Although it is our general philosophy here at Fast Track Physical Therapy and Sports Medicine to use passive modalities sparingly – there are times when each of these things can be appropriate.
Iontophoresis is a technique that can be helpful with some chronic tendon injuries, and is sometimes prescribed by your referring provider. “Ionto” utilizes an electrical current to push a specific chemical compound (usually a type of topical steroid – although not always) through your skin in order to target the affected tissue. With this in mind, it tends to work best for injuries that occur close to the skin (e.g. Golfer’s elbow)
Electrical Stimulation can be utilized for pain management, aiding edema/swelling reduction, or improving muscle control and strength. The most common form of electrical stimulation is TENS (these are often the hand-held units you see advertised on TV or in the malls). Different types of electrical stimulation (E-stim) work on our bodies differently; however, generally it works via stimulating either the blood vessels around the affected area to help to bring blood flow and stimulate the healing process, or by over-stimulating the nerve endings to cause a temporary deadening of the pain. Physical therapists use very specific types of electrical stimulation to potentially speed up the healing process.
Much like a sonogram, therapeutic ultrasound uses sound energy to penetrate tissue. In most cases we use that sound energy to aim at tissue that is too deep or too limited to heat another way. We use that heat to bring blood flow, which helps us to facilitate a good healing environment.