"While rehabilitating equines, I have learned that the saying the more, the better is not true. This saying also applies to laser therapy as a treatment method for tendon and suspensory ligament injuries.
At the beginning of my career, I made the mistake of thinking that laser therapy should be administered to the horse's problem area as much and as often as possible – and always at the same frequencies (Hz) and treatment doses (J).
However, I soon realised that excessive activation of cells does not promote recovery. Laser therapy will not harm, but the treatment does not give results because the body cannot utilise the excessive energy from laser light.
That's when I learned that the body needs time to recover. You can accelerate metabolism, collagen formation, and other natural chemical processes in the body to a certain extent only. You need to be patient to achieve positive treatment outcomes.
Frequency of laser therapy
The frequency of 3+2 and 1+2 has given the best treatment responses in tendon and suspensory ligament injuries. This frequency means that the course of treatment begins with three days of laser therapy, followed by two days of rest. The treatment then continues with one day of treatment and two days of rest.
The acute phase usually lasts about three to four weeks, but the injury may have improved as soon as after two weeks, thanks to laser therapy. The worst inflammation and swelling have subsided during this time, and no more scar tissue is created.
In my experience, tendon and suspensory ligament injuries heal faster with laser therapy than with other treatment methods alone. Rehabilitation on the aqua trainer also has a significant impact on the success of the treatment.
When it is time for the control ultrasound, you can be pretty confident that the injury has healed when the laser therapy no longer causes a reaction in the leg. As the body responds to the energy of the laser light, the leg becomes warm. A healthy leg does not react to the energy of laser light at all.
I have found it helpful to clip the hair on both legs at the beginning of the treatment so that I can compare the difference in temperature between the sore and a healthy leg.
Treatment parameters of laser therapy
In addition to the treatment frequency, I have a proven formula for the selection of frequency. I usually start treating an acute injury at 18,000 hertz, as the high frequency reduces inflammation and swelling.
Cold treatment of the injury has the same effect, and it should be administered three to four times a day for the best results. In connection with laser therapy, it is advisable to give cold therapy before laser therapy.
On the second day of treatment, I stimulate the cells at a low frequency, 1,168 Hz, and on the third day, I return to 18,000 Hz. However, you must adjust the frequency immediately if the horse's response shows that it is not currently able to withstand the selected frequency. After the acute phase, I continue the laser therapy, varying with 10,000 Hz and 1,168 Hz. Depending on the need for treatment, I can also initially use 5,000 Hz, for example, suitable as treatment of wounds.
I determine the treatment dose by the size of the area to be treated. Usually, I only treat the injured area, but if the whole leg is swollen, I will treat the swollen area. I have developed memory rules for determining the therapeutic dose; for example the suspensory ligament is a palm-sized area and for that, I choose 35 joules. The recommended dose for suspensory ligament injuries is 6–8 J/cm2, and for tendon injuries, 2–6/cm2.
The laser therapy device determines the treatment time based on the treatment parameters. A minor problem area needs about 3 to 5 minutes per treatment, but a large one needs three times as much.
The result of treatment: an elastic tendon or suspensory ligament
A good treatment result is a healthy tendon with a significantly recovered fibre structure that withstands the horse's normal, active daily life as well as possible. As mentioned before, you can achieve a good treatment result only by being patient – so forget excessive treatment, as the body needs time to recover on its own between treatment sessions."
The author is Laura Biskop, a pioneer in equine rehabilitation who founded the Stall Biskop horse rehabilitation centre in Kruunupyy in 2010. The company's operations ceased in August 2020 when a fire destroyed the stable. Laura has been using Theralux Touch laser therapy device with wavelength 904 nm.
Theralux tip: When choosing a laser therapy device, keep in mind that device models with wavelengths of 808 nm and 904 nm are most effective in treating tendon and suspensory ligament injuries. The power of the laser therapy device must be higher than 30 mW in order for the energy of the laser light to penetrate the cell membrane and stimulate the mitochondria, which are responsible for the energy metabolism of cells. Read our selection guide.