As you may already know, Certified Athletic Therapists are trained in various forms of therapeutic modalities. Included in these modalities is the comprehensive knowledge and training of electrical stimulation devices, therapeutic ultrasound, cold and heat, cryo-therapy, massage and mobilization. I have now obtained an EMS and TENS machine, along with two gel hot/cold pads.


EMS also called, Neuromuscular Electrical Stimulation; is a form of stimulation, which utilizes gel pads that are placed on the injured area then electrical pulses are the sent into the skin via these pads. The pulses therefore intercept the pain signals before getting to the brain; this helps decrease pain so that we are able to rehabilitate the area faster.


TENS or Transcutaneous Electrical Nerve Stimulation is similar to the EMS stimulation however, the muscles become involved in the signal. The gel pads are used to send electrical stimulation deep into the muscles, causing a movement that is often physically observed. When this occurs the body blocks the pain receptors much the same as an EMS. Along with the decrease in pain, TENS also aids in relaxing the muscles to which it is stimulating. Relaxation of the muscles helps take the pressure off injuries and helps me; the therapist, to access the injury and rehabilitate it.


TOGETHER these electrical stimulations work to decrease pain, increase range of motion, and decrease your recovery time. By using both stimulation techniques you get the best of both worlds. Some people are not big fans of the contraction to which the TENS stimulates, where you feel a physical movement of the area or limb. This stimulation should not be painful in any way, if it is then the machine should be turned down. The particular machine that I have purchased has 12 different settings; these deliver stimulations in different patterns designed for various purposes. These techniques can be used simply for the pain relief and muscle relaxation purpose, as mentioned above. Or, they can be utilized to help teach the muscles how to contract properly. This technique of stimulation can be beneficial when the muscles are weak, having a hard time firing, they have not been used since surgery or a bone break OR in postural corrections; to help the scapulae set correctly.


HOT/COLD pads are primarily used in the clinic to help the muscles get warmed up for treatment or help cool them off after treatment. The gel packs I have acquired are designed so that they do not need to be pre-heated before use, you simply press the “clickies” button and the chemical reaction starts inside. Within seconds they are completely transformed and stay warm for up to two hours. To cool the pack down you place them in the fridge or freezer for 10-15minutes and when you take them out the pack stays cold for up to a few hours. Heat and cold modalities get deep into the muscles to block the pain receptors much like the stimulation would have done. Heat is helpful to use before a treatment, exercise or stretching, it is typically preferred in chronic injuries. Cold is the preferred method to help decrease the pain in acute injuries as well as decrease swelling and bruising; it can also be used after treatment and exercise and stretching.


Modalities are used for various purposes many of which I have not even touched on in this blog post. In the future I will hopefully have the chance to obtain more modalities to use in my clinical setting. For now if you have any questions on the use of modalities listed here, or you have seen used in other clinical settings please feel free to ask me. My contact information can be found on my “Email the Therapist” page.

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