General Information

Modalities are treatments used to facilitate healing. They may be used as a choice of treatment. Brief summaries of modalities follow:

1) Therapeutic ultrasound - used to deliver heat to deep tissues. This helps circulation-aiding healing. It should not be confused with diagnostic ultrasound, which uses a different frequency to examine organs.

2) Muscle stimulation - this stimulation occurs as electrodes are attached to the skin causing muscles to twitch. This can be useful in severe injuries helping to teach muscles to fire in coordinated fashion

3) Ionophoresis or phonophosesis are 2 different procedures where medication is delivered deep to tissues using either a charged medication via electrical current (Ionophoresis) or medication administered with ultrasound (phonophosesis). They are both uncommon but can be used effectively in some cases.

4) Ergogenic medication - we do not recommend or endorse any enhancing neutraceutical (drug like foods), vitamins, stimulants, or medication to assist healing. Despite great claims they are still too good to be true. At present the best ergogenic plan is to drink enough water, follow the Canada Food Guide and get enough sleep.

5) Acupuncture exists in many forms and is used differently by diverse practitioners. A licensed acupuncturist usually as a modality for relieving pain should perform acupuncture. For a local acupuncturist contact the Manitoba Acupuncturist Society. We do not ensure acupuncture as a definite cure for serious illnesses but recommend it only as an adjustment therapy.


The most important rehabilitation tool for injuries is exercise. "Exercise is medicine". It is important to return to activity at a controlled rate so as not to re-injure again.
Try to avoid "too much, too soon" but at the same time unnecessary immobilization will lead to more muscle atrophy or loss of cardiovascular fitness. A good therapist can help guide an injured person towards gradually recovering post injury.
Maintaining a regular level of fitness (flexibility, strength and endurance) is one of the most powerful (and cheap) preventative measures for good health.

Cortisone injections

Doctors to assist in healing often use steroid or cortisone injections.
Cortisone is a natural hormone in the body that is required for daily living. Doctors discovered that giving large injections (pharmaceutical doses) into areas of inflammation could hasten healing.
These "steroids" are not to be confused with "anabolic" or "rhoids " steroids, which are derivatives of testosterone and are not recommended since they may cause serious side effects.
Cortisone and anabolic steroids are called steroids because they chemically belong to the same molecule family, but have very different actions. Cortisone injections are used for specific injuries where there is lots of inflammation. Cortisone is a potent anti-inflammatory drug but should be used carefully.

Some conditions that are benefited by cortisone shots include tennis elbow, rotator cuff tendonitis and ganglion.
The precise administration of this anti-inflammatory drug helps resolve these conditions.
Sometimes only a cortisone injection is used, but it is more important to include it in with a complete program that also works towards strengthening the injured part and making sure the injury does not recur.
Cortisone injections should not be injected into tendons as this causes them to weaken and rupture. Also it is generally advised to limit cortisone injections into weight bearing joints.
Cortisone injections may cause a steroid flare, which will aggravate the joint for a few days. This is actually a reaction to the preservative and does not affect the drugs chance of success.

In summary cortisone injections are a very safe and sometimes under used method of treatment. Patient should be selected so that only those with proper benefits to being injected are given cortisone. Proper knowledge of anatomy and technique placing the cortisone in the exact right place yields results.