Friday, September 18

The Heat Is On!

This Article recently plublished in Therapy Times Magazine and can be reveiwed at

Exploring the next generation in heat therapy.
By Brock Rutherford, ATC

Physical modalities are commonly used in rehabilitation and injury prevention. Among these modalities, superficial heat is found in most clinics and sport medicine facilities. Superficial heat is used to treat a variety of conditions and pathologies including muscle and joint stiffness, pain associated with musculoskeletal dysfunction, and chronic or stagnant inflammation.

Many different superficial heat modalities are used throughout the therapeutic setting. The most common modalities found in the clinic are hydrotherapy, paraffin wax bath, electric heating pads, fluidotherapy, and hydrocollator packs.

Hydrocollator Packs

The hydrocollator pack is a form of so-called moist heat that can be found in almost any physical therapy and sports medicine facility. The term “moist heat” was coined because the modality uses a wet heat source. Although the hydrocollator has been the standard for many years, there are inherent weaknesses and limitations of this modality. In fact, there are no proven results that indicate that moist heat works any better than dry heat.

Some of the limitations include its large size and weight, a warming-up period of four to eight hours, and cumbersome and restrictive pads. The complications from this form of heat therapy include pain, skin rash, and burns. Currently, burns associated with heat therapy are the leading complaint in the physical therapy profession.
Therapy Innovations, a Bend, Ore.-based company that creates physical therapy products, has introduced a new heat modality that will change the way practitioners use superficial heat and quite possibly save institutions thousands of dollars.

Smart Heat System

The new “Smart Heat System” by Therapy Innovations was designed with consideration of the limitations and complications of current modalities. The next generation of superficial heat modalities integrates new technology that allows the practitioner to control the heat therapy applied to their patients. Our Web site explains, “No more guessing, no more towel layering, just true heat at a temperature you decide.”

The system consists of three parts: the heating unit, the therapy heat pack, and the pack cover. The system is designed to work with all three components to provide the most effective superficial heat therapy.

Temperature Control

The Smart Heat heating unit utilizes thin-film Q-Foil® technology to heat up each hot pack to the desired therapeutic temperature. The unit is equipped with temperature sensing technology and custom built controllers enabling the unit to heat any given pack to a set temperature. The unit has capability for four therapy pads at any time and three different temperature settings.

Some of the most common complications that arise from thermotherapy modalities include pain, skin rash, and burns. Due to the nature of the human body and physiology, each person reacts to and perceives heat therapy differently. For this reason, three different temperature settings have been developed.

Our highest (Vigorous) setting is designed to achieve 110°F of skin temperature without the need for protective layering. However, this may not be suitable for all patients. Two other settings (Medium and Soothing) have been developed to accommodate the variations and needs of different patients. Never before has the practitioner been able to select an exact temperature for their desired needs.

Led display indicating a medium setting during the heat-up phase.

After several years in clinics and athletic training rooms, I knew there had to be a better way. Therapists needed an option for superficial heat therapy. We set out to design a product that reduced the risk of burns while still providing therapeutic heat. Thinking of the patient as well as the practitioner, it was truly time to provide a higher technology in therapy. We incorporated new technology that makes heat therapy safer and more efficient for the users.

The temperature control system is equipped with LED indicator lights that tell the practitioner when the therapy pad has reached the selected temperature. This ensures the pad is at the desired therapeutic setting and safe for the therapist to apply. The temperature control eliminates the need for practitioners to use extra towels to buffer the heat from packs that may be too hot and reduces the amount of laundry often found in busy clinics

Heating Time

One of the many advantages of the Smart Heat System is the time required to reach the desired temperature. With the temperature control system, the Smart Heat therapy pads can reach therapeutic temperatures in less than 25 minutes and reheat pads after use in less than 10. The fast heat-up times eliminate the need to run the unit 24 hours a day or over weekends when many clinics may be closed.

The thermal properties of the pads and the insulation of the unit allow the therapy pads to sit at therapeutic temperatures inside the charging unit while drawing very little energy. Tests have proven the Smart Heat System to far exceed the Energy Star conservation standards for appliances.

“The Smart Heat system is ideal for my high school athletic training setting. The quick heat time allows me to transition easily from being a classroom teacher to an effective athletic trainer,” says Ray Stadt, ATC, at
Eisenhower High School in Blue Island, Ill. “The easy sanitation provides peace of mind when using the same pads from student to student. Often I can treat two athletes consecutively between reheating, a capability my old hydrocollator could not match.”

The hot pack used for this system has been designed to exploit the most efficient means of heat-up time, temperature saturation, and heat retention. The pack consists of a two-part medical grade polyurethane gel material, thermal additives, and a thin-film flexible heater.

The thermal additives increase the thermal conductivity of the material as well as increase the heat retention of the polyurethane gel, providing a more even distribution of heat as well as lasting therapeutic temperatures. Using the highest setting, the therapy pads will provide up to 30 minutes of therapeutic heat.

Thermal image of right quadriceps after 7 min. of therapy.

Flexible and Low Maintenance

The result is an extremely flexible and conforming pad that molds to the body, providing greater contact and increased thermal transfer. With four different therapy pads to choose from, Therapy Innovations has made it easier to apply heat to complex joints such as the shoulder and ankle.

“I have finally found an alternative to using outdated hydrocollator packs in the office!” says Joseph Zappala, DC, director of Southwest Health and Fitness in
Costa Mesa, Calif. “When applying heat to patients, we simply unplug the pack and place it on the patient. No more wasted towels and overheating patients associated with scalding hot hydrocollator packs. We couldn’t be happier. We recently remodeled our office and had cabinets built into our rooms to house and conceal our pads.”

The Smart Heat Therapy packs are very soft and flexible, which makes them perfect for treating soreness and pain associated with arthritis. The therapy packs will easily conform to a variety of joints such as the hand and wrist, shoulders, and knees and ankles. It is now possible to treat such conditions with a safer medium or low level heat without the risk of tissue damage.

Late stage post-op rehabilitation can also benefit from this type of heat therapy because the effect of the neurological relaxation and soothing comfort of heat will not be contraindicated by increased swelling.

Waterless Modality

The Smart Heat System is a waterless modality that has very low maintenance and can be easily cleaned and disinfected. The polyurethane gel is solid and will not leak or ooze if the pack is cut or torn, eliminating any mess from old worn-out packs. The therapy packs are easier to handle than moist pads, and with the multiple settings, practitioners can safely lay their patients on the therapy pads. In contrast, it is not recommended that the patient place direct body weight on moist heat packs.

The ability to select a lower temperature therapy pack allows the patient to find the most comfortable position – often the supine position – while receiving heat therapy.

With the aging baby boomer population, the need for such a controllable heat modality may not have come at a better time. People have become more active in their later years than generations before and have a desire to maintain a level of independence and activity. As this population gets older, the need for care and appropriate technology will also rise. The Smart Heat System will allow the treatment of the elderly and aging to be safer and more patient appropriate.