Ben Hemingway-Arnold 05/11/2022

Sports Therapy c3646608

Describe and explain the modality of heat therapy and its current use in sports
clinical practice
Heat therapy also known as thermotherapy is widely used in a sporting environment to aid injury
prevention and rehabilitation. Heat therapy is most commonly used in chronic injuries to help blood
flow, joint stiffness, metabolism, improve extensibility of tissues and relieving muscle spasms.
Application methods include heat packs, paraffin wax, hydrocollator packs, and hydro therapy/hot
water immersion.

Physiological benefits of Heat Therapy

Application of heat therapy can cause an increase in localised blood flow to the area, this process is
called vasodilation during this process, the blood vessels widen to allow more blood to pass through.
Pizzey (2021) showed a decrease in localised blood pressure due to the blood vessel dilation.
Vasodilation will help deliver more blood meaning more oxygen and essential nutrients like Vitamin
C are delivered to the area. Also, carbon dioxide and lactic acid are flushed from the muscle, these
are both harmful and break down the muscle fibres. This process gives the muscles everything they
need in order to heal.

Vasodilation is due to the area heating up, this heat helps metabolism in the muscles (J, 2014).
Therefore making the body more efficient at delivering important amino acids, this will help muscle
fibre function and improve strength. This process will also increase ATP production. ATP is essential
for muscle contraction and when we exercise ATP in the muscles is used up. Heat therapy will help
regenerate ATP stores in the muscles aiding joint stiffness and recovery.

Another physiological benefit on heat therapy in pain reduction (Moayedi et al., 2013), this is shown
through the pain gate theory. When injury occurs pain signals travel through the body to the brain,
it’ll pick one of two paths. A- nerve fibres for acute pain, for example pricking yourself with a pin, or
C- fibres which react to chronic injuries, for example breaking a bone. After this they go through a
‘gate’ in the CNS. However, when heat is applied the gate will close blocking heat. One method is hot
water immersion. Reduced pain can help speed up the healing process as the athlete will be able to
start active rest quicker and it will allow them to be more comfortable.

Therapeutic benefits of Heat Therapy

After an injury, the athletes joints can become stiff. This is because they’ve been inactive for a while
meaning tendons, cartilage and muscles shorten up. This can lead to muscle spasms and cramps.
Other areas may become tight or sore due to overcompensating for the injured area. Using heat
therapy will increase blood flow to the area this will help with the elasticity and joint ROM (Masuda
A;Koga, 2005). Speeding up recovery times as the athlete will be able to restart exercise earlier, it
will also help repair the overused muscles.

Heat therapy is also shown to improve DOMS, the Delayed Onset of Muscle Soreness (J;, 2014).
There are 6 theories hypothesised for the mechanisms of DOM; lactic acid, muscle spasm,
connective tissue damage, muscle damage and inflammation. These mechanisms cause damage to
the muscles and joints, which can in turn lead to injuries and poor performance. Some symptoms of
DOMS are muscle soreness, reduced ROM, fatigue/loss of strength. Studies show heat application
post exercise can help the effects of DOMS, especially muscle soreness. This is due to muscles
relaxing and vasodilation improving oxygen levels and removing the waste products.

Another therapeutic benefit on heat therapy is improved ROM (Usuba M;Miyanaga, 2005).
Increasing the temperature and blood flow is shown to improve the elasticity of the muscles and
surrounding tissues. Pre-event heat therapy is therefore shown to improve performance in sport, for
example, in golf improved ROM can help generate more power behind the swing allowing a longer
drive. Improved ROM will also prevent injury as muscles can be pushed more and move more freely.
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This can be essential especially in demanding sports like football where you may need to play
multiple games in a week. This can also be beneficial in the proliferation and rebuilding phases of an
injury to encourage active movement.

Contraindications of Heat Therapy

Clients should undertake health screening before any type of treatment, there are some conditions
where heat therapy should not be used e.g. diabetes, vascular disease and dermatitis. Is you see any
red flags it’s important you don’t proceed with treatment. It’s important you then check the area for
open wounds, damaged skin or bleeding applying heat to these areas will cause an increase in local
blood flow which can reopen cuts. Application in these areas can also cause more pain. Before any
application of heat therapy, you need to determine if it’s the best method of treatment to use. In
some cases, heat therapy can cause more damage. If applied to sore or swollen areas the increased
blood flow can cause more inflammation. A general rule is to use heat therapy when you want to
increase local blood flow to an area, meaning it’s mainly used during the proliferation stage.
However, there are some exceptions. Due to the nature of this treatment, it’s important to be
careful throughout application for the safety of the client. Heat therapy can cause tissue and nerve
damage. Initially, it’s important to determine skin sensitivity by exposing the area to heat followed
by cold, the client will then determine which one is which. Following this, you must check for
sufficient blood circulation, this is done through squeezing the peripheral extremities, the area
should turn white then quickly return to normal colour, this shows there’s sufficient blood flowing in
that area. These are important methods to determine if the client is safe for treatment. Also, to
minimise risk, skin barriers should be put in place to prevent direct impact, and the application
device should be heated between 40-45 degrees.

Current evidence surrounding Heat Therapy effectiveness

(Masuda, 2005) conducted a study looking into the effects of heat therapy on chronic pain relief
their goal was to clarify the effects and further the research. Their application method was heat
packs a paraffin wax. The study was split into 2 groups, Group A (24 participants) and Group B (22
participants). Group A were treated by a multidisciplinary treatment including cognitive behavioural
therapy, rehabilitation, and exercise therapy, whereas Group B patients were treated by a
combination of multidisciplinary treatment and repeated thermal therapy. Both groups were asked
for a pain score, anger score and depression activity. Group B participants showed a slightly greater
increase in pain, but a significantly greater decrease in anger. Group B patients were shown to return
to work faster than Group A.

Another study conducted by (Usuba M;Miyanaga, 2015) showed ultrasound (US) and infrared (IR)
methods of application beneficial at improving joint ROM in the knee after an injury. This study split
93 rats into 3 groups, stretch with US, stretch with IR and stretch. Both groups with the heat therapy
modalities showed a significantly greater increase in ROM than the group without. This is
transferrable to human anatomy and can allow performers to recover from injuries quicker and get
back to full fitness.

The ethical and legal aspects associated with the modality

One ethical consideration is informed consent, this requires you to detail the process the client is
about to undergo. This will prevent the client backing out in the middle of the treatment and
ensuring they are comfortable. You will also need to explain precautions and side effects of the
treatment. Clients under 16 must have consent from their parents or guardian. Informed consent
can also cover you legally in case they attempt to sue you can use the document to support you.

It's important to consider The Society of Sport Therapist competencies. The SST is a organisation
designed to improve the competence of therapists. They ensure all members are fully trained for
their job. They also provide further training and careers steps in order for members to flourish. Any
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member that joins the SST is obliged to conduct themselves to the highest standards to fulfil the
needs to their patients and clients. Professional standards means being able to act within the legal
and ethic boundaries of their profession. This prevents the member from having legal issues and
providing the best service possible. In conclusion SST covers your back and give you the platform,
skills and knowledge to be a skilled therapist.

References

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