b'CODING Update ComplianceLEGAL NUTRITIONCouncilANJC Leadership LEGAL EASE NUTRITION REHAB Council Executive Directors Update LEGAL Q&A CHIROASSISTINSURANCE Update INSURANCE Update Legislative UpdateTECHNIQUE CouncilAre You Using High MedicareQ&AMedicare Update Power Laser with Your OUR HEALTHAthletic Population? By Dr. Michael KaufmanThree Need-to-Know Concepts The chiropractic field has been using laser therapy for over 30 years to positively impact injured tissue. As chiropractic medicine has a focus on preventative medicine, it is worth reviewing this emerging technology to make sure ANJC members are up to date with current concepts and are utilizing laser properly with their athletic patient population.Not only has the equipment changed over the years, so has the name. Laser therapy is now correctly referred to as photobiomodulation (PBM) in the literature. PBM occurs when an effective dose of photons photochemically, photo-mechanically, and/ or photothermally stimulate tissue at the mitochondrial level. This triggers several positive biochemical changes that can decrease pain, improvedensities (irradiance) significantly impactsThis concept has led professional training inflammation, and accelerate tissuepain perception. 1Treating with higherrooms to start treating athletes both healing. irradiance has the ability to slow downbefore and after competition to maximize 1.Laser is a drug-free alternativeconduction rates and reduce compounddifferent aspects of muscle performance for helping reduce inflammationaction potentials in both C- and A-deltaand minimize delayed onset muscle Mechanistically, laser has been shownafferent nerves. This can result in quicksoreness (DOMS). Many major league to have a significant impact on thechanges in patients pain complaints viapitchers are now having their throwing inflammatory soup which athletes havetrue analgesia, which is a phenomenonshoulders treated with laser both before to manage on a regular basis. Lasersthat cannot be easily accomplished withand after competition to the throwing impact on inflammatory mediators takeslower powered lasers.muscles to improve performance and place via the power of light. It is funda- 3.Maximize recovery and recovery. mentally different from pharmaceuticals,reduce DOMS Whether you are promoting pain reduc-which usually block components of thePreconditioning is a lesser knowntion or sports recovery at your center, inflammatory cascade. This can negativelyphenomenon that can be associated withhigh power laser may help both aspects impact tissue healing. PBM often takesPBM, where influenced cells improveof your practice. place at the source of the injury whichtheir ability to deal with oxidative stress. promotes homeostasis in tissues that areREFERENCES:oxidatively stressed. This can naturallyRecently, Class IV lasers have been used1. Levine, D. et al.Effects of Laser on Endurance of the hasten the process of tissue healing whento precondition skeletal muscle to slowRotator Cuff Muscles.Lasers in Surgery and Medicine. dosed properly.muscular fatigue and reduce biochemical2015; 47(S26): 34-45. stress during and after strenuous exercise. 2. Borsa, P. et al.Muscular Preconditioning Using 2. Fast reductions in pain Phototherapy Improves the Physical Work Capacity of the A study published in February 2019Quadriceps when Applied between Repeated Bouts of Pain reduction is complex. Most lasersfrom the University of Florida looked atResistance Exercise.J Athl Enhanc 2019, 7:6.have the potential to reduce inflammationthe impact laser could have on the work in superficial tissues. But when lookingcapacity of the quadriceps muscle group. 2to create fast pain relief or get resultsLaser was applied intermittently betweenMichael Kaufman, DC, received his Doctor with deeper tissues, clinicians need torepeated bouts of high volume, highof Chiropractic degree from Life University understand how high-power laser intensity isokinetic quadriceps exercise andCollege of Chiropractic in Atlanta and is impacts pain.promoted higher knee extensor torque,Webster-certified. He serves as co-chair of Recent research has shown that treatingincreased power output, and attenuatedthe ANJC Sports Council and is the owner afferent nerves with higher powermuscle fatigue compared to controls.of Kaufman Chiropractic in Skillman.www.njchiropractors.com I 15'