Mark: Hi, it’s Mark Bossert from Top Local. We’re here with Dr. Harold Meinzer of Evolution Wellness in Langley and Vancouver and we’re going to talk about your health. How you doing today, Dr. Harold?
Dr Harold: I’m doing fantastic today. Thanks, Mark. How are you?
Mark: Great. So, meniscus. We’re going to talk about the happy meniscus or meniscus injuries. What’s going on with meniscus rehabilitation these days?
Dr Harold: Well, meniscus is one of those injuries that’s near and dear to my heart just because I tore mine, that’s almost a year and a half ago. I call it the happy/unhappy meniscus injury. Basically meniscus, it’s in the knee joint. It’s these two cushions that are made up of cartilage that our big bone, the femur and our tibia, rotate over and that thing, the meniscus, that helps stabilize the knee joint and also acts as a cushion. It’s one of those injuries that happens with all types of sports. It’s not specific. You could be playing in a non-contact sport as well as a contact sport and still injure that meniscus.
When you do, it’s very painful and can take a long time to get better. Typically that injury is a twisting-type motion. It tears the meniscus. It can occur with other structures within the knee joint, the ACL as well. The other thing I want to just point out is, which I think is funny, is that us older athletes are at risk because it weakens with age just like everything. So it’s that stereotypical middle-aged athletes that we see as well as younger ones, but in the office for sure.
Mark: What’s the process with somebody that’s injured themselves? You twisted your knee today, what do you do?
Dr Harold: Well, then you’re going to get all these great symptoms. You twist your knee, you’re going to feel probably immediate pain, immediate pain from the injury. Sometimes they’ll even hear a pop sound and that popping sound is … It’s always good to remember so you can tell your practitioner about it because that’ll help diagnose. But yeah, that’s not good. You’re going to get swelling around that knee joint. It’s going to be very difficult to bend or even straighten it. Sometimes it’ll lock because there’s little tear in there that flaps and it catches into the knee joint. People call this a catching-type pain and yeah, extremely painful. You’re probably going to be laid up. You’re going to put ice on it right away and it might even take you a couple of days to be able to weight bear on it.
Once you have that injury, whenever you can get into the office, then we’ll do a full exam onto that, possibly send you out for an x-ray or MRI depending. Now here in this province, they’re doing x-rays before MRIs. So you’ll need to have an x-ray done and that’ll be through your general practitioner. Then the treatment will be determined by the extent of the injury, whether it’s mild, moderate, severe. The meniscus is a very interesting structure. Because I describe it like this round donut and on the outside of it it’s a … They call it the red zone, so it’s got blood flow to it. On the inside or white zone, not a lot of blood flow to it. Depending on which part of the meniscus you injure, that will determine how fast you get better. Obviously more blood flow, we always want that to those structures. The white zone is that really bad zone that can take a long time to heal.
Mark: Go through the initial home treatment, the most immediate care, what’s a way to remember that?
Dr Harold: It’s usually the same one as most acute injuries. It’s that rest, ice, compression right away to try to limit the swelling, the joint response. Then if it’s really bad, then you might have to take some medication for it as well. If it’s extreme pain then you can talk to your doctor about that. And that’s the initial phase. You might be, like I say, laid up in bed or on the couch for a couple days before you can even put weight on it. Then there’s also bracing. The Neoprene knee sleeve can be very effective initially just to compress that area to limit the swelling. Once you’re weight bearing, then there’s offloading the joint, so medial or lateral meniscus-type braces that can help you walk. Like for me, I injured my medial meniscus so I have a brace that it just offloads more of that pressure and weight off the lateral side. That allows you to walk and hobble around with a cane too. Yeah, it’s very humbling.
Mark: Now I’ve gotten to that point. I’m mobile, I come into the office, what are you going to work through with somebody?
Dr Harold: Well, we’ll do that exam to determine exactly what’s happened. In that really acute phase then we’re going to use that laser into that area. We’re really going to try to drive as much blood flow to that area, bringing in those byproducts or nutrients and building materials that we want to repair that tissue with. And then we want to get rid of all the metabolic waste that’s built up into that system, so that’s the anti inflammatory effect of laser. It’s very effective to try to drive more blood flow in, accelerate that healing process into that joint. We’re starting to play around with a little bit, which is an interesting new addition to the office which we’ll probably get into another podcast, and that’s the NormaTec compression sleeve.
It’s a really big compression sleeve that fits over the top of your whole leg, like a ski pant. It uses compressed air like an air bladder to pump out all that fluid out of that area as well. So that one is very effective, not so much in the very acute stage, but once you’re able to straighten the leg and have a little bit more mobility, then we can get into that. That would be determined on a case-by-case basis. Then pointing you in the direction of a brace, that’s the next step. And then once you’re able weight-bear and you starting to move again, then we want to start looking at strength and conditioning training into that joint.
Mark: Now, you don’t necessarily prescribe the training regimen. Would you send someone to an exercise physiologist or someone like that, a kinesiologist?
Dr Harold: Yeah, exactly. You want either a physiotherapist or a really great kinesiologist can help put you through the strength training that you’re going to need to build up quadriceps muscle and hamstrings as well to help stabilize the joint so that you can get back to doing something active again, which is so important. I guess right now we’re really trying to keep people away from surgery. I mean, some people might have to have it, but ideally you want to let that tissue heal. Then strengthen, rehab it, try to get back to the sport. If you have to use a brace, use a brace, and then push off any kind of surgery.
Mark: Yeah. Surgery has other effects in the long term, I guess.
Dr Harold: Yeah. Yeah. Scar tissue and then the acceleration of the arthritic condition into the knee. If we leave it to heal on its own, take a longer time frame, then you’re gonna feel better in 20 years because the joint will be healthier. I mean, you don’t want to go through that where you get close to that bone-on-bone. At some point you will if you do too aggressive a surgery.
Mark: And what about treatment protocols? Is it the typical six treatments and every other day sort of thing?
Dr Harold: Yeah. In that acute phase, it’ll be every other day. Depending on how bad it is, it might last longer than six. It could be 8, 10, 12 treatments into that area until it can start to function again and then everything else will go along with the treatment protocol.
Mark: Is this an injury … I’m gonna assume based on my experience with different injuries, is this one that’s going to go up and down? You’re going to feel like you’re really feeling better. Maybe you do your workout, your strength training, et cetera, that you need to do under supervision. And then ouch, the pain comes back and it’s time to get some more treatment. So it’s kind of a back and forth, but generally a stair step climb. Is that a fair way to … How was your experience?
Dr Harold: Yeah, I would say that’s very accurate. You’re going to have these times where things start to calm down. The inflammation is diminished and you’re gonna start feeling, wow, I’ve got full range of motion again. You’re just going to turn a little bit and twist your knee and then whammo, it’s gonna flare up. Especially if you have a flap in there, like a small floating piece, that’ll catch and then it sets that whole cascade of events into action again and then it might take you a week or so to get back to that point and it’s sort of up, down, up, down.
As you start to heal, those little hiccups become more spaced out and you have less of them. But yeah, that’s for sure. It’s a stair step effect all the way the way through. That’s been my experience as well going through it with my own knee. I used the laser, you know, almost immediately after injury. Luckily I have it at my disposal so I could definitely utilized it all the way up. The most painful thing about, I think, my whole injury was… That was a Scrabble injury, which is not a very contact sport or non-contact sport, but a Scrabble. So watch out people for Scrabble.
Mark: You went for the triple word score too soon.
Dr Harold: That’s a whole ‘nother conversation. All my patients ask me, how do you play Scrabble?
Mark: So there you go. If you’re looking for some treatment for your knee injury or even just in case and you’ve got some knee pain, old knee pain, old, even a bit of arthritis in your knees, laser therapy will help an awful lot. That’s been my experience and I think that’s the experience of everyone who goes to see Dr. Harold. You can reach him at (604) 881-2404 to book your appointment. You have to call and book ahead. They’re very busy. Located both in Vancouver and in North Langley and thanks a lot, Harold.
Mark: Hi, it’s Mark Bossert here with Dr. Harold Meinzer of Evolution Chiropractic in Vancouver, and we’re talking lasers. How are you doing today, Harold?
Dr Harold: I’m doing fantastic. Thanks, Mark.
Mark: So, probably the number one complaint of many, many people and I’m sure in your office, low back pain. And how does the laser help with low back pain?
Dr Harold: Yeah, you’re absolutely right. That’s probably what chiropractors are known best for is low back and treating low back. So, low back pain. Statistically it’s about 80% of adults are going to have some kind of low back pain in their lifetime. So that’s a huge number. And walking around right now we’re probably looking at about 25% of the adult population having some kind of low back pain as we speak. So it’s an epidemic out there and it has lots of different causes that can underlie it. Everything from our sedentary position as we’re sitting at desks, so much more, overuse, wear and tear. I guess as we get older are the arthritic changes, all those traumas, car accidents, falling off your ladder, falling out of the trampolines, as I always loved, arthritis, disc injuries, strain, sprain. I mean, there’s so many different ways you can injure your low back, and I think that’s one of the reasons why it’s so common.
Mark: So, what kind of symptoms do people have other than pain, basically?
Dr Harold: Well I find that the symptoms are what motivates people to get in the office. So lots of people are just walking around with that dull, low grade back pain, back ache. They get up in the morning, it’s painful, but it’s not enough to really interfere with their lives. And then, some incident, something happens and it really kind of pushes that pain level up. And then that can get really intense. That can be that sharp, unrelenting pain. And it can even include some of that, like a radiculopathy, something that’s running down into the extremities, like low back pain turning into your glutes, turning into your hamstring, running all the way down to your foot. That usually is something that grabs their attention for patients and then they’re on the phone to get in the office as soon as they can.
Mark: And you’d like to see them earlier in that process, obviously. Is that a fair assumption?
Dr Harold: Yeah, absolutely. Earlier is better, just because things are inflaming. There’s always an inflammatory component and when inflammation takes hold, pain levels go up, and then we’d rather see something in the acute stage than something that’s been chronic low grade for months and months or years. I see it in the office, people have low back pain for years and years. And it’s until it sort of affects their golf game, when they can’t go golfing or doing something they like in the garden, then that’s the big motivation, like, “I got to get this dealt with.”
Mark: And as far as diagnosing and in treatment, what’s the process there?
Dr Harold: Well, usually when you get to the office, we’re going to do a history, an examine and consultation on to what the problem is, and then figure out what the underlying root cause. And then from that point we’ll discuss a treatment plan. A treatment plan within the office, and then there’ll be a treatment plan for patients to take home as well. And the typical stuff, when we’re talking about going at home care would be obviously rest. So if you’re doing something that’s aggravated your low back, we got to stop it. Ice pack, that’s the easiest, cheapest, most convenient way to deal with some of the inflammation, because we’re taking any kind of medication and that’s going to affect liver, kidney, and other functions. And then possibly at the end, once some of that symptomatology is resolved and core stability work, which nobody wants to do. So I like to always give that as homework, but nobody loves that part. And that really is the biggest bang for your buck to strengthen up your low back, is to have a really strong core.
Mark: And as far as the treatment with the laser, how does that fit into your treatment plan?
Dr Harold: Well, typically, when we’re assessing that low back, if there’s some structure that’s underlying that’s causing it, that could be facets or impinged or sacroiliac joint is dysfunctional, then we’ll do some structural work and we can do that with an adjustment, some manual adjustments which people are maybe afraid of or are aware of. And I use some mechanical tools to adjust as well, that’s very low force. And then I incorporate the laser therapy with that. And that’s, again, to reduce the inflammation around that joint, speed up the healing that’s happening, and also some pain management. And if the patient has ongoing muscle spasms and other things that I can’t deal with within my timeframe then a massage therapy appointment would be beneficial for them as well.
Mark: Where does the laser fit into your treatment procedures?
Dr Harold: Laser’s going to be part of my treatment protocol. After we’ve got the diagnosis, we’re going to look at the structure. So structural component, that could be facets or pelvis sacroiliac joint that’s dysfunctional, so I want to correct that structure, and I’ll do that either with manual manipulation, which some people are aware of, and then also use some instrument adjusting, and that’s mechanical instruments that are very, very low impact, very gentle to adjust and we’ll shift the joint over to take pressure off the nerve if that’s the underlying cause, and then create some symptom relief and then we’re going to use the laser for my favourite things. That’s the anti-inflammatory effect and then also some pain management and an acceleration of healing into that tissue and that’ll be part of our treatment protocol. Soft tissue work, I do some into that area as well, but then if it’s outside of my scope or expertise, then we’re going to get them in with one of the massage therapists. Then they can spend an hour with them reducing all that muscle work, bio spasms.
Mark: And at home work, would that include, like you said, core stability work, but also stretching? Is that an important part of maintaining your back?
Dr Harold: Yeah, absolutely. Making sure that all these big muscle groups, not only the back or low back muscle groups, but the big ones in the lower limbs like hamstrings, glutes, quadriceps, all these things that are pulling into the pelvis and can have an effect on to the low back. So for sure some really easy, gentle stretching, some nice yoga movements are a benefit. But usually that’s once that acute pain is gone, then we can start opening up those joints. And then that’s something that you want to continue onwards, depending on how bad the incident is. But yeah, we want to keep mobility in the low back for all patients.
Mark: Typical treatment protocol, what does that consist of?
Dr Harold: Yeah, we’ll probably see the patient in the office quite regularly if it’s an acute low back pain or a problem. We’ll see them a few times a week over the first two weeks and then reassess after that. And usually I would say that we’d get maybe a 20 to 25% change after those first visits, so that real acute pain is down and then things become a little bit more manageable.
Mark: So there, if you have a pain in your low back, get some lasering from Dr. Harold Meinzer at Evolution Chiropractic. You can book your appointment at (604) 881-2404, check out the website, vancouverchiroevolution.com, or, like I said, call and book an appointment. They’re located in Vancouver and North Langley, and Dr. Harold will look after you. Thanks a lot, Harold.
Dr Harold: All right. Thanks, Mark. Have a great day.
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.
Mark: Hi, it’s Mark Bossert here with Dr. Harold Meinzer of Evolution Wellness in Vancouver and North Langley. And we’re here talking about health and how lasers can help you. How are you doing today, Harold?
Dr. Harold: I’m doing fantastic, Mark. Thanks for asking. How are you this morning?
Mark: Good. A little bit sore. I’m going to see you tomorrow for an IT band issue that suddenly feels like I’m being stabbed with a knife on my right leg. And I’m sure we’ll get that handled, but today we’re talking about shin splints. What’s, what’s the deal with shin splints anyways?
Dr. Harold: Ah, shin splints. That’s one of my favourites. That’s a really common athletic injury typically with runners. Maybe makes up about 15 plus maybe 20% of running injuries. And it’s like lower leg pain. So that shinbone or the tibia in the lower leg, people get pain along it. Typically, it’s on the inside of the leg. That’s the really typical… what we call shin splint. And sometimes people get pain on the outside. It can be similar, but when we look at it, we’ll diagnose that. It could be a compartment syndrome or another type of problem. But today we’re going to talk about the inside. Inside of that shinbone where you get all that pain and tenderness, swelling, and it’s sensitive to touch. Typically, when you’re running, then you’re going to get that pain either when you start or maybe midway through. And it can be excruciating. It’ll just shut you down where you basically walking back to the car after.
Mark: So, what are the symptoms? You kind of said some of them, why don’t we go through them in order?
Dr. Harold: Yeah. Typically, it’ll start out with just some tenderness, tenderness as you’re running, and then it will progress from that point. It’s a more and more aggressive pain. You’ll get soreness around that area, and it’ll kind of run vertically up and down along that shinbone. You can look at it, swelling. It’ll be there at a tissue level. Sometimes, you can see that there is a little bit of swelling. And then obviously when we’re exercising it’s going to be exacerbated, and then as the condition continues then, you could get it just getting up in the morning, just throughout your everyday activity when it’s really bad and you can get that pain that’s associated with it. And it’ll be like sharp. It’ll be sharp, stabbing pain.
Mark: So, what causes shin splints?
Dr. Harold: Well, I think of it as a repetitive or overuse type of trauma right around the muscles around the tibia, and also the connective tissue that runs around it. So, sometimes we call it like too much, too soon. Like you’re doing too much, too soon to your body, and tissues aren’t prepared for it. And some of the causes that are underlying it, could be like an over-pronation, if you’re in a bad shoe or you need an orthotic, that could be one of the underlying causes. Obviously, stretching is one of those things that we always try to get athletes to do that nobody likes to do. Stretching pre and also post after your run is a very important time to stretch. If you increased your mileage, and you’re doing that pretty quickly, that will all of a sudden put too much stress and load into the tissue, and cause this type of pain.
And, we also kind of… I always describe it as a bit of like tearing, a tearing that’s happening from the bone or around the bone. So that muscle is actually getting torn off, and then that tearing is really painful, and then causes that pain, right. So, and of course, inflammation, we’re always going to be inflamed around that area when tissues are irritated.
Mark: So, how does the laser treatment help with this, and how does that actually… What does that look like?
Dr. Harold: Well a laser treatment, we’re going to topically treat that, and I’ll also treat around the surrounding muscle as well. Laser treatment will go hand-in-hand with other traditional tried and true traditional treatments, that’ll be rest, ice, we want to do some stretching and soft tissue work around that. Sometimes we’ll put a compression sock or sleeve, that can be beneficial as well just to keep that tissue nice and tight. And then the laser is just going to really accentuate and speed up that healing process. So, for athletes as well as everybody else, we want to get out of pain as fast as we can. And for runners, we want to be running, we don’t want to miss a run, so we always want to be running. So, the laser’s going to speed up that process by reducing the inflammation in that area because the tissues irritated. And then it’s going to accelerate that healing in around those sort of micro tears that are happening into the muscle tissue.
Mark: So how does… If you… kind of training to a higher level and you want to keep your fitness level, what do you do in case like that? Like you can’t run anymore, what happens?
Dr. Harold: Yeah. So then you’re going to shift gears, right. So then if you’re having to train, then you’re going to have to do some training. That could be water running, so you’re doing something underwater. That’s always a good one. Swimming. I always suggest swimming. It’s non weight bearing. Nobody likes to swim, honestly. Maybe like 5% of patients I suggest it to will go like, “Yeah, I want to get in the pool.” Biking is another one, so you can get your cardio up. I always talk about strength training. And so if we can identify weaknesses within your connective chain, then we can strengthen those to try to prevent the injury from happening or reoccurring. And I always liked the core and course stability work. I think all athletes, when you look at them, whether they’re a race car driver or a high jumper or hockey player, the core is sort of one of the most important aspects of their training to keep strong because everything works off of it.
Mark: And, the laser, what’s the course of treatment? Is that our kind of standard six treatments as quickly, fairly, like every other day sort of thing?
Dr. Harold: Yeah, I like that protocol. If we kind of get at it, we’ll do six treatments pretty close in succession, and then reevaluate at that point and we’ll see where we’re at. If we’re 25, 50, 75% better with a athlete, then whether they’re going to start to sort of gradually go back to that, or if we’ve identified other weaknesses, then okay, we need to strength training before you really start increasing the load into the tissue again, so that you don’t fall back into that same same pattern.
Mark: And, what you’ve seen as far as results?
Dr. Harold: Yeah, really great results. I love using it in conjunction with the soft tissue work that I like to do as well. Kind of going through that tissue, stripping it out, but with the shin splints, it’s it’s less of that. If I’m going to do some soft tissue work, then we’ll work on that calf on the posterior part, and try to loosen the calf and Achilles up as well. But it really just accentuates… It just is such a great anti-inflammatory, and just speeds up that whole healing process. That’s one of my favourite protocols.
Mark: So, there you go. If you’re looking for some treatment for your shin splints, and you haven’t had much luck or you’re trying to keep your fitness level up for the racing season or your triathlons, the guy to see is Dr. Harold Meinzer, at Evolution Wellness. They have offices in Vancouver and North Langley. You can reach them at (604) 881-2404. He’ll look after your shin splints lickety-split. Thanks, Dr Harold.
Dr. Harold: Thanks so much, Mark. Have a great afternoon.
Mark: Hi, it’s Mark Bossert. We’re here with Dr. Harold Meinzer, a chiropractor in Vancouver from Evolution Wellness, which has locations in Vancouver and North Langley and we’re here to talk about Achilles tendinitis and how lasers help a lot with this. How are you doing this morning, Dr. Harold?
Dr. Harold: Great. Great, great, great. Thanks, Mark. Yeah, I thought we’d talk about Achilles today just because of the Raptors basketball the other night and Kevin Durant went out with an injury to his Achilles. So I thought, yeah, let’s talk about Achilles injuries, but more specifically to us would probably be like a tendinitis, which is just an inflamed tendon, and I think most people know the Achilles tendon, it’s that big one running from your heel up into your calf. It’s a really big, massive, massive tendon so it can get injured through all sorts of different ways that we like to use and abuse our bodies. Typically like overuse type injuries, like you’re repetitively doing something over and over and over again, over training that’s a really big one, right? So if you’re running and then all of a sudden you want to ramp up your schedule, so you increase intensity, you increase duration, you start adding heal work and other things and your body’s not adapted or ready yet.
That’s always a really big one, and then the one that I see probably most in the office is the deconditioned tissue and that just means vacation tissue. That’s the typical office worker who’s at their desk from 9:00 to 5:00 for the past five or 10 years, does minimal exercise and then softball season starts and their mind thinks, “Man, I can run between first and second,” and as you start to do that, your Achilles goes, “No, I haven’t done this in five years,” and it just blows up on you. So that’s a very common one.
Mark: So when you mentioned blow up, we’re talking about tendinitis, which is essentially, it’s inflammation within the tendon sheath I guess. Is that right?
Dr. Harold: Yeah, that’s right. So it’s inflamed. When I’m talking about blowing up, that would be more of like micro tears into that tissue at worst that can actually rupture and tear and that’s like a surgical procedure and that can take months and months and months to a year to resolve. Sort of the smallest injury would be the tendinitis, the overuse. It’s just irritated, inflamed, and then it’s painful, right? It’s constantly pain as you walk and move and the average person takes 5,000 steps a day, so think of something being irritated and you’re irritating it another 5,000 times per day. So it gets into a real cycle of chronicity.
Dr. Harold: Not synchronicity like Sting, but chronicity.
Mark: Yeah, chronically hurting.
Dr. Harold: Yes, exactly.
Mark: So how does the laser help?
Dr. Harold: Like we’ve been talking about in this whole series is that anti inflammatory effect of the laser. The Achilles tendon is like white tissue. I always think of it as white, like it’s a tendon. Muscle, like your glute or your hamstring is big and beefy is red, red tissue, so it’s got good blood supply. And so the white tissue doesn’t have a lot of blood supply so we really want to increase or maximize the amount of blood that we can get into that tissue for healing. Right? Blood brings those building products for healing, and so we want to get fresh stuff in and we want to take out all the byproducts of that inflammatory condition. So by using that, that works as an anti inflammatory and then also stimulating those cells to repair and the faster we can repair that tissue, then the faster the symptoms will abate.
Mark: So what would an Achilles’ treatment kind of look like when you’re doing that?
Dr. Harold: Typically the Achilles treatment, I always will look into the calf muscle as well. So the calf muscle will start high and then the Achilles turns into that, it goes to the heel. So we use this really awesome applicator. It’s a quartz ball, fibre optic cable, the laser light goes through and that way we can make really great contact with the skin and tissue and then I can roll over top of it and this is the application. So generally I’ll start higher up from where the injury site is and then we’ll work our way down. We’re opening up blood flow high to low and so we’re not just going to just sort of look at that one specific spot that’s injured, but we’ll look a little more globally as how the whole foot and ankle works.
So this is I find a really comfortable treatment because I can put a little bit of pressure into the tissue as well and then any little knot or adhesion, then we work that out as we go through that treatment. So most of my patients always joke it’s like the most comfortable treatment that I offer. They don’t fall asleep, but if it was long enough they probably would.
Mark: Yeah. I can attest. It’s quite comfortable and warm and it feels good actually. So the Achilles is pretty close to the surface, so I imagine that you probably get some pretty good results with this.
Dr. Harold: Yeah, we get really good results with the Achilles. It’s a tough condition to treat just because, like I said before, we’re always on our feet and a lot of people think like, “Oh, I’m resting. I’ve stopped playing softball, I stopped running,” but you’re still on your feet 5000 times, so that really can irritate it. So you know, we will also include some rest, obviously ice. Stretching we have to be careful with. Proper warm ups always for weekend warriors. After the acute condition is done then strengthening into that area and sometimes cross training is effective as well because we’re doing one sport and we’re not doing enough of other things to kind of balance it out, so different types of movements can be effective for that as well.
Mark: What about some of the training kind of protocols and stuff? How soon can someone go back to training? Is it like completely without any kind of pain at all before there’s all the pains gone, like what would you prescribe?
Dr. Harold: Generally if it’s a really acute tendinitis, then we’re going to stop activity depending on the athlete, because some athletes need to train a little bit or be ready for competition. So then we might stop altogether because training at that point is not going to make any difference but we just need them to be able to function at that end result or for that tournament or that race.
So a lot of times we’ll sort of cut everything back, scale it back for like a two to three week period where we’re going to treat them and then we’ll slowly start to try to integrate. So you got to test the water at some point, and then we’ll test the water, see where they’re at and then it’s kind of a case by case basis to see how soon we can integrate that activity back again. But generally we get some great results. Like I say, it’s a very kind of chronic and difficult condition to treat without a laser. That really speeds up that healing process and gets people back on the field, and that’s why the Seattle Seahawks, Toronto Blue Jays all use the same laser in their dressing rooms.
Mark: And are there any other pieces of information that are important to this? Like what about footwear and that sort of stuff?
Dr. Harold: Yeah, I think footwear can make a big difference, that you have a base of support and stability, that you’re wearing the proper footwear for the proper sport, all those things. And also that you’re not using footwear that’s aged or dated. There’s lots of people that are running and they’re doing a lot of kilometres and their shoes should have been thrown out, you know, six months ago. So you really want to look at your feet a little bit differently because they do carry you for your lifetime and treat them well. You want to treat those feet well.
Mark: And the treatment protocol, just to reiterate, I imagine it’s probably similar to some of the other treatments we’ve talked. About every other day, sort of.
Dr. Harold: Yeah. Yeah. Every other day. I’ll try to get them in every other day. Sometimes they’ll do some soft tissue work into that calf muscle as well if I find adhesions that I want to break up and loosen up. That’s not as quite as pleasant as-
Mark: No, it’s not.
Dr. Harold: Lasers, but it needs to be done and so we can break up those adhesions and we’ll treat every other day. Usually I say to patients six treatments and then we’ll reevaluate at that point. I’m not here to sort of waste time or money for people. If it’s not an effective modality at the time for the patient, then we’re going to refer them out to someone else, but generally that six treatment point is that reevaluation point and we’ll say, well are you 50%, are you 80% better? And then we’ll make another determination for the next protocol.
Mark: And do you work with other like athletic trainers or any other experts in this realm as well?
Dr. Harold: I used to treat the BC Ballet with my brother and I’m working with the Langley Rivermen right now. It’s a local junior hockey team, so I like sports and sports injuries. That’s sort of my background with soccer and other sports. I like the sports aspect because I think I understand the mentality of the athlete wanting to get back on the pitch or the field or the ice surface as fast as possible, and sometimes you really need somebody to say like, okay slow it down. We’re going to have to take a little bit of time now so that you’re actually not going to be… so you’ll be back on the ice in a shorter period of time. Sometimes it’s a difficult negotiation with an athlete.
Mark: Absolutely. So there you go. If you have some problems with Achilles tendinitis or any kind of twitches in your Achilles, the guys to see… the guy to see is Dr. Harold Meinzer at Evolution Wellness. You can reach them at (604) 881-2404 to book your appointment. They’re located both in Vancouver and North Langley. You have to call and book because he’s busy. He’s got lots going on, lots of clients who need some pain help and this will definitely help. I’ve had Achilles treatment myself and it worked really well. Thanks a lot, doctor.
Dr. Harold: Thanks a lot, Mark. Have a great afternoon.
Mark: Hi, it’s Mark Bossert here at Top Local, producer of The Evolution Wellness Laser podcast and video series. And we’re here with Dr Harold Meinzer of Evolution Wellness in Vancouver and North Langley. Good morning, Dr, Harold.
Dr Harold: Good morning, Mark. Thanks for having me again.
Mark: So we’re talking about hand osteoarthritis today. I’m sure you see a lot of folks with these kinds of problems.
Dr Harold: Yeah, osteoarthritis is really prevalent in, in our community, especially with the baby boomers. As we’re getting to see more and more of those bell curve changing and those people are showing up in the office. Osteoarthritis is really just wear and tear. And that’s what we all do throughout our lifetime. And it’s sort of like, I kind of like osteoarthritis, unlike most medical doctors. When I hear it, I get excited. Most medical doctors get afraid of it. I like arthritis. Tendonitis, bursitis. I love all those itises because I like treating them with the laser, obviously. And so the way I kind of explain the osteoarthritis is that the cartilage between the joint is worn down, and that causes the bones to rub together, and without a cushion in between there, then that causes some problems, right? Like inflammation, then you get stiffness, you get pain, you get decreased range of motion into there. Decreased mobility. Pain, right? That’s all pain, pain, pain driven.
Mark: So how’s it typically treated at the doctor?
Dr Harold: Well, traditional treatment, because it’s a chronic condition, usually they love the over the counter anti inflammatories or even corticosteroids. So those will be the go-to. And then I think you can also add in with traditional treatment, that would be exercise, range of motion, some stretching, trying to maintain mobility within that joint structure. And I also would include the include diet in that, as well. An anti-inflammatory diet, high in fruits and veggies. That would be very good to reduce some of the symptoms into that joint.
Mark: And the cause of it other than the cartilage wearing away, what is osteoarthritis?
Dr Harold: I call it overuse and abuse. So if we overuse a joint, we only have so much mobility into it and we never take care of it. So if you’re doing a repetitive task over and over and over and over again over 20, 30 years, then you can wear out that joint. Or the good example would be like the professional football player that plays in the NFL for 10 years, and when you x-ray them, you know they’re 30 years old, but their joints look like they’re 65 just because of all the collisions in the abuse that they’ve taken. Old injuries, that’s for sure. That would be like the athlete, and old fractures or car accidents or falls or spills can set in motion, over a long period of time, these degenerative changes into the joint.
Mark: And the laser helps how?
Dr Harold: I like to think of the laser as part of a treatment, meaning that you’re not going to cure the osteoarthritis. If anything, we’re just going to try to manage it, meaning pain management and mobility management. So if we can get patients to reduce the medication that they’re taking because the laser’s affecting the joint in that way, meaning that it’s an anti-inflammatory into that joint area, then I think we’re making headway. It’s just better for the body. It’s easier on liver and kidney, and it’s less taxing to the body. It’s noninvasive. And so it’s a pain management tool is the way I would view it.
Mark: Yeah. 40 years of taking anti-inflammatories is going to have some pretty bad side effects, I would guess.
Dr Harold: Yeah, absolutely. So we want to limit what we’re putting internally into our body. And if we can do something that’s noninvasive, and I always like to do the most conservative care and noninvasive first until you run out and it’s not effective anymore, rather than doing more invasive things. In my mind, the laser is probably the least invasive thing that you can do into your system. Because once you start taking those pharmaceuticals, then that has an effect on your system.
Mark: So what’s your treatment protocol for hand arthritis using the laser?
Dr Harold: The hand is actually really quick to treat, because again, surface isn’t very dense. Most of the joints are very close to the surface so we can get good penetration in and around those joints. And for a typical hand, we would probably do a followup visit of only 10 minutes and we’re just applying the laser over top of all those joints that are achy and sore. And if it’s a couple of fingers, we’d probably include the rest of the hand and wrist just to influence the blood supply to have a bigger change.
Mark: Have you noticed any results? Like I know sometimes people’s fingers, and I’m not sure if this is osteo or not, arthritis, people’s fingers start to get deformed as the body tries to deal with the pain, I guess. Have you noticed any results with limiting that or starting to slow that down, that process?
Dr Harold: Yeah, that’s a great observation because as that joint degrades and the cushion’s gone, then the bone on bone wear, your body starts sort of trying to cement it together. So then you get more bony growth and then the joint becomes deformed. Certain other arthritic conditions can really have, like rheumatoid and other ones systemically can push the fingers in all different directions. That’s a little bit different than what we’re talking about today. But the osteoarthritis would be the wear of it and then your body laying down bone to try to almost cement it together. So then it really will limit the amount of joint mobility. So with the laser, the two things that we can get at best would be pain reduction in there and then just slowing down that process. Just trying to slow down the process of your body trying to basically kind of cement you together.
Mark: So there you go. If you need some osteoarthritis … Well, what about other parts of the body? Hand is one thing. What about the rest of the body? I mean there’s a lot of other parts that have arthritis.
Dr Harold: Yeah, absolutely. And the hand would be just like a gateway to talk about the rest of the body because a joint is really a joint. And so once that cartilage is worn down between it, whether it’s your cervical spine, your elbow, your knees, it’s the same kind of treatment protocol. Like we’re going to use the laser to reduce that, inflammation-wise, and try to create mobility into that area. So yeah, the same principles apply to all the other joints in your body, whether it’s your feet, knees, shoulders, we’ll treat them all here at the clinic.
Mark: So there you go. If you have osteoarthritis and you want some pain relief, the guys to see are Evolution Wellness, you can reach them at (604) 881-2404 to book an appointment either at their Vancouver office or in North Langley, and you have to call ahead and book because they’re busy. He’s got a lot of patients to see for doing this kind of treatment. And it works extremely well. As a practitioner of getting treatment myself, it’s an awesome, beneficial, easy to do treatment. Thank you, Dr Harold.
Mark: Hi it’s Mark Bossert, producer of the Evolution Wellness laser series and we’re here with Dr. Harold Meinzer of Evolution Wellness in Vancouver and Langley. Today we’re going to talk about a very common thing, one I’ve suffered from myself actually, carpal tunnel syndrome. How you doing today, Dr. Harold?
Dr. Harold: I’m doing fantastic, Mark. Thanks for asking. How are you?
Mark: I’m really good. So, carpal tunnel. It hurts like a bugger. How can you help it with lasers?
Dr. Harold: Yeah, carpal tunnel. It’s very interesting but plagues a lot of people and we see it in the office all the time. It’s that wrist complaint, the median nerve going through that carpal tunnel. Pressure on it causes tingling, numbness, all sorts of peripheral symptoms into the wrist and hand, really kind of loves these fingers and can be caused from a variety of things. Lots of people get it from repetitive overuse or typing or ergonomic things as well, as it could be from overuse with … like your case, I guess, you can let us know, repetitive overuse with tree planting.
Mark: Of course, the little tweaks with mousing, you know, if you aren’t switching to different mice and track pads, et cetera. I’ve noticed in the past too.
Dr. Harold: Well, the biomechanics of the wrist and how your ergonomic setup is at your desk and your work station makes a huge contributing or play into this. You really don’t want to be up and about like this, which a lot of people are, on top of the desk top. Really want to be at sort of 90 degrees with the elbow and then the wrist will stay flat. You can’t see it on the screen, but so that wrist is sort of flat in that position instead of like this or on the desk top, which looks funny on camera and it even looks funny on the desk too.
Mark: Well, I notice a lot of times when I really found it at my … I was laying, resting my wrist on the desk top and typing or trying to move the mouse. That’s when I really felt it. I got ergonomically smart, no more issues. However, when the pain’s happening, how do you treat it with lasers?
Dr. Harold: Well, it’s sort of an inflammatory, right? So it’s compression on that nerve as it goes through that tunnel. So obviously, we want to correct whatever biomechanical fault. If you’re on the desk top and you’re doing weird things that … Obviously, we got to stop doing that. We’re going to smack you on the wrist. We’re going to crack those things. Then, we’re going to use a couple different techniques, again, and always, I guess, with … In my clinic, I like to assess the soft tissue and then making sure that there’s no adhesions within the flexor extensor group of the wrists and arm. That would be just some myofascial release. But then using the laser.
Lasers are great as that natural anti-inflammatory. This is irritation compression and it’s angry at you, so we want to reduce the inflammation in this area and in and around the wrist. By doing that with the laser, then we’re going to reduce the symptoms and symptomatology. So it’s correcting biomechanics, laser, a little soft tissue work, and then, obviously, some cold at home. That could be a really great little trifecta to get that system back into working condition.
Mark: Do you ever recommend using aspirin or any kind of anti-inflammatory like that?
Dr. Harold: Yeah. Patients can use that at home at their discretion, or if they want to talk about that with their physicians. For me, we stay out of … With my license, we stay out of sort of that type of arena. I’m just really going to focus in on using that laser to reduce the inflammation. Typically, with these types of injuries, it’s superficial, so there’s not a lot of tissue to penetrate. That’s different than, say, if you’re going to into a glute or a hamstring, which is a very dense and thick tissue. This is superficial, so we get, I think, even better results within the wrist and hand by reducing that inflammation.
Mark: What’s your typical sort of treatment course?
Dr. Harold: The protocol for that would be … I probably would see somebody over two weeks. We’d see them every other day for a treatment. The treatments are pretty quick because there’s not a lot of tissue to go through. So it would probably be a 10-minute sort of follow-up to 20-minute follow-up, depending if it’s one issue or two issues. And then I would also make sure that in my exam we’ll look at the wrist also, if there’s any dysfunction at the elbow as well, because that can be interconnected into it. And if you want to trace the nerve root back to what’s happening in the cervical spine, sometimes I’ll even do some laser work in the cervical spine where the nerve root comes out that’s innervating that entire arm. That would be more of an extreme case.
Mark: Right. Basically, if you’ve got a gravelly feeling and a lot of pain in your wrist, lasers could be a really noninvasive, quick, quicker way of, a non-painful way of creating some healing.
Dr. Harold: Yeah, that’s absolutely correct. That’s well put, something that’s with no side effects. There’s no detriment to it. There’s no breaking of bonds. It’s just stimulation into our body’s natural healing and increasing blood flow to that area for that anti-inflammatory effect. You also get a little pain killing, endorphin and keplin release into that area. But really, just speeding up our body’s natural healing. A lot of times these inflammatory conditions just need that bump up to get ahead so that that system starts working, and then pain levels will drop off.
Mark: I think it’s important in this case, especially, that because this can be a repetitive use thing, that it is an ergonomic … There has to be a change in how you’re doing things in order for there to be a change in the long-term prognosis of how … Are you going to get sore again? Is that right?
Dr. Harold: Yeah, absolutely. If you don’t change the underlying mechanism of injury, then you’ll be back to see me. I mean, I love my patients but I’d like to see them less, if that being said. So if we can solve that problem but then have it reoccur over and over again and then we’re sort of chasing our tail. So we’d want to kind of look at the underlying what your sort of … probably your work station looks like, correct that. Then, with that, that will also help in reducing the amount of irritation that’s happening on a daily basis along with the laser and soft tissue work and ice and cold. All those things will play a part in it, for sure.
Mark: So carpal tunnel, is this kind of related to some of the other tendonitis type of things that people might come to see you about?
Dr. Harold: It’s a little bit different because the carpal tunnel would be more like a nerve irritation that happens through the tunnel. It’s like a neuropathy or a nerve irritation, where like we talked about before where we have tennis elbow or golfer’s elbow, that would be more of a tendinopathy within that muscular system. So similar, both are irritated, but different structures.
Mark: . Have you got sore wrists, the guy to see is Dr. Harold Meinzer at Evolution Wellness. They’re located in Vancouver and North Langley. You can reach to book at 604-881-2404. You have to call and book ahead. He is always busy. Thank you so much, Dr. Harold.
Dr. Harold: Yeah, thanks for having me again, Mark. It was great to talk with you.
Mark: Hi, we’re here. We’re talking about lasers and laser treatment to relieve pain with Dr Harold Meinzer, of Evolution Wellness in Vancouver. I’m Mark, I’m producer of this video series. Of course today we’re talking about Golfer’s elbow. How are you doing Dr. Meinzer?
Dr. Harold: Good morning. I’m doing fantastic. I thought we could maybe touch on some Golfer’s elbow, because tis the season, as they like to say. Spring is in the air, and golfers are ready to hit the course, or some of them are. I’ve been waiting all winter, the fair weather ones. Now it’s time. Here we go.
I think, maybe I’ll just touch on some of the symptoms, because people might not know or get confused with tennis elbow. Golfer’s elbow is in that inside of that elbow. They call it medial epicondylitis, which is a fantastic word, and I like to use it as much as possible whenever somebody comes in. That’s gonna cause pain, tenderness, stiffness, even can cause weakness into the wrist and hand, and even, at times, tingling and numbness all the way down into there. That can be, you know, disturbing in your everyday life, not only on the golf course.
Mark: It’s not just golf that might cause this, kind of in interior arm pain?
Dr. Harold: No, no golf … that’s what it likes to be known as, golfer’s elbow, but it’s anything that’s causing pain on that medial side. That’s where all these flexor tendons come in and go right down to your hand. Some of the examples would be, for sure golf, that’s the primary one. You know, racket sports can do it, or a throwing sport, repetitive weightlifting in the gym. Or something at work, repetitive movements at work, wrist, and hand, and elbow movements can then cause that type of pain in through here.
That’s really like excessive stress into that area. Really forceful movements, and gripping of rackets, and your golf clubs, obviously. Then, also improper biomechanics. If you’re doing something incorrectly, like your golf swing, throwing movements, but your biomechanics aren’t right, then that can cause it as well. Then, my favourite is the weekend warrior or the seasonal warrior, now. That’s the tissue that’s de-conditioned. It’s just been on holiday all winter and then golfing, you know, the sun comes out, everybody goes, “Let’s go golf.” You haven’t done anything to prepare this tissue to work, in that way, and that de-conditioned tissue, then it gets really angry at you.
Mark: Lasers, again, that’s gonna help with the healing process, reducing the pain, getting people back on the healing track, but also back to doing their sport that they want to do or their work that they need to do. Is that right?
Dr. Harold: Yeah, that’s right, and doing it quicker. Usually, with my treatment protocol, we’re going to address the soft tissue, so I’ll use some soft tissue work to release myofascia and muscle tissues because, again, that can be a small micro and kind of adhesions in there. We want to lengthen and make sure that tissue is opened up, and then we’re going to use the laser application all around that elbow to reduce the swelling, and then improve that healing, and the time as well. Right? We can shorten that … that state where it’s not gonna get into a chronic state. Then, usually, you know, rest the nights after treatment is always good as well. I thought today, maybe I’ll, I got the laser fired up here that we’ll take a look at it, and I’ll show you how we actually do that application onto, onto that area.
Mark: Absolutely. That sounds really good.
Dr. Harold: Whenever we’re dealing with lasers and true lasers, we’re always gonna use safety glasses as part of the protocol. Some people, they’ve been to other practitioners where they come in to see me and said, “Yeah, I had laser done”, and I always ask, “Did you wear sunglasses?” A lot of them are like, “No, we don’t wear sunglasses.”
Well then that laser wasn’t a true laser. It was probably a led light or, or SLD light, sort of being called a laser, but a true laser, you always got to wear safety glasses when you’re in the visual field. We’ll throw safety glasses on, and who doesn’t want to wear safety glasses or sunglasses in the office? Right?
It’s really a great system. This is the LightForce laser right here. I can set it up in multiple ways with the amount of power that I’m outputting, but we’ll talk about that on a later podcast.
If I drop the cable, the light goes through, comes through this attachment head, and there’s a quartz ball at the end, and you can see there’s a nice little red dot. That’s my guide dot. It tells me where the laser’s pointed, because it’s actually infrared. The laser produces infrared light, so we wouldn’t actually see it, so this is just a way for me to tell exactly where I’m pointing.
The idea is that we make contact with the skin, and contact’s important, so that we can get deeper penetration. Then, we’re just gonna roll over top of that area and apply the laser. When I turn it on, you’re gonna hear some beeping.
Then, it’s just gonna, kind of roll over top of that area. Real simple, real easy. It will create a little-bit of warmth as, as it’s applied. That warmth is just a byproduct of the light. It’s a very simple type of treatment, and for the elbow, it would only be a few minutes, and then we’ll do the soft tissue therapy as well. Then at home rest and ice.
Super comfortable, it’s probably the most comfortable treatment you’ll ever have in, you know, as a modality. Doesn’t hurt, just feels really soothing and deep. Then, we’ll try and do a number of treatments in a row. Usually, I say six sessions in a row, and then we’ll reevaluate at that time.
Mark: A non-invasive, no side effects, very fast, effective treatment in most cases, maybe not always, but often?
Dr. Harold: Yeah, absolutely. There’s … no bonds … no bonds are broken. Some people think, is it an x ray? Is it gonna destroy tissue, or anything like that? Nope. No bonds … bonds are broken. It’s a stimulatory effect to the cell, and it just speeds it up.
Mark: There you go. If you need some help, with any kind of golfer or elbow injuries, the guys to see … or the guy, the guy to see is Dr. Harold Meinzer. You can reach him at Evolution Wellness. There’s two offices, one in Vancouver, one in Langley call (604) 881-2404 to book your appointment, and get some help, and get back to healing.
Mark: Thank you, Dr. Harold.
Dr. Harold: Yup. Thanks so much. I’m here to help.
Mark: Hi it’s Mark Bossert, producer of the Evolution Wellness video series. And of course we’re talking lasers with Dr. Harold Meinzer of Evolution Wellness in Vancouver and Langley. And today we’re talking about tennis elbow. What’s going on with lasers and tennis elbow, Dr. Meinzer?
Dr. Harold: Well, ’tis the season. Spring starting, summer’s around the corner, people are starting to get the tennis rackets out and getting their elbows moving again. Those rusty elbows that haven’t gripped a tennis racket in nine months. And so in the clinic we’re starting to see a few trickle in already. And really tennis elbow’s just the lateral epicondyle here and all these muscles come back and insert into that elbow. So we’re gripping, it’s like a strain, sprain type of injury, they get inflamed, and it’s an -itis. And inflammation into that area. So I love that. Any -itis is one of my favourites. Tendonitis, bursitis, arthritis. All the I-tises. Most doctors don’t want to talk to you about them, but I really enjoy discussing it and also treating it.
So that condition, when it’s inflamed around that elbow, we really like to start with a laser treatment. So laser’s going to help again in those specific ways of reducing inflammation, speeding the healing around those cells, and reducing pain. So we want to get people back on the tennis court because it’s important that we are active and healthy and get our joints and body moving. But with these repetitive injuries, when we’re using it over and over again, and it’s just not used to it right? It’s deconditioned, it’s been sitting around all winter not doing too much. And now we’re going to really load it with high forces, as we’re gripping and hitting the ball with the racket.
So I think that if we can reduce the inflammation, we really get great results with those -itises like that. The lateral epicondylitis, it’s a great word to say. And also with my treatment protocol, I don’t just look at, just the lasers, I’d like to do some soft tissue work, some myofacial release into that tissue, open it up, and any little adhesions and buildup of sort of I call it sticky spots, I want to break that up and open that tissue up. So when we combine those two together we got a really great therapy to help people with lateral epicondylitis, or tennis elbow.
Mark: And when you do the protocol, typical time frame for people to get back to their being able to be active again.
Dr. Harold: Yeah, that’s a great question, if it’s a real chronic condition it might take a little longer. Usually I’d say with most of these conditions, I like to get six treatments in, in a pretty sequence, in a short period of time, and really get after it, and try to change that tissue. And then after that we can reevaluate. We’ll say, okay, we’re 50, 80, 70% better, and then we can cut back treatment and then people will be back onto the tennis court.
Generally if it’s a real high level athlete then they’re going to try to be training through some of this. But if it’s just a recreational player, we might ask them to take a week or two off, just to reduce that stress and load into that area while we treat it. And then we’ll hopefully have resolution. But really great results with it overall.
Mark: And would they be doing any other kind of treatment at home? Like using ice or compression or anything else?
Dr. Harold: Yeah absolutely, ice therapy would be fantastic. And that’s I think such a controlled way to deal with inflammation. It’s cheap, accessible, really easy to do. Most people are honestly just a little bit lazy with it. But application of ice over top of that area repeatedly over that time frame of this six treatments can really help speed things along as well.
I always feel that inflammation is one of those key things, the faster way to get rid of that inflammatory, all those products then pain levels just drop right away too.
Mark: Sure, because that extra volume of inflammation product, as you called it, is basically charging that area with a ton more content.
Dr. Harold: Yeah. Chemicals and metabolic waste, and that all just stirs it up more, gives it more aggravation to the tissue.
Mark: Your body’s saying, “Get that out of here. I can’t feel better with this stuff in the way.” Basically. Can’t heal.
Dr. Harold: Absolutely.
Mark: So the big value that I see, and I just want to confirm this with you with the laser, what I’ve noticed with it, is that it’s non-invasive. So it’s very easy. It works what way my body actually heals itself, it’s just accelerating it a little bit. And it’s basically no fuss, no muss. It’s really easy to do and produces great results. Is that your experience with doing this?
Dr. Harold: Yeah absolutely. It’s probably the least invasive treatment that we can do. We’re just putting a light source on top of that area. And it’s just telling your body .. your body is naturally healing, it’s just giving it that real big upsurge of energy to do it at a faster rate. And that’s why all the pro sports teams, whether it’s the Bluejays or Seahawks, pretty much every professional athlete is using it, because you can just shorten those injury times so you can get back on the field, or for somebody, or patient, maybe back on the tennis court faster without pain.
So I think when you’re using these types of therapies, I like to go most conservation to going up that chain, I think this is really the most conservation treatments. There’s no side effects to it. There’s no ill, there’s no broken cells or any kind of chains that are broken up. People think, “Oh it’s like an X-ray.” Or anything like that, no, there’s nothing to do with that. It’s just a stimulatory effect.
Mark: It’s basically stimulating the mitochondria.
Dr. Harold: Yeah, that’s a great word, yeah. And in school we kind of called it the mighty mitochondria, or that’s how teachers loved to propose it for us to remember, because that’s the energy, or the power plant of the cell. And so when you stimulate that power plant to generate more energy, then that energy is used by the cell then to heal at a faster rate.
Mark: And actually cold stimulates the mitochondria too. That’s really the value beyond reduction of inflammation?
Dr. Harold: Yeah. The cold is really going to vasoconstrict that area with the blood flow to try to limit how much products of inflammation are going into that area. Where the laser is going to open up that blood flow and because we want to push in all those good building materials for repair, and then it speeds up the blood flow to get rid of all that metabolic waste. So it works as this unit of blood flow and lymphatic drainage. It works as an anti-inflammatory in that area, natural anti-inflammatory.
Mark: And when’s the best time for somebody. If I just felt the twinge from the first back or forehand I hit this year, or should I wait and really make it really painful before I come to see you?
Dr. Harold: Sooner the better. You don’t want to get that tissue get really angry and build up. Because you might not be playing tennis every single day, but you’re still using your hand and elbows as you’re gripping, you’re opening a jar, or you’re using it to hold the coffee mug. So you’re still always using it, and then it’s part of a repetitive overuse injury. So the faster you can deal with it, the better. I think that’s with most things in life right? We want to get to it as fast as we can, then the end result will be quicker. Less pain, back on the court, quicker. If you let it linger and become then a chronic condition, then that’s harder to change over and it will take longer.
Mark: So there you go. If you got any kind of tennis elbow or any kind of elbow issues, carpal tunnel syndrome, any sort of overuse injury, pain, the guy to see to get it taken care of with the fancy pew pew, laser is Dr. Harold Meinzer, you can reach him at Evolution Wellness, they’re in Vancouver and Langley, and the best place to call on the 604-881-2404 to book your appointment. You have to book ahead, he’s busy. Thank you Doctor.
Mark: Hi, it’s Mark Bossert, producer of the Evolution Wellness video series with Doctor Harold Meinzer of Langley, Vancouver and Aldergrove. And of course today we’re talking about shoulder injuries. Do you see a lot of shoulder injuries in the clinics?
Harold: Yeah, shoulder injuries are really common in the clinic and they’re notoriously a really difficult joint or also conditions to treat. The shoulder joint has a lot of moving parts, a lot of muscle and we have so much mobility with it, but then it can leave us vulnerable to have all sorts of injuries. So within the clinic I like to, you know, always do an assessment, a history exam, an assessment on the joint, what’s working, what’s not working, what’s dysfunctional. And then usually trying to employ some sort of soft tissue treatment. But we’re here to talk a little bit more in depth about laser and how the laser can help these types of conditions.
Mark: So having had numerous different shoulder injuries myself, how does the laser actually help with the healing inside the joint?
Harold: Well, usually what my protocol entails is that when we start treating a shoulder, and if we are having a shoulder injury, whether it’s the AC joint or even some soft tissue problems within the upper trapezius muscle or other rotator cuff muscles, is that I usually always start where the nerve roots exit. So the nerve roots are what’s controlling that entire shoulder and arm. So usually I like to start with the soft tissue and over top of those nerve roots and then proceed along that pathway of the nerve in and around that shoulder joint. And so the laser is going to help in a couple of key ways. We’re going to use it and as it’s being applied to the shoulder joint, it’s going to help with reduction in shoulder pain. So pain by, with every patient that’s a thing that you want to get away from as soon as possible.
And so the laser is going to reduce pain by releasing endorphins and enkephalins in that area. And those are sort of pain blocking molecules that we naturally produce. So it’s not anything new into the joint, we’re just stimulating the body in that way. And then as that laser is working, we’re increasing blood flow to that area. We need blood flow for healing. We want all those material, the building materials for repair and healing if the joint’s injured, but we also want to pull out and get rid of inflammation. And so that’s the lymphatics. So we want to open up the lymphatic channels and we increase the blood flow to that area. And those two things work as a really nice and strong anti inflammatory. Again, natural with no side effects to that area. So I think those are two key things and we’ll talk about another in a second. But if you’ve got a question, but it’s really important to to reduce the inflammation. Once inflammation is reduced, then range of motion will start to increase. And obviously we want that pain level to diminish right away.
Mark: So what’s a typical treatment series for a shoulder problem?
Harold: Typically for most conditions, I like to give the modality at least six treatments. So I could do a series of six treatments and we do them pretty sequential. So I don’t want a lot of time between them. And we do it every other day. And so that really keeps energy into that system. So the laser itself is stimulatory, so we can stimulate the body and that can run. In the literature they say for up to 24 hours. Everybody’s a little different. So some people have changed pretty quick within an hour or two or immediately. And some people have it after 10 or 12 hours, they’ll have bigger changes. So, but we want to keep those treatments close together. So I say the minimum, we want to give the therapy a chance of six treatments, and then after the six we’ll be re-evaluating and see, okay, where are we at? Are we at 50% improvement? 70? 20? Do we need to add or change anything within our protocols?
Mark: And is it mostly the, when a patient’s experiencing this, is it mostly first there’s a reduction in pain and then the range of movement comes back? Is that, typically …
Harold: Yeah, a lot of times those will happen the quickest. So the inflammation diminishes and they kind of self fulfill as well. So the range of motion increases, there’s less inflammation. Because there’s less inflammation, there’ll be less pain as well. And then when you add the endorphins and enkephalins in there, that even can drop it further. And the third thing that we haven’t touched on too is that as that laser goes into the tissue, it really is a stimulatory effect into the cell. So it gives that cell more energy so that we can have greater turnover within the cell for that healing. So then we can have longstanding changes versus just sort of symptomatic changes. Because we want repair of that tissue.
Mark: So are you seeing a lot of, like, this seems very obvious, any sports that use shoulders a lot? Like paddling or volleyball or football.
Harold: Yeah, like all those sports. And then you think of people, the weekend warriors that sit at their desk all day and don’t do much and then they go play softball on the weekend, you know, swinging motions, you know, and then traumatic injury, right? Sliding into the base or falling out of the tree or whatever that you’re doing and trying to clean your gutters. And you fall and the crazy thing is that you’ll, I’ll even see something like sleep injuries when we think that we should be at rest and should have no injuries and someone sleeps on their shoulder funny and kind of kinks themselves, get up after eight hours of sleep and you just can’t move your shoulder. So we get the gamut of sports to trauma to a sleep injury.
Mark: And I imagine that because it’s effective, there’s a lot of pro sports teams, baseball, football, basketball that are using this?
Harold: Absolutely. All the pro sports teams are using it. And there’s a probably a couple of videos you can find. Toronto Blue Jays or one of the users of it as well as you know, Seattle Seahawks and other elite athletes. But it works for us mortals as well. The elite athletes obviously are great. They’re in top physical form, but they want the fastest therapy to get them back on the field. And this therapy is fast. It’s not invasive, it’s all natural. It doesn’t affect any kind of drug testing or anything like that. So it can get them back on that field as fast as possible. We really don’t have any other modality that can stimulate the body and the body’s natural healing mechanism to speed up what it would do other than laser. Nothing else will do that. No ultrasound or TENS or any other unit will do that. So it’s really unique in that it really stimulates right at the cellular level turnover, which is I think one of the coolest things.
Mark: And protocol for how soon after injury this can be applied?
Harold: Yeah. So immediately after, in the acute stage, that’s where we want to get at. The sooner the better because then we can stimulate that blood flow and then the repair system. So your body doesn’t have as big of a chance to inflame. It’s going to inflame, but then we can modulate it. So the faster you can get repair into that joint, the more organized it’ll be and the better that tissue will heal and the better outcomes you’ll have.
Mark: So there you go. If you’re looking for treatment for your shoulder problems in Vancouver, North Langley or Aldergrove, you can give Doctor Harold a call to book. They’re busy. You have to book ahead. Give him a call at (604) 881-2404 to find out where he is this week and book an appointment. Thanks a lot, Doctor.
Harold: Yep, thanks. Look forward to seeing all these shoulder injuries this week. Thanks.