Learn tips about Class IV laser therapy and other health related topics on the LightForce Therapy Lasers blog! Check back weekly for updated posts.
Score a Home Run When Treating Baseball Injuries With Laser Therapy
Guest Blog Post by Perry Nickelston DC, NKT, FMS, SFMA
Baseball players throw – they throw a lot. They also get hurt a lot. During the action of throwing, players have to generate massive force from the foot all the way up, over, and out to the throwing arm. It’s this generation of force, coupled with the inability to slow these movements down, that can often cause injuries. Deceleration injuries are the most common in all sports.
Deceleration, otherwise known as eccentrics, is the ability to control movement. In baseball you have to control throwing, running, sliding, frequent start and stop motions and unexpected impacts. When an athlete has the inability to control force, musculoskeletal injuries occur. Force production is strength. Stability always precedes force production. Three of the most common injuries in the sport of baseball occur from an inefficient control of force and stability in the shoulder, knee, and hip.
Many major league baseball teams are currently using a technology called Deep Tissue Laser Therapy for their athletes. Using laser therapy over affected areas can decrease recovery time and accelerate athletes’ return to the field. Laser therapy stimulates injured areas to recover at a faster rate (through a process known as photobiomodulation) by increasing blood circulation and modifying certain cellular processes in a noninvasive manner. It may also be combined with other treatment modalities like therapeutic taping to complement these effects.
Here are 3 big treatment areas to cover when using laser therapy for baseball injuries:
The Thoracolumbar Fascia (TLF)
The thoracolumbar Fascia is a vitally important area for treatment of musculoskeletal injury/pathology and when developing a long-term strategy for recovery and regeneration treatment protocols. The TLF is a key component of the Posterior Oblique Subsystem of movement including your latissimus dorsi and opposite side glute max.
This is the primary force generation and stabilization system of your backside. If you want to throw you need to own this system and most athletes don’t. If there is a restriction in the TLF, the arms and legs need to work harder to generate force. Arms and legs are designed to amplify force, not generate it. When they are called on the do both the body is at greater risk of injury.
Treat the TLF with a dose of approximately 4000 to 5000 joules. Don’t just treat this region when it’s the primary source of pain either – it should be treated for any and all injuries of the body.
A major cause of knee injury is tightening of the popliteus muscle. The popliteus is the unlocking mechanism of the knee when walking, by medially rotating the tibia during the closed chains portion of the gait cycle, and it’s also used when sitting down and standing up.
The popliteus is often referred to as the ‘key’ to unlocking the knee since it begins knee flexion by laterally rotating the Femur on the tibia. It’s also attached to the lateral meniscus of the knee. Pain in the knee is often attributed to overuse of this muscle. The knee can’t unlock and it torques in itself injuring tissue. Deep tissue laser therapy to the posterior part of the knee with slight flexion will help relax the popliteus that is overworking. Every ACL injury should have the popliteus muscle evaluated.
Apply a dose of approximately 2,000 joules to the posterior part of the knee.
The infraspinatus is one of the four rotator cuff muscles of the shoulder that give the glenohumeral joint stabilization. This muscle is often overused when someone does not have efficient function in the posterior oblique subsystem mentioned earlier. Over activity of the infraspinatus is the most common cause of pain in the anterior part of the shoulder. Its action is to externally rotate the humerus. The infraspinatus is also going to have eccentric control of shoulder internal rotation during the end part of a throw. If this muscle is too tight, it will not allow full range of motion in the glenohumeral joint and the elbow may compensate.
Apply a dose of approximately 3000 J to the entire infraspinatus and posterior compartment of the shoulder.
Application of deep tissue laser therapy to these three areas will go a long way to helping recovery of baseball injuries. Laser therapy should play a major role in the comprehensive regimen of sports injury recovery and prevention.
Maximizing Results with On-Contact Laser Therapy Treatments: Tips & Strategies
Guest Blog Post by Perry Nickelston DC, NKT, FMS, SFMA
Successful laser therapy application depends on sufficient dosage of laser light energy reaching the target tissue. Key phrase: target tissue
There are superficial structures that interfere with efficient absorption of laser photons to deep structures:
There are a few ways to increase efficient absorption of light to reach deeper structures of the body:
- Proper Wavelength
- Higher Power
- Contact Delivery Method
Contact delivery is the easiest and fastest way to maximize light penetration through the superficial structures listed above.
For example, let’s look at a hamstring strain:
- Treatment Option 1: 15 watts continuous wave 4,000 joules of energy delivered off-contact. Less joules reach the target in allotted time
- Treatment Option 2: 15 watts continuous wave 4,000 joules of energy delivered on-contact with a laser massage ball deep pressure contact. More joules reach target in same time.
Same dosage parameter. Different sensory input and patient outcomes.
10 tips to maximize results with contact delivery:
- Simply start delivering treatments on-contact with the massage ball and you are already ahead.
- Always keep a perpendicular angle to the skin when applying pressure to ensure optimal delivery and minimal scatter of photons.
- Change speed of application. Go slower with deeper pressure and alternate with fast light pressure. Different neurosensory input into the nervous system and tissue.
- Vary contact motion direction. Do circles, squares and grids to stimulate tissue.
- Vary of treatment area sizes. Do larger strokes with the massage ball intermixed with smaller sizes, especially over area where you feel more tightness, restriction or adhesions.
- Add active range of motion from the client. The more movement they can initiate the better. More motion means delivery of light into more area. The patient will also feel range of motion increase and pain decrease during the course of treatment.
- Add passive range of motion for joint, capsular or ligamentous injury. Passive range of motion to tolerance is an effective way to increase photon delivery into joint spaces.
- Change pressures. The body cannot feel pain and pressures at the same time. Use this to your advantage by pressing harder into muscular tissue. You will also reach deeper fascial layers which are often the most restricted and chemically damaged. Use lighter pressure over superficial areas and body interfaces such as the posterior medial tibia.
- Treat key fascial points in the body that transmit force, regardless of the location of pain. The ability to transmit force is a key function of fascial integrity. Laser the following 4 places with 1,000 joules of energy each: a) bottom of both feet b) glute max and TFL junction c) thoracolumbar fascia d) C7-T1 fascial bridge.
- Move upstream and downstream from the site of pain. For example, if your elbow hurts, laser the elbow. Then treat the bicep/ tricep upstream and the forearm downstream. For knee pain, laser the knee and then treat the quad and hamstrings upstream and calf/shin downstream.
What to do next:
Think about a client you may have been struggling with that you can begin using these techniques on right now. Start using the system. Pick one strategy and use it with everyone. Make your way through the list and gravitate towards the ones you like most. If you don’t have a laser massage ball, get one and get busy! It’s a game changer…
5 Places to Look for Pain When Assessing the Shoulder
Guest Blog Post by Perry Nickelston DC, NKT, FMS, SFMA
The shoulder is one of the most complex joints in the human body. So much activity happens here and so does a lot of chaos. Next to the lower back it’s the most common area of the body to suffer from pain, discomfort and injury. Why? It’s supposed to be a very mobile joint moving freely and easily. It’s also supposed to be stable and able to resist movement. Every joint in the body should be both mobile and stable. If that balance is compromised, the body suffers inefficient movement patterns and compensations occur. The most common compensations are tightness, stiffness, fascial restrictions, trigger points (muscle knots), decreased mobility, and pain.
Here are 5 key places to focus on when assessing the shoulder:
1. Bicep tendon
The bicep acts as a functional flexor of the humerus. It often moves medially out of the bicipital groove of the humerus causing anterior shoulder pain. You can feel popping or grinding when the tendon pops in and out of the groove. A simple test to assess if the biceps tendon is vulnerable is to bring the arm up in front of the body level with the floor and palm up. Lightly press down on the wrist and see if the arm drops from pain or weakness. If so, it indicates a subluxated bicep tendon.
Laser Treatment Tip: Laser the anterior shoulder with approximately 1,000 joules of energy at 9-10 watts.
2. Supraspinatus tendon/muscle
The supraspinatus is a functional abductor of the arm working with the lateral deltoid. It does the first 35 degrees of shoulder abduction. If the lateral deltoid is weak or inhibited, the supraspinatus must take over the role and it works too hard. This overuse causes tendinitis and eventual tearing when the tendon cannot take the repetitive force loads. Palpate the muscle deep to the upper trapezius as the arm is taken across the midline of the body to expose the muscle. The patient may jump or grimace if the muscle is inflamed.
Laser Treatment Tip: Laser the belly of the muscle and down the lateral aspect of the arm with approximately 2,000 J of energy at 9-12 W.
3. Pectoralis minor
The pec minor muscle is a very busy player in scapular stability. It depresses the scapula, protracts it, and downward rotates it. That’s a lot of work. The pec minor is usually over active because of the rounded posture of today’s lifestyle with cellular phones. Forward flexion of the torso and lack of extension feed the tightness. Pain in the anterior shoulder and bicep are classic signs of pec minor over activity. Weakness of the middle trapezius and rhomboids in scapular retraction cause dominance in the anterior pectorals. The pec minor will almost always be a culprit in shoulder pain.
Laser Treatment Tip: Laser the anterior Pectoralis structures with 1,000 J at 9-12 W using the massage ball. Do both sides!
An external rotator of the arm is often loaded with fascial adhesions and muscle knots. It overworks for larger prime mover muscles in the posterior shoulder, such as the rear deltoid, latissimus dorsi, and middle trapezius. When this muscle is dysfunctional, it refers pain to the anterior shoulder so it’s an elusive culprit in pain. The glenohumeral joint gets pulled anterior, leading to impingement. Palpate the Infraspinatus and the client will usually display the ‘jump sign’ (where they do a side-take jump from the pain).
Laser Treatment Tip: Laser the Infraspinatus and entire middle back with 2,000 J of energy at 9-15 W of power.
5. The cervical spine
The neck has a direct correlation to shoulder dysfunction. Nerves from the neck pass through the shoulder complex and they also control the shoulder via neural input. Shoulder muscles like the levator scapula and trapezius influence scapular control and affect the neck. Every upper extremity musculoskeletal condition should be treated in conjunction with the neck.
Laser Treatment Tip: Laser the cervical spine with 2,000 J at 7-10 W of power.
It’s highly recommended to treat each one of these areas with shoulder dysfunction. There is never just one culprit in shoulder pain. Treating the non-painful shoulder can improve function of the other due to fascial connectivity and force generation.
To watch a treatment video demonstrating how to use RockTape and laser therapy to optimize outcomes when treating shoulder injuries, click here.