Maximizing Results with On-Contact Laser Therapy Treatments: Tips & Strategies

Guest Blog Post by Perry Nickelston DC, NKT, FMS, SFMA

Successful laser therapy application depends on sufficient dosage of laser light energy reaching the target tissue. Key phrase: target tissue

There are superficial structures that interfere with efficient absorption of laser photons to deep structures:

1. Skin
2. Fat
3. Blood
4. Water

There are a few ways to increase efficient absorption of light to reach deeper structures of the body:

1. Proper Wavelength
2. Higher Power
3. Contact Delivery Method

Contact delivery is the easiest and fastest way to maximize light penetration through the superficial structures listed above.

For example, let’s look at a hamstring strain:

• Treatment Option 1: 15 watts continuous wave 4,000 joules of energy delivered off-contact. Less joules reach the target in allotted time
• Treatment Option 2: 15 watts continuous wave 4,000 joules of energy delivered on-contact with a laser massage ball deep pressure contact. More joules reach target in same time.

Same dosage parameter. Different sensory input and patient outcomes.

10 tips to maximize results with contact delivery:

1. Simply start delivering treatments on-contact with the massage ball and you are already ahead.
2. Always keep a perpendicular angle to the skin when applying pressure to ensure optimal delivery and minimal scatter of photons.
3. Change speed of application. Go slower with deeper pressure and alternate with fast light pressure. Different neurosensory input into the nervous system and tissue.
4. Vary contact motion direction. Do circles, squares and grids to stimulate tissue.
5. Vary of treatment area sizes. Do larger strokes with the massage ball intermixed with smaller sizes, especially over area where you feel more tightness, restriction or adhesions.
6. Add active range of motion from the client. The more movement they can initiate the better. More motion means delivery of light into more area. The patient will also feel range of motion increase and pain decrease during the course of treatment.
7. Add passive range of motion for joint, capsular or ligamentous injury. Passive range of motion to tolerance is an effective way to increase photon delivery into joint spaces.
8. Change pressures. The body cannot feel pain and pressures at the same time. Use this to your advantage by pressing harder into muscular tissue. You will also reach deeper fascial layers which are often the most restricted and chemically damaged. Use lighter pressure over superficial areas and body interfaces such as the posterior medial tibia.
9. Treat key fascial points in the body that transmit force, regardless of the location of pain. The ability to transmit force is a key function of fascial integrity. Laser the following 4 places with 1,000 joules of energy each: a) bottom of both feet b) glute max and TFL junction c) thoracolumbar fascia d) C7-T1 fascial bridge.
10. Move upstream and downstream from the site of pain. For example, if your elbow hurts, laser the elbow. Then treat the bicep/ tricep upstream and the forearm downstream. For knee pain, laser the knee and then treat the quad and hamstrings upstream and calf/shin downstream.

What to do next:
Think about a client you may have been struggling with that you can begin using these techniques on right now. Start using the system. Pick one strategy and use it with everyone. Make your way through the list and gravitate towards the ones you like most. If you don’t have a laser massage ball, get one and get busy! It’s a game changer…

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