Physiotherapy for Physical Education trainees

Dr.R.Kalidasan
Dept. of Physical Education
BHARATHIDASAN UNIVERSITY
TIRUCHIRAPPALLI - 620 024
PHYSIOTHERAPY FOR PHYSICAL TRAINEES
8/3/2017 1Physiotherapy - Kalidasan

Physiotherapy
Other names
Physical therapy
PT
Physical
‘Physical’ mean bodily
Therapy
‘Therapy’ is basically a Greek term which means
treatment.8/3/2017 2Physiotherapy - Kalidasan

Treatment without medicine
Natural treatment – (No Food restriction)
Certain medicines have side effects
When electricity is passed into the body many feel
it will suck the blood
Blood drinking dracula
Massage is studied scientifically
Relieving the pain and back to normal position
Intensity and volume –consultancy – Gym
Solution and prevention are two angle of
physiotherapy

Physicians like Hippocrates and
later Galen are believed to have been the
first practitioners of
physical therapy
advocating massage
manual therapy techniques and
hydrotherapy to treat people in 460 BC.

Definition
The treatment of disease, injury or
deformity by physical methods such
as exercise, heat treatment, cold
treatment, massage and so on,
rather than by drugs or surgery is
called as Physiotherapy.

Physical medicine
Physical intervention
Physiotherapists (or) physical
therapists

Physical therapists are closely involved in the care and wellbeing of
athletes including recreational, semi-professional (paid) and
professional (full-time employment) participants. This area of practice
encompasses athletic injury management under 5 main categories:
•acute care - assessment and diagnosis of an initial injury;
•treatment - application of specialist advice and techniques
to encourage healing;
•rehabilitation - progressive management for full return to
sport;
•prevention - identification and address of deficiencies
known to directly result in, or act as precursors to injury, such
as movement assessment
•education - sharing of specialist knowledge to individual
athletes, teams or clubs to assist in prevention or
management of injury8/3/2017 7Physiotherapy - Kalidasan

Guiding Principles of Physiotherapy
•Circulation and tissue fluid inter change
maintained or increased
•Maintenance of joint mobility or increasing
the joint range of motion
•Maintenance or increase of muscle power
•Adequate respiration
•Prevention of complications

NEED AND IMPORTANCE OF PHYSIOTHERAPY
•Physiotherapy is the most commonly
prescribed treatment to assist in the recovery of
many injuries and conditions.
•Chronic pain, car and sports injuries and
challenges with mobility can all be greatly
improved with the use of physiotherapy.
•Range of Motion
•Exercise
•Neurological Disorders
•Cardiopulmonary Conditions
•Pain Management8/3/2017 9Physiotherapy - Kalidasan

•Physiotherapy techniques contribute to promote
healing and recovery from injuries
•Restoring one's former range of movement
•Usability of certain body parts
•Promoting increased blood circulation
•Relief to certain neurological or mental conditions
•Prevention

To prevent the sports injuries
Fitness of the player/athlete
Warm-up exercise
Cooling down exercise
Proper follow-up rules during games
Proper clothing and footwear for the specific game
Protective clothing and equipments
Extremes of environmental conditions
Fatigue
Common sense

PT management commonly includes
prescription of or assistance with
•specific exercises
•manual therapy and manipulation
•mechanical devices such as traction
•physical agents which includes heat, cold,
electricity, sound waves, radiation, rays,
prescription of assistive devices,
prostheses, orthoses and other
interventions

Hydrotherapy
Formerly Called as Hydropathy
Hydrotherapy is the external application
of Water.
Part of medicine and alternative medicine
•naturopathy
•occupational therapy
•Physiotherapy8/3/2017 13Physiotherapy - Kalidasan

Involves the use of water for pain relief and treatment
Water - Temperature and pressure
Stimulate blood circulation

Various therapy used in the present-day hydrotherapy employ
Water jets
Underwater massage
Mineral baths

Uses
Water therapy may be restricted to use in physical
therapy, and as a cleansing agent.
However, it is also used as a medium for delivery of
heat and cold to the body, which has long been the
basis for its application.
Hydrotherapy involves a range of methods and
techniques, many of which use water as a medium
to facilitate thermoregulatory reactions for
therapeutic benefit.

Hydrotherapy which involves submerging all
or part of the body in water can involve
several types of equipment:
•Full body immersion tanks
(a "Hubbard tank" is a large size)
•Arm, hip, and leg whirlpool

The appliances and arrangements by means of
which heat and cold are brought to bear are
(a) packings, hot and cold, general and local,
sweating and cooling;
(b) hot air and steam baths;
(c) general baths, of hot water and cold;
(d) sitz (sitting), spinal, head and foot baths;
(e) bandages (or compresses), wet and dry;
(f) fomentations and poultices, hot and
cold, sinapisms, stupes, rubbings and water
potations, hot and cold.

Benefits of hydrotherapy
Relaxed and calm effect
Stimulates nerve endings to create an invigorated feeling
Exfoliates and cleanses skin
Improves skin tone
Enhances skin circulation

Physiological effects
Most heat increases the heating by causing
increase in superficial tissue temperature and muscle
relaxation
Improve local circulations
Relieve the pain by lessoning, new sensibility and
relax in muscle spasm
Increase metabolic changes
Eliminating the waste products and promotes repair8/3/2017 20Physiotherapy - Kalidasan

Cryotherapy
“Cryotherapy" – Greek term
cryo means cold and therapy means cure.
It has been used as early as the 17th century.
Cold has been found to be a very effective
modality in treating certain athletic injuries.
Ice has advantage over cold water as it takes
latent heat for its melting, so injured, part gets
quick cooling effect.

Types of Cryotherapy
•Ice packs
•Cold whirlpool (குளிர் நீர்ச்சுழி)
•Ice whirlpool
•Ice massage
•Ice sprays (Commercial chemical cold)

Soft tissue injury
•Sprain (சுளுக்கு)
•Strains (over stretching muscle)
•Contusions
•Relieving muscle spasm
• Trigger points

Contra-indications
It should not be used
•Circulatory disorder
•Coronary heart disease
•External hemorrhage
•Cold allergy

Time, type and duration of Cryotherapy depends upon
•Site of injury
•Type of injury
•Severity of injury
•Structure involved
•Type of effect to be obtained

Physiological effects of cold
•Reduction in swelling and inflammation
•Reduction in pain through an anaesthetic effect
•Decrease in muscle spasm, by reduction in nerve
conduction and muscle spindle excitability
•Reduction in the metabolic and oxygen needs of the
injured tissues limiting the extent of the initial
injury.

Ice massage
Take the pieces of ice cube
Rub the skin – circular or to and fro
movement
Apply treatment for approximately three
to ten minutes and repeat a number of
times per day

Immersion – Select desired water temperature
Tap water – 12.8º C (53º F)
Water with ice (slush)
approximately 0º C to 4º (32º F to 39.2º F)

Icepacks
Use crashed ice, as these contours more easily to the
body part – place in a double layered disposable
plastic bag.
Apply treatment approximately twenty minutes per
hour and repeat a number of times per day.
Re-freezable commercial packs.

Ice Spray
Evaporate coding – ethyl chloride or Flouri-methane
spray.
These sprays cool by the heat exchange effect of
rapid evaporation and result in reflex muscle
relaxation.
For those individuals who have never experienced
Cryotherapy treatment, or for those who do not
seem to tolerate ice massage or ice immersion, begin
the treatment with sprays.

Thermotherapy
Otherwise called as Heat therapy
Use of heat as therapy (pain relief & health)
External application of Heat
(Conduction, convection and radiation)
Forms
• Hot cloth
• Hot water bottle
• Ultrasound
• Heating pad
• Hydro collator packs
• Whirlpool baths
• Cordless FIR heat therapy wraps8/3/2017 31Physiotherapy - Kalidasan

Heat therapy commonly used for rehabilitation purposes.
Beneficial to those
• arthritis patients
• stiff muscles & injuries to the deep
tissue of the skin
• an effective self-care treatment for
conditions like rheumatoid arthritis
(முடக்கு வாதம்)8/3/2017 32Physiotherapy - Kalidasan

Contra-indications of thermotherapy
•Tumor or malignancy (கட்டி அல்லது புற்று ந ோய்)
•Recent injury
•Recent contusion
•Diabetes
•Hypertension
•Cardiac impairment
•Recent burn or sunburn
•Edema (நீர்க்கட்டு)
•Directly over eyes or external genitalia
•Cerebrovascular accident (பெருமூளை இரத்தக் குழோய்கள்)
•Fever
•Open wounds or skin infections
•Sensory impairment
•Pregnancy

The therapeutic effects of heat include
• increasing the extensibility of collagen tissues;
• decreasing joint stiffness;
• reducing pain;
• relieving muscle spasms;
• reducing inflammation, edema, and aids in the post acute
phase of healing;
• and increasing blood flow.
The increased blood flow to the affected area provides
proteins, nutrients and oxygen for better healing.

Conduction (கடத்தல்) is the exchange of thermal
energy, while the body’s surface is in contact with
the thermal agent, such as hot packs.
Convection (வெப்பச்சலனம்) is faster process and
involves contacting the body’s surface with heat
energy through a fluid or gaseous method; such as a
whirlpool bath or a steam bath.
Radiation (கதிர்வீச்சு) is the transfer of heat energy in
electromagnetic rays through a conducting medium,
such as infrared lamps.

Moist heat is transferred by
conduction and convection.
Dry heat is transferred by radiation.
Moist heat is the best form of heat
for enhancing general relaxation.

Contrast bath
Form of hydrotherapy
Hot/cold immersion therapy
Use of hot and cold water
(alternating between hot & cold)

Benefits of contrast bath
•Decreasing pain
•Decreasing swelling (வ ீக்கம்)
•Decreasing / controlling inflammation
•Improve mobility
•Improve muscle recovery after exercising
•Increase circulation in area of injury and
restricted blood flow8/3/2017 38Physiotherapy - Kalidasan

Contrast bath treatment to whom
•Injuries that cause swelling and pain around
the joints & soft tissue in the body
•Acute injuries to limbs or joints (over 72 hours)
•Condition with reduced blood flow
•Muscles hypertonicity resulting in cramps or
spasms
•Repetitive strain activities such as carpal
tunnel syndrome
•Chronic Regional pain Syndrome (CRPS)

Contraindications
•Local malignancies
•Peripheral vascular disease (PVD)
•Impaired sensation
•Bleeding and acute inflammation
•Diabetes and neuropathy

Procedure
•Fill two tubs, large buckets
•Fill one with hot water (98 ° – 110° F)
•Fill the other one with cold water (45° – 70° F)
•Make sure you use a thermometer to verify the
temperatures throughout the whole treatment
•If swelling is present, keep the temperature below
102° F and make it shorter in duration
•If a joint is swollen (enlarged) & hot, use cold; never
heat
•Soak (முழுவதும் நனை) the affected area
•Start in the hot water for 3-4minutes

•Switch immediately soaking in the cold water for 1 minute
•If the cold water is not tolerated for the full minute, place it
back in the hot water for 3-4 minutes then return it to the
cold water for as long as tolerated up to one (1) minute.
•Always start with the hot water and end with the cold
water, except:
•Rheumatoid Arthritis – end in the hot water and dry the
area thoroughly
•The joint is swollen and hot, then only use cold water
•Repeat the above steps three to four (3-4) more times
(about 20 minutes)

•More hot water may need to be added to maintain the
right temperature for the “hot bath” (it might decrease from
switching back and forth between the hot and cold water).
•Add this while soaking in the cold bath.
•Make sure to stir while adding hot water to avoid
increasing the temperature too much (do not exceed 110°
F), which can result in burn.
•The extremity being treated will be desensitized from being
in the cold water making it difficult to discern if the
temperature is too hot.
•To increase the effectiveness of the contrast bath, add ice
or ice packs to the cold water to help maintain the
temperature between 45° and 70° F.

ALTERNATE METHOD
If water baths are not available or practical for the
area being treated.
Use a heating pad or a hot wet towel to the
affected area for 3-4 minutes.
Alternate using an ice pack wrapped in a towel or
a dampened frozen wash cloth or towel for 1 minute.
Repeat the above steps three (3) more times.

Whirlpool bath
therapeutic bath
a bath in which water moves around in strong
currents to massage a person’s body
a bath in which the body is immersed in swirling
water as therapy or for relaxation.
a device that swirls and often heats the
water in such a bath.

a tub or pool containing or equipped with such a
device.
a bath having a device for maintaining the water in a
swirling motion.
Types of Whirlpool baths (Movable & Fixed)
•Whirlpool tank
•Vibra bath unit
•Water fit

Health benefits
•Relaxation (stress relief)
•Improved blood circulation
(better circulation)
•Sore muscle
•Joint relief
•Flexibility
•Better sleep

Contraindications
•Diabetes mellitus
•Varicose veins
•Advanced arteriosclerosis
•Advanced peripheral vascular
diseases

Procedure
Whirlpool bath (105 – 110 Fahrenheit) / (96.8 F to 105.8 F or 36 ° C to 41° C)
The client must shower first and the therapist must check
the pulse prior to beginning the treatment.
The pulse should be checked every five minutes.
Stop the bath immediately if the pulse rate increases twenty
beats per minute and the client becomes dizzy or weak.
Assist the client in and out of the spa and offer tepid water
in a plastic cup.
Use a cool washcloth on the client’s face to provide comfort.
Twenty to thirty minutes treatment. (15 to 45 minutes)8/3/2017 49Physiotherapy - Kalidasan

Types of tank
•Low buoy tank
•High buoy tank
•Extremity tank
Procedure
Whirl pool tank is filled with water
Water temperature is checked by hand &
thermometer
Adjust the client8/3/2017 50Physiotherapy - Kalidasan

Precaution
An electrical safety inspection – qualified
technician.
Avoid whirlpool treatment - Hemorrhaging or
swelling.
Never live leave the client alone.
Cleaning the tank.

Steam Bath
Is a steam-filled room for the purpose of
relaxation and cleansing.
It has a long history, going back to Greek and
Roman times.

HISTORY
The origins of the steam bath come from the Roman
bath, which began during the height of the Roman
Empire.
Ancient Roman baths served many community and
social functions within Roman society.
Everyone in Rome used Roman public baths,
regardless of socioeconomic status.
These Roman baths were supplied by natural hot
springs from beneath the ground.8/3/2017 53Physiotherapy - Kalidasan

Historical parts of a spa
Roman
medieval
Georgian and
Victorian have been restored in Bath
England and is available as a public
bath or Thermae

MODERN STEAM BATHS
Today, natural steam baths still exist, and often
still use similar systems that the Romans used,
which contain pipes and pumps that bring
water up and into the large pool areas,
wherever the natural springs exist
Heaters are also now used to maintain warm
temperatures in the baths

There are many different types
of steam baths, which are
different from saunas.

Common forms of steam bath
Turkish baths
Steam showers
Steam rooms

Advantages of Steam Bath
Relieves tension & Reduces stress
Clears the skin
Aids in Weight loss (losing fats)
Opens the sinuses
Removes toxins & other negative energy
Treats cardiovascular diseases
Promotes health blood flow
Gives emotional stability & Self confidence

Disadvantages of Steam Bath
•Since steam baths uses tap water, the things in it will be
absorbed by your skin such as chlorine, and other chemicals
which may not be healthy to your body.
•The humid temperature of a steam room is an easy breeding
ground for bacteria and other viruses which may pose a risk
in your health.
•Improper installation of these steam baths may cause
headaches to the users.
•The heat emitted from the steam room may not be good for
those who have asthma and heart problems.
•It is quite costly.

Sauna bath
Sauna bath helps to take care of
skin and overall well being
conveniently.
Sauna means a enclosed place
where water is converted to
steam.

Sauna has been a way of life in Finland,
where it was invented, many years ago.
One of the first written descriptions of
the Finnish Sauna was in 1112.
The earliest Sauna was dug into an
embankment in the ground.
Later Saunas were built above ground
with wooden logs.

Sauna bath
• opens the pores on skin
• helps body to remove toxins
• other impurities
from within the body & blood
benefits for once skin, muscle
relaxation and lowering the blood
pressure8/3/2017 62Physiotherapy - Kalidasan

Sauna uses
 temporarily relieve symptoms of the common cold
 increases the heat tolerance threshold
 may improve performance in endurance sport
 rheumatic pain (with cold shower)
 usefulness for appetite loss and mild depression
 reducing symptoms in chronic fatigue syndrome
 rheumatoid arthritis
Saunas use dry heat (உலர் வவப்பம்)
whereas steam rooms use
more moist heat (ஈரமாை வவப்பம்)

Many of the sauna
therapeutic trials used a
regular schedule of at least 5
days a week and often daily for
one to three months, then
several times a week for
extended periods.

Sauna Vs Steam Room
While steam baths use moist heat,
saunas offer dry heat sessions.
Steam rooms are kept at around 100
to 114 degrees Fahrenheit while
saunas are much hotter - up to 100 °C
(212 °F, the boiling point of water).

Hot water fomentation
Latin "fovimentum“ - "a warm application."
"foment" - warm or heat up.
fomentation - treatment by warm

A fomentation is a local application of
moist heat by means of cloths (largely
wool) wrung from boiling water or
heated in a steam chest.

Benefits
•Relieve pain
•Decrease swelling
•Internal injuries
•Liver swelling
•Stomachache
•Headache
•Hernia8/3/2017 68Physiotherapy - Kalidasan

Types of fomentation
•Hot fomentation
•Hot & cold fomentation
•Prawahika fomentation

Hot water fomentation
2-3 litres of boiled water
Piece of woolen cloth or soft towel & immerse
it in hot water by holding both ends
Towel soaked in hot water completely
Squeezed
Open and spread the towel or without
spreading and keep in the body part8/3/2017 70Physiotherapy - Kalidasan

Fomentation by bottled filling with hot water
3 bottles should be filled with hot tolerable water &
close their month well with corks
Blanket should be spread (covered) over patient
after putting 2 bottles on his/ her chest or stomach
& third bottles between both his / her legs
Sweating start from body

Fomentation by rubber bag filled with hot water
Similar to bottles fomentation

Precautions
in cases of unconsciousness
paralyzed sensation
diabetes
dropsy
take great care to avoid burning

Thank you for your attention!

Physiotherapy for Physical Education trainees

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