In order for Chiropractic to enter this arena and carve out the much desired turf amongst the other professionals working for a team, there must be a professionalism and consistency in the protocol brought to a program. There must be a bigger purpose other than to relieve pain. The massage therapist can relieve pain. The physical therapist can relieve pain. The medical doctor can relieve pain. Stealing their precious turf in the locker room is virtually impossible. But, to become the biomechanics specialist with an iron clad protocol that is easily understood by all will lead Chiropractors to a corner in the locker room which is uninhabited. That is, until players, coaches and medical personnel begin to understand and appreciate the value and benefits of detecting and correcting biomechanical faults.
Ally of Strength and Conditioning Department
Strength and Conditioning Departments are highly concerned with all physical, biomechanical and structural information on an athlete, however, are unable to perform, interpret and provide the same testing and treatment that Chiropractors are skilled at providing. This relationship thus becomes the most important relationship for all Chiropractors interested in working with teams. As discussed in the article Raising Chiropractic's Value in Pro Sports, the Strength Coach and the Chiropractor should work hand in hand in reviewing each others evaluation of an athlete and the rehabilitative program should be cooperatively understood for the long term benefits of the athlete.
Chiropractic Rehab Program
True Chiropractic rehabilitative care can only begin with the absence of symptoms. If symptoms brought the athlete in for care, then symptoms need to be resolved prior to any rehab program.
Objective findings can come from multiple sources. One of the more valued objective structural tests available to the Chiropractor is that of the standing x-ray. There are many marking systems which show if an athlete is structurally aligned and balanced. Structural defects, or imbalances, include pelvic rotations, subluxations (locked joints), increased or decreased curves and narrowing or swelling of the disc spaces.
Some of the more popular markings used to show structural status are the gravity line, as seen on the lateral L-S view, dropped from the center of the body of L3, straight down. This gravity line should bisect the anterior third of the sacral base. If the line is anterior or posterior to this point, weight is being handled by parts of the spine not designed to handle the weight, and eventual problems are predictable. A second marking is that of the sacral base angle, which is normally 36°-42°. An angle greater or lesser will suggest a pelvic angle inconsistent with normal positioning of the pelvis, thus producing a work load which will not be tolerated well. These findings become compounded with the introduction of any athletic activity and are key references when setting up a rehab program.
The length of care and treatment in setting up a rehab program will be influenced by many factors. Typically, the age and health of the athlete are the two most important criteria, but the degree of structural defect usually dictates the amount of time needed for maximum improvement. Frequency of treatments and specifics of treatment provided will vary from doctor to doctor, technique to technique and patient to patient. A successful time frame for most rehab programs dealing with spinal rehabilitation will take anywhere from 3-6 months. The ultimate goal is to have objective improvements on a final re-examination, which will include re-x-rays, as well as any other contributing tests which were initially performed.
During this 3-6 month period, proper treatments and therapies are provided. Improved habits are taught. The integration of rehabilitative exercise and conditioning will provide the maximum potential benefits to all patients. Working with a strength coach, or physical personal trainer, will enhance Chiropractic rehabiltative care. This program can also include nutrional support and positive psychological training. But, the critical component here is time, and if a Chiropractor cannot communicate to and manage the patient for a long enough period of time, the likelihood of success is reduced greatly.