Other Considerations in treatng injury

During the rehabilitation period after injury, athletes must alter their training and conditioning habits to allow the injury to heal sufficiently. The sports therapist must not neglect fitness training in designing a rehabilitation program. Consideration must be given to maintaining levels of strength, flexibility, and cardiorespiratory endurance. Modality use should be combined with antiinflammatory medication, particularly during the initial acute and acute inflammatory phases of rehabilitation. A complete discussion of the effects of various medications on the rehabilitation process appears further

1.9. Study a summary list of indications, contraindications, and precautions in using

the various modalities. This list may aid the sports therapist in making decisions regarding the appropriate use of a therapeutic modality in a given clinical situation.

INDICATIONS AND CONTRAINDICATIONS FOR THERAPEUTIC MODALITIES
Therapeutic Modality	Physiological Responses (indications for Use)	Contraindications and Precautions
Electrical stimulating currents – high voltage	Pain modulation Muscle reeducation Muscle pumping contractions Retard atrophy Muscle strengthening Increase range of motion Fracture healing Acute injury	Pacemakers Thrombophlebitis Superficial skin lesions
Electrical stimulating currents – low voltage	Wound healing Fracture healing Iontophoresis	Malignancy Skin hypersensitivities Allergies to certain drugs
Electrical stimulating currents – interferential	Pain modulation Muscle reeducation Muscle pumping contractions Fracture healing Increase range of motion	Same as high-voltage
Electrical stimulating currents – Russian	Muscle strengthening	Pacemakers
Electrical stimulating currents – MENS	Fracture healing Wound healing	Malignancy Infections
Shortwave diathermy and microwave diathermy	Increase deep circulation Increase metabolical activity Reduce muscle guarding / spasm Reduce inflammation Facilitate wound healing Analgesia Increase tissue temperatures over a large area	Metal implants Pacemakers Malignancy Wet dressing Anesthetized areas Pregnancy Acute injury and inflammation Eyes Areas of reduced blood flow
Cryotherapy – cold packs, ice massage	Acute injury Vasoconstriction – decreased blood flow Analgesia Reduce inflammation Reduce muscle guarding / spasm	Allergy to cold Circulatory impairments Wound healing Hypertension
Thermotherapy – hot whirlpool, paraffin, hydro-collator, infrared lamps	Vasodilation – increased blood flow Analgesia Reduce muscle guarding / spasm Reduce inflammation Increase metabolical activity Facilitate tissue healing	Acute and postacute trauma Poor circulation Circulatory impairments Malignancy
Low-power laser	Pain modulation (trigger points) Facilitate wound healing	Pregnancy Eyes
Ultraviolet	Acne Aseptic wounds Folliculitis Pityriasis rosea Tinea Septic wounds Sinusitis Increase calcium metabolism	Psoriasis Eczema Herpes Diabetes Pellagra Lupus erythematosus Hyperthyroidism Renal and hepatic insufficiency Generalized dermatitis Advanced atherosclerosis
Ultrasound	Increase connective tissue extensibility Deep heat Increased circulation Treatment of most soft tissue injuries Reduce inflammation Reduce muscle spasm	Infection Acute and postacute injury Epiphyseal areas Pregnancy Thrombophlebitis Impaired sensation Eyes
Intermittent compression	Decrease acute bleeding Decrease edema	Circulatory impairment

Cryotherapy

1.10. Translate the following into English.

ФИЗИОТЕРАПИЯ

Спортивные врачи прибегают к использованию различных форм терапевтического воздействия в дополнения к другим видам лечения. При выборе формы терапевтического воздействия они должны руководствоваться как теоретическими знаниями, так и практическим опытом. Например, токи электрической стимуляции могут быть использованы для того, чтобы стимулировать афферентные нервы (sensory nerves) для модуляции боли, стимулировать эфферентные (motor) нервы для вызова мышечных сокращений, для введения химических ионов в поверхностные (superficial) ткани по медицинским показателям (for medicinal purposes), а также для создания электрического поля в тканях для стимулирования процесса излечения.

1.11. Summarizes the various modalities that may be used in each of the four phases

with help of the table below.

Clinical Decision Making on the Use of Various Therapeutic Modalities in Treatment of Acute Injury
Phase	Approximate Time Frame	Clinical Picture	Possible Modalities Used	Rationale for Use
Initial acute	Injury – day 3	Swelling, pain to touch, pain on motion	CRYO ESC IC LPL Rest	↓ Swelling, ↓ pain ↓ Pain ↓ Swelling ↓ Pain
Inflammatory response	Day 2 – day 6	Swelling subsides, warm to touch, discoloration, pain to touch, pain on motion	CRYO ESC IC LPL Range of motion	↓ Swelling, ↓pain ↓ Pain ↓ Swelling ↓ Pain
Fibroplastic-Repair	Day 4 – day 10	Pain to touch, pain on motion, swollen	THERMO ESC LPL IC Range of motion Strengthening	Mildly ↑ circulation ↓ Pain – muscle pumping ↓ Pain Facilitate lymphatic flow
Maturation – remodeling	Day 7 - recovery	Swollen, no more pain to touch, decreasing pain on motion	ULTRA ESC LPL SWD MWD Range of motion Strengthening Functional activities	Deep heating to ↑ circulation ↑ Range of motion, ↑ strength ↓ Pain ↓ Pain Deep heating to ↑ circulation Deep heating to ↑ circulation
CRYO, Cryotherapy; ESC, electrical stimulating currents; IC, intermittent compression; LPL, low-power laser; MWD, microwave diathermy; SWD, shortwave diathermy; THERMO, thermotherapy; ULTRA, ultrasound; ↓ decrease; ↑ increase

1.12. Act out the conversation below.