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Laser therapy provides non-invasive treatment
for elite athletes and weekend warriors.

Laser Therapy Video http://www.youtube.com/watch?v=lOBNnAogh_g&noredirect=1

BY MIKE FROSTAD, ATC, GEORGEPOULIS, MA, ATC,AND GLENN COPELAND, DPM

Athletic trainers and medical professionals
specializing in sports medicine
are bombarded with requests
to try the latest rehabilitation and
physical therapy devices. While it's important
to stay abreast of new technologies and evaluate
legitimate interventions, you don't want to
waste time or money on modalities that have more marketing behind them, instead of solid clinical evidence.

Class III lasers have been used in Major
League Baseball for years and have proven effective.
However, about a year ago, we started using
a class IV laser with the Toronto Blue Jays and
were impressed with the results.

In addition to expediting athletes' recovery time after injury or surgery, the device also serves as an injury prevention tool. For example,
by treating a starting pitcher's shoulder before
every game, we warm up the joint, help prevent
stiffness and optimize on-field performance.

The basic science behind laser therapy is
compelling. Cells absorb the light and undergo
significant positive changes. Studies have shown
that impaired cells have a stronger response to
laser light than healthy cells. Light produces the
most benefit where it's needed most.

Lasers work by impacting cellular function.
Damaged cells absorb and become energized by
photonic energy; this function has been documented
with more than 2,000 clinical studies over the last 30 years. Stimulated cells increase
ATP production and dramatically reduce inflammation,
pain and swelling.Thus, this modality
may be considered a healing process as it corrects
compromised cellular function and allows the body to heal.

The following conditions can respond favorably
to class IV laser therapy if you comply with general
treatment parameters. Age and injury severity
determine individual protocols.

Shin splints. Mild improvement of shin splints
occurs with 1 treatment. You can expect significant
improvement after 3 to 4 sessions. Other
modalities may take a week or longer to incite
the same results.

Studies have shown that impaired cells have a
stronger response to laser light than healthy cells.

Tendinitis (shoulder). We use laser therapy to
help warm-up athletes prior to throwing. Players
notice less stiffness when they start throwing and
decreased soreness and fatigue after throwing,
compared with other modalities.

Rotator cuff strain (acute). Decreased soreness
is attributed to the anti-inflammatory and
analgesic effects of class IV lasers. The effects
allow more range of motion (ROM) earlier in the
rehab process, and athletes can start strengthening
exercises sooner.

Partial medial meniscectomy. Players treated
the day after surgery can achieve full passive
ROM by day 3, with little to no pain.
Previously,
athletes didn't achieve these type of results until
week 1.

Pain-free, full ROM allows players to throw
with normal mechanics by day 7. Reaching this
level takes about 2 weeks using other modalities.

Arthroscopy portals. Laser treatment over
arthroscopy portals decreases healing times in
order to remove sutures after 8 days. Without
laser treatment, sutures are usually removed in
to 10 to 14 days.

Ulnar collateral ligament reconstruction.

The full results of laser use during this recovery
process are yet to be determined. However, using
a laser over the incision decreases scar tissue and
increases vascular activity to the area.

Its use over acupuncture points improves
the overall feeling of the elbow when throwing.
A pitcher may be able to return to his previous
level of competition 2 to 3 months sooner
(9 to 10 months postop) than other rehab
modalities permit.

Plantar fasciitis. From pro athletes to weekend
warriors, 70 percent to 80 percent of patients
with plantar fasciitis resolve symptoms after 12 to
16 treatments. To achieve these results, perform
treatment 3 times per week for 4 to 6 weeks.

Achilles tendinitis. Our overall success rate
of laser therapy on Achilles tendinitis is about 75
percent. But athletes need approximately 20 treatments;
severe cases may require 30 sessions.

Morton's neuroma. Only 8 to 10 treatments
are needed to treat this condition, which responds
with about an 85-percent success rate.

In addition, the following injuries have been
successfully treated with laser therapy: turf toe, medial epicondylitis (golfer's elbow), lateral epicondylitis (tennis elbow), patellar tendinitis,
muscle strains (quadriceps, hamstrings, forearm,
shoulder, oblique), joint sprains (mainly ankles
and knees), carpal tunnel syndrome, neck pain
and low back pain.

This year, the Toronto Blue Jays started using
laser therapy in their minor league rehab facility.
In addition to providing continuity of care
between the major leagues and players sent for
rehab, it's being used extensively during spring
training and on minor league players who
need rehab.

Laser therapy has decreased our athletes' pain
levels following a variety of acute injuries. As a
result, we're able to keep more players on the field,
even if they're not performing at 100 percent.
The therapy has also decreased the number of
days a player is out of the game due to injury.

Professional baseball players aren't the only
population benefiting from this therapy. College,
high school and amateur athletes, industrial
workers and others suffering from disparate
acute or chronic soft tissue and musculoskeletal
injuries can also benefit.

The therapy's positive results stimulate compliance
as patients start to feel less pain and
experience faster, lasting results.

Non-invasive pain relief that reduces swelling
and inflammation is crucial to healing. Instead of
recommending anti-inflammatory medications,
our standard treatment protocol now combines
orthoses with shockwave and laser therapy.

We keep identifying more conditions among
our athletic clients that can be successfully treated
with laser therapy. Athletic trainers, therapists
and other health care professionals should
investigate this promising modality. ¦

Mike Frostad, ATC, is athletic training and
rehabilitation coordinator, George Poulis,
MA, ATC, is head athletic trainer, and Glenn
Copeland, DPM, is team podiatrist for the
Toronto Blue Jays. Dr. Copeland is the former
CEO of Cleveland Clinic Canada.


©2009, Reprinted with permission from Merion Publications Inc., Publishers of ADVANCE Newsmagazines. ADVANCE Reprints 1-800-355-5627, ext 1446.

www.advanceweb.com/rehab ADVANCE FOR DIRECTORS IN REHABILITATION • JUNE 2009

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