If you have suffered from an injury such as bursitis, tendonitis, or arthritis you may been to physical therapy to help decrease your pain and improve your function. In addition to therapeutic exercise and manual therapy, rehabilitation specialists use a variety of modalities to help reduce pain, facilitate healing and restore function. Here are some of the most common modalities used by our expert therapists.
There are a few types of electric stimulation, also known as e-stim, that physical therapists may use during your rehab program. These different types can be used to achieve different goals depending on several factors. The two main types that our therapists use include transcutaneous electrical neuromuscular stimulation (TENS) and neuromuscular electrical stimulation (NMES):
TENS When our body is hurt, our brain has to first process pain signals and formulate the idea that something hurts before we feel the pain. These signals have to pass through a gate that only allows one signal to go through at a time. TENS units use pads that electrically stimulate the area around your injury/pain, giving off a tingling sensation. Since only one signal can go through the gate at a time, your body stops process the pain you were feelings, reducing or even eliminating it.
NMES After surgeries, injuries, or long periods of immobilization, our muscles forget how to contract properly. In these cases, a therapist may use NMES (also called Russian stim) in conjunction with strength exercises to facilitate the mind-body connection that is broken. NMES uses electrodes that are placed in specific areas of a muscle that are not contracting properly. These electrodes introduce electrical impulses that work to contract your muscle, helping you to improve neuromuscular recruitment.
Dry needling focuses on releasing irritable muscular knots, called trigger points, and "loosening" shortened muscles. There are many injuries and conditions that can result in trigger point formation, such as repetitive movements, poor posture and poor biomechanics. In the past, physical therapists would utilize different techniques to combat this issue, including manipulation or mobilization, in order to “reset” the muscle. Now, we have learned that a well-placed needle can reset the muscle with less pain and less work than before.
Therapeutic ultrasound is a treatment that has been used in physical therapy clinics for over 50 years. With this modality, an electric charge is applied to a crystal, which produces ultrasonic waves that pass through your skin and to tissues. These waves provide heat to injured body parts that lie deep within your body that cannot be heated with a standard hot pack alone. Ultrasound is also thought to improve cellular function by making microscopic gas bubbles near your injury expand and contract rapidly, a process called cavitation. This expansion and contraction are thought to speed up the healing process in your injured body part.
For patients with neck or back pain, therapeutic traction can help for a variety of reasons. While it can help stretch the muscles and joint structures around your spine, it can be also decrease compressive forces in the neck and back, which can help take pressure off of the discs that reside between the vertebrae (spinal bones). It can also open up the spaces where nerves exit the spinal canal, which can help relieve pressure off of a compressed nerve. While therapists can manually provide traction with their hands, mechanical traction allows them to gently and consistently apply traction to your neck or back for extended periods of time.
Light therapy involves the application of lasers and other light sources to injured tissues, in order to “feed” light-absorbing molecules called chromophores. Chromophores use the energy from absorbed light to produce more ATP, the cellular energy needed to synthesize enzymes, DNA, RNA and other materials critical to the repair process. Light therapies have been shown to be effective in a variety of applications, including the treatment of carpal tunnel syndrome, lower back pain and even wound healing.
OTHER COMMON MODALITIES
The most common modalities are also the ones that are easiest to replicate at home. At some point in time, we’ve all used an ice pack or a heating pad to help sooth an injury. While both can help treat an injury, they act through different mechanisms that can be beneficial for your therapy treatment.
MOIST HEAT When heat is applied to the body, it can help decrease pain while increasing mobility, allowing for (temporary) pain-free movement. This helps prime the body for exercise, similar to warming up before exercising. Unlike regular heating pads, moist heat penetrates deeper and faster into injured tissue, helping patients make more significant functional improvements. Our clinics use moist heat packs in various sizes, allowing them to be applied to each body area effectively and safely while maximizing their effectiveness.
COLD THERAPY Unlike heat, cold therapy is used to reduce blood flow and inflammation during the acute phase of healing. Cold therapy can also temporarily reduce or prevent swelling and inflammation in an injured joint or muscle following exercise, making it a useful post-exercise modality. In some cases, a cold compression machine may be used on your knee, ankle, or shoulder to enhance this reduction in swelling.
While these modalities can enhance your therapy outcomes, remember that modalities are used to augment your overall physical therapy program. Your physical therapist will teach you exercises and strategies that will not only help treat your injury or condition, but help you to prevent future problems. To stay up-to-date on the latest news and tips from us, like us on Facebook and follow us on Twitter by clicking below.