The use of acetic Acid iontophoresis in the management of a soft tissue injury.

Background: Contusions are common injuries that occur in athletics. If repeated, complications like myositis ossificans can occur. This case describes the examination and treatment of an athlete with an acute soft tissue injury.

Objective: To describe the treatment approach used with a hockey player who sustained a soft tissue injury in his upper extremity.

Case description: A 19 year old male sustained a soft tissue injury to his upper arm while playing hockey. The athlete complained of pain rated a 2-3 out of 10. He had a well circumscribed, firm, 8 by 5 centimeter palpable mass present along the lateral arm, and was able to passively flex his elbow from 56° to 135°, demonstrating a 56° loss of elbow extension. Functionally, he was able to perform most activities of daily living, but he was unable to play hockey. Over 29 days, the athlete was treated one time with pulsed ultrasound and ice and nine times with iontophoresis using a 2% acetic acid solution. Additionally, the athlete performed pain-free active range of motion exercises for the elbow.

Outcome: Following treatment, the athlete's pain resolved, the palpable mass disappeared, and his passive range of motion at the elbow was 0° to 135°. Most importantly, the athlete was able to resume playing hockey.

Discussion: Acetic acid iontophoresis may be a successful intervention for soft tissue injuries of the upper extremity. In this case, it appeared helpful in decreasing the athlete's impairments and contributed to quicker resumption of all functional activities in less time than previously reported in the literature using traditional treatment interventions.