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Sesamoiditis affecting metatarsophalangeal joints

Keywords Sesamoiditis of metatarso-phalangeal joint, Turf toe

Treatment Plan

Twice a week for a minimum of 4 weeks, then treat weekly for four weeks, then treatment every two weeks, then monthly / as needed to minimise symptoms

IntentionStimulate lymph nodes to reduce inflammation

& oedema

Heal injuries and local inflammation

De-activate trigger points

Analgesia

Probe

LED Cluster 810nm 1W laser Cluster

810nm 200mW laser 810nm 1W laser Cluster

Pulse 2.5Hz 2.5Hz Continuous Continuous

Tx Time 1 Min 1 Min 30 seconds 30 seconds

Tx Targets

Inguinal, popliteal fossa lymph nodes

Posterior first MCP joint and tendon

Local associated myofascial trigger / tender points Any myofascial trigger point in the calf / shin / plantar flexors/ extensor or peroneal muscles. Ones shown are examples

Spinous processes and ipsilateral nerve root exit of L4 - S2

The colours represent which probe to use and where to place it

version 16.1

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Specific Evidence:

A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Bjordal JM, Couppe C, Chow RT, Tuner J, Ljunggren EA Aust J Physiother 2003 49(2) 107-16 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12775206

General evidence across disease category: Inflammation - tendons, fascia, soft tissue injuries

Kiritsi O, Tsitas K, Malliaropoulos N, Mikroulis G. (2010) Ultrasonographic evaluation of plantar fasciitis after low-level laser therapy: results of a double-blind, randomized, placebo-controlled trial. Lasers Med Sci. Mar; 25(2): 275-81.http://www.ncbi.nlm.nih.gov/pubmed/19841862

Jastifer JR, Catena F, Doty JF, Stevens F, Coughlin MJ Low-Level Laser Therapy for the Treatment of Chronic Plantar Fasciitis: A Prospective Study. Foot Ankle Int 2014 Feb 7

Ng GY, Chung PY Effects of a Therapeutic Laser and Passive Stretching Program for Treating Tendon Overuse. Photomed Laser Surg 2012 Jan 11

Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM. (2008) Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy. Am J Sports Med. May; 36(5): 881-7.http://www.ncbi.nlm.nih.gov/pubmed/18272794

Marcos RL, Arnold G, Magnenet V, Rahouadj R, Magdalou J, Lopes-Martins RA Biomechanical and biochemical protective effect of low-level laser therapy for Achilles tendinitis. J Mech Behav Biomed Mater 2013 Sep 9 29C 272-285

Casalechi HL, de Farias Marques AC, da Silva EA, Aimbire F, Marcos RL, Lopes-Martins RA, de Carvalho PD, Albertini R Analysis of the effect of phototherapy in model with traumatic Achilles tendon injury in rats. Lasers Med Sci 2013 Nov 2

Morimoto Y, Saito A, Tokuhashi Y (2013) Low level laser therapy for sports injuries. Laser Ther 2013 22(1) 17-20 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=24155545

Guerra FD, Vieira CP, Almeida MS, Oliveira LP, de Aro AA, Pimentel ER LLLT improves tendon healing through increase of MMP activity and collagen synthesis. Lasers Med Sci 2012 Nov 21

Laraia EM, Silva IS, Pereira DM, Dos Reis FA, Albertini R, de Almeida P, Leal Junior EC, de Carvalho PD Effect of Low-Level Laser Therapy (660 nm) on Acute Inflammation Induced by Tenotomy of Achilles Tendon in Rats. Photochem Photobiol 2012 May 21