Posts Categorized: Chiropractic
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 global success, and it is doing so in a fast, efficient way. In fact, Dr. Oz has called it the “no-pill pain buster.”
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 result 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. This condition can affect the weekend warrior to the elite athlete.
The application of cold laser therapy, officially known as low-level laser therapy (LLLT) reduces short-term inflammation. Additionally, laser therapy significantly lowers the risk of arthritis frequently resulting 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 athletes minimize downtime. For the past decade, LLLT has revolutionized treatment in the professional sports world including NBA, NFL, MLB, NHL and USA Cycling athletes, as well as Ironman triathlon competitors, competitive runners, college athletes, former Olympic athletes, and elite cross-fitters.
Mechanism of Action
LLLT works to photobiostimulate chemically damaged cells via specific wavelengths of light in a coherent manner. Coherence means that light photons propagate in the same direction, amplitude and phase. This is important to maximize the depth of penetration in order to trigger a biological response.
The cell membrane within the skin absorbs these photons via a photochemical effect, not photothermal; therefore, LLLT does not cause heat damage to the tissues.
When cells are chemically damaged through injury, they stimulate the pain cycle. LLLT excites kinetic energy within the cells by transmitting these healing stimuli that are 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, ATP synthesis, and elevate collagen formation substances to prevent scar tissue. This is a critical step in reducing chronic, disabling myofascial pain syndromes. Simply stated, LLLT enables athletes to get out of pain faster and heal at the same time.
I have found the laser to be a superior tool for the rehabilitation of athletes. LLLT is a scientifically proven and effective treatment for a wide range of sports injuries, including acute and chronic pain; neck and back pain; bursitis; jumper’s knee; tennis elbow; Achilles tendonitis; chronic joint pain of the elbow, wrist, and fingers; plantar fasciitis; and shoulder injuries. As supported by the literature in the field, I see consistent results with my athletic patients for a variety of conditions:
The ease of using the laser and the speed with which the athletes respond are key features of LLLT. Most laser treatment sessions last from just three to five minutes. In my experience, 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, elastic therapeutic tape or any rehab-oriented protocol.
An Example: Ankle Sprains
One specific application for LLLT is ankle sprains, which have an 80 percent recurrence rate and high rates of subsequent chronic symptoms. The most frequently seen ankle injury is an ankle inversion sprain.
There are a host of causes and risk factors for ankle sprains; a previous history of ankle sprain is the most common risk factor. I’ve found LLLT to be instrumental in reducing the swelling and tissue damage that are typically associated with an acute ankle sprain. I’ve seen recovery times that have been literally decreased by days.
Chronic ankle sprains is where the benefits of LLLT can truly be seen. Interestingly, most athletes with chronic ankle sprains have a proprioceptive deficit in that injured ankle. Proper proprioceptive exercises coupled with laser therapy have enabled many of my athletes to avoid the recurrence so commonly seen with the injury.
After an ankle sprain, there is a significant delay in the onset of activation of the gluteus maximus on the injured side. LLLT applications to the gluteal regions have helped facilitate the gluteus maximus muscle in chronic ankle sprains.
Low-level laser therapy has varied benefits and functions as a superior alternative to analgesics, NSAIDs, medications and other modalities. Furthermore, LLLT reduces the need for surgery and has virtually no contraindications. Highly effective, non-invasive and safe, LLLT is easy to implement in any chiropractic setting.
In my many years of practice dealing with high-school, college, and professional athletes, I have found LLLT to be the best means for rapid recovery and increased performance from a sports injury. I consider it the most efficient, most versatile tool of the 21st century for sports injuries.
- Low-level laser therapy is an effective treatment for sports injuries, particularly jumper’s knee, tennis elbow and Achilles tendonitis.
- Low-level laser therapy has been recommended as a treatment option for tennis elbow.
- Low-level laser therapy reduces pain after treatment in acute neck pain and up to 22 weeks after completion of treatment.
- Low-level laser therapy has positive effects on exercise-induced skeletal muscle fatigue and changes in biochemical markers related to post-exercise recovery.
- A double-blind, randomized, controlled trial showed that LLLT and exercise therapy is more effective than exercise therapy alone for the purposes of improving pain and active / passive ROM in patients with subacromial syndrome.
- LLLT has been shown to be effective for treating chronic neck and shoulder pain, as well as chronic heel pain from plantar fasciitis.
If you think chiropractors simply “crack” backs, you’re not alone. Scott Duke, D.C., owner of Duke Chiropractic in New York City, is accustomed to hearing this misconception.
“Sports chiropractors who are trained in muscle work, such as Active Release Technique (ART) and Graston, are probably the best manual therapists for preventing injury and optimizing performance,” says Duke. “That’s why there’s always a sports chiropractor on Olympic and professional sports teams.”
For runners, chiropractic can be used for injury prevention because it emphasizes proper alignment of the spine and pelvis. The most common running-related injuries Duke sees in his patients, which range from recreational runners to Olympians and New York City Marathon winners, are plantar fasciitis, Achilles tendonitis, IT Band Syndrome, patella (knee) tracking problems and hip bursitis.
Duke’s first step in treating these injuries: Search for misalignment.
“Malalignment of the spine can cause unnecessary tension on one particular body part versus an equal distribution of pressure,” he says. “I can’t take care of anyone’s chronic IT band problem without making sure their pelvis is in as perfect alignment as it can be. Otherwise, it’ll continue to wear, tear, and put strain on that one particular body part.”
What Causes Improper Alignment?
Major causes of improper alignment include running in the same direction on the same course every day; running often slanted surfaces, such as a beach; and not replacing shoes every few hundred miles.
Fix these training errors that cause misalignment with a few simple tweaks:
- Vary your running surface—pavement, track, asphalt, grass, dirt, wood chips—a few times a week, and you’ll naturally run on different courses.
- Run as close to the water as possible when on the beach, as the sand tends to be more flat there.
- Buy two of the same type of running shoes, and switch between the pairs.
At Fix Body Group we are bombarded weekly by injuries and trauma to the shoulder, especially the rotator cuff muscles. Most people have heard of injuries and tears to the rotator cuff. Whether you are a Crossfit athlete, baseball fan, desk jockey or weekend warrior in a local gym, everyone fears the rotator cuff and the pain and suffering an injury there is supposed to coincide with. However, as we will describe below, often these injuries are extremely treatable and have a very high success rate, if the proper approach is taken.
While by nature, especially compared to the hip or other joints, the shoulder in naturally less stable, these type of injuries are often very preventable and can also be healed very successfully with conservative physical and manual therapy methods. We employ a mix of sports therapies, A.R.T. , massage, and chiropractic work to help re-balance the shoulder by strengthening weak muscles and relieving tightness and scar tissue buildup in tight muscles, ligaments and tendons.
Lately, we’ve encountered a number of problems that have to do with one rotator cuff muscle in particular, the subscapularis. The subscapularis, or “subscap” as it’s often called in short, is extremely important for both normal function of the shoulder joint, and also the healing of an injured shoulder. Because it lies beneath the scapula (and thus derives it’s name), and posterior to the rib cage it is very hard to access and treat, except by the most skilled and knowledgeable of therapists. Many doctors, massage therapists and PT’s don’t really know how to access it for manual therapy, and there are few ways to really create a positive response in this muscle otherwise.
The subscapularis will become very tight in swimmers, ballplayers, surfers, boxers, Crossfit athletes, and anyone who uses a mouse, keyboard, or steering wheel for long duration. You might know this muscle is affected if you have trouble bringing your arm up overhead and rotating externally, as if winding up to throw a baseball. If you have trouble with these motions please consider getting an assessment to find out if this muscle, or another rotator are compromised. This muscle is not easily stretched or lengthened at home, and is best treated using an advanced manual therapy technique such as Active Release Technique as we do here at Fix Body Group. Many of our desk jockies, Crossfitters, and professional fighters can attest to the powerful change that can be made on this muscle, and ultimately the entire shoulder joint.
A recent topic in the athletic world is the role of inflammation in healing and adaptation to training. This is particularly of note to our running, cycling, and triathlete patient base that train many hours per week and are constantly at war with inflammation, pain, soreness, and fatigue. This topic is fleshed out in greater detail in an excellent blog linked here:
If you don’t have time to read the article (which you really should take the time) I will outline some of the main points.
1. Inflammation is often a desired, and necessary response to injury or training. Without it, adaptation can be less effective.
2. NSAID’s (or Non Steroidal Anti Inflammatory Drugs) inhibit training adaptations in muscle according to research.
3. Recent studies show that anti-inflammatory drugs don’t always reduce pain. This flies in the face of what is commonly believed and thus brings into questions of placebo with NSAID’s.
4. Use of NSAIDs sparingly and in the acute injury phase is recommended.
At Fix Body Group we often recommend the use of NSAID’s but the timing and types of issues always are brought into play in making these decisions. While this must always be dealt with on a case-by-case basis, we generally approve of the suggestions in this blog. Using NSAID’s (and let’s not forget ICE!) in the acute but not chronic phase of injury is recommended. Icing as done by many runners and endurance athletes such as ice baths, along with use of NSAID’s to treat general training soreness is not recommended.
This goes hand in hand with what the elite athletes I’ve worked with for years are doing. Elite athletes often take doses of NSAID’s and use ice baths during competitions, so that they can prepare for the next round or day without care for training response from the event. In training they typically limit or avoid these practices to allow their body maximum adaptation to the training stimulus.
Remember, soreness is a good thing in training, it means you have taxed the fibers and musculoskeletal system. Soreness can also be thought of as a governor, forcing your body to slow down for a few days until both the metabolic, nervous, and musculoskeletal systems are recovered and ready for more. If you acquire a simple ache, tendon injury or something that is more than general soreness consult with your health care professional and generally some advil for about three days would be a good idea. If you have questions about different kinds of soreness or what you should do in these scenarios please leave comments below or call to speak to one of our providers. Happy training!
The Fix team will be out in force at the Pacific Beach Movin’ Shoes store to provide injury screening and diagnostics this Saturday 8/31, from 9-11:30am. Our team of chiropractors, therapists, and trainers will analyze your imbalances and deficiencies and suggest action steps for improvement.
Movin’ Shoes will also hold a labor day sale so if you need some shoes or would like to get recommendations for shoe choices make sure to come by also. Knowing your physical risks and limitations through our injury screen will be helpful when you go to purchase shoes.
Thanks to Movin’ Shoes and we’ll see you all out there!
Check out facebook here to get more information:
We would like to thank San Diego’s Free to Breathe and race director Roger Drews of Challenger Productions for a great event this morning!!! This community race does great work to support Lung Cancer. We were in Point Loma bright and early Saturday to donate a raffle prize and do some work on injured walkers and runners. Special congrats to team member Jonathan Pierce for winning their 5K this morning! Proud of you Jon!