Physiotherapy is a branch of rehabilitative healthcare that alleviates and prevents movement dysfunction, and restores functional independence and physical mobility. Treatments may include mobilization, manual therapy, soft tissue therapy, ultrasound, laser therapy, electrostimulation, individualized exercise programs, and patient education.
Ultrasound Therapy is a high frequency (greater than 20,000Hz) sound wave that enters the body and travels through tissue by absorption, reflection, and refraction. Ultrasound produces thermal and non-thermal effects. High-intensity ultrasound produces thermal effects such as increase tissue temperature, increase circulation, reduce pain and muscle spasm, and soften scar tissue (dysfunctional tissue). Low-intensity pulsed ultrasound produces non-thermal effects such as facilitates tissue healing by altering the cell membrane permeability, increase histamine release, increase rate of protein synthesis, increase macrophage responsiveness.
Electrotherapy is low frequency electrical current that stimulates sensory and motor nerve fibres. Transcutaneous Electrical Nerve Stimulation (TENS) is electrical stimulation of sensory nerve fibres for pain relief. Two theories of pain control using TENS are gate control theory and opiate-mediated theory. According to the gate control theory of pain, transmission of a painful stimulus to the brain from the spinal cord is inhibited therefore providing pain relief. The perception of pain decreases when the electrical stimulation is on and carries over after electrical stimulation has been turned off due to interruption of the pain-spasm-pain cycle. According to the opiate-mediated theory of pain control, electrical stimulation promotes the release of the body’s own natural pain killing substances known as endorphins into the body therefore providing pain relief. Neuromuscular Electrical Stimulation (NMES) is electrical stimulation of motor nerve fibres for enhancing muscle performance. Electrical stimulation of motor nerve fibres promotes voluntary muscle contractions which help to increase muscle strength and endurance for muscle atrophy and muscle re-education.