Tendinitis occurs when the flexible bands of fibrous tissue that connect muscles to bones become inflamed and painful. As individuals age, tendons become less flexible and rates of injury increase. Because they are found throughout the body (e.g. hands, wrists, elbows, shoulders, hips, knees, ankles, and feet), tendon injuries rank as one of primary injuries seen in physical therapy settings. Tendon injuries are common among athletes, but can affect gardeners, workers, and even musicians.
Current treatments for tendinitis (i.e. inflamed tendons) revolve around stretching and conditioning exercises as well as the judicious use of anti-inflammatory medications, TENS units, massage, and ice/heat compresses. In recent years, high-intensity laser therapy (HILT) has come to the forefront of techniques for fast, reliable, and safe treatment of tendinitis. New research has added weight to the claims made regarding this new therapy.
HILT stands for high-intensity laser therapy, a technique that uses laser emissions to achieve deep tissue penetration. The result is a high thermal gradient as well as photochemical effects that seem to improve tissue repair and increase lymphatic drainage in injured areas. A comprehensive understanding of the mechanisms by which lasers produce lasting pain relief has not been assembled, but some clues have been uncovered from studies on everything from bone health to herniated discs. At least part of the healing comes from modulation of cellular activity and, as a result, modulation of hormone and cell signaling pathways. Several studies have demonstrated cytoproliferative effects as well, suggesting that laser therapy may increase cell recruitment to areas of injury and thus speed healing.
The effects of HILT on everything from orthodontic pain to herniated disc syndromes have been explored. Most studies reveal the same trend, with HILT leading to pain relief and increased range of motion (ROM) at a fast rate early in therapy. Over the long term, HILT provides no significant advantage. In other words, studies seem to indicate that HILT jumpstarts healing when used early in recovery. A March 2015 study, published in the journal ManualTherapy, found that HILT produced good results early in treatment, but that the effects are comparable to standard therapy over longer periods of time. This follows well with other studies that indicate that HILT is effective in speeding healing, even if it doesn’t change overall outcomes.
HILT and Tendinitis
A 2009 randomized clinical study published in the journal Physical Therapy, found that patients treated with HILT showed significantly greater decreases in pain versus patients treated with ultrasound. The same study also showed better outcomes in terms of joint mobility, functionality, and muscle strength. In May, 2015, a second study from the journal Energy for Health, produced similar outcomes.
The benefits of HILT in treating tendinitis are determined by the skill of the practitioner in determining initial settings and in adjusting laser settings based on patient feedback. Like any technique in physical therapy, the efficacy of HILT is dependent on training and conscientious use. With appropriate training, HILT can provide an effective means of treating tendinitis, particularly during early stages of therapy, returning individuals and athletes to health sooner than other treatment modalities.
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