A “modality” is a method, machine or device that assists with injury treatment. Common sports medicine modalities used by athletic trainers include ice and cold therapy devices, hot packs, whirlpool, cupping, intermittent compression units, therapeutic ultrasound and electrical stimulation.
What Does Ice Do?
►Reduces pain by slowing nerve impulses.
►Reduces swelling by decreasing capillary permeability (less fluid escapes from bloodstream into tissues).
►Decreases spasm by inhibiting involuntary muscle contraction.
►Decreases secondary cell death after a soft tissue injury by lowering surviving cells’ need for oxygen. Healthy cells can be damaged around the injured area since swelling, congestion and damaged blood vessels reduce blood flow and oxygen. Ice application allows the healthy cells to “hibernate,” reducing their need for oxygen, thereby reducing secondary cellular injury. Secondary cell death contributes to more proteins in the tissues, which attracts fluid (swelling). Therefore, reducing secondary cellular injury reduces swelling.
►Ice can penetrate up to 2 inches into the injured tissues.
►Use ice for initial injury care and for the first few days after injury.
►Use after rehabilitation exercises to control inflammation and any exacerbation of symptoms.
What Does a Hot Pack Do?
►Decreases pain by blocking nerve impulses.
►Increases blood flow, which brings healing nutrients to the injured area.
►Increases muscle/tendon flexibility.
►Increases cell metabolism, accelerating the healing process.
►Decreases muscle spasm by inhibiting involuntary muscle contraction.
►Assists removal of waste products left behind by injury.
►Superficially increases tissue temperature 1-3 cm deep.
►Use heat after the initial inflammation resolves (usually 2-3 days after injury) and once swelling is gone. Using heat too soon after an injury can increase swelling, so if you’re not sure what to use, choose ice.
What Does Electrical Stimulation Do?
►Decreases pain by blocking nerve impulses.
►Decreases muscle spasm by inhibiting involuntary muscle contraction.
►Stimulates the healing process.
►Helps muscles learn to contract again after injury or surgery.
►E-Stim is often combined with heat or ice to maximize pain relief.
What Does Therapeutic Ultrasound Do?
►Stirs up molecules in tissues, producing deep heat (1-2 inches into tissues).
►Increases blood flow, which brings healing nutrients to the injured area.
►Stimulates cellular protein production, thereby stimulating the healing process.
►Improves elasticity/flexibility of muscles and tendons.
►Increases macrophage activity. Macrophages are special cells that clean up debris in an injured area.
►Reduces scar tissue and reduces inflammation.
►Increases collagen formation (an important protein in ligaments and tendons).
►Increases fibroblast activity. Fibroblasts are "repairing cells" that appear 3-5 days after injury. They produce important proteins and form new collagen.