More Than Skin Deep

posted by on Friday, September 05, 2014

Low-level laser therapy has revolutionized treatment of sports injuries in the professional world with its ability to treat inflammation, provide deep tissue therapy and accelerate pain relief. For practitioners, its ease of use and rapid results often bring a return on investment in just a matter of months. Dr. Robert Silverman, DC, CNS, CCN, discusses how this modality works and how it can fit into your practice.

Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding universal success. And doing so at the speed of light.

Trauma from sports injuries causes damage to the cells that make up soft tissues. These damaged cells release chemicals that provoke a natural inflammatory response in the body, which results in redness, swelling, warmth, and pain in the injured area. Persistent or recurrent inflammation can predispose athletes to early onset arthritis or degenerative changes in their joints.

The application of low-level laser therapy (LLLT) reduces short-term inflammation. Additionally, laser therapy significantly lowers the risk of arthritis, which frequently arises from sports injuries. Laser therapy is used by professional sports teams and athletes to treat inflammation, provide deep tissue therapy, and accelerate pain relief to help minimize downtime.

For the last decade, LLLT has revolutionized treatment in the professional sports world including the NBA, NFL, MLB, NHL, the U.S. cycle team, Ironman competitors, Road Runners Club of America, college athletes, former Olympic athletes, and elite CrossFitters.

How it works

LLLT works to photobiostimulate chemically damaged cells via specific wavelengths (e.g., 635 nm) of coherent light.1-4 Coherence means that the light photons propagate in the same direction, amplitude and phase. This maximizes the depth of photon penetration to trigger a biological response.5

In contrast, an LED (light-emitting diode), which scatters light, is less effective at deep penetration.6 The cell membranes within the skin absorb photons by way of a photochemical effect that is not photothermal; therefore, LLLT does not cause heat damage to the tissue.7

When cells are chemically damaged through injury, they stimulate the pain cycle. LLLT excites kinetic energy within the cells by transmitting healing stimuli in the form of photons. Once photons reach the cells of the body, they promote a cascade of cellular activities.

LLLT can ignite the production of enzymes, stimulate mitochondria, increase vasodilation and lymphatic drainage, promote ATP synthesis, and elevate collagen formation to prevent or decrease the formation of scar tissue.8 This is a critical step in reducing chronic and disabling myofascial pain syndromes. Simply put, LLLT enables athletes to feel relief faster and heal at the same time.

Laser therapy can be an elite tool for the rehabilitation of athletes, and this is reinforced by the literature in the field.9-12

The ease of using the laser and the speed at which athletes respond to it are key features of LLLT. Most laser treatment sessions last from just three to five minutes. Its versatility is unmatched because it can be a stand-alone treatment or used in conjunction with chiropractic adjustments, soft-tissue release, instrument-assisted treatments, kinesiotaping, and virtually any other rehab-oriented protocol.

LLLT’s ease of use makes it a great fit. Fiscally, it is a sound investment. It improves your clinical outcomes and achieves patient satisfaction, thus inspiring them to spread the word about you. Implementing LLLT consistently attracts new patients to whom you can offer more services. As for ROI, LLLT adopters typically recover the cost within six months.

LLLT is a scientifically proven and effective treatment for the following (sports) injuries:

  • Acute and chronic pain
  • Neck pain
  • Back pain
  • Bursitis
  • Jumper’s knees
  • Tennis elbow
  • Achilles tendonitis
  • Chronic joint pain of the elbow, wrist and fingers
  • Plantar fasciitis
  • Shoulder injuries

Among its many benefits, LLLT:

  • Is nontoxic
  • Has virtually no contraindications
  • Is noninvasive
  • Is easy to implement
  • Creates no side effects or pain
  • Is safe and effective
  • Offers an alternative to analgesics, NSAIDs and other medications
  • Reduces the need for surgery

The key to choosing the right laser for your practice is to understand the type that best treats the patients you normally see. For sports rehab, consider a laser with coherent light that has an NHN (lamp, nonheating) FDA clearance. These lasers use wavelengths of light from the visible light spectrum versus the infrared lamp (ILY) lasers, which cause topical heating of tissues. LLLT has been proven as an effective method for relief of pain and rapid healing.13

References

1Karu T. (2007). Ten lectures on Basic Science of Laser Phototherapy. (p.277). Grängesberg, Sweden: Prima Books.

2Carrinho PM, Renno ACM, Koeke P, et al. Comparative study using 685-nm and 830-nm using lasers in the tissue repair of tenotomized tendons in the mouse. Photomedicine and Laser Surgery. 2006;24(6):754-58.

3YA Vladimirov, AN Osipov, GI Klebanov. Photobiological principles of therapeutic applications of laser radiation.Biochemistry. 2004;69(1):103-113.

4Enwemeka CS, Parker JC, Dowdy DS, et al. The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomed Laser Surg. 2004;22(4):323-329. doi:10.1089/1549541041797841.

5Karu TI. (2003). Low power laser therapy. Biomedical Photonics Handbook. T. Vo-Dinh, ed. (p. 48-1, 48-25). CRC Press: Boca Raton, FL

6Huang YY, Sharma SK, Carroll J, Hamblin MR. Biphasic Dose Response in Low Level Light Therapy — An Update.Dose-Response. 2011; 9(4):602-618.

7Olsen IM, French-Constant C. Dynamic regulation of integrin activation by intracellular and extracellular signals controls oligodendrocyte morphology. BMC Biology. 2005;3:25. doi:10.1186/1741-7007-3-25.

8Karu T. Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J. Photochem. Photobiol. B. 1999;49:1-17.

9Morimoto Y, Saito A, Tokuhashi Y. Low level laser therapy for sports injuries. Laser Ther. 2013;22(1):17-20.

10Bisset L, Coombes B, Vicenzino B. Tennis elbow. Clin Evid (Online). 2011;27:1117.

11Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 2009;374(9705):1897-908. doi: 10.1016/S0140-6736(09)61522-1. Epub 2009 Nov 13.

12Cesar E, Leal P, ÁLvaro.Effects of Low-Level Laser Therapy (LLLT) in the Development of Exercise-Induced Skeletal Muscle Fatigue and Changes in Biochemical Markers Related to Postexercise Recovery. J Orthop Sports Phys Ther. 2010;40(8):524-532. doi:10.2519/jospt.2010.3294.

13U.S. Food and Drug Administration. “Radiation Emitting Product Codes.” www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD_rh/classification.cfm?PCD=NHN. Last updated July 7, 2014. Accessed July 1, 2014.

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