shoulder_pain1Light in the visible red spectrum has noted therapeutic benefits, and it does this by enhancing cellular energy and signaling.  When an injured cell has more available energy, it can repair itself faster and activate certain other biological processes involved in healing.  Red light in this wavelength does not generate much heat, so heat isn’t doing the healing.  It’s photobiomodulation at work– a human version of photosynthesis, the process by which plant life creates food for itself using sunlight.

Because of its wavelength range (620-750 nm) red light tends to get absorbed by water-dominant human tissue, especially red blood cells.  Just beyond the visible red on the spectrum of light is infrared light (IR), which is not visible to the human eye, but still has therapeutic benefit (most of the heat radiating from the earth is infrared).  Infrared has a higher wavelength and can penetrate deeper into human tissue, and does generate more heat than non infrared light.  In fact, infrared lamps commonly used by acupuncturists and physical therapists are considered a radiating heat modality.

Since it is considered generally save for use, the FDA allows manufacturers of red light therapy devices to sell directly to the consumer, without a doctor’s prescription.   Those who have photosensitive skin however my want to speak with their doctor first before trying red light therapy, as it may cause pigmentation.

There are numerous red light devices on the market for personal use; some better than others.  They include hand held devices, mats and lamps.  There are even portable infrared saunas.    For small areas such as an ankle, wrist or shoulder, try using a hand held device.  The one I personally use and recommend is the TendLite.  This is a stainless steel, high quality compact device resembling a small flashlight.    3-4 one minute doses, twice a day for three days is a good protocol for most conditions.  For larger areas such as general low back pain or spasm or leg pain after running, try an infrared lamp, mat or sauna.

The Shoulder Joint – A Complex Joint Vulnerable to Breakdown

Ok, let’s talk about treating common shoulder joint pain.  The shoulder joint, or gleno-humeral joint is a unique ball and socket type synovial joint.  Unlike the hip joint, the shoulder joint has a shallower insertion point that allows it to move as it does — in wide arcs and in multiple planes (try doing that with your knee!).  It is enclosed by the rotator cuff, which is basically formed by the several tendons attached to the humeral head (the proximal end of your humerus, or upper arm bone) and capsular ligaments that connect the humerus to the other end of the shoulder joint, the glenoid fossa of the scapula, a shallow bowl-shaped indentation.  There are six major muscles that move the shoulder, and therefore six tendinous attachment points.

Above and around the ball of the shoulder joint are bursae, which are jelly-like pads that serve to reduce friction during shoulder movement.   Inside the shoulder joint capsule itself is the synovial lining (this is the tissue that gets inflamed in cases of rheumatoid arthritis), the cartilage lining and the labrum, a rigid cartilaginous support structure that helps position and stabilize the humeral head onto the glenoid fossa.

As you can see, your shoulder joint has many structures involved in its function.  This means there are more chances for something to go wrong– a tear, a strain, a malposition and so on, compared to a simpler joint like a knuckle.

If you have pain and/or clicking noises (called crepitus) in your shoulder; have restricted movement such as limited ability to raise your arm above shoulder level, something is obviously wrong in the shoulder joint.  It could be a rotator cuff tear (tear of tendons and or capsular ligament), labrum tear, bursitis (inflammation of a bursa), thickening of the supraspinatous ligament due to shoulder subluxation (malposition of joint), arthritis or fluid build up.

Physical therapy (exercise, stretches) has its limitations, especially in cases like adhesive capsulitis (frozen shoulder); therefore, shoulder conditions are ideal for red light therapy.  The challenge is in accessing the affected structures.

The shoulder is covered by the deltoid muscle, which can be quite developed especially in men.   It is thickest in the belly of the muscle (center, meaty part) but thinner on its ends (tendon) where it inserts into the scapula (acromion) and clavicle (collar bone).  Avoid the belly, and apply the red light over the tendon area of the deltoid muscle.  Also, don’t forget that you can access the shoulder joint underneath, via your axilla (arm pit).  This is a great technique, as there are no muscles obstructing it (see third image below).

Below is a diagram of shoulder anatomy to give you a  better idea on how to target critical structures like the shoulder bursae, tendons and capsular ligaments when using red light therapy.  You’ll want to use a device like the TendLite that can focus the light over a small area of about 2 cm.

shoulder-images

 

Palpate your shoulder and locate the locus of pain.  Internally and externally rotate your shoulder joint and press in front, on top underneath and behind it with your index finger to find tender spots.

Once you’ve found one, keep your shoulder in that position and apply the red light for 60 seconds.  Do this 3-4 times.  You may want to move to areas around the sore spot, for good measure.  The thin, small space just under the “cliff” of the acromion process is an ideal spot to focus the light.  It will get absorbed by the subacromial bursa and supraspinatous tendon, common sources of shoulder pain and stiffness.

Do this over a week to ten days, and you should notice improvement.  Avoid overly-stressing your shoulder joint during this time period to allow proper healing.

Below is a video where I show you how to do it.

 

 

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