Therapeutic modalities had an entire course devoted to it in my educational curriculum and there is more and more research being done on the topic. There is plenty to learn about the theory and application of each individual type of modality from ultrasound to electrical stimulation and plain old ice.
I definitely learned a lot and the use of modalities has been definitely beneficial for me as a clinician, especially for acute injuries. However, I have found myself and others at fault for relying upon modalities too much. There are too many clinicians relying upon the "powers" of modalities instead of using the power of movement and rehabilitative exercises. I'm not saying that they don't have their place because they definitely do but they often are too heavily relied upon.
There is the old "80/20" rule and I feel that some people use 80% modalities and 20% corrective exercises in their treatment approach. My opinion is that this should be reversed and heavy reliance upon modalities is just an example of chasing pain. I think some of us clinicians might fall into the trap of abusing modalities because they can lower pain and improve function for patients temporarily. Unfortunately, your body isn't deficient in e.stim or ultrasound and therefore it can not be a true fix or cure. This may not apply to injuries as a result of improper training plans or lack of rest. Nevertheless, sometimes it is too easy to rely on modalities when we don't know or haven't given enough attention to finding the true problem.
I don't think that having an ignorance of the true dysfunction or and ignorance of knowing how to find the dysfunction is a good reason to rely on modalities. Yeah, they work great for temporary uses and acute issues or post operative pain. However, they can be time consuming, inefficient, and take away from the direct patient-provider time and relationship.
I hope that I can continue to refine my ability to identify and treat true dysfunction efficaciously in my patients. I do not want to be stuck icing the same athletic injury for months straight or be the clinician that is never seen prescribing rehab exercises. I found in my clinical rotations during my undergrad that high school athletic trainers were onto this secret because of their lack of access to modalities. This is it for my rant of the day.
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