Therapeutic Modalities for Musculoskeletal Injuries

Craig R. Denegar, PhD, ATC, PT, is a professor in the department of kinesiology and director of the doctor of physical therapy program at the University of Connecticut. He has more than 30 years of experience as an athletic trainer and extensive clinical practice experience related to persistent orthopedic pain. Denegar is a member of the National Athletic Trainers' Association (NATA) and is the former vice chair of free communications on the NATA Research and Education Foundation: Research Committee. He is also a member of the American Physical Therapy Association and in 2003 was the recipient of the William G. Clancy Medal for Distinguished Athletic Training Research. In 2004, he received the Distinguished Merit Award from the Pennsylvania Athletic Trainers' Society. Currently, Denegar serves as the senior associate editor and on the editorial board of the Journal of Athletic Training. He also serves on the editorial board of the Journal of Sport Rehabilitation. In his spare time, Denegar enjoys playing soccer, cycling, and studying the history of the American West. He and his wife, Susan, live in Mansfield Center, Connecticut. Susan Foreman Saliba, PhD, ATC, PT, is an assistant professor in the Curry School of Education at the University of Virginia at Charlottesville. She has over 20 years of clinical experience and has taught therapeutic modalities annually during that time. Susan is a member of both the NATA and the American Physical Therapy Association (APTA) and has served on the NATA's Educational Executive Committee and the Free Communications Committee of the NATA Research and Education Foundation. She is currently conducting research on clinical application of therapeutic modalities. Ethan Saliba, PhD, ATC, PT, has been teaching therapeutic modalities at the University of Virginia at Charlottesville for over 25 years. He is the head athletic trainer and associate athletics director for sports medicine, and he oversees 25 varsity sports. Saliba is a certified athletic trainer, licensed physical therapist, and sport-certified specialist who has written extensively on various aspects of athletic injuries and rehabilitation. Saliba was honored as the NATA Head Athletic Trainer of the Year in 2007.

Chapter 1. The Contemporary Use of Therapeutic ModalitiesLegal Aspects of Therapeutic Modality Application: Practice Acts and Negligent TreatmentThe Rehabilitation Plan of CareChapter 2. Psychological Aspects of RehabilitationPsychological Response to InjuryMaximizing Compliance With a Rehabilitation Plan of CareBarriers to Successful RehabilitationClinical Outcomes and Efficacy of Therapeutic ModalitiesA Word About PlaceboChapter 3. Tissue Injury, Inflammation, and RepairHealing Tissues and Inflammation: An OverviewAcute Phase of the Inflammatory ResponseRepair Phase of the Inflammatory ResponseMaturation Phase of the Inflammatory ResponseChronic InflammationSwellingChapter 4. Pain and Pain ReliefWhat is Pain?Pain and the Physical ExamPain AssessmentTransmission of the Pain SensationPain Control TheoriesChapter 5. Persistent Pain and Chronic PainWhere and How Pain Sensitivity IncreasesSources of Persistent PainChapter 6. Impact of Injury and Pain on Neuromuscular ControlIntegration of Components of Neuromuscular Control Into a Rehabilitation Plan of CareWhy Is Neuromuscular Control Lost?The Role of Therapeutic Modalities in Restoring Neuromuscular ControlChapter 7. Evidence-Based Application of Therapeutic ModalitiesThe Need for Evidence-Based PracticeTools Necessary for Assessing OutcomesFinding and Assessing the EvidenceBeyond the RCT - Systematic Review and Practice GuidelinesChapter 8. Cold and Superficial HeatEnergy TransferCryotherapy and CryokineticsSuperficial HeatHeat and Cold: Contrast TherapyHeat, Cold, and Contrast Therapy: Deciding What to ApplyChapter 9. Principles of ElectrotherapyBasics of ElectricityTypes of Electrical Current: Alternating, Direct, and PulsatileParameters of Electrical StimulationElectrode ConsiderationsChapter 10. Clinical Uses of Electrical StimulationPain Relief: Transcutaneous Electrical Nerve StimulationMuscle Reeducation: Neuromuscular Electrical StimulatorsIontophoresis and Stimulation of Denervated Muscle: Direct Current (DC) StimulatorWound Healing: Microcurrent Electrical Nerve StimulatorChapter 11. Ultrasound, Diathermy, and Electromagnetic FieldsApplication of Acoustic Energy:UltrasoundEfficacy of Ultrasound Therapy for Musculoskeletal ConditionsApplication of Electromagnetic Energy: Diathermy and Pulsed Electromagnetic FieldsEfficacy of Diathermy and PEMF Therapy for Musculoskeletal ConditionsStimulation of Fracture HealingChapter 12. Low-Level Laser TherapyElectromagnetic EnergyLaser ProductionProperties of Laser LightLaser ClassificationLaser Parameter SelectionComparing Low-Level Laser Therapy TreatmentsBiological Effects of LaserSafety ConsiderationsContraindications and PrecautionsChapter 13. Mechanical EnergyManual TherapyIs Manual Therapy Effective?TractionIntermittent CompressionTraction and Intermittent Compression: Effective Therapies?Chapter 14. Treatment Plans for Acute Musculoskeletal InjuriesManagement in the Acute Stage: Rest, Ice, Compression, ElevationModalities Used in Addition to RICERepair PhaseMaturationChapter 15. Neuromuscular Control and BiofeedbackVolitional Control and BiofeedbackClinical Applications: Restoring Control of Volitional ContractionClinical Applications: Functional ProgressionLearning RelaxationChapter 16. Clinical Management of Persistent PainTreating Persistent PainDiagnosis and Plan of Care ProblemsTreating Chronic PainGlossaryIndexAbout the Authors