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Three Part Question

In [adults with acute hamstring tears] is [therapeutic laser beneficial] at [decreasing pain, improving function, improving repair quality and reducing recovery time]?

Clinical Scenario

A 23 year old patient presents with a two day history of an acute grade 2 hamstring tear which occurred toward the end of the first half of a football match. The patient has been using the standard protection, rest, ice, compression, elevation (PRICE) acute injury management regime and referred for physiotherapy. You plan to begin an active exercise based rehabilitation programme following day 5 post injury. You have heard from a colleague who works in sports medicine that application of localised laser therapy can help improve pain, function and the quality of the repair site, and therefore wonder if it should form part of your treatment plan.

Search Strategy

The MEDLINE (1966-11/2014), CINAHL (1982-11/2014), AMED (1985 – 11/2014), SPORTDiscus (1830 – 11/2014) and EMBASE (1996 – 11/2014) databases were searched using the Ovid interface.

The Cochrane Library was also searched.

(Hamstring.mp. OR femoris.mp. OR gracilis.mp. OR semimembranosus.mp. OR semiteninosus.mp.) AND (exp Lasers/ OR exp Laser Therapy, Low-Level/ OR therapeutic laser.mp. OR high powered lasers.mp. OR exp Phototherapy/)

For Cochrane: (Laser therapy OR therapeutic laser) AND muscle injury.

Limited to humans and English Language.

Search Outcome

No papers were found that had studied the effects of any form of laser therapy on function, repair and recovery time following acute hamstring muscle tears in humans. Three papers were identified that investigated the effect of laser application following delayed onset muscle soreness/exercise induced muscle soreness but these were excluded as this condition is not comparable pathologically to macroscopic muscular damage and therefore irrelevant to the question.

Comment(s)

The identification of three studies investigating the effect of laser on delayed onset muscle soreness/exercise induced muscle soreness warrants a separate BET in future. It appears that at present, evidence and justification to support the use of laser therapy in muscle injury is extrapolated from studies that utilise animal models only. Therefore it is clear that further high quality research is needed to investigate the effects and consequences of laser application in human acute muscle injury and hamstring muscle injury management.

Editor Comment

RB

Clinical Bottom Line

Presently there is no evidence for the use of any form of laser therapy in the treatment of acute hamstring muscle tears.