‘The weatment sesion is generally for 20 10 30 minutes (1,57). EMS is contraindicated over ddemand-type pacemakers, ver the carotid sinus, and in pregnancy and cardiac conditions. Tontophoresis is the use of a corticostercid oF anesthetic solution coupled with electric stimu lation. This is similar to phonophoresis, and its uses are similar. HYDROTHERAPY Hydrotherapy is aterm used for several devices that are used to treat injuries and aid in the re- habitation of the athlete. Several factors con- tribute to the effectiveness of hydrotherapy. ‘The warm water creates a relaxing environ- ment, which helps to reflevively decrease mus- cle spasm and decrease discomfort. The buoy ancy of the water helps to support the trunk and limbs, and decrease gravitational forces al- lowing easier active range of motion in gravity- climinated postures. The density of the water also creates resistance for low-level, active- resistance exercise training, Hydrotherapy is used for joint mobilization, in creatment of mus ce spasm, in progressive resistive exercise rain- ing, in burn treatment, and in the creaument of athletes with arthritis ‘Huubbaid tanks are used for immersing the en- tire body up to the neck. The temperature is generally between 36.7°C and 372°C, or be- tween 37.8°C and 383°C for more vigorous heating, The athlete is teated for 10 to 20 min- ‘ues, and may undergo passive and active range of motion during or after the Hubbard tank tueatment. Duc to the extensive immersion in the Hubbard tank, there is a contraindication ‘to treating athletes with cardiac conditions and Circulation problems Pool Therapy Pool therapy can offer a higher level of condi: tioning exercise than exercise performed in ei ther whirlpools or tanks. The athlete is placed in a therapeutic pool with water up to the chest and he or she either stands oa the bot- ‘tom of the pool or is suspended in the deep end of the pool. Training is given in active range of motion and condi cexercies. Various paddles and inflatable exercise devices add a seater resistance effect to the athlete's exercises Pool therapy allows an athlete to move from range of motion exercises to progrestive reis- tive exercise in his or her rehabilitation. Contrast Bathstod for joine mableton, in reatment of mus cle spasm, in progressive restive exercise ean ing, fn burn ceatment, and in dhe tetmene of athletes with archritis. WHIRLPOOL, ‘A whirlpool isa tank of heated water that circu- lates through the tank with a mechanical pump. A whirlpool treatment consists of im- ‘mersing an extremity or the body up 0 the ‘chest in the circulating water, Upper limb teat- ‘ment temperature is generally between 37.8°C and 40.6°C. Lower limb treatment temperacure is generally between 37.8°C and 38.9°C, al- though temperatures up to 46°C may be toler- ated. The athlete is treated for 5 to 20 minutes, I is believed that the circulating water causes ‘mechanical stimulation to. the skin, which causes a reflex anesthetic effect and a decrease in muscle spasm. The athlete may undergo pas- sive and active range of motion exercises in the whirlpool or after completing the whirlpool ‘treatment. seater resistance fect to the athlete's exercises. Pool therapy allows an athlete to move from range of motion exercises to progressive resis: tive exercise in his or her rehabilitation. Contrast Baths In this variation of the whirlpool tchnique, the athlete is placed alternately in warm water berween 38°C and 44°C for 10 minutes and in ccald water at 10°C to 15°C for 1 minute, then alernated between the warm water for 4 min- tutes and the cold water for 1 minute, fora total treatment time of 20 minutes. This technique benefits. muscle strains, joint sprains, and ‘edema. Contraindications include peripheral vascular disease and the contraindications pre viously noted in the sections on therapeutic hheat and therapeutic cold (13,5). BIOFEEDBACK Sports medicine biofeedback may be used as an aid to taining the athlete in the relaxation of chronic tight muscles. The technique is 10