An in-depth look at the physiological benefits of laser therapy in joint rehabilitation

Laser Therapy

Joint rehabilitation requires a strategic and comprehensive treatment approach, integrating soft-tissue techniques, fascial manipulation and functional movement patterning. Restoring optimal range of motion and reducing pain by transitioning a client from passive to active care should be the primary goal. Decreasing time spent in the passive phase of care and empowering patients with painless functional active rehab of the kinetic chain helps improve compliance.

What if you could use a modality to significantly increase recovery times and heal chemically damaged cells while strengthening surrounding tissue? Or decrease passive therapy and accelerate the natural regeneration process of injured joints? Laser therapy can be the answer you have been searching for to enhance clinical outcomes and patient satisfaction.

Understanding the therapeutic mechanisms of action involved with laser therapy and treatment protocols are essential. Successful use of any modality in clinical practice ultimately depends on the skill of the practitioner. Let’s take an in depth look at the physiological benefits of laser therapy and how it can be integrated into acute and chronic joint rehabilitation programs.

Physiological Benefits of Lasers

The US Food and Drug Administration (FDA) approved the first low-level Class III laser (LLLT) in 2002 and the first Class IV therapy laser in 2003. The most significant clinical and therapeutic difference between Class IV lasers and Class III is that the Class IV can produce a primary biostimulative effect on deeper tissues. Reaching deep tissue structures is critical to joint rehabilitation and recovery. If you cannot reach the intended target tissue with adequate therapeutic laser dosages, your overall clinical results will diminish.

Laser therapy excites the kinetic energy within cells by transmitting healing energy known as photons. The skin absorbs these photons via a photo-chemical effect, not photo-thermal; therefore it does not cause heat damage to the tissues. As such, laser can be safely used on patients who have metal joint replacements without the risk of injury. Laser light does not excite or interact with the molecules in metal or plastic.

Once photons reach the cells of the body, they promote a cascade of cellular activities. They can ignite the production of enzymes, stimulate mitochondria, increase vasodilatation and lymphatic drainage, synthesize ATP and elevate collagen formation substances to prevent scar formation. This is a critical step in reducing long-term disabling chronic myofascial pain syndromes and joint restrictions.

Photobiomodulation, also known as laser biostimulation, is the medical technique in which exposure to laser light enhances tissue growth and healing. Here is a partial list of positive effects of photobiomodulation on the body, all of which are a crucial part of long-term healing.

  • Increased leukocyte activity (acceleration of tissue repair and decrease of pain);
  • Increased neovascularization (new vessel growth and increased oxygenation);
  • Increased fibroblast production (speeds tissue repair);
  • Increased tensile strength (helps prevent re-injury);
  • Stabilization of cellular membrane of damaged cells;
  • Enhancement of ATP production and synthesis;
  • Decreased C-Reactive protein Neopterin and acceleration of leukocytic activity;
  • Enhanced lymphocyte response with reduction of Interleukin 1 (IL-1);
  • Increased prostaglandin synthesis;
  • Enhanced superoxide dismutase (SOD) levels;
  • Stimulation of vasodilation with increased angiogenesis (new blood vessels).

Success Factors

Principal factors of success with deep-tissue laser therapy for fascial restrictions and joint rehabilitation include optimal dosage, power, wavelength and accurate clinical diagnoses.

Maintaining or restoring movement of specific segments is the key to preventing or correcting musculoskeletal pain. Fundamentally, joint rehabilitation is about movement, and lots of it. The base foundation of functional movement is proper joint mobility and stability.

Without adequate mobility and stability of joints in the kinetic chain, you end up with dysfunctional movement. Activities of daily living are then built on dysfunctional movement patterns, resulting in compensation and injury.

Microtrauma results from small amounts of stress imposed on the body over time caused by poor biomechanics; the body compensates with suboptimal joint alignment, muscle coordination and posture. Joints begin approximating in an effort to gain stability lost from muscular weakness and compensation.

This process, known as “joint centration,” is an inherent protective mechanism of the body which, if left uncorrected, may cause osteoarthritis, degeneration and decreased mobility.

Postural movement patterns are learned early in life by the central nervous system (CNS). However, structural or functional body stressors (e.g., tension, trauma, genetics), may prevent optimum posture. Faulty postures from physical compensations alter joint mechanical behavior, flexibility and range of motion. The increase in mechanoreceptor stimulation from locked joints results in neuro-reflexive muscular changes. Long-standing over-activation of abnormal joint reflexes causes changes in spinal cord memory that eventually “burns a neural groove” in the CNS as the brain and cord are unknowingly saturated with a constant stream of inappropriate proprioceptive information.

Inherently, the brain comes to rely on this faulty information about where it is in space to determine how to establish perfect posture. The brain simply forgets what its alignment should be. In other words, the body now makes the abnormal its new normal. Neurology wins every time. The silent progression of faulty postures and dysfunctional movement patterns are part of the reflexogenic relationship between muscles and joints. Neurogenic muscle activation patterning by combining laser therapy and functional movement rehabilitation is an effective way to “reprogram” the CNS for optimal function and reverse abnormal patterning.

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