____________________________________________________________

Use of Physics in Different Modalities Used by Physiotherapists in

Clinics to Treat Patients
____________________________________________________________

Introduction
Physiotherapy is a vital medical discipline that focuses on restoring movement,
alleviating pain, and promoting overall health in individuals suffering from physical
impairments, injuries, or chronic diseases. Modern physiotherapy incorporates
advanced physical modalities, each founded upon distinct physical principles. These
therapeutic interventions leverage various energy forms such as mechanical,
electrical, electromagnetic, and photonic energy to bring about physiological changes
within body tissues.
This assignment will cover five widely employed physiotherapy modalities:
• Ultrasound Therapy
• Interferential Therapy (IFT)
• Shortwave Diathermy (SWD)
• Transcutaneous Electrical Nerve Stimulation (TENS)

For each, the modality, underlying physics, patient types, and pain types treated are
discussed in detail.
1. Ultrasound Therapy
Ultrasound therapy is a therapeutic intervention in which high-frequency sound
waves are transmitted into the body’s tissues to stimulate physiological processes.
Delivered through a handheld transducer coupled with a conductive gel, these
ultrasonic waves either generate localized heat (continuous mode) or create
mechanical effects (pulsed mode) to promote healing, reduce inflammation, and
alleviate pain.
Ultrasound therapy operates based on the mechanical propagation of sound waves at
frequencies typically ranging from 0.7 to 3.3 MHz. An Ultrasound Machine with
different parts was shown for better visual understanding.
Physics Principles and Complete Process
These waves travel through tissues via longitudinal wave propagation, wherein
particles oscillate parallel to the wave’s direction.
Key processes include:
1. Acoustic Impedance and Wave Transmission: Different biological tissues
possess varying acoustic impedances. At tissue interfaces, ultrasound waves are
partially reflected, transmitted, or refracted based on impedance mismatch. The
proportion of transmitted energy determines therapeutic efficiency.
2. Absorption and Conversion to Heat: As the sound waves penetrate deeper,
tissues absorb this mechanical energy, converting it into thermal energy through
molecular vibration, causing localized hyperemia and tissue extensibility.
3. Cavitation: Alternating compression and rarefaction phases in the ultrasonic field
induce the formation and oscillation of microbubbles within tissue fluids. Stable
cavitation supports cellular activities and microstreaming.
4. Acoustic Microstreaming: Ultrasonic waves produce a unidirectional flow of
interstitial fluid around vibrating bubbles, influencing cellular membranes,
promoting ion exchange, enhancing collagen synthesis, and accelerating tissue
repair processes. Both continuous and pulsed ultrasound modes manipulate these
 physical processes to achieve desired therapeutic outcomes — thermal for muscle
relaxation and pain relief, and mechanical for tissue repair and inflammation
control.

Types of Patients It’s Used For

• Soft tissue injuries (sprains, tendinitis)
• Post-operative patients (scar tissue management)
• Osteoarthritic joints
• Muscular adhesions
Types of Pain Treated
• Chronic inflammatory pain
• Acute musculoskeletal pain
• Post-surgical discomfort
 2. Interferential Therapy
IFT employs medium-frequency alternating currents delivered via surface electrodes
to alleviate pain, reduce swelling, and improve circulation. Two separate currents
intersect within the target tissue, producing a therapeutic low-frequency beat
frequency that penetrates deeper tissues effectively.

Physics Principles and Complete Process

IFT is grounded in the physics of alternating current interference. It uses two
independent medium-frequency alternating currents, typically around 4000 Hz and
4100 Hz, intersecting at the treatment site.
Key processes include:
1. Interference of Currents: When two currents of slightly differing frequencies
cross paths, their amplitudes combine in constructive and destructive interference
patterns, creating a third, resultant frequency known as the beat frequency (equal
to the difference between the two original frequencies).
2. Skin Impedance Reduction: Medium-frequency currents encounter lower skin
impedance compared to low-frequency currents, enabling deeper tissue
penetration without discomfort.
3. Beat Frequency Production: The generated beat frequency (e.g., 100 Hz) within
the tissue provides the therapeutic stimulus, modulating nerve activity and
promoting endogenous pain control mechanisms.
4. Physiological Effects of Electrical Stimulation: The electrical field alters ion
concentrations, enhances membrane permeability, and activates sensory and motor
nerves. Low beat frequencies (0–10 Hz) produce muscle contractions for edema
reduction, while higher frequencies (80–150 Hz) activate sensory fibers to relieve
pain through the Gate Control Theory and endorphin release.

Types of Patients It’s Used For

• Musculoskeletal injuries
• Edema management
• Neuralgic and radicular pain
• Chronic pain conditions
 3. Shortwave Diathermy (SWD)
SWD applies high-frequency electromagnetic waves to deep tissues for the purpose
of producing therapeutic heat. It improves tissue extensibility, reduces muscle spasm,
and enhances metabolic processes, facilitating recovery from deep-seated
musculoskeletal conditions.

Physics Principles and Complete Process

SWD utilizes electromagnetic waves at 27.12 MHz frequency to deliver energy to
the tissues. The heating occurs via two mechanisms: capacitive and inductive
methods.
Key processes include:
1. Electromagnetic Wave Transmission: The high-frequency oscillating electric
and magnetic fields penetrate tissues, causing the displacement of charged
molecules.
2. Dielectric Heating (Capacitive Method): In capacitive setups, alternating
electric fields cause dipole molecules, like water, to oscillate. This rapid
 reorientation creates frictional heat as molecules attempt to align with the rapidly
changing field.
3. Inductive Heating (Inductive Method): In inductive techniques, the oscillating
magnetic field induces eddy currents within conductive tissues (muscle, blood),
converting electrical energy into heat via electrical resistance.
4. Tissue Depth and Selectivity: High water-content tissues (muscles) absorb
energy more effectively due to higher conductivity, whereas fatty tissues offer
insulation, limiting depth.
The generated deep heat raises tissue temperature by 3–5°C, leading to vasodilation,
improved oxygen supply, increased metabolism, and enhanced waste removal,
supporting tissue healing and pain control.

Types of Patients It’s Used For

• Deep muscle or joint injuries
• Athletes with muscle spasms
• Arthritic conditions
• Post-immobilization joint stiffness
 4. Transcutaneous Electrical Nerve Stimulation (TENS)
TENS is a surface-applied electrotherapy technique that delivers controlled electrical
impulses through electrodes to modulate pain perception by stimulating peripheral
nerves.

Physics Principles and Complete Process

TENS is based on the principle of low-frequency electrical stimulation, typically
between 1–200 Hz, which modulates nerve conduction and pain signalling via
different physiological mechanisms.
Key processes include:
1. Electrical Current Conduction: Delivered via electrodes, the electrical current
traverses the skin and subcutaneous tissues. Current amplitude and pulse width are
adjusted to preferentially stimulate sensory (Aβ) and/or motor (Aα) nerve fibers.
2. Gate Control Theory: High-frequency stimulation (50–150 Hz) activates large-
diameter Aβ fibers, which inhibit the transmission of pain signals through small-
diameter Aδ and C fibers at the spinal cord’s dorsal horn, effectively “closing the
gate” to pain impulses.
3. Endorphin Release: Low-frequency stimulation (1–10 Hz) induces rhythmic
muscle contractions, triggering endogenous opioid release, which binds to pain
receptors and reduces pain perception.
4. Electrical Impedance Management: Proper electrode placement and adjustment
of pulse duration and intensity ensure safe, comfortable, and effective current
distribution across tissue types with variable electrical impedance

Types of Patients It’s Used For

• Chronic back, neck, and joint pain
• Post-operative recovery
• Neuropathic pain management
• Labor pain control
Types of Pain Treated
• Chronic musculoskeletal pain
• Neuropathic pain
• Post-operative pain
Conclusion
This assignment emphasizes the pivotal role of physics in the safe and effective
application of physiotherapy modalities. Each modality leverages specific physical
processes — whether through mechanical wave transmission, electromagnetic
induction, electrical nerve modulation, or photonic energy absorption — to achieve
therapeutic outcomes. A comprehensive understanding of these underlying physics
principles not only enhances clinical efficacy but also ensures personalized,
evidence-based care for patients.