Which of the following is a precaution or contraindication for PAMS?

• A. Excellent sensation
• B. Active infection
• C. Normal healing after injury
• D. Recent repair of tendon or ligament

Answer: (B)

Active infection at the treatment area is a contraindication for PAMS. When an infection is present, the goal is to contain and treat the infection, and applying energy-based therapy could disrupt local defenses, potentially worsen the infection, or spread it. PAMS aims to promote healing and tissue activity, but doing so over an active infection can be counterproductive or risky. Once the infection is resolved, PAMS can be considered.

The other scenarios describe conditions that do not inherently prohibit PAMS: having good sensation means the patient can safely report tolerable therapy, and normal healing indicates no ongoing pathology that would forbid treatment. A recent tendon or ligament repair may require caution in some contexts, but it isn’t an automatic contraindication the way active infection is.