Therapeutic Modalities

In addition to hands-on therapy, exercise prescription, and patient education, Max Health Institute & Physiotherapy Fredericton practitioners may use therapeutic modalities as part of your treatment plan.

Types of Therapeutic Modalities

Here are some examples of therapeutic modalities that are utilized at both of our Max Health Fredericton clinics.

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Acupuncture is the practice of penetrating the skin with thin, solid, metallic acupuncture needles which are then activated through gentle and specific movements of the practitioner’s hands or with electrical stimulation. Most people report feeling minimal pain as the needle is inserted. The inserted needle may produce a sensation of pressure or ache.

Acupuncture is part of the ancient practice of Traditional Chinese medicine. Traditional Chinese medicine practitioners believe the human body has more than 2,000 acupuncture points connected by pathways or meridians. These pathways create an energy flow (Qi, pronounced “chee”) through the body that is responsible for overall health. Disruption of the energy flow can cause disease. By applying acupuncture to certain points, it is thought to improve the flow of Qi, thereby improving health.

Western medicine explains acupuncture’s effects within a different framework. Some Western scientists believe that acupuncture stimulates the central nervous system, signaling the body to release various substances including endorphins, immune system cells, opioids, neurotransmitters, and neurohormones. These may help control pain, change how the body experiences pain, and promote physical and emotional well-being by stimulating the body’s natural healing abilities.

WHAT CAN I EXPECT FROM MY ACUPUNCTURE TREATMENT?

Most people find their acupuncture treatments relaxing. Others may experience minimal discomfort. Adverse effects and complications are almost entirely absent.

Aching, heat, and heaviness may be experienced during acupuncture treatment. This is the “Qi effect.” For most patients these sensations are brief.

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Dry Needling is a treatment technique whereby a sterile, single-use, fine filament acupuncture needle is inserted into the muscle to assist with decreasing pain and improving function through the release of myofascial trigger points.

WHAT ARE MYOFASCIAL TRIGGER POINTS?

Myofascial trigger points are painful, tense areas that are found in muscles. Trigger points can affect muscles and the fascia leading to myofascial pain and dysfunction.  A myofascial trigger point, also known as a knot in the muscle, is a group of muscle fibres which have shortened when activated but unable to lengthen back to a relaxed state after use. The presence of a myofascial trigger point in a muscle can lead to discomfort with touch, pain with movement, and decreased joint range of motion.  (Simons et al., 1999).

HOW DOES DRY NEEDLING WORK?

Dry needling assists with decreasing local muscular pain and improving function through the restoration of a muscle’s natural ability to lengthen and shorten by releasing myofascial trigger points.

WHEN IS DRY NEEDLING RECOMMENDED?

Dry needling treatment can help:

• release myofascial trigger points (muscle knots),
• with pain management,
• restore movement at a joint if inhibited by myofascial trigger points.

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Interferential Current (IFC) is a physical modality that is typically used to help relieve pain over a specific area of the body. The IFC machine produces an electrical current that stimulates the nervous system to interrupt the pain signals felt by the brain. The engineered frequency of IFC crosses the skin with greater ease and with less stimulation than with TENS, and is generally more comfortable and better tolerated by patients. IFC also has the ability to penetrate deeper tissues than the TENS machine.

HOW CAN IFC HELP?

1. IFC increases localized blood flow which can improve healing by reducing swelling (the additional blood flowing through the area takes edematous fluid away with it) and as a result helps remove damaged tissue and bring nutrients necessary for healing to the injured area.

2. IFC stimulates local nerve cells that can have a pain-reducing effect by blocking the transmission of the pain signals to the brain or by stimulating the release of pain reducing endorphins.

3. Some degree of muscle stimulation as muscle contraction can be achieved through external application of an electrical current, overcoming some of the muscle inhibition often caused by local injury and swelling.

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Low level laser therapy (LLLT) is used by some physiotherapists to treat various musculoskeletal condition. LLLT is a non-invasive light source treatment that generates a single wavelength of light. It emits no heat, sound, or vibration. Wavelengths between 660 nm and 905 nm have the ability to penetrate skin, and soft/hard tissues. This light can have a good effect on pain, inflammation and tissue repair.

Some conditions were Laser Therapy can help are:

• Osteoarthritis of the knee, hip and ankle
• Rheumatoid arthritis
• TMD (jaw pain)
• Shoulder impingement syndromes
• Hip or shoulder bursitis
• Low back disc degeneration
• Disc herniation
• Sciatica
• Neuropathic pain
• Tendonitis
• Tennis elbow
• Plantar fasciitis

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Shockwave is essentially a sound wave. A device is held against the affected site. This device has a projectile that moves up and down its shaft (the projectile itself is never directly in contact with the patient), creating a high energy sound wave to the injured tissue. The highly compressed air that shoots the projectile back and forth 3-4 times per second makes a loud noise that shockwave therapy is known for.

This type of modality is often used to accelerate tissue repair and cellular growth, improving function and mobility. It’s often used to help treat chronic conditions (such as tennis elbow, plantar fasciitis) where scar tissue has built up overtime and needs broken down. Shockwave therapy helps to reset the tissue to its former state.

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Athletes, as well as the general public, often make use of taping as a protective mechanism in the presence of an existing injury. Some of the goals with taping are to restrict the movement of injured joints, to reduce swelling through soft tissue compression, to support protect joints and ligaments from injury or re-injury.

There are multiple types of tape your therapist may use at Max Health depending on the nature of your injury.

Benefits of taping include:

• Pain relief
• Improvement of joint stability
• Increased athlete confidence
• Prevention of injury or re-injury
• Reduces strain on injured or vulnerable tissues
• Corrects faulty biomechanics
• Inhibits muscle action
• Facilitates muscle action
• Enhances proprioception
• Compresses in the presence of edema or lymphatic drainage

Conditions that may benefit from taping:

• Shoulder injuries
• Ankle and wrist sprains
• Knee pain
• Heel pain such as plantar fasciitis
• Shin splints
• Tendinopathies such as tennis elbow
• Muscle strains such as hamstrings, groin, quadriceps

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Cupping therapy is one of the oldest and most effective method of releasing the toxins from body tissue and organs. Cups are placed on the skin to create suction. This causes the tissue beneath the cup to be drawn up and swell causing increase in blood flow to affected area. Enhanced blood flow under the cups draws impurities and toxins away from the nearby tissues and organs towards the surface for elimination.

Benefits of Therapeutic Cupping include:

• Helps to reduce pain and inflammation
• Used for deep tissue massage.
• It is safe, non-invasive and inexpensive treatment.
• Helps to increase the blood flow to sore areas in muscles.
• Provides necessary nutrients to the area being treated and promotes healing.
• Can provide pain relief and help ease the symptoms of many common disorders of muscles.
• Can be very relaxing and help to reduce muscular restrictions, scars and adhesions, to decrease swelling, increase range of motion.

WHAT CAN I EXPECT FROM CUPPING THERAPY?

The suction will feel tight at first (not painful) while it draws your skin up into the cup. That sensation passes quickly as your therapist moves on to place the next cup. After placing each cup on your back, shoulder, calf, etc., your therapist will repeat the suction process.

At Max Health Fredericton, our goal is to keep you comfortable while applying our cupping technique. You’ll likely have circular marks around the areas where the cups were. The marks should resolve within 5-10 days. Redness of the skin is normal and the skin/muscles may seem a little a sensitive to the touch. This should resolve shortly after the session.

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Ultrasound is applied using the head of an ultrasound probe placed in direct contact with your skin via a specialize gel (transmission coupling gel). Therapeutic ultrasound may increase healing rates, tissue relaxation, tissue heating, local blood flow, and scar tissue breakdown.

The effect of therapeutic ultrasound via an increase in local blood flow may help reduce local swelling and chronic inflammation and, according to some studies, promote bone fracture healing. The intensity or power density of the ultrasound can be adjusted depending on the desired effect. A higher power density (measured in watt/cm2) may soften or breakdown scar tissue.

At Max Health, there may be a few reasons your therapist will choose to use ultrasound. We use evidence- based research when using ultrasound on musculoskeletal rehabilitation.

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Splinting immobilizes, supports, and protects the arm or hand. Occupational therapists (OTs) are training in the fabrication of custom splints to be used to support function, as well as assist and/or increase range of motion.

Splints are made from thermoplastic materials which are pliable when heated but hold their form when cooled. These splints can be easily removed for hygiene, wound care, etc.

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