20 July 2026 | Joaquín Peña 

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Invasive physiotherapy has developed by progressively bringing therapeutic interventions closer to the anatomical structure responsible for pain or dysfunction. In this LAPI Talk, Joaquín Peña retraces that evolution and explains why LAPI® can be understood as a new step in the discipline rather than simply another device or isolated technique.

The webinar begins with the broader transformation of physiotherapy. Traditional rehabilitation has long relied on manual therapy, therapeutic exercise and physical agents applied from outside the body. These approaches remain essential, but their effects can be limited when the target tissue is deep, anatomically complex or difficult to reach with sufficient precision. The growth of ultrasound-guided procedures changed this scenario by enabling physiotherapists to identify specific structures in real time and perform more accurate interventions.

Within this evolution, techniques such as dry needling, percutaneous electrolysis and percutaneous neuromodulation expanded the possibilities of invasive physiotherapy. The needle became more than a mechanical instrument: it also served as a means of delivering a physical stimulus directly to a selected tissue or neural structure. This progression required a higher level of anatomical knowledge, ultrasound competence, clinical reasoning and procedural safety. It also helped establish invasive physiotherapy as a specialised field within musculoskeletal rehabilitation.

LAPI® introduces photonic energy into this same percutaneous and ultrasound-guided framework. Instead of relying exclusively on the transmission of laser energy from the skin surface, an optical fibre is positioned close to the intended target. The webinar presents this concept as intratissular photobiomodulation: a method designed to deliver light directly within the treatment area while reducing the obstacles associated with superficial application, including the absorption and scattering that occur as light travels through different layers of tissue.

This distinction is central to the idea of a new paradigm. The innovation is not simply the use of a laser, since laser therapy has been employed in rehabilitation for decades. The change lies in combining photobiomodulation, invasive physiotherapy and ultrasound guidance in a single clinical procedure. This approach allows the clinician to think differently about treatment depth, target selection and energy delivery.

The webinar also places innovation within a wider clinical process. A technically advanced intervention is not effective merely because it reaches the tissue. The physiotherapist must first interpret the patient’s symptoms, functional limitations, loading history and ultrasound findings. The target, treatment parameters and access route must then be selected according to the individual case. Training in asepsis, needle handling and ultrasound-guided procedures is therefore an integral part of the methodology rather than an optional addition.

Another important message is that LAPI® should not be viewed as a replacement for therapeutic exercise, progressive loading or the other components of rehabilitation. Invasive treatment can become one phase of a broader strategy aimed at reducing symptoms, improving tissue conditions and creating a more favourable opportunity for functional recovery. Clinical reassessment remains essential to understand what has changed and how the rehabilitation plan should progress.

Ultimately, the evolution described in the webinar is an evolution of professional capability. Physiotherapy moves from treating a general area toward identifying and addressing a specific biological target with increasing precision. LAPI® represents the convergence of technology, ultrasound imaging, photobiomodulation and advanced clinical reasoning. For physiotherapists already working with invasive techniques, it opens a new field of possibilities while reinforcing the need for evidence, rigorous education and responsible clinical practice.

23 July 2026 | Joaquín Peña 

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Photobiomodulation is often described through its clinical effects, but understanding how it works requires a closer look at the relationship between light, tissue and cellular metabolism. In this LAPI Talk, Joaquín Peña examines the scientific foundations of photobiomodulation and explains how those principles change when laser energy is delivered directly to the injured tissue through an invasive approach.

The starting point is that photobiomodulation is not based on cutting, burning or destroying tissue. It uses controlled light energy to influence biological processes. When photons are absorbed by cellular photoacceptors, they can modify mitochondrial activity and trigger signalling pathways associated with energy production, oxidative balance, vascular responses, inflammation and tissue repair. These effects help explain why laser therapy has been studied in pain management and musculoskeletal rehabilitation.

However, the presence of a laser alone does not guarantee an effective biological response. The webinar emphasises the importance of dosage and treatment parameters. Wavelength affects how light interacts with tissue and how deeply it can penetrate. Power, irradiance, energy, fluence, treatment time, emission mode and the size of the treated area all influence the dose that reaches the target. Photobiomodulation follows a dose-dependent response: too little energy may be insufficient to stimulate a meaningful effect, while excessive or poorly controlled energy may reduce the intended response or create unwanted thermal effects.

This is one of the main challenges of conventional transcutaneous laser therapy. Before reaching a deep structure, light must pass through the skin and other tissues. Along the way, part of the energy is reflected, absorbed or scattered. The final dose at the lesion can therefore be very different from the dose emitted at the surface. Increasing power is not automatically the solution, because the tissues closer to the applicator may receive more energy without guaranteeing that the deeper target receives the correct photobiomodulatory dose.

LAPI® approaches this problem by modifying the route of delivery. Through an optical fibre introduced under ultrasound guidance, laser energy can be applied closer to the pathological tissue. The objective is to reduce the distance between the emission point and the biological target, making the treatment geometry more direct and the delivered dose more controllable. In this context, intratissular photobiomodulation is not simply superficial laser therapy performed with a needle. It requires a specific understanding of anatomy, ultrasound imaging, fibre positioning, parameter selection and safety.

The talk also highlights the importance of distinguishing photobiomodulation from thermal or ablative laser procedures. The therapeutic goal is biological modulation, so the clinician must work within parameters that support the intended cellular response while avoiding unnecessary temperature increases. This makes the choice of wavelength, dose and emission mode inseparable from clinical reasoning.

A further implication is that every tissue and every pathology cannot be treated with an identical protocol. Depth, vascularity, tissue composition, chronicity and the characteristics of the lesion may alter how light is absorbed and how the tissue responds. Protocols provide a framework, but they must be applied with an understanding of the patient, the target and the therapeutic objective.

By connecting cellular mechanisms with clinical dosimetry, the webinar provides the scientific rationale behind LAPI®. Its central message is that effective photobiomodulation depends on delivering the right light, at the right dose, to the right tissue. Bringing the emission point closer to the lesion may offer new possibilities, but those possibilities depend on precise technique, appropriate training and a rigorous approach to treatment planning.

27 July 2026 | Josè Moyano 

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Tendinopathies are among the most frequent and challenging conditions encountered in musculoskeletal physiotherapy. They can involve persistent pain, reduced load tolerance and impaired function, while their clinical presentation varies considerably according to the tendon, the patient and the stage of the condition. In this LAPI Talk, José Moyano moves from theory to clinical practice through real cases treated with LAPI®, illustrating how intratissular photobiomodulation can be incorporated into the management of tendon pathologies.

A central point of the webinar is that the treatment does not begin with the device. It begins with clinical reasoning. Before an invasive procedure is considered, the physiotherapist must understand the patient’s history, symptoms, functional limitations and response to loading. Tendon pain is not explained by an ultrasound image alone, and structural abnormalities do not always correspond directly to symptom severity. Clinical examination and imaging must therefore be interpreted together.

Ultrasound plays a key role in the process. It helps the clinician identify the tendon, examine its structure and surrounding tissues, recognise areas of altered echogenicity or vascularity and plan a safe access route. During the procedure, real-time guidance supports accurate positioning of the optical fibre in relation to the selected target. This precision is especially important in anatomical regions where nerves, vessels or other sensitive structures are nearby.

The cases presented show how LAPI® is used as a targeted intervention rather than a generic application over the painful area. The clinician defines the objective of treatment, selects the access point and adjusts the parameters according to the characteristics and depth of the tissue. Through intratissular delivery, photonic energy is applied close to the pathological area with the aim of producing a photobiomodulatory response while maintaining control over the treatment site.

The webinar also makes clear that procedural safety is part of clinical effectiveness. Correct patient selection, informed consent, aseptic preparation, sterile handling and competence in ultrasound-guided invasive techniques are essential. LAPI® is intended for trained professionals who can manage both the technological and clinical aspects of the intervention.

An important feature of the case-based approach is reassessment. Changes in pain, movement, strength or load tolerance can be evaluated after treatment, but an immediate change should not be confused with complete tendon healing. Tendon adaptation is a biological and mechanical process that develops over time. For this reason, follow-up and the progressive reintroduction of load remain crucial.

LAPI® is therefore presented as one component of a multimodal rehabilitation plan. The intervention may help modify pain and local tissue conditions, but long-term recovery also depends on education, exercise, progressive loading and the management of the factors that contributed to the tendinopathy. The treatment should create an opportunity for rehabilitation, not replace it.

The clinical cases underline the importance of personalisation. Two patients with pain in the same tendon may have different functional demands, stages of pathology and recovery goals. The decision to use an invasive approach, the selection of parameters and the timing of treatment must reflect those differences. Outcomes should be measured not only through pain scores or ultrasound findings, but also through the patient’s ability to return to meaningful activities and tolerate the required loads.

Overall, the webinar offers a practical view of how LAPI® can be integrated into tendon rehabilitation. Its main lesson is that technology produces value only when it is guided by diagnosis, anatomy, safety and a structured rehabilitation strategy. The combination of ultrasound precision, intratissular photobiomodulation and progressive functional recovery represents the clinical pathway at the centre of the LAPI® method.

4 Junio 2026 | Joaquín Peña 

¿Por qué LAPI representa un nuevo paradigma en fisioterapia invasiva? Descubrí cómo llegamos aquí, qué se está logrando clínicamente y por qué cambia la forma de tratar patologías. Una conversación sobre la evolución de la disciplina.

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11 Junio 2026 | Joaquín Peña 

Cómo funciona realmente la fotobiomodulación cuando el láser llega directo al tejido lesionado.  Entendé la base que sostiene LAPI.

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18 Junio 2026 | Jose Moyano 

Casos reales de patologías tendinosas tratadas con LAPI. De la teoría a la práctica.

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LAPI Talks are online educational webinars dedicated to the evolution of invasive physiotherapy, invasive laser therapy and photobiomodulation. Each session explores the scientific principles, clinical applications and practical opportunities of advanced technologies used in musculoskeletal rehabilitation.

LAPI Academy webinars are primarily designed for physiotherapists, healthcare professionals, researchers and educators interested in invasive physiotherapy, ultrasound-guided procedures, laser therapy and advanced rehabilitation techniques.

They are particularly relevant for professionals who already use invasive techniques and want to expand their clinical knowledge through an evidence-based approach.

Previous experience can be helpful, but it is not always required. The webinars combine scientific explanations, clinical concepts and practical examples, making them valuable both for experienced professionals and for physiotherapists who want to learn more about invasive laser therapy.

LAPI Academy webinars may cover topics such as:

- the evolution of invasive physiotherapy;
- the scientific foundations of photobiomodulation;
- invasive laser therapy;
- ultrasound-guided physiotherapy;
- tendon rehabilitation;
- musculoskeletal disorders;
- clinical reasoning;
- treatment protocols;
- safety and asepsis;
- practical clinical applications.

Each webinar focuses on a specific scientific or clinical aspect of advanced physiotherapy.

Invasive laser therapy is an advanced physiotherapy technique in which laser energy is delivered directly to the target tissue through a percutaneous optical fibre.

This approach is designed to bring photobiomodulation closer to the treatment area and support highly targeted interventions in musculoskeletal rehabilitation.

Because it is an invasive technique, it requires specific training, clinical knowledge and strict attention to safety and asepsis.

Photobiomodulation is the use of light energy to stimulate biological processes within tissues.

In rehabilitation, it is studied and applied to support tissue repair, modulate inflammation, reduce pain and promote recovery. During LAPI Academy webinars, photobiomodulation is explored from both a scientific and clinical perspective.

Yes. LAPI Academy webinars are developed with an evidence-based approach and explore the scientific principles behind laser therapy, photobiomodulation and invasive physiotherapy.

The sessions may include references to published studies, clinical research, biological mechanisms and practical experience from qualified professionals.

Depending on the topic, webinars may include clinical examples, treatment approaches and real-world applications.

The objective is to connect scientific knowledge with clinical practice and help physiotherapists understand how advanced technologies can be integrated into patient assessment and treatment planning.

LAPI Talks are designed as focused educational sessions and generally last approximately 30 minutes.

The concise format allows participants to explore a specific topic while receiving relevant scientific and clinical information in an accessible way.

The language of each webinar is indicated on the registration page. LAPI Academy organises educational activities for an international audience, with content that may be available in English, Spanish or Italian.

To register, select the webinar you are interested in and complete the online registration form.

After submitting your details, you will receive the information required to access the session.

Certificate availability may vary depending on the webinar. Any information concerning certificates, attendance requirements or continuing education credits will be specified on the individual event page.

Registration conditions may vary depending on the event. Any participation fee, free-access option or registration requirement will be clearly indicated on the individual webinar page.

LAPI Academy webinars provide an opportunity to:

- explore the latest developments in invasive physiotherapy;
- understand the science behind invasive laser therapy;
- learn from experienced professionals and international experts;
- examine practical clinical applications;
- improve treatment safety and clinical reasoning;
- discover new approaches to musculoskeletal rehabilitation;
- stay informed about the future of advanced physiotherapy.

Participants who want to deepen their knowledge can explore LAPI Academy courses, practical training programmes, scientific resources and advanced educational activities dedicated to invasive laser therapy and physiotherapy.