Physical Therapy Modalities

In addition to therapeutic exercise, physiotherapy and other common treatment methods, we use a variety of physical modalities to reduce pain, facilitate healing and restore function. Physical modalities are treatment tools that can assist to relieve pain, improve circulation, decrease swelling, reduce muscle spasm as well as improve the body’s overall ability to heal. These modalities have various mechanisms of action, from increasing or decreasing tissue temperature, to stimulating our nervous system or muscle tissue. 

Take a look at some of the treatments available below.

Devices for passive movement therapy are used during the first phase of rehabilitation after injury or joint surgery. The splint repeatedly moves the patient’s joint within a predefined range of motion. Thus, daily exercise initially increases the limited range of motion of a given joint. Passive movement therapy ensures safe exercise during the healing and tissue regeneration phase, reduces postoperative pain and minimizes the risk of inflammation.

Advantages and use of splints:
  1. Increases and improves the range of motion of the joint.
  2. Significantly shortens the length of rehabilitation.
  3. Improves metabolism in the joint and prevents joint stiffness.
  4. Improves hematoma absorption.
  5. Reduces acute or chronic soreness of stiff joints.
  6. The treatment is without side effects.
  7. Reduces the consumption of analgesics.

Conditions not applicable:

  1. Fever.
  2. Infectious diseases.
  3. Epilepsy.

We recommend to use splint 1-3 times a day for 2-4 weeks, depending on the condition of the joint.

Electrotherapy machines are a popular option used in physical therapy and rehabilitation. Electrotherapy (also known as electrical muscle stimulation) uses an electrical source that supplies electrical impulses to a patient’s body. This stimulation is performed to support and facilitate muscle healing and tissue regeneration.

When is electrotherapy used?
  1. Relaxation of muscle cramps.
  2. Prevention and stopping of muscle atrophy due to non-use.
  3. To enhance local blood circulation and flow.
  4. To enhance the range of motion.
  5. For pain relief (chronic, post-traumatic and post-operative acute).
  6. Prevention of deep vein thrombosis after surgery and wound healing.
  7. For joint pain.
  8. To relieve postsurgical pain.
  9. For strengthening weakened muscles, for improving motor skills.
  10. Tendonitis.
  11. Bursitis.

Conditions not applicable:

  1. Application directly on the compoun wound.
  2. Malignant tumors.
  3. Patient with pacemaker.
  4. Pregnancy.
  5. Skin infections.
  6. Fever.
  7. Chemotherapy.

A small amount of healing colourless gas (CO2) is applied through a needle connected to the applicator on the dispenser hose to painful areas in the subcutaneous tissue (subcutaneously). The gas is absorbed very quickly and improves local blood flow. The application relieves pain and accelerates wound healing. It is especially suitable for those who suffer from reduced blood flow in the limbs, ischemic heart disease, sacrum or degenerative diseases of the joints and spine with painful syndromes. Immediately after administration, the patient feels slightly cold at the injection site.

We recommend gas injections for:

  • Back and spine pain.
  • Joint pain, inflammatory and degenerative joint diseases, osteoarthritis, rheumatism.
  • Vascular problems, vasoneurosis, ischemic disease of the lower limbs, conditions after myocardial infarction.
  • Painful stiffness of the muscles, most often on the back, spreading to the limbs or head.

Conditions not applicable:

  • Inflammation of the skin, subcutaneous tissue and veins at the intended injection site.
  • Melanoma (skin cancer).
  • Decreased sensitivity at the intended injection site.

High-powered laser or high-intensity laser therapy (HIL) has photochemical effects that stimulate the oxidation of mitochondria and ATP by providing high energy output within tissues, which leads to increased cellular metabolism and reduced pain and inflammation. Unlike medication, laser therapy reduces pain without adverse side effects. HIL can cause rapid swelling absorption and exudate removal by increased metabolism and blood circulation.

High power lasers are able to deliver a lot of energy within a short period of time, so that therapeutic doses are achieved quickly.

Five things you should know about the high intensity laser therapy:

  1. Reduces pain and inflammation without side effects.
  2. Can be used for acute and chronic conditions.
  3. The treatment can be adapted to every situation.
  4. Patients feel relaxed and simply great.
  5. Treatment is quick and pleasant.

High-intensity laser therapy can treat a various number of conditions including:

  1. Shoulder joint pain.
  2. Radial epicondylitis (tennis elbow, golfer´s elbow).
  3. Rheumatoid arthritis (RA).
  4. Heel spur.
  5. Cervicobrachial syndrome.
  6. Bursitis.
  7. Lumbar and joint pain.
  8. Torn muscle.
  9. Trigger points.
  10. Ankle sprain
  11. Osteoarthritis of the knee, hip and ankle.
  12. Spinal disc degeneration.
  13. Herniated disc.
  14. Sciatica.
  15. Tendonitis (inflammation of the tendons).

Conditions not applicable:

Conditions not applicable for high level laser treatment are: applications in the eye area – the possibility of direct eye irradiation and retinal damage, cancer, irradiation of malignancies and potential precancerous growths, irradiation of patients with cochlear implants, irradiation of endocrine glands.

Other condistions where High- Powered Laser is not applicable

  1. Pregnancy
  2. Children (i.e. paediatrics)

There are relatively few conditions for not using a therapeutic laser, and many are relative rather than absolute.

What is low-level laser therapy (LLLT)?

Low-level laser therapy (also known as a “cold laser”) is the application of red and near-infrared light to an injury or lesion, leading to improved wound and soft tissue healing, reduced inflammation, and relief from both acute and chronic pain.

LLLT is used to increase speed, quality and strength in tissue regeneration and can resolve inflammation or relieve pain (analgesia).

How does LLLT work?

The effectiveness of cold laser therapy lies in its ability to force the body to heal. By penetrating the target tissue, the laser light stimulates the mitochondria in the target cells to produce additional ATP, which promotes cell repair and regeneration. The laser simply starts the healing process, and because the laser used operates in a specific range of wavelengths that is not thermal, there is no risk of tissue damage or other complications.

What is low-level laser therapy’s intended use?

Acute / chronic pain: LLLT increases the permeability of the cell membrane and causes sodium reabsorption and excretion of potassium molecules, removing the gradient and thus the pain signals at the source.

Musculoskeletal conditions: Therapeutic laser treatment provides patients with a safe, effective, and painless therapy that uses the body’s own natural healing systems to relieve pain, increase joint mobility, increase tissue integrity, and promote cell regeneration.

Low-level laser therapy has been shown to be effective in the treatment of:

  1. Back, knee, shoulder pain.
  2. Fibromyalgia.
  3. Tendinopathy (tendonitis / tendendosis).
  4. Muscle pain.
  5. Sports injuries.
  6. During postsurgical rehabilitation.
  7. Wound healing.
  8. For inflammation: LLLT has an antiedemic effect.
  9. In arthritis: LLLT treatment can provide significant relief of symptoms by reducing joint inflammation, relieving pain, increasing the range of motion of the joints, and improving the production and effectiveness of immune cells.

Conditions not applicable:

  • Applications where there is a risk of direct exposure of the eye (risk of irreversible retinal damage).
  • Malignant disease (cancer).
  • Epilepsy.
  • Direct application to the thyroid gland.
  • Febrile states.
  • Applications in the abdomen during pregnancy and menstruation.
  • Chest area in people with a pacemaker.
  • Head area in people with electronic ear implants.
  • Thrombocytopenia and other bleeding conditions.

Lymphatic drainage is a lymphatic drainage massage (a form of gentle massage) that supports the movement of lymphatic fluids around the body. Fluid in the lymphatic system helps remove waste and toxins from body tissues. Some medical conditions can cause the accumulation of lymphatic fluids.

Lymphatic drainage is a therapeutic massage. The massage uses very low pressure and long, gentle rhythmic strokes, which increase lymph flow and reduce toxins in the body. It transports nutrients and oxygen to the cells, collects toxins along the way and flushes them out of the lymph nodes.

Lymphastim BTL works on the principle of pneumatic pressure therapy, which compresses the limb and causes pressure waves.

Conditions not applicable:

  1. Acute congestive heart failure.
  2. Acute renal failure.
  3. Active blood clots.
  4. Active infections.
  5. Active bleeding.
  6. Acute inflammation
  7. Malignant tumors
  8. Thrombosis – can lead to free floating blood clots in the circulatory system.
  9. Menstruation – can increase flow.

Magnetic therapy is a type of physical therapy in which the body is exposed to a low-frequency magnetic field.

The magnetic field has minimal side effects on the human body, but is highly effective in treating painful and inflammatory conditions. Magnetic wave therapy dilates blood vessels, increases blood circulation, improves their oxygen supply and speeds up metabolism, thus helping the body to heal. This method also accelerates healing, strengthens and stabilizes bone tissue, relaxes and rejuvenates muscle tissue and relieves pain. It is an excellent tool for the treatment of tendinitis, rheumatism and joint swelling.

When is magetic threapy used?

  1. Injuries – especially fractures, torn ligaments and muscles, degenerative, inflammatory and functional diseases of the musculoskeletal system
  2. Movement problems, back pain, neck pain, joint pain
  3. Swelling and inflammation, bruises, stiff muscles

Conditions not applicable:

  1. Patient with pacemaker.
  2. Bleeding of any origin, such as menstruation, rectal bleeding….
  3. Heart attack.
  4. Anticoagulant drugs.
  5. Low blood pressure.
  6. Malignant tumors

Paraffin heat therapy is used to relieve pain, inflammation and stiffness caused by arthritis. This form of thermotherapy effectively increases blood flow to aid in rehabilitation or to warm up a part of the body before other therapies or exercises.

You can use paraffin wax (it can also be called paraffin or wax) to apply moist heat to your hands or feet, which relieves pain and relieves stiffness in osteoarthritis. Paraffin effectively helps reduce pain and relaxes hands and fingers before exercise.

Paraffin is specifically indicated for:

  • Swelling and vascular disorders, especially of posttraumatic origin.
  • Resting state of arthritis, osteoarthritis and other joint and peri-articular diseases when accompanied by localized swelling and pain.

Conditions not applicable:

  1. Occurrence of convulsive abnormalities, phlebitis and if there is a risk of release of embolisms or thrombosis. 
  2. If the cardio-dynamic condition is not correct, paraffin should not be used in large-scale or general applications.
  3. It should also not be used if you feel uncomfortable. 
  4. Inflammation of the skin or wounds, scars, etc.
  5. Skin cancer.

In rare cases, allergic reactions to wax occur, which means that treatment should be stopped.

People who are unable to cope with direct heat, such as people with diabetes or varicose veins, should avoid paraffin treatment.

Shock wave is a multidisciplinary device used in orthopedics, physiotherapy, sports medicine, urology. Its main advantage is rapid pain relief and restored mobility. Together with non-surgical therapy without the need for pain medication, it is an ideal therapy to accelerate the recovery and cure of various indications causing acute or chronic pain.

This very effective therapy is based on the transmission of acoustic radial waves to an acute or chronic painful area. Relieves pain, accelerates regeneration and accelerated tissue repair and cell growth, analgesia and mobility recovery. It can also be used to prevent damage to muscles and tendons.

How the shock wave works in our body:
  1. The shock wave accelerates the synthesis of procollagen. The therapy forces the newly formed collagen fibers into a longitudinal structure, which causes the newly formed tendon fibers to be denser and more rigid, creating a firmer structure.
  2. Acoustic waves break up existing calcifications. Shock wave therapy initiates the biochemical decalcification of calcium accumulation in a toothpaste-like consistency and treats the tendon. The granular calcium particles are then removed by the lymphatic system.
  3. Acoustic waves generated by shock wave therapy reduce the concentration of substance P (substance P is a neurotransmitter that mediates pain information through C-fibers, transmits pain to the central nervous system) and triggers pain relief.
  4. The application of acoustic waves creates capillary microruptures in tendons and bones. As a result of microruptures, the expression of growth factors is significantly increased. As a result of these processes, arterioles are remodeled, stimulated to grow, and new ones are formed. The new blood vessels improve blood supply and oxygenation to the treated area and promote faster healing of the tendon and bone. 

IMPORTANT WARNING:

Refrain from any physical activity, exertion or strain for 36 hours after the shockwave treatment.

Don’t play sports!

You can drive a car.

Common Uses:

  1. Heel spur.
  2. Shoulder pain with or without calcifications.
  3. Achilles tendon pain.
  4. Radial or ulnar epicondylitis.
  5. Patellar tendinopathy.
  6. Muscle triggering (painful) points.

Treatment Benefits:

  1. Rapid outpatient treatment.
  2. No anesthesia required.
  3. Gentle treatment.
  4. High effectiveness of treatment.

Conditions not applicable:

  1. If you are pregnant.
  2. If you have a blood coagulation disorder (including thrombosis).
  3.  If you are taking oral anticoagulants.
  4. If you have been injected with a steroid in the last 6 weeks.
  5. If you have a pacemaker installed.
  6. If tumors are present at the treatment site.
  7. If you have an infection or abrasion of the skin at the treatment area.
  8. If you are under 18 years old.

The Super Inductive System which is based on the healing effects of a high-intensity electromagnetic field is the perfect treatment for painful conditions of the neuromuscular and joint systems. The design of the applicator allows to carry out the therapy without the need for direct contact with the skin and with regard to the comfort of the patient and therapist.

The therapy is based on the interaction between a high-intensity electromagnetic field and the human body.

Once the electromagnetic field is generated by a coil located in the applicator, the neuromuscular tissue is depolarized and muscle contraction occurs. Using the Super Inductive System you can effectively treat various disorders of the nervous, muscle and joint systems.

How many treatments do I need?

The number of treatments depends on your health condition. Although the Super Inductive System therapy provides immediate relief, it is recommended to carry out up to 5 therapies in acute conditions and up to 10 therapies in chronic conditions to maintain long-term results.

 The Super Inductive System can heal many health states including:

  • Carpal tunnel syndrome (also known as repetitive stress injury – RSI)).
  • Nerve regeneration.
  • Breath enhancement.
  • Joint and muscle pain.
  • Patellar tendinopathy.
  • Impingement syndrome.
  • Reduction of spasticity.
  • Spinal mobilization.
  • Prevention of muscle atrophy.
  • Fracture.
  • Heel spur.

Non-applicable conditions:

  • If you are pregnant.
  • If you have a blood coagulation disorder (including thrombosis).
  • If you have a pacemaker installed.
  • If parts of your body has metal implants, such as an endoprosthesis.
  • If you have cancer.
  • If you have a fever.

TR-Therapy is a device based on the cooperation of radio frequency current with tissues in the body. It is transmitted to the body through the contact of the body and electrodes. Current dissipation leads to a selective increase in the temperature in the tissue under the theristatic electrode controlled by the therapist with the effect of relieving pain, muscle relaxation, local increase in blood flow, reduction of swelling.

TR-Therapy can be used to treat acute and chronic musculoskeletal disorders such as muscle cramps, degenerative joint disorders, spine pain and soft tissue injuries.

Conditions not applicable:

  1. Treatment for children
  2. Pregnancy.
  3. Tissues infected with bacteria, acute inflammation.
  4. Serious heart and respiratory diseases.
  5. Hypesthesia
  6. Inflammation of the skin, its damage or irritation.
  7. Bleeding conditions, menstruation.
  8. Malignancies or suspicions.
  9. Cachexia.
  10. Fever.
  11. Infection.
  12. Metal objects and active medical devices (pacemakers, insulin pumps).
  13. Application to endocrine glands and gonads.
  14. Area of large sympathetic plexuses.
  15. Peripheral nerves just below the surface of the skin.

Therapeutic ultrasound is a treatment modality commonly used in physical therapy. It is used to deeply heat the soft tissues in the body. These tissues include muscles, tendons, joints and ligaments.

Therapeutic ultrasound is used primarily for two different effects: for deep heating and for non-thermal use.

Effects of deep heating: Ultrasound is often used to deeply heat soft tissue structures in the body. Deep heating of tendons, muscles or ligaments increases circulation in these tissues, which is considered to aid in the healing process. Ultrasound-raising of tissue temperature is also used to reduce pain.

Non-thermal effects (cavitation): Ultrasound introduces energy into the body. This energy causes microscopic gas bubbles to expand and contract rapidly around your tissues, a process called cavitation. The expansion and contraction of these bubbles is thought to help accelerate cellular processes and improve the healing of injured tissue.

Conditions not applicable:

  1. Compound wounds.
  2. Metastatic lesions or any active area of cancer.
  3. Metal implants.
  4. Pacemaker.
  5. Pregnancy.
  6. Around the eyes, chest or genitals
  7. Broken bones
  8. When implanted electrical stimulation devices.
  9. In acute infection.

During the bath, the upper limbs are massaged with a stream of water flowing under pressure from the nozzles. The whirlpool bath in mineral water is excellent in case of insufficient blood supply to the upper limbs, also suitable for post-traumatic conditions, such as fractures.

We add salt from the Dead Sea to the bath, which has a significant effect on muscle and joint nutrition thanks to minerals.

Effect of whirlpool bath:
 
  1. Relieves and eliminates fatigue.
  2. Reduces muscle tension and muscle and joint pain.
  3. Relieves rheumatoid limb pain,
  4. It provides excellent results in rehabilitation after injuries, injuries and after operations.
  5. It regulates blood circulation.
  6. It pumps blood into the muscles and oxygenates them.
  7. Relieves the inflammatory condition of the joint.
Conditions not applicable:
  1. Skin disease or infection.
  2. Acute heart problems.
  3. Fever.
  4. Compound wounds.

Distance electrotherapy is a procedure that has a beneficial therapeutic effect on painful conditions, supports the healing of tissues of the musculoskeletal system and skin treatment (shin ulcers, diabetic ulcerations, etc.) It is primarily intended for supportive physical therapy / or inflammatory in nature) as well as chronic (usually degenerative) in nature. All this is done without the need to apply contact electrodes to the patient’s body.

The non-contact principle of electrotherapy significantly reduces the contraindication and risks of this procedure in comparison with conventional contact electrotherapy. It completely eliminates the risks of burns and chemical burns to the skin and allows the procedure to be applied over clothing, a bandage, plaster or orthosis.

Conditions not applicable:

  1. Patients with an implanted electrical pacemaker (e.g. most commonly a pacemaker) or any electronic replacement affecting vital functions (e.g. electronically controlled insulin delivery).
  2. Circulatory uncompensated patients – cardiac, patients with coronary insufficiency, preinfarction, fresh myocardial infarction, severe acute heart rhythm disorders, patients with acute central stroke.
  3. Thrombosis.
  4. Menstruation.
  5. Pregnancy.
  6. Application to risk-altered manifestations of skin pigmentation.
  7. Diseases accompanied by higher temperature.
  8. Infectious diseases.