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Cold and Superficial Heat
Terms in this set (100)
The absence of heat is
What are the most common therapeutic modalities used and why?
-cold and heat
-easily available and cost effective
What do cold and heat use?
conduction of heat to or away from the body
What does an application of cold do?
decreases temp of the skin and deeper tissue
What does an application of heat do?
increases temp superficially; mainly with the skin
What are modalities for deeper heating? Why are they used?
-ultrasound and diathermy
-help with recovery (injury response cycle)
-can cause injury (pain response)
Where does energy go?
HIGH TO LOW concentration
What is the four ways energy is transferred?
3. Radiant Energy
What is conduction?
transfer of heat through direct contact between a hotter and cooler area
In conduction the amount of temp change depends on?
the temp difference between the two surfaces and the length of time they are in contact
What happens faster surface temp cooling or deep temp cooling?
surface temp cooling
What happens when a larger area is heated or cooled?
temp at the center of the area changes more rapidly
What are examples of conduction?
ice bags, ice massage, moist heat packs
What is convection?
transfer of heat by the movement of air or liquid between regions of unequal temp
In convection, how is the rate and extent of the temp change determined?
difference in temp between the medium and tissue, length of exposure and size of the area being treated
What are examples of convection?
What is radiant energy?
emitted from surfaces with temp above 0 degrees. Due to this the body emits radiant energy but can also absorb it and the superficial tissue is heated
What are examples of radiant energy?
heat lamps (infrared or baker's lamps)
Why aren't heat lamps used anymore?
increase risk of burns
In radiant energy (heat lamp), amount of energy depends on?
-Inverse Square Law (distance from the lamp)
-Cosine Law (angle of the lamp)
-output of the bulb
-length of exposure
What is conversion?
energy is changed from one form to another
True/False: Conversion is a form of superficial heat or cold.
What are examples of conversion?
ultrasound and diathermy
What is crypotherpay?
application of cold for therapeutic purposes
What is cryokinetics?
therapeutic combination of cold and exercise
What is an example of cryokinetics?
ankle range of motion exercises while using the cold whirlpool
Why is crushed ice better?
conforms to the skin better, more surface area covered
Why do we suck the air out?
air is an insulator which causes the ice to melt quicker and the skin to stay warm, increase surface area covered by ice
What is the treatment time for an ice bag?
What does commercial cold packs do?
increase risk of burn due to the possibility of a freezer being colder than 32 degrees and freezer burn adhering to the skin
What does Game Ready do?
-can use over wound dressings without getting them wet
-upper extremity 40-60 mm HG (low or medium)
-lower extremity 60-100 mm HG (medium or high)
-elevate if possible
-intermittent compression with cold
What does an ice massage do?
-colder than ice bag
-continuous block of ice increases the surface area of ice in contact with skin
-no air pockets to trap heat
-applied in circular motions or strokes
-5-10 mins or until patient is numb
What does an ice immersion bath do?
-can increase ROM if pain function is limited
What does a vapocoolant spray do?
-no temp change below epidermis
-brief numbing of skin
-may effective in treating trigger points associated with myofacial pain
What does a cold whirlpool do?
-Jets circulate the water because breaks down the thermopane
-Jets also give a massaging effect (anagleisa)
-greater surface areas is exposed to cold
-breaking the thermopane allows tissue to cool more rapidly
-can increase ROM if pain limits function
What is the thermopane?
the boundary layer of water around the extremity that is warmer than the cold bath due to energy transfers (heat) from the skin to the water
What does loss of thermopane allow?
tissue to cool more rapidly
Why are there jets in the cold tub?
breaks down the thermopane layer
To prevent thermopne in ice immersion, what should you do?
move the body/ body part around to break the layer
What are advantages of thermopane?
What is circumferential cooling?
-entire limb or joint is cooled
-greater surface area is exposed to cold = decrease in tissue temp
If you ice (anything cold related) an athlete before activity, what should you make sure the athlete does?
-cold is 30 mins before
-warms up before going in because if they don't have a warming up period it will decrease muscle firing
At rest, what is skin temp after treatment?
below reapplication levels for over 1 hour following a 30 min treatment if cold pack application
When cooling is followed by physical activity what happens and why?
-more rapid rewarming
-increase in blood flow = increase tissue temp
What are the physiological effects of cold with blood flow?
-localized cooling lowers the metabolic activity and oxygen demands on the cell = less overall tissue damage because more cells survive the congestion in capillaries
-vasoconstriction and decreased local blood floow occur to superficial and deep tissue to localize damage tissue
What are the physiological effects of cold with muscle spasm and function?
-decreases the pain to decrease the spasm
-break the pain-spasm cycle
-decrease sensitivity of muscle spindles= relaxation of spasms
-decreases force production of muscle
What is reflex contraction?
-following injury, muscle spindles feel a stretch of the muscle and respond by contracting
-used to splint the area and prevent further injury
-try to contract that area and restrict all damage to that area
What should athletes do before practice?
What should athletes do after practice?
What are the physiological effects of cold with nervous system?
-sensation is diminished because neural impulse can't be transmitted from the periphery to the sensory cortex
-decrease nerve conduction velocity which leads to numbness or analgesia- pain relief
What is CBAN? times?
Cold: 0-3 min
Burn: 2-7 min
Ache: 5-10 min
Numbness: 7-12 min
What is the first goal of treatment and rehab?
What are indications for cold?
-Pain relief (#1)
-Acute injuries- sprains, strains, inflammation, DOMS (delay onset muscle soreness)
-Decrease in Muscle Spasm
-abjunct to therapeutic exercise
What are contraindications for cold?
-allergies-cold uticaria (allergic reaction to cold; hives and itching)
-Peripheral nerve injury
What is the Reynaud's phenomenon?
reflex vasospasm of distal arteries usually in toes or fingers. Restriction in blood flow results in blue, gray, or purplish discoloration of skin with burning, tingling, or numbness
What are precautions to cold?
-Slow healing wounds
-decreased sensation in area
-poor local circulation
What is the hunting's response and what does it do?
-a reflex increase in vasodilation of area after being subjected to a prolonged period cold
-defense mechanism, tissue temp increases, found to occur after 30 mins of treatment
-try to fight against frostbite
What is the hunting's response important?
need breaks between cold therapy application
When is cold application most effective?
compression and elevation
What does superficial heat do?
increase in skin temp and superficial subcutaneous tissue
How deep does superficial heat go?
How deep does deep heat (ultrasound/diathermy) go?
Superficial heat has little effect on?
temp, metabolism and blood flow of areas below the skin expect areas of little fat like fingers and toes
What is heat used for?
decrease pain and muscle spasm
What are examples of superficial heat?
-moist heat pack
What is the temp of hydrocollator?
170 degrees F (76.6 degrees C)
When using a moist heat pack, what should you do?
provide adequate layers (towel) between the skin to decrease chances of burns
When using heat always check to see if athlete has developed what?
How long should you use a moist heat pack?
What does a warm whirlpool do?
-heat around an entire joint
-jets cause an massaging effect - beta-endorphins
What does heat do to the body?
massing effect which may add to analgesia effect- Gate Control Theory (beta-endorphins)
What temp should the warm whirlpool never pass?
115 degrees F
What disadvantage can a warm whirlpool cause?
stress the body's ability to dissipate heat, treatment can result in hyperthermia and heat illness
What is a paraffin bath?
-7 parts paraffin wax and 1 part mineral oil
-heated to 125-127 degrees F
What is a paraffin bath used for?
hands and wrists
What should a paraffin bath not be used on?
What does a paraffin bath do?
dip body part in- let dry and repat 4-5 times: place in a plastic bag and wrap in a towel for 20-30 mins
What replaced heat lamps and why?
moist heat packs because cost and convenience
What law does heat lamps use?
inverse square law
What is fluidotherapy?
What does a fluidotherpay do?
-contains ground cellulose material that is heated to 120-125 degrees and blown around a chamber with air
-heats through convection and massage
-allows PROM and AROM
What can a fluidotherpay be used on?
-not gravity dependent
What are the physiological effects of skin temp in superficial heat?
-increase skin temp
-increase metabolic activity, increases O2 uptake, nutrients, and waste removal of superficial structures
What happens to the tissue elasticity during superficial heating?
increases by stretching after heating
What happens to the nervous system during superficial heating?
-increases pain threshold
-increase nerve conduction velocity
-decrease ability to produce muscle tension
-analgesia- beta endorphin response
-pain spasm cycle= decreases sensitivity of muscle spindles which decreases spasm thorough a spinal reflex
True/False: Heat alone will alter visoelastic properties of tissue.
True/False: Heat alone will not increase thickness of fluid or elasticity of tissue.
What will improve elasticity of tissue?
stretching after heating
What are indications of heat?
-acute and chronic injuries
-infection- always properly cover (staph)
What are contraindications of heat?
-poor or reduced sensation
-vascular insufficiency or disease
-eyes, genetalia, abdomen of pregnant female
-skin lesions, open wounds
What are precautions of heat?
-coronary heart disease
What is contrast therapy?
alternating heat or cold
What are two most common transitions?
-cold whirlpool to warm whirlpool
-Ice bag to moist heat pack
What are indications of contrast therapy?
-subacute or chronic injury
-increase blood flow/circulation
-decrease muscle spasm
-increases lymphatic return
What are contraindications of contrast therapy?
-peripheral nerve injury
What are precautions of contrast therapy?
-coronary heart disease
How full and what temp should the pools be at in contrast therapy?
What is the physiological response to contrast therapy?
-decreases sensitivity of muscle spindles
-increase lymphatic return
-creates superficial pumping action
-alternating between vasoconstriction and vasodilation
In contrast theory, how does it work if heat has a minimum effect on deep blood flow?
Can be effective where there is minimal tissue and more joint surface area is exposed
What injures is the contrast theory commonly used in?
foot and ankle injures
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