular motion for
about five minute. The therapist will ask the patient to let he/she know if they start
feeling a warm feeling because that is not a good sign.
Another very important application is called EMS. EMS stands for electrical
muscle stimulation. This is a machine that causes an involuntary muscle contraction. This
machine is also commonly used after major surgeries to help regain muscular strength.
This is also used very often if the patient has just had a brain injury. The EMS will help
re-teach the muscle how to move. This application is used by placing sticky pads on the
patient’s north and south ends of their injury. Depending on the muscle size the physical
therapist will use two or four sticky pads. The sticky pads are attached to wires, which are
attached to a machine. The physical therapist will put the machine on a numbered
strength, according to the patient’s ability, that will increase their recovery time. If it is
set on a lower number then the strength of the contraction will not be as great. There are
many different settings but the most common is to set it as a 30 second contraction with a
minute rest for about 15 to 20 minutes. With this setting the therapist will usually ask the
patient to try to contract their muscle along with the machine. Another setting is to have
the first contraction weak and the therapist will make them stronger and closer together as
the time increase.
When I was younger I had to go through a lot of therapy for my knee. Every time
I went to the therapist all three of these applications were used on me. After researching I
have come across that these are the most common applications used. I never really
understood why I always had to ice and heat my knee because I didn’t feel any different
afterwards. Now I know exactly why. I also never understood what exactly the ultrasound
was doing to me. I could never feel anything happening inside of me but now that I know
there was really a lot going out inside of my body I am very thankful for that machine.
Every time I heard the word ultrasound I thought that it was just a machine to use during
pregnancy but now I know that it is a lot more than that. These different applications
have helped physical therapists for many years now and will keep helping them for many
years to come. After interviewing Al Yesilonis, he told me that these are his three
favorite things to use for his patients because he feels it gives them the best recovery
time. I spent a day in his office and I watched his routine. He puts ice on just about every
patient as soon as they come in and he uses the two machines on everyone that he can use
them on. I also talked to some of the patients before and after their therapy session and
most of them felt a lot better walking out of the session then they did coming into it. This
can only mean one thing, and that is that these applications really do work.