Heat application, electrical stimulation, traction, and massage are just a few of the physical therapy modalities that may be used at different stages of your recovery. While some modalities may only be able to be used during a treatment session, others can also be done at home.
This article explores 12 common physical therapy modalities, including how and why they are used. If your therapist recommends one for you, they should be prepared to explain the reason for using the modality and what to expect from treatment.
Exercise can be passive or active.
Passive exercise is one that requires you to simply relax while another person, like a physical therapist, applies the stress. One example of this is a hamstring stretch where a person lifts your leg to elongate the hamstring muscle on the back of your thigh. Active exercise is exercise that you perform under your own power. Walking on a treadmill, hip strengthening exercises, or straight leg raising exercises are all active exercises.
If you attend physical therapy in a clinic, at home, or while in the hospital, you will likely be engaged in some form of exercise to help improve your mobility. Home exercises are often also prescribed.
The home program is a group of exercises that you perform on your own. They can be very important to helping you return to normal function.
Ultrasound is administered by your physical therapist using an ultrasound machine. A wand called a sound head is pressed gently against your skin and moved in small circular sweeps near the site of injury. A small amount of gel is used so the ultrasound waves are absorbed into the skin and muscles.
There are two theories about how the stimulation works: the gate theory and the opiate theory.
Other forms of electrical stimulation may be used to contract muscles. This is called neuromuscular electrical stimulation (NMES) and is used to help your injured muscles “relearn” how to function properly.
To use lumbar traction, you must be strapped into a mechanical machine. There is a vest that helps support your ribs and another device that wraps around your pelvis. The vest and pelvic device are stabilized with straps, and a mechanical force is applied with a machine.
Cervical traction is applied in either the sitting or lying position. If sitting, a harness is attached to the head and a pulley system is used with a small weight attached. The weight provides the traction force while you sit comfortably in a chair.
In lying, or supine, traction, a specific device is used. You must lie down on your back and strap your forehead into the device. Then, a pneumatic pump is used to help provide the traction force to your neck.
While you may think of your joints moving as hinges, there is a gliding motion that also occurs between the joints of the body. This gliding motion is increased during joint mobilizations. The degree to which your therapist moves each joint depends on the amount of pressure and the direction of force applied to the joint.
While joint mobilization is a passive treatment, your physical therapist can teach you self-mobilization techniques so you can manage your problem independently. This can help you return to normal function quickly and offer you a strategy to prevent future problems.
There are many massage techniques, including effleurage, petrissage, and trigger point massage.
In a physical therapy clinic, hot packs are kept in a device called a hydrocollator. This is a large tank of hot water. The hot packs are cloth packs filled with a sand, clay and silica mixture. They absorb the hot water and are wrapped in terry cloth covers and towels before being applied to your body.
The hot pack is usually kept on the injured body part for 15 to 20 minutes.
Cold packs are usually applied for 15 to 20 minutes. Like hot packs, care must be used to prevent skin damage from getting too cold.
Most often, a steroid like dexamethasone is used in the treatment of inflammation. This steroid can help decrease pain and swelling of tissues that occurs when they are inflamed.
Iontophoresis can be used in the treatment of other conditions as well, depending upon the medication that is used during treatment. It is not a replacement for active physical therapy, but can be added as part of an overall plan.
To apply light therapy, your physical therapist will hold the light-emitting wand directly over your injured body part and press a button to activate the light.
Light therapy can be used in the treatment of chronic pain, inflammation, or wound healing.
The theory behind light therapy is that photons of light carry energy, and this energy applied to injured tissues can help improve cellular processes and speed healing or decrease pain.
Kinesiology tape is applied to the skin, and it can be kept in place for a few days.
It may be used for various purposes, including:
Muscle inhibitionMuscle facilitationBruising and swelling managementPain relief
Since K-tape is a newer treatment modality, it has yet to be fully tested, and gains made with it may be due to the placebo effect.
Whirlpools can be hot or cold. The usual temperature for a hot whirlpool is between 98 and 110 degrees Fahrenheit. A cold whirlpool bath is typically 50 to 60 degrees Fahrenheit.
Whirlpool baths have a motor or agitator that helps move the water around the body part that is being treated. This motion can have a soothing effect, and can also be used in the treatment of wound debridement.
A typical whirlpool session involves placing your body part to be treated into the water and relaxing while the water swirls around it. Gentle exercises can be performed to help improve motion around the body part while it is in the whirlpool.
Care must be taken to ensure that the whirlpool bath is not too cold or hot, as temperature extremes can damage your skin during treatment.
