Raising Chiropractic's Value in Pro Sports

Through Vision, Management and Communication

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Chiropractic Exam

Balance, range of motion and symmetry are key issues when performing an athletic exam. If current standing x-rays have not been taken or are not available, new x-rays should be taken of the cervical spine, the lumbo-sacral spine and pelvis. Hip joints should always be included. Detecting positive objective structural findings, both on the exam and x-rays, is critical in motivating and educating the athlete to participate in a complete corrective care program. Without objective findings, it becomes much harder to convince an athlete of the benefits of complete chiropractic care.

Assessment in the Strength and Conditioning Department

When a new player comes to the team, one of the first things done is to review his medical jacket, which is a log of all prior injuries and treatments. Most players have gone through the Indianapolis Combine, which provides significant physical information on the player. When prior injuries exist, an in-depth history will then be taken by both the trainer and strength coach. A former strength coach may be contacted by the new team to determine what a player can and can't do. The player is then asked what he can do, what he feels comfortable doing and exactly what his psyche is with any existing injury.

At this point, a visual physical exam takes place, checking out the shoulders, the hips, the alignment of the spine, the gait as they walk to and from, the foot placement as they run and move and the entire kinesthetic circle of movement. Very little, if any, weighted movement will be done in the first week.

Balance and strength are critical components of an athlete's conditioning. One legged squats are used to check for both, while also determining ankle and knee flexibility. Football, for example, is a one legged game, and without one legged strength, a player will never make it. These two areas are further tested with a teeter board squat, or a prisoner's squat, which is a series of squats with the athlete's hands behind their head and then in front of them. This immediately tells the flexibility or inflexibility of a players hips. In the game of football, if hips are tight and restricted, a players movement will be severely compromised, especially, a defensive back, wide receiver or running back. Tight hips also hinders the explosive ability of an offensive or defensive lineman. Finally, with the teeter squat, if a player teeters one way or the other, restrictions or pains in one or both ankles should be considered.

A player is then asked to perform a solid hold for one minute on the low back hyperextension machine. This will check for strength in the low back, hips and hamstrings. It's important to watch a player during this exercise as weaknesses produce deviations during the exercise. One minute is a reasonable time to quickly assess the strength of an athlete.

Psychological Evaluation

During any evaluation process, both physical and psychological are looked at very closely. If an athlete can't perform specific exercises, but has a tremendous amount of "want to", they are termed a medical reject. On the other hand, a player who can perform but is unwilling to is a much more serious problem. This is the infestation of "don't want to work attitude". Sports is a working business. You must have athletes who are willing to work at all times and improve.

Chiropractic Report of Findings

In a report of findings, athletes tend to want to know how to get rid of pain so they can quickly get back. Although pain is important and current injuries must be of primary concern, long term structural improvements should always be the ultimate goal for the athlete. The first objective is to "put out the fire". Immediate reduction of symptoms, through treatment, physical therapy, ice/heat, nutritional supplementation or medication, restriction of activity and whatever other recommendations are needed should be implemented first. This period can last anywhere from one to eight weeks. However, once reduced, structural improvements should then become the primary concern. This is where chiropractors can begin to separate themselves from the rest of the medical staff and improve their relationship with the strength and conditioning departments. Management and communication skills become paramount.

The second phase of care, "rehabilitation", should take all positive objective findings and develop a program that will help turn those positive findings into negative findings. A positive Lasegue's, for example, will most often be eliminated once the first phase of care is completed. A severely increased sacral-base angle, however, as seen on a lateral L-S x-ray, takes a committed effort on both the athlete's and doctor's parts, and can only improve with proper treatment and exercise over a long enough period of time. This phase can last anywhere from 3-6 additional months, and re-x-rays should become a key component to determining what changes have taken place. Depending upon the degree of structural defects and the number of prior x-rays an athlete has had, at least one and maybe two sets of re-x-rays will be appropriate during and after this phase of care.
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