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The use of trans cranial low level laser therapy for the management of mild traumatic brain injury.

By: Daniel J. Bourassa, DC

Mild traumatic brain injury (mTBI) and concussion syndromes have been a subject of increasing interest in both medicine and the media. As neuromuscular specialists, chiropractors see a significant percentage of a patient population with a history of traumatic head and neck injuries resulting in mTBI. These practitioners are uniquely positioned to diagnose and treat this health problem. In cases of mild TBI, the term “mild” refers to the severity of the consequences of the injury. Secondary symptoms include chronic headaches, anxiety, depression, insomnia, social withdrawal, seizures, and other indications of CNS dysfunction. The WHO report recommends that DCs only “facilitate a path to good recovery for mTBI patients through early education and positive reassurance as well by providing treatments aimed at reducing associated spine and headache-related pain.”


Early symptoms:

  • Any loss of consciousness up to 30 minutes.
  • Any loss of memory of events immediately before of after the accident (up to 24 hours).
  • Any alteration of mental state at the time of the accident (e.g., dazed, disoriented, or confused).
  • A Glasglow Coma Scale score falling below 13 after 30 minutes (review ER Records).
  • Headache
  • Dizziness or vertigo
  • Lack of awareness of surroundings
  • Nausea with or without memory dysfunction
  • Vomiting

Later symptoms:

  • Persistent low-grade headache
  • Lightheadedness
  • Poor attention and concentration
  • Excessive or easy fatigue
  • Intolerance of bright light or difficulty focusing
  • Intolerance of loud noises
  • Ringing in the ears
  • Anxiety and depressed mood
  • Irritability and low frustration tolerance

Research has demonstrated low level laser therapy (LLLT) delivered thranscranially to be both safe and effective in the treatment of mTBI and other conditions of the central nervous system. Current research is a wake-up call for chiropractic physicians to consider transcranial LLLT in mTBI cases.


Over the last 15-20 years, a great deal of research has looked at the role fascia plays in pain, reduced function, range of motion and more.

For example, Stecco has shown that an increased concentration of hyaluronic acid in the extracellular matrix can cause stiffness and pain. By using a deep form of manual treatment, the clinician can actually reduce the concentration ( for viscosity) of the hyaluronic acid and thereby reduce pain and increase range of motion and function. We also know that fascia covers every cell in our body. There is a growing body of research showing that treatment in the eccentric position hastens recovery. Remember, there are no local problems and there are no local treatments, we must look at the body as a whole and look at how the fascia interconnects multiple body parts.

Scar formation is a natural part of the wound healing process. Scars are formed by fibrous connective tissue assisting would repair in the skin and other body tissues. Scars are formed on the skin, underlying tissue, and internal organs where an injury occurred, an incision was made, some part of the body was cut, or a disease infected and caused damage to the tissue. The damaged tissue is replaced by scar tissue to maintain the normal body processes (Waibel & Rudnick, 2015), but scar tissue is unlike normal tissue and may cause pain and limitations in motion, thus needing medical intervention.

Scar formation on organs or muscles can alter the way the tissue moves. Movement is altered around a scar because the flexibility of the scar tissue is different from that of normal tissue. The scar tissue is weak and less elastic. It is vulnerable to injury.

Smaller forms of scar tissue are called adhesions. Adhesions cause the inability of tissue to glide and slide over one another, resulting in stiffness and reduction in strength and range of motion. The nerves become entrapped in the tissue instead of being able to slide through the muscles, which limits range of motion of the involved limb.

Reduced range of motion can be avoided with a prescription of manual therapy and correct motion exercises to help avoid myofascial adhesions around the affected area. Treatment of scars can be easily performed in chiropractic, massage, or physical therapy clinics. For the best outcomes to improve scar tissue flexibility, intervene as early as one can without disrupting tissue healing. Using kinesiology tape can help lift the skin allow for fluid to move easier to the heart.

The latest CDC statistics show that , in 2012, 54 out of 100 people had self-reported musculoskeletal conditions. That is six times more than self-reported cases of cancer, double that of respiratory disease, and one-third more than circulatory disorders. If we extrapolate that to a more current population in the United States of 321 million, that equates to 173 million people reporting musculoskeletal problems in 2012.

Many of these are spine patients who suffer long term without any type of bio-mechanical assessment or functional case management. Why does health care fall short with spinal conditions despite the compelling literature that states the opposite in treatment outcomes?

The front line of medical care for spine-related pain is typically the prescription of pain medication, particularly at the emergency care level, and then if that doesn’t work, a referral is made to physical therapy. If physical therapy is unsuccessful, the final referral is to a surgeon. If the surgeon does not intervene with surgery, then the diagnosis becomes ” nonspecific back pain,” and the patient is given stronger medication since there is nothing the surgeon can do. ¬†FOr surgical interventions that result in persistent pain, a commonly reported problem, there is an ICD-10 diagnosis for failed spine surgery.

According to Mulholland (2008), “[Surgery] Spinal fusion became what has been termed the ‘gold standard’ for the treatment of mechanical low back pain, yet there was no scientific basis for this.” Simply put, surgery does not correct the underlying biomechanical failure or the cause of the pain.
Opioid pain medication use presents serious risks, including overdose and opioid use disorder. From 1999 to 2014, more than 165,000 persons died from overdose related to opioid pain medication in the United States.

Clearly, there needs to be a nationwide standard for the process by which patients with spine pain are handled, including academic and clinical leadership on spinal biomechanics. The only profession that is poised to accomplish such a task is Chiropractic.

MDs tend to use medication, including analgesics, muscle relaxants, and anti-flammatory agents, for the treatment for acute nonspecific spinal pain, whereas DCs favor spinal manipulation therapy as the primary treatment for this condition.


Firefighters have very physically demanding, psychologically taxing, stressful, and dangerous occupations, resulting in frequent cardiovascular events, Musculoskeletal injuries, and behavioral health concerns.These issues compromise health, fitness, and well-being throughout their career and into retirement, severely impacting the ability to protect our communities.

The purpose of this article is to provide an overview of: the current state of wellness and fitness programs in the fire service, our firefighter wellness and fitness projects in the Tampa Bay region, barriers to implementation of these programs; and recommendations for successful implementation of firefighter wellness and fitness programs.

Many stakeholders agree that firefights need to be physically fit and psychologically healthy in order to have long and successful careers. Thus much emphasis has been placed on strategies to improve and maintain wellness and fitness, including fire service guidelines, such as the IAFF-IAFC Wellness Fitness Initiative. Low back pain and injuries are some of the most common and disabling disorders in firefighters.

Properly designed and implemented wellness and fitness programs will help transform fitness across the State of Florida and, ultimately, the United States. Based on our recommendations and the guidance of well-versed stakeholders, this is a real possibility. Regional implantation will serve as a model-enabling other fire departments to replicate and standardize and approach addressing all current and future needs for firefighters who serve and protect and protect our communities.

Through successful implementation at the regional and national levels, such programs will result in improvement health and wellness outcomes that will be delivered in a cost-effective and pragmatic manner, Stay tuned for our future updates from our Florida-based firefighters Wellness and Fitness initiatives.

Originally published in Florida Fire Service Magazine, October 2016, Copyright Florida Fire Chief’s Association

Antibiotics; In our modern day to day lives it comes as no surprise that they are some of the most prescribed drugs in the world. They are responsible for saving countless lives yet their vast and frequently indiscriminate use, combined with a deficit of new antibiotics, has led to the current global health threat of antibiotic resistance. Probiotics present a logical and natural solution to reduce the distribution caused by antibiotics and return the gut macrobiotic back to baseline following such treatment.

For example, Vitamin D has emerged as something of a miracle supplement in recent years with hundreds of research studies suggesting that it may be useful in preventing conditions such as osteoporosis, autoimmunity, cardiovascular disease, cancer, and much more. Having a Vitamin D deficiency has even been linked to obesity.

Recent statistics suggest that between 40 to 50% of healthy adults, infants, toddlers, as well as pregnant women are deficient in Vitamin D. Why? Because the active form of Vitamin D increases calcium absorption from food in our digestive tract.

However, recent research has suggested that nearly every cell of our body has receptors for Vitamin D, which includes influencing our immune system, blood pressure regulation, insulin secretion, and cell differentiation. Magnesium supplementation along with Vitamin D supplementation was more effective at correcting a Vitamin D supplementation alone.

UltraSlim is the only treatment for immediate, permanent fat removal without dieting, exercise or pills.

The peer-reviewed scientific journal Scoliosis published effects of chiropractic scoliosis treatment. The results support the conclusion that the chiropractic treatment of scoliosis is very safe.

This Lays the foundation for future studies into the effectiveness of chiropractic scoliosis treatment, and encourages potential patients that the chiropractic care of scoliosis – is a safe and viable option for them.

The article can be accessed online at .

Scoliosis is the official journal of Society of Scoliosis Orthopedic Rehabilitation Techniques (SOSORT).

From Pee Wee to Varsity to Professional sports athletes at every level face similar challenges namely, they want to perform at their best and avoid injuries on the field. And when the inevitable damage does occur, whether from accidents or over training, they look to get back in the game as fast as possible. In this situation, the doctor of chiropractic is often the essential solution.

And chiropractors are on staff with virtually all professional sports franchises and are highly visible at the Olympic Games.

An MD will largely look to address trauma and treat with medication, a DC is attuned to movement, mechanics, and musculoskeletal concerns. Furthermore, the list of banned substances for athletes is a long one-highlighting the importance of a non-pharmacological approach to healthcare and wellness. A chiropractor also has a number of treatment modalities that are noninvasive, such as low-level laser therapy and kinesiology taping, which work in conjunction with the adjustment to achieve results that other healthcare professionals can’t deliver.

A key to being a sports chiropractor is educating the athlete on the benefits of not just resolving their injuries, but using chiropractic for prevention and maximizing performance.

Pes Anserine Bursitis!

Pes anserine bursitis is the result of inflammation of a bursal sac at the medical aspect of the knee. The pes anserinus is the anatomic term used to infentify the insertion of conjoined tendons sartorius, gracilis, and semitendinous into anteromedical proximal tibia.

This type of bursitis is a fairly common finding, pronation of the feet should be suspected and evaluated.

History, such as that he or she has been experiencing medical knee pain after taking a long walk or hike. Custom -made, flexible functional orthodics can reduce the effects of medical knee pain. The knee joint is the largest in the body!

Bursae are closed sacs with synovia that contain fluid. They are located adjacent to areas of friction where tendons may rub against themselves or bones.

Direct trauma, excessive pronation of the feet, and a consequential increased Q-angle are common causes of pes anserine bursitis.

Adjunctive physiotherapy, including interferential muscle stimulation, ultrasound, and cold laser, may prove helpful. Nutritional supplements to quiet the inflammation and benefit the tissue repair should also be considered.

The lumbar spine and pelvis balance on the lower extremities during standing, walking, and running. If leg or foot asymmetries or misalignments exist, abnormal forces transmitted along the closed kinetic chain can interfere with spinal function.

Most chronic low-back pain is the result of some form of structural weakness or failure. The cause of chronic lumbar and spine breakdown is micro-trauma, which is produced by the following conditions:

  • Biomechanical errors
  • Structural asymmetries
  • Tissue weaknesses
  • Excessive external loads

That source is often found to be an imbalance condition in one or both of the feet. The feet are the foundation of the body.

When excessive pronation or arch collapse of the foot is present, a torque force produces internal rotation stresses to the leg, hip, pelvis, and low back.

In patients with degenerative changes in the lumbar discs and facets, the external force of heel strike may aggravate and perpetuate low-back pain.

An anatomical difference in leg length produces abnormal structural strains on the pelvis and low back.