• Acute or chronic pain

• Acute swelling or contusion

• Myofascial trigger points

• Muscle guarding

• Muscle spasm

• Acute muscle or ligament strain

• Bursitis

• Tenosynovitis

• Tendinitis

• Delayed onset muscle soreness

• Reducing temperature

Precautions

• Over an open wound or superficial nerve

• If there is impaired sensation or mentation

• Very young age or very old age

• Hypertension

Contraindications

• Raynaud's disease

• Areas of circulatory compromise

• Hypersensitivity to cold

• Cold intolerance

• Cryoglobulinemia

• Paroxysmal cold hemoglobinuria

• Peripheral vascular disease

• Over a regenerating peripheral nerve

• Subacute or chronic inflammatory conditions

• Subacute or chronic pain

• Decreased range of motion

• Facilitated healing

• Muscle guarding

• Muscle spasm

• Myofascial trigger points

• Subacute muscle strain or sprain

Precautions

• Pregnancy

• Cardiac insufficiency

• Impaired circulation

• Poor thermal regulation

• Edema

• Metal in the area

• Demyelinated curve

• Over areas where topical counterirritants have been applied

Contraindications

• Acute musculoskeletal conditions

• Recent or potential hemorrhage

• Thrombosis

• Impaired sensation or mentation

• Malignancy

• Infrared irradiation of the eyes

• Over an open wound

• Acute and post-acute conditions - specifically for non-thermal ultrasound

• Soft tissue healing and repair

• Scar tissue

• Joint contracture

• Chronic inflammation

• Increase the extensibility of collagen

• Reduction of muscle spasm

• Pain modulation

• Increase blood flow

• Soft tissue repair

• Increased protein synthesis

• Tissue regeneration

• Bone healing

• Inflammation associated with myositis ossificans

• Plantar warts

• Myofascial trigger points

Precautions

• Fractures

• High-intensity ultrasound may cause pain and impair healing

Contraindications

• Thermal ultrasound for acute and post-acute conditions

• Thrombophlebitis

• Eyes

• Reproductive organs

• Pregnancy

• Any implanted cardiac rhythm device including pacemakers

• Malignancy

• Epiphyseal areas in young children

• Total joint replacements

• Central nervous system tissue

• Post-acute musculoskeletal injury

• Muscle guarding

• Joint contracture

• Myofascial trigger points

• Pain management

• Soft tissue healing

• Nerve healing

• Bone healing

Precautions

• Impaired circulation

• Poor thermal regulation

• Pelvic area during menstruation

• Obesity

Contraindications

• Acute injury of inflammation

• Areas with ischemia

• Impaired sensation or impaired mentation

• Thrombosis

• Fluid-filled organs or areas of the body

• Joint effusion

• Over the eyes

• The head if wearing contact lenses

• Over moist clothing and moist wound dressings

• Malignancy

• Testes

• Pregnancy

• Epiphyseal growth plates in children

• Cardiac pacemaker and other implanted medical devices

• Intrauterine devices

• Watches or jewelry

• Lymphedema

• Traumatic or chronic edema

• Venous stasis ulcers

• Wound healing following surgery

• Prevention of deep vein thrombosis (DVT)

Precautions

• Impaired sensation or mentation

• Uncontrolled hypertension

• Malignancy

• Superficial peripheral nerves

Contraindications

• Compartment syndromes

• Peripheral vascular disease

• Presence of deep vein thrombosis (DVT)

• Local superficial infection

• Congestive heart failure (CHF)

• Acute Pulmonary Edema

• Displaced fractures

• Facilitation of wound healing

• Pain reduction

• Increasing the tensile strength of a scar

• Decreasing scar tissue

• Decreasing inflammation

• Bone healing and fracture consolidation

Precautions

• Impaired sensation or mentation

• Light sensitivity

• Tattoos

Contraindications

• Directly over the eyes

• Malignancy

• Low back or abdomen during pregnancy

• Within 4-6 months of radiation therapy

• Over hemorrhaging areas

• Over thyroid glands

• Epiphyseal plates in children

• Acute, post-acute, chronic pain

• Stimulation of denervated muscle

• Retarding muscle atrophy

• Muscle strengthening

• Muscle reeducation

• Stimulation of venous and lymphatic circulation

• Management of edema

• Muscle spasms

• Muscle guarding

• Wound, fracture, tendon, ligament healing

Precautions

• Impaired sensation

• Impaired mentation

• Cardiac disease

• Areas of skin irritation or open wounds

Contraindications

• Pacemaker or implanted cardiac defibrillator

• Malignancy

• Pregnancy

• Placement of electrodes of the carotid sinus

• Areas where venous or arterial thrombosis or thrombophlebitis is present

• Muscle re-education

• Regaining neuromuscular control

• Increasing isometric and isotonic strength of a muscle

• Relaxation of a muscle spasm

• Decreasing muscle guarding

• Pain reduction

• Psychological relaxation

Contraindications

• Any musculoskeletal condition that a muscular contraction might exacerbate

• Spinal disc bulge or herniation

• Spinal nerve root impingement

• Joint hypomobility

• Subacute joint inflammation

• Muscle spasm

Precautions

• Structural diseases or conditions that affect the spine such as: tumor, infection, rheumatoid arthritis, or prolonged systemic steroid use

• Pressure of traction harness may be hazardous with hiatal hernia or with vascular compromise

• Displaced annular fragment

Contraindications

• Osteoporosis

• Fractures

• Where motion is contraindicated

• Acute injury or inflammation

• Joint hypermobility or instability

• Peripheralization of symptoms with traction

• Uncontrolled hypertension

• Pregnancy

• Positive vertebral artery test (for cervical traction)

• Decrease pain

• Decrease neuromuscular excitability

• Stimulation circulation

• Facilitate healing

• Restore joint mobility

• Remove lactic acid

• Alleviate muscle cramps

• Increase blood flow

• Increase venous return

• Retard muscle atrophy

• Increase ROM

• Edema

• Stretching scar tissue

• Adhesions

• Muscle spasm

• Myositis

• Bursitis

• Fibrositis

• Tendinitis

• Re-vascularization

• Raynaud’s disease

• Intermittent claudication

• Dysmenorrhea

• Headaches

• Migraines

Contraindications

• Arteriosclerosis

• Thrombosis

• Embolism

• Severe varicose veins

• Acute phlebitis

• Cellulitis

• Synovitis

• Abscesses

• Skin infections

• Cancers

• Acute inflammatory conditions

  
  

P - Protect their injury

E - Elevate the affected area

A - Avoid anti-inflammatories like ice or NSAIDs like ibuprofen

C - Compression on the affected area

E - Educate themselves from a physical therapist or reputable source on their injury and specifically how to care for it

In the subacute and chronic phases of healing, one should...

L - Load their injury: this means to add resistance to their area to prevent loss of muscle ability or prevent further injury later on

O - Optimize thoughts surrounding their injury. Be positive!

V - Vascularize: an important component to wound healing is promoting blood flow to the affected area

E - Exercise to promote function and healing of the injury