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If you have ever been injured and done therapy with an athletic therapist or a physical therapist to facilitate a full recovery, you will be aware of the modalities of ultrasound, electric stim and more recently laser therapy that are commonly applied.
The principles on which all three of these modalities are based are all very sound. They have all proven to be effective ways to manage pain by promoting healing.
Unfortunately, owners of a particular modality sometimes attempt to discredit the others in an effort to enhance their own status but a more experienced therapist is seasoned enough to appreciate the value that they each carry. What happens sometimes is, like everything else, one client might respond to one better than another. Of the three mentioned above, the most recent hype is laser therapy. While I was studying for my bachelor’s degree in athletic training, laser therapy carried little credit, but since then, the technique and/or principles have been developed and now the results speak for themself.
Electric stimulation can be applied in a number of ways to effect pain and function. The nervous system which carries messages to the brain which affects everything that happens in the body, accomplishes this by electric pulses.
This makes the link to the modality of electric stimulation, a bit clearer. I have had many clients who swear by this modality and feel its effects, while others do not prefer it at all and the same applies for both ultrasound and laser.
Ultrasound uses sound waves to influence in particular, soft tissue healing and circulation. It can be used as a heating tool (thermal) or non-thermal affecting tissue in the deeper layers below the skin. The ultrasound modality is another tool that has a broad spectrum of suitable applications.
Laser therapy targets the mitochondria cells of tissue to facilitate healing (as does the ultrasound to some extent). The absorption of the red laser light initiates ATP production which is the body’s fuel source which, when broken down, produces energy for the muscles and organs of the body. Whereas injury generally discourages movement and encourages more of a “shut down” mode, the use of the laser beam of light stimulates greater cell activity. More activity in the cell means continued healing, hence the improve physical response.
Some of the more easily accessible modalities applied in therapy are heat and cold therapy, but another topical application starting to take notice are wheatgrass products. This more natural remedy is from the 1930s and is said to contain “growth factors” and therefore have a significant impact on tissue regeneration.
Sometimes, the therapists become so familiar with the settings and capabilities of their modalities that it starts to look very simple to do. I parallel it with the CSI Miami television characters who, in all their glamour, will sometimes simply be required to put some piece of evidence into a clear solution, then watch it turn blue to confirm the substance is a narcotic of sorts. It can make one think, “But I can do that!”
A few clients have explored purchasing their own equipment so that they can apply it themselves on demand. While the portable e-stim/TENS units are effective and less likely to cause harm the ultrasound machines are definitely a bit more involved. There are simpler units that make it more difficult to injure oneself but then the question of effectiveness is called to question. I wonder to myself, “Maybe we are making this thing look too easy?!” Because it seems that the efficiency is causing patients to question the complexity or the risks.
I was told by someone the other day, that a person they knew recently purchased a diagnostic ultrasound machine on an Internet site, at a very affordable price and claimed it did the same thing he saw the doctor do on him when he went to be evaluated. Despite my advice that it could not possibly be the same thing, he insisted it was before I could even finish my point.
The individual completely played down the work done by the doctor, as if it could be replaced with a basic understanding of human anatomy. I was completely baffled.
Respect the role of the therapist in dealing with athletic injuries. Quite often, the results outshine the technique and understanding what not to do is just as important as understanding what to do. Regardless of how simple or how complicated a skill may look, the progress is what matters most. There is always a significant measure of training and forethought that goes into designing the rehab protocol.
Asha De Freitas-Moseley is a certified athletic trainer with the National Athletic Trainers’ Association of the USA. Athletic training is practiced by athletic trainers, health care professionals who collaborate with physicians to optimise activity and participation of patients and clients. Athletic training encompasses the prevention, diagnosis, and intervention of emergency, acute, and chronic medical conditions involving impairment, functional limitations, and disabilities (www.nata.org).
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