In the above video, Gloria Hall, editor in chief of Chiropractic Economics, interviews Kirk Gair, DC, about the following article he wrote for issue 12 of the magazine.
Download video transcript (PDF)
How to improve patient outcomes for sports injuries
Positioning yourself as the sports injury expert for youth athletes, college athletes and adults is a great way to expand your practice and treat more patients. And by integrating high-energy non-thermal lasers into your treatment protocols, you can enhance your results for sports cases very quickly, easily and effectively, which will lead to a stream of motivated patients.
Youth sports has changed dramatically in the past 10-15 years. Parents see sports as a way to get their kids into their choice college with a scholarship, as tuition has exploded.
Kids start year-round, single-sport specialization as young as five years old. Baseball, softball, soccer, cheerleading, basketball, hockey and even football have kids rarely getting breaks longer than a couple of weeks.
Injuries are increasing, and pediatricians are often unprepared and unskilled in treating them.[1] Recommendations for Tylenol and to shut down for six to eight weeks with no treatment to aid in recovery leads to the injury coming right back when kids return to their sport. As DCs, we can help them with our unique knowledge and treatment methods.
How often are injuries occurring?
Middle and high school athletes who specialize in one sport for more than eight months out of the year have twice the rate of injury as kids who don’t specialize.[2] Injuries are more severe and require more serious treatment, such as surgery, at an earlier age than before.
When I worked at the Dodgers/Angels Fantasy Camp, I was in the dugout with Dodgers from their 1980s World Series teams and Tim Salmon from the Angels Championship team. I asked them a simple question: “What do you think of the year-round sports specialization for kids?”
The answers were emotionally charged, and it was like I kicked a hornets’ nest as the pros thought it was ridiculous how intense kids’ training is today, and the lack of time off meant less recovery time than pro players get.
Limited time off increases injuries
Salmon was coaching high school baseball and said when he played, they did no baseball activities from the end of the season until spring training so they could heal.
Constant play has led to Tommy John (ulnar collateral ligament reconstruction) surgeries occurring earlier and at a higher rate.[3] Arm injuries, especially of the shoulder and elbow, and the need for surgery the longer the sport is played are a big concern now.[4] Osgood-Schlatter, chronic ankle injuries, ligament tears, spinal injuries and concussions have all been on the increase.
Factors that drive patients to your office
Parents and coaches desperately search for doctors who can safely get their kids back faster. Having to shut down for six to 12 weeks is a death sentence for a sports season. You can consistently get athletes back out there between 30-70% faster for many injuries with my methods, and this will lead to coaches and parents referring your practice to the rest of the team.
The best injuries for referrals and word of mouth
Based on my past 21 years of focusing on sports injuries and performance enhancement, here are my favorites:
- Shoulder injuries, ranging from strains to acromioclavicular (AC) separations to tears
- Elbow injuries, even postoperative Tommy John
- Knee injuries, from strains to tears to Osgood-Schlatter
- Concussions
I use a combination of high-energy, non-thermal lasers, chiropractic, soft tissue work and taping for these conditions. The most important and unique part of the treatment to repair tissue is the use of lasers.
In live seminars, I get doctors into groups to do advanced neurorecalibration techniques with lasers to quickly enhance muscle strength and range of motion (ROM), but in the limited space of this article I will show you how easily you can use lasers to enhance tissue repair with simple point-and-shoot techniques.
Start with having the athlete perform the movement that is painful. I may have them do a batting move, throwing motion, squat, lunge, running positions, etc., and rate their pain.
Test the myotomes and rate their pain. Tell them the goal during the treatment is to decrease their pain or increase their ROM between 10-30% during that session, and that they will do the same motions after the laser session. You want to manage their expectations for that initial session.
Applying the laser
For best results I combine violet, green and red non-thermal, high-photon-energy lasers. Many doctors mistakenly believe these wavelengths cannot impact deep tissues, even though Level 1, placebo-controlled, randomized clinical studies on the low back,[5] heel pain/plantar fasciitis[6] and neck/shoulder prove that they do. A 635 red laser reduced chronic low back pain 58% after eight sessions, and after 12 months it dropped another 17.5% with no additional sessions.
The American Chiropractic Association’s sports chiropractor of the year, Robert Silverman, DC, and I were co-lead investigators on a peer-reviewed paper for chronic neck and shoulder pain that led to the first FDA clearance for a green and violet laser.
The paper showed that 81% of patients in our study received a greater than 30% reduction in pain and increase in ROM in a single session. At the 48-hour follow-up, the subjects reported an even greater pain reduction, with an average of 65% less pain and 32 degrees greater ROM.[7] Here is the protocol for a shoulder, elbow or knee:
Place the laser in a stand over the affected area. These lasers are applied hands-free, from a distance and do not need to move. Pulse at 8/25/42/125 Hz for between 7-10 minutes.
Have the patient do movements with the affected area in the pain-free ROM.
Frequency: Two to three times per week for three to four weeks. Can do daily if they need to get back faster.
Have patient perform the same tests that caused pain/limited ROM and assess improvement.
Protocol for concussion support
Athletes can be frustrated at poor performance and endurance after a concussion, and poor school performance can be an issue as well.
Non-thermal, 632-nm red lasers can favorably modulate the glial cells in the brain to prevent them from attacking healthy tissue and to return to an anti-inflammatory state instead of becoming primed, especially if there are multiple concussions in the patient’s history.[8],[9] The protocol for concussions can also be very simple.
- Place the patient under the laser and apply it either transcranially or over the arteries in the neck to be picked up by the circulatory system and moved to deeper tissues, which is a method the Russians have used for decades.[10]
- Use pulse settings of 1/10/40/60 or 40/60/40/60 and do between five to 15 minutes.
- If the patient has trouble tracking the ball or with their visual fields, have them perform eye tracking exercises while the laser is applied, like cardinal fields of gaze, fixation, etc. I also find it beneficial to have them smell essential oils if they are having memory issues or interact with apps like Lumosity while under the laser.
- Frequency varies for this one based on severity.
Final thoughts
Lasers are still underutilized in chiropractic offices, even though interest in them is exploding in the population.[11] Adding this therapy to your practice can help enhance your patient outcomes to such a level that your unsolicited referrals will increase dramatically. Laser therapy does not require a steep learning curve, as point-and-shoot protocols are highly effective, and patients may notice changes immediately after treatment.
Kirk Gair, DC, has been using high-energy, non-thermal lasers since 2004 and teaching doctors internationally and researching lasers since 2017. His peer-reviewed research on green and violet lasers led to the first FDA clearance for a combination laser of those wavelengths for chronic neck and shoulder pain. He has worked with professional athletes, celebrities, Olympic gold medalists and world record holders; he has also been featured in Kharrazian Institute for Functional Medicine and in Izabella Wentz’s New York Times best-selling book, “Hashimoto’s Protocol.” He has a private practice near Los Angeles, California, and a highly interactive and free Facebook group (facebook.com/groups/drgairlasertherapy). This article was written on behalf of Erchonia.
References
1. Jayanthi NA, et al. Health consequences of youth sport specialization. J Athl Train. 2019;54(10):1040-1049. https://pubmed.ncbi.nlm.nih.gov/31633420/. Accessed
June 9, 2025.
2. Biese KM, et al. Overuse injury risk increases with year-round sport participation in middle school aged athletes. Orthop J Sports Med. 2019;7(3 Suppl):2325967119S00058. https://pmc.ncbi.nlm.nih.gov/articles/PMC6700911/. Accessed June 9, 2025.
3. Miller J. The need for speed: Tommy John surgery has become most prevalent in youth baseball players. [News]. https://www.nbc26.com/sports/youth-sports/the-need-for-speed-tommy-john-surgery-has-become-most-prevalent-in-youth-baseball-players/. Accessed June 9, 2025.
4. Shanley E, et al. Arm injury in youth baseball players: A 10-year cohort study. J Shoulder Elbow Surg. 2023;32(6S):S106-S111. https://pubmed.ncbi.nlm.nih.gov/36828286/. Accessed June 9, 2025.
5. Sammons T. Two randomized, double blind, placebo-controlled trials evaluating the efficacy of red 635nm low level laser for the treatment of low back pain. OROAJ. 2021;17(3). https://www.researchgate.net/publication/350126820/. Accessed June 9, 2025.
6. Macias DM, et al. Low-level laser therapy at 635 nm for treatment of chronic plantar fasciitis: A placebo-controlled, randomized study. J Foot Ankle Surg. 2015;54(5):768-772. https://pubmed.ncbi.nlm.nih.gov/25769363/. Accessed June 9, 2025.
7. Sammons T, et al. Assessing the impact of high photon energy wavelengths on the treatment of chronic neck and shoulder pain. Evid Based Complement Alternat Med. 2023:6672019. https://pubmed.ncbi.nlm.nih.gov/37829623/. Accessed June 9, 2025.
8. Song S, et al. Low-level laser therapy regulates microglial function through Src-mediated signaling pathways: Implications for neurodegenerative diseases. J Neuroinflammation. 2012;9:219. https://pubmed.ncbi.nlm.nih.gov/22989325/. Accessed June 9, 2025.
9. Leisman G, et al. Effects of low-level laser therapy in autism spectrum disorder. Adv Exp Med Biol. 2018;1116:111-130. https://pubmed.ncbi.nlm.nih.gov/29956199/. Accessed June 9, 2025.
10. Moskvin SV, Khadartsev AA. Methods of effective low-level laser therapy in the treatment of patients with bronchial asthma (literature review). Biomedicine (Taipei). 2020;10(1):1-20. https://pubmed.ncbi.nlm.nih.gov/33854908/. Accessed June 9, 2025.
11. Light therapy market to witness robust growth, surpassing $1.5 billion by 2034. Future Market Insights. [Press Release]. https://www.pharmiweb.com/press-release/2025-05-23/light-therapy-market-to-witness-robust-growth-surpassing-usd-15-billion-by-2034/. Accessed June 9, 2025.
