Mark: Hi, it’s Mark Bossert. We’re here with Dr. Harold Meinzer of Evolution Chiropractic in Vancouver and North Langley and we’re talking lasers. How are you doing this morning, Dr. Harold?

Dr Harold: I’m doing great, very excited to be talking about my favourite topic, lasers, again.

Mark: So, lasers and shoulders, fluid filled sacs as you described it.

Dr Harold: Yeah, I thought today we’d just maybe start to tackle the shoulder. Shoulder’s such a complex, really big joint. It gives us mobility like no other joint that we have. But we can run into problems and dysfunction with the shoulder as well so I thought today, this morning, we’d start talking just about shoulders in general and maybe starting off with something as simple as the bursa or the bursa the sac, as you were saying. The fluid filled sac that sits between it.

Everybody kind of talks about rotator cuff, rotator cuff muscles and those are the four primary muscles but really there’s eight sort of movers of the shoulder and if somebody’s not working and somebody’s working harder and that can cause problems as well.

With bursa, that fluid filled sac, that sits right in there. Kind of grows between the bone and the soft tissues, a kind of a good way to think of it, like a little cushion. That can get aggravated, inflamed, stiffness, sore, pain. It can even feel hot to the touch too for some conditions and so that would be considered bursitis. Itis is inflammation so that’s one of my favourite things as everybody knows, bursitis, arthritis and tendonitis. My three favourite things. That bursa becomes inflamed, that’s a painful condition patients come into the office with that all the time.

Mark: What’s the causes of that inflammation?

Dr Harold: I think always it’s those repetitive overuse traumas. We use that joint all the time but typically it would be overhead throwing for sports. That’s one that we see in the office all the time. Baseball, you got people also playing volleyball. You got tennis players, always using one over the other and just too much. Too much, too fast again for people.

Mark: Throwing for your dog.

Dr Harold: Ah, that’s a great one, yeah. Especially if you got one of those retriever type dogs that just want to, can go for three hours. Your shoulder cannot do that.

Mark: And how does this typically, when I’ve had issues from throwing for my dog for instance, where it kind of showed up for me was I would wake up at night, trying to sleep on my side and my shoulder was really sore. Would wake me up. Is that kind of it? What are the sort of typical ways that this manifests that people will notice it?

Dr Harold: Yeah, that’s exactly one of the most common ones. You sleep on your side, you compress the bursa, gets irritated and boom, you’re waking up all night long. That’s very, very common. And then it could be any kind of movement. You get up in the morning, you don’t think about how much we do with our arm and shoulder. You reach for coffee, you’re on the computer all day, all those things and then it’s just pain, pain, pain. It’s just irritation pain and it’s kind of like it becomes chronic and just doesn’t go away. And then typically after it reaches that point, especially if it’s disturbing your sleep, then they are coming into the office like, I got to do something about this. It’s been bugging me for three months, for six months. A lot of times it’s a real chronic thing when they’re coming into the office. Always like to deal with issues sooner. Sooner is always better but yeah, for those types of people it’s like, these chronic, chronic painful conditions.

Mark: The treatment, what will you recommend for people to start getting ahead of this?

Dr Harold: Well typically they don’t come see me right out of the gate, they’ll try other modalities first because they’ll probably see their GP and then they want to, the GP will probably want to put them on some kind of anti-inflammatory. That’s irritated tissue so they want to reduce the inflammation. And if that’s not working, then they’ll go as far as corticosteroid injections into that tissue to try to again, reduce the inflammation. I think those are both invasive therapies and I like to treat it with the laser because that’s a really the least invasive therapy you can have and it’s doing the same thing. It’s a reduction of inflammation into that tissue and speeding up of that healing process. That would be my start point and in treating that, probably conservatively six sessions is kind of my introductory. We’ll do every other day for six treatments and reassess at that time and really what should happen is the reduction in pain, increase in mobility and more smiles on people’s faces. And their dogs’ too.

Mark: What about other, rest and ice and what else is sort of the big picture beyond just the laser treatment? What else helps reduce the pain?

Dr Harold: Yeah, that would be your at home or homework as I call it. Always the cold pack would be the first thing to reach for. And I like to use that cold pack on off, on off. Five minutes, you don’t have to try to freeze your entire body with it. A lot of times patients just go overboard. They want to do 20 minutes, 30 minutes. Really five minutes on, five to 10 minutes off. You want to be able to feel the tissue, it’s cold to touch and then let your body warm up. I think of it as a vasoconstriction. It constricts all the blood flow and then as your body starts to heat up, it warms up again. You’re kind of going through these cycles and for me I’d rather have people do it over a longer period time, more cycles than just one or two really long ones.

Mark: Essentially with that and especially with the laser, what you’re attempting to help the body do is reduce the inflammation because that really speeds up the healing process as much as it can be speeded up naturally.

Dr Harold: Yeah, absolutely. Yep, that’s fair. And the reduction of the inflammation in that area, it’s removing metabolic waste and lactic acid and just junk from it but I sometimes think of it like when you hit your thumb with a hammer and you’re getting that really sharp pain and if somebody start grabbing your thumb and just pushing it 500 times a day, it’s just going to become irritated. That’s kind of what we do with our shoulder because we’re using it all the time and all those movements then are irritating to that bursa, so rest, ice, all those things at home really will help speed up that process. And then when we use the laser, that’s that real big push to get over top of that hump of inflammation and also the acceleration of that cell to heal.

Mark: And the results that you’ve been having with treating shoulders with the lasers.

Dr Harold: Yeah, they’ve been really, really great in office and super encouraging. It’s a difficult condition to treat because it is so chronic. I think we’ve really got some great treatment and there’s other options if you wanted to integrate some massage therapy into the clinic as well. And then once you’re feeling better, if there is a strength or an imbalance issue into the tissue, then where do you need to go? And what do you need to strengthen so that you don’t have this reoccur? Especially if you’re an athlete and you’re going to be using that tissue again.

From an athletic point of view the laser is fantastic. It’s not introducing anything new into the system especially for high level athletes. If you’re Olympic caliber that you don’t want to take certain things just because that could show up with any testing. I think it’s really again, noninvasive. It’s probably the most comfortable treatment you’re going to have. It’s just this nice warm light that sits on it and we get some really great turnovers. In quick, quick time.

Mark: Last question is, what about scar tissue? Does the laser help with breaking down scar tissue?

Dr Harold: People kind of think about lasers like if you have a big keloid or scar, that’s going to kind of somehow break it up. Laser’s going to help prevent that scar tissue because when you’re putting it onto the tissue, it’s just going to organize it better and it’s going to heal in a more organized pattern so you have less of that scar tissue but it’s not going to blast through or break up stuff that’s there. You can do that with other sorts of manual therapies, massage therapy and other things but we’ve used the laser post-surgery with some knees and hips and the scarring has been really fantastic. It’s just been less.

Mark: Or in my case it was jiu jitsu and a well applied arm bar that went and my shoulder went, tck.

Dr Harold: Not good.

Mark: But it felt great afterwards. Range of motion came back. Not the best way to do it. Don’t do that.

Dr Harold: Don’t do that.

Mark: Come and see Dr. Harold first at Evolution Wellness. You can see him in Vancouver or their North Langley office. Call 604 881-2404 to book your appointment. You have to book ahead, he’s always busy. Popular guy. Thanks a lot Dr. Harold.

Dr Harold: Yeah, okay. Thanks Mark, have a great week.