One of the lasers that I use for treating
tendonopathy diseases is the Diowave 10, 15 watt
or 30 watt laser. There are others. You can use
a 10 watt laser, but the higher wattage in the
laser, the faster the onset and increased tissue
penetration This is called peak power.
A 980 wavelength is very important to ensure
deep tissue penetration without getting photon
to the damage tissue. There will be little to no
effect. This is why power is important as well
a wavelength. This is part of the therapeutic
window for tissue penetration. The concise
principle with how the laser treatments work on
plantar fasciitis or any painful, inflammatory
tendonopathy is through bio-stimulation or photo-
modulation.
Laser light is absorbed into the mitochondria
where ATP production take place. ATP is needed
for most bio-chemical pathways in the human
body, including the inflammatory response. Pain
has other pathways that lasers address,i.e, Na
pump blocking. I will supply detailed bio-
chemical pathways as well as scientific
literature. if you desire further explanation.
I will address the protocol which is the
original quesion by Dr. Papp-Mlodzienski (sorry
for the lengthy introduction). One of the
beauties of laser bio-stimulation is the ability
to improved joint mobility. I will address any
soft tissue equinus as well as plantar fasciitis
condition. We know as podiatrists that the role
of equinus in pf is very damaging
PROTOCOL: We treat the popiteal fossa to open up
the NV bundles. We treat any pain in the
gastrocnemius muscle heads as well as the soleus
area. We treat the ankle and then the plantar
fascia. Treatment time is between 5-10 minutes.
Typical relief is seen in most patients with 1-3
treatments. Most patients will experience a
dramatic change in ankle joint mobility and or
pain reduction. The purpose of laser physical
medicine is to reduce or give the patient the
laser non-invasive option instead of local
steriod injections or NSAIDs. You can
incorporate the laser treatment along with local
steriod injections but it ISN'T necessary or
needed.
The first treatment with any high-energy laser
is typically dramatic within the first
session. The goal at all times is to increase
ROM at the ankle joint (equinus) reduce pain and
reduce the inflamatory conponent of the
condition. Biomechanical treatment is always
part of any laser treatment program that I
teach.
Disclaimer: Dr. Zuckerman sells lasers.
David Zuckerman DPM, Woodbury, NJ,
footcare@comcast.net
