Why doesn’t C.O.A.S.T. use ultrasound?
Studies over the past 20 years have demonstrated that ultrasound (US) isn’t very effective for anything. It can be used to heat a small area of tissue, but is not as effective in heating tissues as exercise. For many years (before studies were done), people believed US was a cure all—-pain, inflammation, edema, scar tissue reduction, promote healing. We know better now.
Why is US still used in healthcare settings?
1) Not everyone stays current with research 2) insurance companies still reimburse for this service 3) it is simple to use 4) MD’s and patients demand it. In my opinion, the main reason US is still used is to pad the bill.
Why doesn’t C.O.A.S.T. use electrical stim/TENS/NMES?
Again, in general, research does not support the use of electrical stimulation, especially when used for stimulating muscle contraction (NMES). Exercise is much more effective. There is some benefit for using it for pain relief (TENS), but it has not been demonstrated to be more effective than other interventions such as exercise.
Why is electrical stim still used in healthcare settings?
See my response for US. There are situations where electrical stimulation can be a better option than exercise, but not typically in an outpatient orthopedic setting.
Why do you emphasize high repetitions with strengthening exercises?
Research clearly demonstrates that higher repetition exercises provide more benefits than lower repetition exercises (of the same intensity). Among the benefits: promotes healing/repair and tissue toughening (making tissues structurally stronger), enhances muscle memory and patterning, speeds up strength gains.
Why do you emphasize holding stretches for several minutes?
Research clearly demonstrates that the longer a passive stretch is held, the more effective the stretch is for lengthening the muscle. Stretches are not effective if held for seconds vs. minutes. Studies also show that short duration stretches have no significant effect on scar tissue.