Event riders and jumpers tend to suffer knee pain, since maintaining balance in half seat or two point position puts a lot of stress there. Keeping the quadriceps and the vastus medialis oblique will help keep your knee healthy, but if you have pain at a horse show, getting cold laser treatment can reduce the pain, inflammation, and swelling, and allow you to focus on your competition.
Weakness around the hip muscles is often another area that needs to be addressed with a strengthening program to improve the alignment at the knee.
Tight muscles are another possible cause that can contribute to abnormal tracking of the patella. Deep tissue massage, rolfing, structural integration are all names for the therapies that can help in the long term.
If you are suffering from ‘bone on bone’ knee pain the pain isn’t directly due to a lack of cartilage in the knee. (Cartilage doesn’t have any nerve endings therefore there are no nerve fibers to transmit pain. For example, there are a lucky few that have been diagnosed with ‘bone on bone’ and do not have any knee pain. The only thing they experience is weakness in the knee joint). Instead, ‘bone on bone knee pain’ is due to the nerve endings in the bone being irritated. Overactive or irritated nerve fibers are the main reason a patient feels pain. Many times people will complain of pain and tenderness on the bone itself or in severe cases a patient will complain of a burning or searing type pain. Either way, cold laser therapy helps eliminate/reduce ‘bone on bone’ knee pain through several different processes. The following list is just some of the events that occur with cold laser therapy to help decrease knee pain.
There is an increase in Endorphins
Cold laser therapy reduces excitation or irritation of C-fibers (the sensory nerve fibers that transmit pain)
Cold laser therapy stimulates and increases Nitric Oxide production. Nitric oxide is important because it helps normalize cell action potential and indirectly vasodilates nerve cells which enhances oxygenation.
Cold Laser restores and increases nerve cell action potential. Cold laser therapy allows the action potential to be restored in nerves thereby decreasing the constant ‘firing’ of the nerves.
Bradykinin levels decrease. By reducing bradykinin levels this results in pain reduction.
There’s an increase in the release of acetylcholine. Acetylcholine helps normalize nerve signal transmission which in turn helps reduce of pain.
There is a normalization of ion channels. Cold Laser therapy promotes normalization of Ca++, NA+, K+ concentrations resulting in pain reduction.
Some of you who know me may have seen me hobbling around the last few months. It all started when I tripped on an uneven sidewalk and sprained my left ankle. Simple, right? Not exactly. As my ankle healed, my right knee (or so I thought) started hurting. Proprioception at its finest! (See my post:)
The pain kept getting worse and worse. I used my cold laser almost daily. I even resorted to taking naproxen, which I try to avoid. I don’t like taking any kind of medication, but I had to function. Finally (I know: I’m an idiot!!) I put two and two together and realized it was not my knee that was hurting, but the muscle that attached to it in the back. So, while I was sitting on the couch, watching TV, I started massaging my leg. I hit on a stress point on the upper hamstring and I applied direct pressure, just as I do on horses and dogs. It was excruciating! I always try to bring sensitivity and empathy to my 4-legged clients, but this drove the point home in a new way. OMG! I did cross fiber friction and kneading, and more direct pressure. When I stood up, not only was the pain cut in half, but my balance felt different.
This morning I went up and down stairs smoothly and almost without pain. Tonight, I will watch The Voice, and give myself another treatment. I think a long hike is in my immediate future. And now that the pain is subsiding, I am going to need a lot of yoga stretches, as I’m finding many of the muscles on the right side of my body are very tight from this ordeal.
A client being treated (successfully) for knee pain asked how the laser alleviated pain immediately. While there has been extensive research to show that the laser works to relieve pain, there are no definitive answers as to how. What is known is that cold laser therapy increases the release of endorphins, blocks firing of pain fibers, increases nitric oxide production, increases the levels of acetylcholine (which regenerates damaged nerves), and decreases levels of inflammatory chemicals.
Horses and dogs can’t tell me that their pain is gone, but when I see them licking their lips and closing their eyes so peacefully, I get the message!
Yesterday I saw a pony who struggled to walk up a steep hill. He over flexed one of his hind legs at every step. Once he got to level ground, he walked more evenly, but he still did not look completely comfortable. When I checked his leg, I found some very tight fascia right behind the stifle. I massaged it, but didn’t feel that I had done everything possible, so I got out the cold laser. The laser emits no heat, but his leg became very warm to the touch. What that told me was that circulation was being stimulated to the area. If a muscle is so tight that blood can’t squeeze through to the capillaries, massage to loosen tight fibers and then the cold laser to stimulate blood flow is an ideal combination. The pony has a big show next week and I will be watching to see how he is feeling now.