Laser therapy is excellent for enhancing wound repair, particularly in troublesome wounds in highly mobile areas which can result in delayed repair.
Laser stimulates cells through photobioactivation and helps by activating the cells responsible for repair and regrowth.
It doesn’t cause a thermal response (i.e. increased heat) due to the low levels of light, however the level of light is significant enough to encourage cell proliferation and motility, thereby enhancing the speed of repair. Laser can also help with muscles which have become ‘locked’ in spasm, helping to release the spasm and provide pain relief to then allow me to work on the area with manual therapy.
- Increased nitric oxide production
- Increase in the release of beta endorphins
- Decreased bradykinin levels within the surrounding tissues
- Ion channel normalization within the individual cells
- Stabilization of the action potentials within the individual nerve cells
- An increase in the localized and systemic serotonin levels
- Increased release of acetylcholine
- Blocked depolarization of C-fiber afferent nerves
Reduction in the inflammatory process is accomplished by a similar cascade of events. These are:
- An inhibition in the synthesis and secretion of inflammatory prostaglandins yet a stimulation of those prostaglandins that have a vasodilatory and anti-inflammatory action
- Stabilization of the cellular membrane in regard to Ca++, Na+ and K+ concentrations
- Enhancement of ATP production and synthesis stimulating the metabolic activity and the production of fibroblasts
- Reduction in interleukin 1 production
Microcirculation is primarily stimulated by the release of nitric oxide and increased levels of serotonin. This increase in circulation and subsequent vasodilatation allows for an increase in leukocytic and macrophage activities.
What are the top clinical applications for deep penetrating laser therapy?
There are four broad areas where photobiomodulation is of great benefit to the equine athlete. These are:
- To accelerate the rehabilitation and healing of many common lameness disorders.
- To maintain the peak performance within any equine athletic discipline.
- To prevent the occurrence or recurrence of athletic injuries.
- As an essential component of stem cell and PRP treatment protocols.
Combining deep-penetrating laser therapy with traditional therapeutic regimens accelerates the recovery time of many common lameness disorders in horses. Pharmacological approaches and rehabilitative physical therapy techniques, such as hyperbaric oxygen therapy and underwater treadmills, complement each other to reach the unique therapeutic goal for each patient.
Several of the most common applications of laser therapy for the treatment of lameness disorders include:
- Tendon and suspensory injuries such as tears, tendinitis and desmitis
- Synovitis and tenosynovitis
- Back disorders
- Wound healing
One of the most important aspects of equine sports medicine is the maintenance of these athletes at their highest level of performance. Deep-tissue laser therapy is an invaluable tool for this endeavor.
All athletes have to endure the rigors of training. This training results in pain and soreness. Periodic therapeutic laser applications allow these equine athletes to recover faster and therefore train more efficiently.
The ability to use laser therapy to prevent injuries is often overlooked or even considered non-efficacious. How important would it be to establish blood flow and elasticity within the tissues of the suspensory tendon in an equine athlete predisposed to stress in this area before a competitive event? Deep-penetrating laser therapy accomplishes this therapeutic goal.
How often do you have to apply laser therapy for it to be effective?
Laser therapy is cumulative in effect. Each treatment is complementary to the last on a cellular level. Each case is unique and a therapeutic goal should be established, setting realistic expectations for the owner or trainer.
If the condition is acute, i.e., a soft tissue injury or wound, or chronic, i.e., a high suspensory desmitis, treatment is accomplished in three phases. Initially, the therapy should be administered aggressively (every day or every other day for several treatments). This is analogous to the loading dose of a pharmacological agent.
A high level of stimulation within the tissue is the first goal. Secondly, there is a transition phase that consists of once- or twice-per-week treatments as dictated on a case-by-case basis. Lastly, especially in chronic disorders, a maintenance phase should be in place.