Views From The Clinic – VOL1 – Treating Rotator Cuff Injuries With Class IV Lasers & Shockwave Therapy
By Dr. Ernie Bagnulo – WIN HEALTH SOLUTIONS
Rotator cuff injuries are caused by various mechanisms, the most common being repetitive strain injury (RSI) and trauma. In either case, the presenting symptoms usually involve pain around the glenohumeral joint as well as the anterior portion of the shoulder, at the tendinous attachment.
When a tendon irritation occurs and inflammation and patient discomfort are elevated, we have found that treatment utilizing the LiteCure Class IV Laser Therapy has been most effective to minimize discomfort and increase mobility. This is especially helpful prior to therapy when we ask our patients to become more active and challenge the mechanics of the joint in question in a manner they may not perform on their own.
We have used Class IV Laser Therapy prior to initiating active treatment in order to achieve a level of comfort that allows for a more productive treatment afterwards. Often the patients request Laser therapy because it has a soothing and warm sensation and the results can be felt almost immediately. The dosage time is minimal and manageable compared to class IIIb lasers; 5-10 minutes is the usual treatment time.
Where the Laser truly shines is when we use it in combination with our Storz Focused and Radial Shockwave machines. As rotator cuff injuries become chronic and fibrosis develops and the tendon becomes thick and mal-adapted, we have used Shockwave therapy and Laser collaboratively to obtain results greater than using each modality individually.
Shockwave therapy creates an impact and microtrauma to a local area, in this case the rotator cuff, and the result is an increase in oxygenated blood and phagocytic activity to help void the area of cellular debris. Laser aids by increasing the production of nitrous oxide and thus resulting in vasodilation, this is one of the reasons these two modalities work so well together. Laser also helps to stimulate metabolic activity and increase the proliferation of healthy cellular activity and turnover.
Both modalities have been excellent investments for us and our patients. They are both used numerous times daily and we really on them for their excellent outcomes.
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