A new literature review
published in the Journal of the American Academy of Orthopaedic Surgeons, points out that therapeutic modalities (physical therapy) is an important part of the recovery process for patients suffering from pain or injury. According to the report, a wider scope of physical therapy options is showing promising results and supports standard exercise and manipulative therapy programs, that improve bone-and-joint-based function as the patient heals.
“Ultimately, having access to an exceptional orthopaedic team with the best therapy options improves the overall effectiveness of the program,” says Dr. Michael McDermott, SRO orthopaedic surgeon and co-director of The Sports Medicine Center at SRO. “This review by the JAAOS supports the importance of our practice with all patients: therapists and physicians working closely together to ensure consistent rehabilitation of post-surgical patients. This includes the use of a wide range of therapeutic modalities as part of the patient’s recovery process, all of which only enhances positive outcomes.”
About the review
According to the review published in the Journal of the American Academy of Orthopaedic Surgeons, therapeutic modalities falling under the purview of physical therapy — can be a useful addition to exercise or to manipulative therapy to help improve bone-and-joint-based function affected by pain and/or injury.
The lead author of the review stated that a variety of therapeutic modalities are traditionally used by physical therapists, athletic trainers and occupational therapists to reduce pain and restore strength and function. These modalities are used in conjunction with rehabilitation exercise protocols to maximize function and to allow patients to achieve their functional and athletic goals.
Standard therapies cited by the review aimed at supporting patients’ progress through a series of rehabilitation phases typically include:
- Acute recovery: This phase focuses on the tissue healing, pain and inflammation reduction, and minimizing the impact of the recovery process.
- Subacute or intermediate: This phase follows a progression in strength and neuromuscular re-education, to return range of motion, flexibility, and posture to normal standards.
- Advanced strengthening with appropriate sequencing: This phase incorporates strengthening exercises for improving strength, power, and endurance to help prevent re-injury.
- Return to sport or activity: This final phase prepares the patient or athlete for safe return to activity or sport.
The newer modalities explained
Supporting this list of tried-and-true physical therapy options is the use of hot/cold or cryotherapy; cupping therapy (brought to the main stream via the Rio Olympics); and electrical stimulation. Review authors contend that these newer modalities, when used in conjunction with rehabilitation exercise protocols, help to maximize function and allow patients to achieve their practical and athletic goals.
Research has long supported use of cold to reduce inflammation, and thermotherapy — use of heat specifically for stretching and joint mobilization techniques to increase range of motion. Both cold and hot therapies can be helpful in managing pain sensations. This practice is called cryotherapy.
A rage among high profile athlete, cupping therapy is offered on theory that the suction of the cups mobilizes blood flow to an area to promote healing and recovery. While the effectiveness of the practice has yet to be scientifically verified by rigorous study, it has been supported by results and hailed by professional athletes who benefit from the procedure.
When used in conjunction with exercise therapy, electrical stimulation is reported to be most effective among patients in neuromuscular re-education (the clinical process of re-learning how to regain normal, controlled nerve and muscle movement) specifically following anterior cruciate ligament (ACL) reconstruction. Iontophoresis (providing medication through the skin by a direct, mild electrical current) may have a small role in short-term pain reduction but is not recommended for longer term use.
“SRO’s Sports Medicine and Rehabilitation Center is among the leading practices that has prided itself on providing physical and occupational therapy services that are on the cutting edge of rehabilitation,” explains Dr. McDermott. “Depending on the patient and the medical situation our physical therapy treatments can include manual therapy, exercise, postural and ergonomic education, and modalities such as ultrasound, electric stimulation, paraffin, moist heat, and ice. So, we can wholeheartedly support the American Academy of Orthopaedic Surgeon’s review on the use of an assortment of recovery methods.”
About Santa Rosa Orthopaedics
SRO has set the model for exceptional orthopedic care for more than 60 years. In addition, SRO offers a broad range of nonsurgical and surgical treatments aimed at conditions that commonly affect bones, joints, tendons connective tissues and ligaments. To make an appointment or to learn more about SRO Orthopedic Surgeons, please visit the SRO website or call 707.546.1922.
