NEUROQUANTOLOGY | May 2023 | Volume 21 | Issue 6 | Page 213-217| doi: 10.48047/nq.2023.21.6.

NQ23025
Nidhi Suresh Sharma et al/THE EFFECTIVENESS OF LASER WITH CONVENTIONAL PHYSIOTHERAPY FOR BICEPS FEMORIS TENDINITIS: CASE
REPORT

THE EFFECTIVENESS OF LASER WITH

CONVENTIONAL PHYSIOTHERAPY FOR
BICEPS FEMORIS TENDINITIS: CASE REPORT
Nidhi Suresh Sharma1, Amreen Shaikh2, Shruti Dnyaneshwar Ramekar3,Priyanka Abhay
Joshi4,Aisha Nabeela Ahmed5,Mahvish Fatema Khan6,Dnyana Sameer Ambekar7.
Affiliations: -
Nidhi Sharma1
Affiliations: - Assistant Professor, Ojas college of Physiotherapy, Jalna, Maharashtra, India. Email
ID:nidhi.ns9595@gmail.com
Shaikh Amreen Afsarpatel2
Affiliations: Clinical Physiotherapist, Musculoskeletal department, MGM School of
Physiotherapy, Aurangabad, a constituent unit of MGMIHS, Navi Mumbai. Maharashtra, India
Email ID: amreenshaikh96pt@gmail.com
Shruti Dnyaneshwar Ramekar3(Corresponding Author)
Affiliations: -Intern, MGM School of Physiotherapy, Aurangabad, a constitute unit of MGMIHS,
Navi Mumbai, Maharashtra, India. Email ID: shrutiramekar111@gmail.com
Priyanka Abhay Joshi4
Affiliations: -Intern, MGM School of Physiotherapy, Aurangabad, a constitute unit of MGMIHS, 213
Navi Mumbai, Maharashtra, India. Email ID:priyankaajoshi5@gmail.com
Aisha Nabeela Ahmed5
Affiliations: -Intern, MGM School of Physiotherapy, Aurangabad, a constitute unit of MGMIHS,
Navi Mumbai, Maharashtra, India. Email ID:aaashuqergu@gmail.com
Mahvish Fatema Khan6
Affiliations: -Intern, MGM School of Physiotherapy, Aurangabad, a constitute unit of MGMIHS,
Navi Mumbai, Maharashtra, India. Email ID:amaankhank509@gmail.com
Dnyana Sameer Ambekar7
Affiliations: -Intern, MGM School of Physiotherapy, Aurangabad, a constitute unit of MGMIHS,
Navi Mumbai, Maharashtra, India. Email ID:dnyanaambekar0@gmail.com

ABSTRACT
Background: Tendons transmit tensile strength from muscles to the bone area, and when they are
injured, tendinopathy develops, which is an inflammatory process that happens within the tendon.
Laser therapy is the application of monochromatic, short-wavelength light to a specific area.
However, several benefits for tendon injured have been reported. So, the aim of this case report is
to see the effectiveness of LASER with conventional physiotherapy for biceps femoris tendinitis.
Case presentation:A 42-year-old, lab-worker recommended to MGM Physical therapy in
Aurangabad. He developed pain in his left knee as a result of standing work about 2-3 months ago.
The discomfort was worse in the morning and while cross-leg sitting, and it was accompanied by
muscle tightness and soreness that lasted for the rest of the day. Due to his severe pain, he was
unable to work.

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 NEUROQUANTOLOGY | May 2023 | Volume 21 | Issue 6 | Page 213-217| doi: 10.48047/nq.2023.21.6.NQ23025
Nidhi Suresh Sharma et al/THE EFFECTIVENESS OF LASER WITH CONVENTIONAL PHYSIOTHERAPY FOR BICEPS FEMORIS TENDINITIS: CASE
REPORT
Conclusion: In a patient with biceps femoris tendinitis, pain was reduced by LASER and exercise
treatment.
Keywords: Laser,Biceps Femoris Tendinitis, Biceps Femoris, Tendinitis,Physiotherapy,Laser therapy.
DOI Number: 10.48047/nq.2023.21.6.NQ23025
Introduction-
A cracking biceps femoris tendon causes
lateral knee soreness, but it's an unusual
occurrence1. Biceps femoris tendon injury in
isolation is uncommon; most injuries occur
near the knee following dislocation or multi-
ligamentous injury2.The incidence of
tendinopathy is responsible for about 30% of
the number of musculoskeletal diseases and
sedentary lifestyles, coupled with the specific
requirements of physical and sports activities
contributed to its increase3.In both function
[running and sprinting] and isolated strength
training-related, muscle-loading conditions,
previous research has shown that the two
functions of the hamstring muscles, bicep
femoris, and semimembranosus are modified
in a specific sequence and with a converging
frequency of contraction4.
For patients with chronic pain, a variety of
therapeutic options are available, starting
from conservative therapies such as dry
needling, auricular acupuncture, massage, or
physical therapy, laser therapy, to more
invasive procedures such as surgery or
injection5. The adverse patient outcome
related with tendon injury, as well as the
limited power for tendon regeneration, has
sparked a renewed interest in tendon therapy
methods. Low-intensity laser therapy requires
the usage of single, coherent light with short
wavelengths to a specific area. It's been used
to treat tendonitis since 1960, and research
from the 1980s show that it helps in a variety
of ways3.Therefore, this case aim is the
effectiveness of LASER with conventional
physiotherapy for biceps femoris tendinitis.
Case description-
A 42-year-old man work as Lab technician,
was referred to MGM Physiotherapy in
Sr Manual-muscle Right-side leg
no technique MMT
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NeuroQuantology2023;21(6):213-217
Aurangabad. He had pain in his left knee
around 2-3 months ago as a result of standing
work. The discomfort was more noticeable in
the morning and during cross- leg sitting, it
was followed by tightness of muscles and pain
that persisted the majority of the day. He was
unable to work due to extreme pain.
Patient information-
Subjective examination-
For the past 2-3 months, the patient has been
complaining of chronic left side knee
discomfort. The pain increased day by day
when cross leg sitting, and the beginning of
pain was gradual on lateral side of the knee.
The pain would begin with long-standing 214
work, for an extended period of time. The
pain began in the morning while running,
walking, and standing for long periods of time.
According to the patient's past medical
history, he has experienced trauma3 months
back. He had an injury, and the pain became
intermittent during his everyday activities.
The pain got worse when remained cross-
legged, and it was just constant during cross-
legged sitting. On the first day of pre-
treatment, pain on the Visual analogue scale
[VAS] was 5/10 at rest and 8/10 at its worst.
The activities of daily living [ADL] of the
patients were substantially impaired. He
works 6 hours a day (stands 4 hours) and has
one weekly off.
Clinical Finding -
Physical examination-He is a mesomorph,
with a BMI of 24.9, which is perfect. The
lumbar Lordosis is slightly diminished in this
posture examination. Knee is slightly
hyperextended on the left side. Muscle power
is tested shows in table 1.1
Left side- leg
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 NEUROQUANTOLOGY | May 2023 | Volume 21 | Issue 6 | Page 213-217| doi: 10.48047/nq.2023.21.6.NQ23025
Nidhi Suresh Sharma et al/THE EFFECTIVENESS OF LASER WITH CONVENTIONAL PHYSIOTHERAPY FOR BICEPS FEMORIS TENDINITIS: CASE
REPORT

pre 1st week post 2nd pre 1st week post 2ndweek
1. Hip muscles
Grade 4 Grade 4 Grade 3 Grade 4
2. Knee muscles Grade 4 Grade 4 Grade 3 Grade 4
Table 1.1:Baseline MRC muscle power grading [pre -treatment and post-treatment]
Patient Time line- In the last 2-3 months, the assessed on the basis on subjective and
patient has had a complaint. At the present, objective evaluation findings. The minimal
the intensity and frequency of his pain while joint effusion involving the knee joint was
standing and sitting cross-legged has noticed in an MRI scan of the left knee
increased during the day, impairing his ADL. joint.Finally, biceps femoris tendinitis was
Diagnostic assessment-Some radiological diagnosed.
investigations, such as MRI and X-ray, were

215

Fig 1.1:X-ray left side knee

Therapeutic intervention-
The POLICE treatment was used in
conjunction with a stronger emphasis on
active rehabilitation techniques such as
[Protection, Optimal Loading, Ice,
Compression, and Elevation] for acute soft
tissue injuries. Bracing was employed to
restrict optimal loading to the joint while it
was in the weight-bearing position. Use a bag
of frozen peas or crushed ice wrapped in a
warm cloth to the painful area for 15-20
minutes every 1-2 hours same method was
applied. To reduce pain and adhesion, the
treatment strategy included electrotherapy
modalities with ultrasound therapy twice a
2
week at 0.8 watt/cm for 7 minutes.To relieve
discomfort and swelling, the patient received
interferential therapy [IFT] at 100 Hz beat
frequency with 2-pole technique for 15
minutes for 3-4 days along with LASER
therapy using a semiconductor laser diode
with a wavelength of 830nm-15nm in
continuous mode with positive pressure per
session twice a week for 2- weeks with
exercises6.Furthermore,LASER
therapycontinues and start with myofascial
therapy and muscular energy technique begin
with 10 repetitions of on the biceps femoris
muscle, as well as ergonomic advice. Lastly,
patients were provided lifestyle
recommendations after therapy to help them
continue their normal routine. We provided
them detailed instructions on how to have
good posture, prevent extended periods of
standing, and educating the patient about
exercise and change in lifestyle in between
daily standing work.
Follow-up and outcomes –
Outcomes used was Visual analogue scale
[VAS], Knee injury and osteoarthritis outcome
score [KOOS] scale for knee, Katz index of
independence [ADL].

Outcome Pre-treatment Post-treatment

measures 1stDay of 1stweek last Day
of2ndweek
VAS scale 7 2

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 NEUROQUANTOLOGY | May 2023 | Volume 21 | Issue 6 | Page 213-217| doi: 10.48047/nq.2023.21.6.NQ23025
Nidhi Suresh Sharma et al/THE EFFECTIVENESS OF LASER WITH CONVENTIONAL PHYSIOTHERAPY FOR BICEPS FEMORIS TENDINITIS: CASE
REPORT
KOOSscale
Katz index of 4
independence
Table- 1.2 outcome measures pre 1st week and post 2ndweek
Intervention adherence and tolerability-
The patient played an active role by looking at
specific rehabilitation and exercises.
Adverse and unanticipated events-
Neither unpleasant or unexpected incidents
happened.
Strength associated with case report-
In individuals with biceps femoris tendinitis,
the treatment strategy centered on pain and
muscle activity to reduce local symptoms.
LASER therapy is a useful course of treatment
for adult individuals suffering from
musculoskeletal discomfort. This physical
therapy technique is useful for biceps femoris
tendinitis.
Weakness associated with case report-
Patient education and physical technique are
two topics you should be acquainted about.
Discussion-
A patient had biceps femoris tendinitis, which
is inflammation of the biceps femoris tendon,
which is located on the outside of the back of
the knee. There was limited evidence from
studies related to the management of biceps
femoris tendinopathy with LASER therapy.In
clinical rehabilitation, VAS, KOOS scale, and
Katz index of independence active daily living
scale [ADL] and management component
[LASER] are used as each evaluation tools.The
lack of concepts and samples associated with
the research showed in this review, and the
fact that well-known data-bases were used,
contributed Nogueira AC et al 2015 conclude
that all studies found in this review showed
Informed consent-
Yes, patient ‘s informed consent was taken.
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44% 67%
6
that application of low intensity laser was
effective than chance in improving the factors
evaluated in bicep tendinitis.It was also shown
that an exercise programme combination with
laser could aid in the rehabilitation of
injuries3.Similarly, laser therapy and
rehabilitation were applied in this study, and
the finding of this research study show that
LASER combined with exercise is a useful
intervention in the treatment of bicipital
tendinitis.Miyamoto GC et al 2019 published a
systematic review study on exercise therapy
in the treatment of tendinopathies of the
lower limbs about the prescription of exercise
therapy in the treatment of tendinopathies or
specific exercise because some exercise
therapy is more effective than any other type
of intervention and if there is a best form of
exercise therapy, considering modality, dose,
216
and intensity, for the treatment of lower limb
tendinopathies7. And hence the case report is
proved that there was significant effect on
LASER with conventional physiotherapy in
biceps femoris tendinitis.
Patient perspective-
The patient stated that he was stressed during
his standing work, and his complaint was a 7
on the VAS scale on day one, but during the
second week of treatment, the discomfort
had decreased to a 2 on the VAS scale. In a
patient with biceps femoris tendinitis, pain
was reduced by LASER and exercise
treatment.
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 NEUROQUANTOLOGY | May 2023 | Volume 21 | Issue 6 | Page 213-217| doi: 10.48047/nq.2023.21.6.NQ23025
Nidhi Suresh Sharma et al/THE EFFECTIVENESS OF LASER WITH CONVENTIONAL PHYSIOTHERAPY FOR BICEPS FEMORIS TENDINITIS: CASE
REPORT

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