Patient condition: A 25 year-old software developer for Mango Co.

His job requires him sit in front of his computer

from 9:00 am until 5:00 p.m. He travels from his office to his home in Naga City every weekdays, he doesn’t have time
to exercises because he is tired. He spends his weekends binging his favorite American crime series in Netflix. Last
month, as he was walking from the terminal to his house, he felt a sudden and severe pain along with a snapping or
popping feeling at the back of the thigh and lower buttock. When tried touching his thigh, it was tender; he tried looking
the back of his thigh, thinking he was just bitten by an insect, instead he saw bruises. As he cannot walk, bend and stand
properly because of the pain, he decided to seek professional help.

State the effect/s if the modality can be applied

MODALITIES
Hot moist pack
Paraffin wax bath
Infrared radiation
Microwave diathermy
Shortwave diathermy
Ultraviolet radiation
Can be applied
OR
OR
State the reason/s why if the modality can’t be
Cannot be applied
applied
Can be applied Heat application can reduce pain levels and
increase soft tissue extensibility before stretching,
superficial agents such as hot packs can be applied
over the tight hamstrings but cannot increase the
temperature of the deeper hamstring muscles
(short head of biceps femoris) and the associated
tendons. Because the posterior thigh of the patient
is tender, placing weight over the affected area
may cause discomfort to the patient.
Cannot be applied Paraffin can only be used for heating distal
extremities as it can maintain good contact with
these irregular contoured foot and hands. It is not
suggested for the thigh is a large body part and the
slow application of the hot paraffin may lose its
heat before the whole thigh is being covered with
wax.
Can be applied If used to treat deeper tissue is not a suitable
heating agent because it cannot penetrate on
greater tissue depth however infrared modalities
can reduce the sensation of pain. It can be a
treatment done together with therapeutic exercise
Infrared, a heating agent produce relaxing effect
on skeletal muscles as it reduces the gamma
efferent firing.
Can be applied When the treatment goal is to increase tissue
temperature in a deeper structure covering a large
area to (the posterior thigh), diathermies can be
used. Continuous are used for local relaxation to
decrease muscle guarding and both subacute and
chronic pain. Microwave diathermy, a deep
heating agent, can be applied to the patient
however it does not penetrate as deep as
shortwave because spacing is required between
the skin and the applicator. It is most effective on
areas covered with low subcutaneous fat such as
the distal tendons of the hamstrings.
Can be applied Deep heating agent such like the short wave
diathermy is suitable for the patient’s intervention
since his underlying soft tissues are tender and
will not tolerate too much loading (flexible pads
are not that heavy). Its heating effects is said to
have increase pain threshold, reduction of
contractures and muscle guarding through
muscular relaxation. Diathermy selectively heat
tissues that are high in water contact such as the
muscles. This is a better heating agent than the
microwave diathermy because if its greater tissue
depth penetration.
Cannot be applied UVR heating effects are not what is sought for the
patient’s well-being, it causes skin erythema and
Vitamin D synthesis. It is relatively used for skin
conditions such psoriasis and wound healing, not
 for tight muscles. Long exposure may cause
tanning on the person’s skin than increasing the
temperature for muscle’s increased flexibility.
Laser Can be applied Laser are effective in for its analgesic and
relaxation effects for neuromusculoskeletal
conditions.
Ultrasound Cannot be applied Ultrasound is particular well suited in heating
tissues with high collagen content because they
have high absorption coefficients. Muscles, on the
other hand have relatively low absorption
coefficient so US is not an ideal physical agent.
Cold therapy Can be applied Applying cryotherapy can increase the pain
threshold and decrease the sensation of pain
because the cold temperature fully or partially
block the transmission of painful stimuli to the
brain cortex. The cold temperature felt by the
patient acts as a counterirritant. With longer
cooling for even a few minutes, a decrease in
gamma motor neuron activity reduces the force of
muscle contraction.
Whirlpool Can be applied Because hydrotherapy is used for strengthening
muscles because of its resistance property, low-
boy and high-boy whirlpool tanks are for
immersion up to the waist and the patient can
actually move while the heat is applied. The
neutral warm whirlpool can decrease muscle tone
while hot whirlpools is recommended for pain
control and increase soft tissue extensibility.

REFERENCES:

 Prentice, W.E. (2002). Therapeutic Modalities for Physical Therapist (2nd Edition). New York City, NY: McGraw-
Hill Companies.
 Cameron, M. H. (2013). Physical Agents in Rehabilitation: From Research to Practice. (4th Edition) St. Louis, Mo.:
Elsevier/Saunders.