The article presents the evaluation of the effects of the therapeutic program using High Power Laser Therapy in the treatment of injury to ankle joint ligament of sportsmen. The study was done in the Reha-athletica cabinet of dr Grzegorz Głąb in Cracow.
Introduction
Practising sports entails the risk of injuries. Particularly, team game players are exposed to injuries involving acute mechanical damage due to a great force. Regardless of the discipline, one of the most frequent injuries is an ankle joint sprain resulting in the injury to the joint capsule, tendons, ligaments and bones. The time factor always plays a major role in sports rehabilitation; therefore, it is where they constantly look for therapeutic methods which would lead to the regeneration of the damaged structures as quickly as possible, yet not leaving any side effects. The studies conducted so far clearly show that the combination of numerous methods gives the best therapeutic effects and such a measure only, particularly in sportspeople, may bring about an immediate, yet long-lasting effect.
Purpose
The purpose of the study was to assess the effects of the therapeutic programme using the high power laser therapy in sportsmen after the torsion ankle joint injury.
Description
The study was carried out in 6 players: 2 football players, 3 handball players and 1 volleyball player. A second degree injury to at least one or two ankle joint ligaments was established in all of the patients. The degree of the injury was established in the ultrasound examination.
Each of the patients underwent the same therapeutic procedure. For the first two days, to prevent haematoma from developing and oedema, the patients used cold compresses for 20 minutes every two hours. In addition, they were recommended to reduce their daily activity but they were allowed to burden their limbs painlessly. From day 3 to 4 after the injury, they started the therapeutic programme which involved high power laser therapy sessions, deep transverse massage and―after one week―central stabilisation training and proprioception training.
The high power laser therapy used the Polaris HP equipment made by Astar with wavelengths of 808 nm and 980 nm; power from 2 to 6 W for every source at a dose from 10 to 50 J/cm2; duty cycle from 20 to 80%, grading the power as well as dose and duty cycle. The first four sessions used the frequency of 3,000 Hz and then 700 Hz was applied. The procedure was performed dynamically in the areas of oedema and injured ligaments.
The first visit before the programme started,then after 2 and 4 weeks and after it ended, i.e. after 6 weeks, was intended as pain assessment and a subjective evaluation of the stability and function using the 10-point VAS; furthermore, an ultrasound examination was carried out before and after the therapy.
Results
The analysis of the procedure results showed the greatest pain reduction as early as two weeks after the therapy started and the feeling of pain in the majority of the patients was reduced completely in the following weeks (Fig. 1).
The patients assessed the feeling of instability in the ankle joint injury to be over 6; they reported feeling instability mostly during walking on an uneven ground and when changing the direction. The feeling subsided by half quite quickly in the patients’ opinions for it was as early as two weeks later, which may result from the faster regeneration of the ligaments after the high power laser therapy since gentle proprioception training was introduced after one week only.
The general evaluation of the function before the examination was definitely the worst out of all the parameters examined due to haematoma, oedema, limited mobility and pain which prevented normal movement. The subjective evaluation of the function improved gradually with further sessions and with the lapse of the time after the injury.
The ultrasound examination in all the patients showed the complete regeneration of all damaged structures in the follow-up examination after six weeks of the therapy. Two of them presented small oedema in the fibularis muscles and one of them reactive synovial membrane hypertrophy.
Out of six patients, five patients returned to full training after five to six weeks.
Conclusions
The use of the high power laser therapy under the therapeutic programme in the patients after the torsion ankle joint injury had a considerable impact on reducing pain and, moreover, could have an effect on improving the stability and function of the joint.
Description
The study was carried out in 6 players: 2 football players, 3 handball players and 1 volleyball player. A second degree injury to at least one or two ankle joint ligaments was established in all of the patients. The degree of the injury was established in the ultrasound examination.
Each of the patients underwent the same therapeutic procedure. For the first two days, to prevent haematoma from developing and oedema, the patients used cold compresses for 20 minutes every two hours. In addition, they were recommended to reduce their daily activity but they were allowed to burden their limbs painlessly. From day 3 to 4 after the injury, they started the therapeutic programme which involved high power laser therapy sessions, deep transverse massage and―after one week―central stabilisation training and proprioception training.