Modalities / Healing Agents
We are thrilled to offer a wide range of the most advanced modalities that speed the healing process in conjunction with appropriate manual treatments and therapeutic exercise. Cold laser, ultrasound, transcutaneous electrical stimulation (TENS), neuromuscular electrical stimulation, parrafin bath, cryotherapy, thermo therapy, Kinesiotape, McConnell tape, iontophoresis and others.
Hot and Cold Therapy Uses:
Injuries during athletic participation or work participation are all too common. It is likewise
common for individuals to use ice and heat as a way to decrease pain and/or soreness for
athletes with injuries. Knowing when to use hot vs. cold modalities is crucial. Each has
beneficial effects on injured tissue when administered correctly. Each can also have negative
effects if administered incorrectly, unfortunately.
The following list represents a sample of various types of heat therapies. Electric heating pad,
microwave safe heating packs, whirlpool, diathermy, exercise warm-up, ultra sound and
therapeutic exercises are all methods of heat therapy. An appropriate warm-up allows the
muscles to prime safely so they are prepared for the sequential exercise. Exercise is an
effective method to heat the body from the inside out. For athletes participating in sports, a
dynamic warm-up is recommended. Biking and elliptical training can be used to warm-up in a
more controlled environment.
Heat modalities are highly appropriate when performed before activities, and are beneficial to
relieve stiffness and chronic pain. It should not be applied to new injuries less than 1 week old
to avoid further inflammation to the injury.
Higher temperatures increase blow flow and circulation through a process called vasodilation.
Warm tissue is more pliable, thus muscles are more primed for activity and can also be relaxed.
Pain gaiting is one avenue by which heat can relieve the discomfort of an injury. It is influenced
by heat replacing pain pathways going to the brain, thus crowding out pain perception in the
For questions that are more specific, talk with your Doctor of Physical Therapy to determine
which modality or warm-up is most appropriate.
Cold / CryoTherapy:
The following list gives a sample of some more common cold therapies. Ice massage, ice pack,
gel pack, ice bath are all methods of cold therapy that can be effectively applied to maximize
had anted healing and human performance.
Cold modalities can be administered after an acute injury or upon completion of an activity. It is
ideal to apply cryotherapy to injuries less than 1 week old like a sprain or strain. Injuries such
as strains of the muscle or sprains of the ligament respond favorably to cryotherapy.
When an injury occurs, the blood supply is altered through the inflammatory response. The
circulatory system that is responsible for bringing oxygen and nutrients as well as removing
wastes goes to work to heal the injury, but can compromise injured tissue if left in an area to
scar. A chronic toxic environment can be introduced causing inflammation and altered healing
to the injured area. This prolonged altered PH and chemical change then causes slowed
healing. The use of cold therapy induces a process called vasoconstriction thereby slowing
blood flow to the injured area and decreasing levels of toxic blood pooling. This, in turn, slows
and prevents further edema or inflammation. Cryotherapy also promotes the pain gaiting
principle where the nerves that sense cold crowd out pain pathways going to the brain. Another
way to temporarily remove pain while healing tissue for long term success.
Signs to pay attention to when ice and heat modalities are not enough:
1. Tendons, muscles or joints remain weak after a period of 1-2 weeks.
2. Pain persists at same levels for more than 1 week.
3. Function or abilities are decreased for more than 1 week.
Another healing gem to put under a refrigerator magnet is that the often misused RICE acronym
should be replaced with the POLICE acronym. RICE stands for Rest, Ice, Compress and
Elevate (the injured tissue). This archaic thought prepares our bodies for Rest. In contrast, the
POLICE principal; protect, optimal load, ice, compress and elevate will allow for proper healing
and improve human performance for whatever you do. It trains your body to correctly adapt to
high level function as tissues heal.
For specific questions regarding the appropriateness of hot and cold therapy talk with a Doctor
of Physical Therapy or call your Medical Provider.