Physiologic Therapeutics in Sports
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 13 from RC’s best-selling book:
Second Edition ~ Wiliams & Wilkins
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Chapter 13: PHYSIOLOGIC THERAPEUTICS IN SPORTS
Chiropractic physiologic therapeutics is defined by the ACA Council on Physiotherapy as the application of forces and substances that induce a physiologic response and use and/or allow the body’s natural processes to return to a more normal state of health.
This section is not intended to be instructional in specific modality application, but rather to bring to attention commonly utilized procedures and their rationale within the management of sports injuries. For this reason, emphasis will be on application-rationale within athletics, indications, and contraindications, rather than technique.
Physiologic therapeutics make use of the therapeutic effects of mechanotherapy, hydrotherapy, electrotherapy, light, heat, cold, air, soft-tissue manipulation, and massage. The rational application of these natural forces requires a knowledge of the actions and effects on pathophysiologic processes.
The use of physiotherapy to facilitate basic chiropractic care has been popular within the profession since the turn of the century. However, any therapeutic agent possesses a potential for effectiveness and a potential for danger. Each modality has its indications and contraindications, and certain precautions must be observed if the modality is to be applied safely and effectively in line with the biophysics and physiologic responses involved.
When properly applied, benefits are gained in normalizing function, preventing and minimizing pain and deformities, and maintaining what has been gained in treatment. The physician-operator must be well acquainted with the physics involved and the underlying application fundamentals to properly prescribe or utilize an appropriate modality, as well as be skilled with the technique of application, its intensity and duration, and to effectively analyze the anticipated effects.
Effects of Common Physical Agents
Each of the common physical agents utilized has more or less specific primary effects and secondary effects. Heat from any source, for example, has a primary thermal effect with secondary effects in hyperemia, sedation, and attenuation of microorganisms. Cold from any source offers a hypothermal primary effect with secondary effects of decongestion, ischemia, and sedation.
Photochemical and electrochemical effects are seen with some physical agents. For example, sunlight, heated metals, and carbon or mercury-vapor arcs present primary photochemical effects and secondary effects of erythema, pigmentation, and activation of ergosterol. Galvanic current offers a primary electrochemical effect and secondary polarization and vasomotor effects.
Kinetic and electrokinetic effects are seen with other physical agents. For example, vibration, massage, traction, and therapeutic exercise offer primary kinetic effects with secondary actions of muscle stimulation, increased venous and lymph flow, stretching of tissue, and reflex stimulation. Electric currents (eg, low-frequency, alternating, interrupted, sinusoidal) present primary electrokinetic effects with secondary effects of muscle stimulation, increased venous and lymph flow, tissue stretching, and reflex stimulation.
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