What is a sports chiropractor?
A sports chiropractor is a highly trained and knowledgeable provider of chiropractic medicine. Sports chiropractors have advanced expertise in both the prevention and rehabilitation of sports-related injuries. They also have advanced training in the use of musculoskeletal imaging studies as well as expert-level knowledge in sport-specific strength and conditioning techniques and optimal biomechanics.
When did chiropractic begin?
Chiropractic medicine was first practiced in 1897. Since then, its growth has been exponential. There are more than 70,000 active licensed chiropractors in The United States alone.
Chiropractic comes from the Greek words cheir and praktos, (“hand” and “done”) meaning “done by hand.” This name was chosen by the developer of the chiropractic profession, Daniel David Palmer. He realized that although there had been various forms of spinal manipulation for hundreds if not thousands of years, no one had developed a systematic approach to spinal manipulation or developed a philosophical or scientific explanation for the effects of spinal manipulation.
Chiropractors are now the third largest group of medical providers in The United States, behind only physicians and dentists. Over the years, chiropractic developed subspecialties of chiropractic care. This allowed chiropractic physicians to focus their care to benefit certain groups (e.g. athletes).
A sports chiropractor is a Doctor of Chiropractic (DC) sub-division. A Chiropractor must complete a four-year doctoral graduate school program at a nationally accredited university. The chiropractic curriculum requires a minimum of 4,200 classroom, laboratory, and clinical rotation hours. As a part of the 4-year degree, 2 years of advanced anatomy and physiological sciences are required, followed by the completion of the Chiropractic national boards part 1.
Part 1 consists of 110 questions in each of these sections:
- General Anatomy
- Spinal Anatomy
The next 2 years include clinical sciences followed by testing in the Chiropractic National Boards part 2, 3, physiotherapy, and 4.
Part 2 of national boards consists of 110 questions in each of these sections:
- General Diagnosis
- Neuromusculoskeletal Diagnosis
- Diagnostic Imaging
- Chiropractic Principles
- Chiropractic Practice
- Clinical Sciences
Part 3 of the chiropractic national boards consists of a 2-part examination with 110 questions related to nine clinical areas:
- History taking
- Physical examination
- Neuromusculoskeletal examination
- Diagnostic imaging
- Clinical laboratory and special studies
- Diagnostic and clinical impressions
- Chiropractic technique
- Case management
- Supportive interventions
The physiotherapy exam is taken jointly with the part 3 exam and consists of questions related to the following:
- Thermotherapy (hot packs, ultrasound and cryotherapy)
- Electrotherapy (interferential stimulation, high voltage therapy, electrical stimulation, TENS, microcurrent)
- Mechanotherapy (cervical and lumbar traction, massage, trigger point therapy, bracing, orthotics, taping)
- Phototherapy (cold laser, ultraviolet light therapy)
- Functional assessment (gait, movement patterns, muscle imbalance evaluations)
- Exercise Physiology (neurobiology of training and conditioning, biochemistry of training and conditioning)
- Endurance Training (aerobic capacity and adaptation, cardiovascular rehabilitation),
- Muscle rehabilitation (stretching techniques, strengthening protocols)
- Neuromuscular rehabilitation (balance and alignment, coordinated movement patterns, core and spine stabilization)
- Disorder-specific rehabilitation (spine and pelvis, upper extremities, lower extremities)
Part 4 of the chiropractic national boards consists of three major sections: diagnostic imaging, chiropractic technique, and case management. Each section is divided into 20 stations.
These requirements are very similar to those for medical physicians and osteopathic physicians.
In addition to this basic training in chiropractic medicine, a chiropractor may take post-graduate residency programs in which he/she can attain board certifications in specific areas of chiropractic. These residency programs are offered in chiropractic colleges and may take 1-3 years to complete. They include up to 300+ coursework hours followed by an oral and written examination.
The chiropractic board certifications include:
- Sports medicine
- Family practice
Sports chiropractors can obtain two further educational certifications: CCSP® and DACBSP®.
A DC is eligible to sit for the Certified Chiropractic Sports Physician (CCSP®) exam when one of the following educational requirements has been fulfilled:
- Course completion of at least 100 hours of postgraduate education in a CCSP® program at an accredited college
- Completion of a Masters of Science (MS) program related to athletic training, exercise science, biomechanics or other sports equivalent programs from an accredited college.
- Completion of the first year of a sports medicine residency program at an accredited college
- Possession of current certification as an Athletic Trainer (ATC)
The CCSP® exam is a five-hour exam consisting of 250 multiple-choice questions. The exam must be taken within three years of completion of the post-graduate education listed above to be relevant in education and research.
The CCSP® certification is a pre-requisite and must be active for the DACBSP® certifying exam. In addition, at least one of the following advanced educational criteria must also be met:
- Complete 200 hours of postgraduate education in the DACBSP program at an accredited chiropractic college
- Complete a Masters of Science (MS) degree in a sports medicine related program
- Complete a sports medicine residency program
The DACBSP® certification exam consists of a written examination and a six-station practical exam. Other requirements include a written research project that must be completed within 5 years of exam completion and 100 hours of practical sideline experience which must be complete before the exam is taken.
Types of care and treatment offered
Sports chiropractors treat a lot more than just sports-related injuries. They treat typical office employees, car accident victims, weekend warriors, amateur athletes, and professional athletes in a variety of sports. Regardless of your injury or your athletic ability, sports chiropractors are best suited to help you recover, stay injury-free, and achieve personal best records in your sport.
Sports chiropractors treat common repetitive trauma injuries and specific injuries. A sports chiropractor has at least a general understanding of most sports, their common injuries and the mechanism of those injuries. Sports chiropractors also understand biomechanics and physics force vectors that are related to those injuries.
Athletes who participate in trauma sports such as football, hockey, and rugby benefit greatly from sports chiropractic care. It can help manage back pain, shoulder injuries, concussion symptoms and more.
Overhead athletes such as rock climbers, swimmers, and baseball players can benefit from sports chiropractors to correct shoulder impingement, elbow tendonitis, and neck pain.
Endurance athletes can also benefit from sports chiropractic treatment to correct muscle imbalances from repetitive use leading to hip, knee, and foot injuries.
Sports chiropractors are trained to use biomechanic testing, muscle testing, and posture evaluation and often test and retest to asses the progress in the recovery program they prescribe. They are also trained to utilize MRIs, musculoskeletal ultrasound, x-ray, and CT scans to get a more in-depth evaluation of injuries.
Sports chiropractors use all the tools at their disposal for treatment. Chiropractic manipulation is one facet of treatment and may be used to help increase, restore, or improve range of motion.
The following are treatments that may be utilized by a sports chiropractor:
- Manual muscle therapy
- Strength and conditioning
- Pulley exercises
- Olympic lifting exercises
- Lifting technique training
- Kettlebell exercise
- Barbell exercises
- Stretching activities
- Core strengthening exercises
- Kinesiotaping and rock taping
- Vibration therapy
- Cold laser therapy
- Advanced soft tissue techniques (Active Release Techniques®, Graston, IASTM, etc.)
As stated, sports chiropractors may also employ many other traditional therapies such as cryotherapy, immobilization, mobilization, and thermotherapy. This depends on how chronic or acute the injury may be, the timing of the injury, and the severity of the injury.
As primary treatment physicians, chiropractors are frequently sought after for diagnosis, prognosis, correction, and treatment of injuries if there is an overlap in the scope of practice. Many sports chiropractors were athletes themselves. Many athletes from amateur to professional levels will seek out a sports chiropractor to enhance their pre-season and post-season training performance and utilize them to prevent injury.
Sports chiropractors have advanced knowledge of sports nutrition and supplementation. Nutrition and supplementation are important for performance enhancement, injury recovery, and injury prevention. Athletes have high demands placed on their bodies and need nutritional information which allows them to harness the full benefits of their strength and conditioning training.
When injured, supplements help aid recovery. When competing, nutrition and supplements help enhance performance by facilitating strength, endurance, and power output. When training, nutrition helps to take an athlete to the next level.
Because the overall focus of a sports chiropractor is to promote and restore proper biomechanics, strength, and optimal body function, they make ideal consultants for athletes at any level. The expertise they provide can be applied to almost all aspects of athletic training, which makes them invaluable in the world of sports medicine.
While physical therapists are considered the main providers of rehabilitative care in a post-operative scenario, sports chiropractors also have the tools to help aid and speed up recovery. The area also helps strengthen muscles and joint before an operation to aid in the recovery process after surgery.
Philosophy of chiropractic
The first school of chiropractic medicine was founded in Davenport, Iowa in 1897.
Since then, chiropractic care has become popular in all 50 states and in more than 50 countries across the globe.
Chiropractic medicine is a science and a philosophy. The philosophy is built around the concepts of vitalism, holism, conservatism, naturalism, and rationalism.
Chiropractic focuses on neurological and musculoskeletal integrity with the intent to relieve pain and positively impact health and well-being without the intervention of drugs or surgery. The overriding principle of care is that structure affects function. That is to say, if you fix the alignment of the spine through manipulation, you can fix bodily function. Spinal manipulation is a highly technical and specific treatment that re-aligns the vertebrae.
The purpose of spinal manipulation, according to the philosophy of chiropractic, is to realign the structure to take the pressure off of nerves and allow the body time to heal itself. When your spine is aligned, the body will function at its best.
Though spinal manipulation is the foundation on which chiropractic was founded, incorporation of other treatment options is an important part of chiropractic care. Chiropractors incorporate rehab exercises, dietary and nutritional supplementation recommendations, and lifestyle modification counseling into their care.
Sports medicine chiropractic is a non-invasive and non-surgical approach to drug-free pain relief. This approach to pain relief is comprehensive and adopts many different avenues to attain overall wellbeing.
Chiropractic therapy is a subdivision of medicine that has become widely popular amongst health-conscious individuals. It has become a well-accepted branch of medicine, and research continues to show the benefits of chiropractic care.
These days, people use chiropractic care and conventional medicine conjointly to achieve their health goals. The combination of conservative care and modern medicine complement each other and offer the opportunity to accelerate recovery from injuries while maintaining overall health.
Deciphering a the abbreviated letters at the end of a doctor’s name may seem like alphabet soup, but knowing what those letters mean is the key to finding the right chiropractor. These abbreviations can give a person some much-needed insight into a doctor’s education and experience.
While doctors of chiropractic are trained in musculoskeletal disorders, spinal manipulation, and mobilization techniques, they can choose to become a specialist in a particular area. Like medical doctors, physical therapists, and dentists, chiropractors also choose to specialize in providing a standard of care that exceeds standard practices.
The following is a list from the American Chiropractic Association of chiropractic specializations. A chiropractor comes out of school with general knowledge and a basic skill set. Further training and specialization allow chiropractors to treat highly complex sports, occupational, or traumatic injuries. If untreated, these injuries may lead to chronic illness. The added education is an important step to successfully treating these conditions.
- Diplomate of the American Chiropractic Board of Radiology (DACBR): This specialist undergoes further education and residency to acquire complete competency in interpreting diagnostic imaging results related to X-rays, CT scans, MRIs and musculoskeletal ultrasounds.
- Diplomate of the American Chiropractic Rehabilitation Board (DACRB)– This specialist undergoes extensive postgraduate training in the latest treatments and evidence-based physiologic therapeutics and rehabilitation techniques to treat injuries resulting from an accident or a sports injury. There are striking similarities to a DACBSP sports chiropractor from a rehabilitation perspective. From a professional perspective, sports chiropractors excel.
- American Board of Chiropractic Acupuncture (DABCA)– The holistic therapies of chiropractic and acupuncture are combined to eliminate nervous system interference. The chiropractic acupuncture combination has been around since the 1960s and has gained a large following due to its drug-free therapy benefits. This approach treats disease and injury through energy modulating points on the skin and affects the underlying fascia of the musculoskeletal system. Treatments may involve needle insertion with red light therapy, electrical stimulation, and pressure therapy.
- Diplomate of the American Chiropractic Board of Nutrition (DACBN/CBCN)– The nutrition diplomate specialist uses advanced nutritional strategies to prevent and treat diseases related to the gut, cognitive disorders, obesity, and cardiovascular disease. The approach is often specific to the disease and may involve food allergy testing and a whole foods diet approach. Nutrition Specialists also spend over 300 hours of post-graduate study learning how nutrition impacts the body through metabolic processes.
- Diplomate of the American Chiropractic Board of Internal Medicine (DABCI)– These chiropractic physicians specialize in the treatment of chronic disorders involving, Lyme disease, fibromyalgia, Chron’s disease, irritable bowel syndrome (IBS), cardiovascular disease and others. These doctors are skilled in treating disease processes through diagnostic testing such as special testing of the blood.
- Diplomate of the American Chiropractic Board of Orthopedist (DACO/DABCO)– Orthopedic chiropractic specialists can treat acute joint-related issues caused by sports injuries, occupational injuries, or chronic joint diseases. Chiropractic orthopedists use X-rays, MRIs, and CT scans to determine the nature of your problem in conjunction with your history. They commonly treat shoulder, elbow, knee, wrist, ankle, and hip pain.
- Diplomate of the American Chiropractic Neurology Board (DACAN/DACNB)– The neurology diplomate is the most comprehensive neurology program in the world. The program even supersedes those in the medical neurology board. They provide examinations and treat complex conditions relating to stroke, concussion, ADD, ADHD, and rare neurological conditions. The program is a 300-hour post-doctoral functional neurology course with a rigorous written and performance exam. Patient assessment and treatment may take hours to complete to fully assess all areas of the brain and spine.
- Diplomate of the American Chiropractic Board of Sports Physician (CCSP/DACBSP)– This specialist undergoes further education and residency to acquire complete competency in sports medicine and exercise science in order to treat injuries related to sports and athletics, develop and increase athletic performance, and promote physical fitness.
- Diplomate of the American Chiropractic Board of Pediatrics (DICCP)– This specialist focuses on a holistic approach to pediatrics and child development. They assess and evaluate women looking to become pregnant, women during pregnancy, birth, infancy, toddlers, children, and adolescents.
- Diplomate of the American Chiropractic Board of Occupational Health (DACBOH)– Occupational health specialists treat and diagnose work-related neuromusculoskeletal injuries. The focus can help employees maintain their work status while simultaneously saving companies thousands of dollars per year by preventing absenteeism, turnover, and work-related injury claims.
As a supplement to these specializations, chiropractic physicians may seek further education and obtain other certifications that benefit their patients. With new and emerging research and technology for patient care, certifications such as Active Release Technique can help patients recover from generalized pain or catastrophic injuries.
Why visit a sports chiropractor?
Athletes demand a lot from their bodies. Runners need the energy to go further. Athletics athletes need to repeat the same movements and absorb that energy hundreds of times per day. Trauma athletes expose their bodies and brains to trauma for the love of the game. Putting your body through these activities can be traumatic in the moment or build up micro-traumas over time. This can result in a minor or serious injury.
Sprains and strains occur naturally from training and are quick to heal. But, when they heal improperly, your body can start to misalign. Your body starts to adapt to the new you. It starts to use muscles to make up for the change. Your body starts to create muscle imbalances to accommodate these new muscle firing patterns. The imbalances lead to overuse of some muscles and underuse of others. Some muscles become tight and others overly flexible and weak. All of this occurs behind the scenes, so you probably won’t feel a thing until it’s too late.
Seeing a sports chiropractor can help athletes to prevent these silent problems from leading to injury. If you have already experienced an injury, sports chiropractors can help to reverse engineer the problem and find out what you are doing in your sport that is causing you to create these imbalances which lead to injury. Some sports are unilateral, such as baseball or golf, so these imbalances are a natural occurrence in the sport.
Do professional athletes use chiropractors?
The list is extensive. When professional athletes train, they use all the tools they can to guarantee peak performance, and that includes a chiropractor. Here are a few names of athletes that relied on sports chiropractors:
- Rich Froning
- Joe Montana
- Jerry Rice
- Dennis Alexio
- Aaron Rodgers
- Jay Cutler
- Ronnie Coleman
- Phil Mickelson
- Arnold Palmer
- Tiger Woods
Getting the edge in athletic performance is big business. Many of the aforementioned athletes and other well-known professional athletic organizations are using sports chiropractors because they are one of the most effective and affordable ways to improve performance and prevent injury. The following are a list of organizations that utilize sports chiropractors:
- The National Football League (NFL) offers chiropractic care services to all 32 teams.
- 28 teams in Major League Baseball (MLB) use sports chiropractors for home and spring training.
- U.S. Olympic athletes use chiropractic care at the Olympic training facilities located in New York, California, and Colorado. Bill Moreau, D.C., is the managing director of the United States Olympic Committee (USOC) Sports Medicine Team.
Many of these athletes rely on chiropractic care while competing and even after their career has ended. Take, for example, Ronnie Coleman. He would lift so much weight that he now continuously sees a chiropractor. He has had numerous back surgeries and still visits a chiropractor frequently.
Why do elite athletes consider spinal manipulation to be important?
Sports chiropractors are more than just chiropractors that offer spinal manipulation.
Sports chiropractors offer comprehensive care that goes SO much further for their patients than a simple spinal manipulation! Sports chiropractors have in-depth knowledge of biomechanics and strength and conditioning training that can be adapted to physical therapy and therapeutic exercise. They offer sport-specific deep tissue massage and advanced soft tissue technique. They employ a variety of stability and muscular reeducation exercises to rehabilitate athletes at amateur and elite levels.
Let’s look at some similarities and differences between professions in the medical community. We’ll take a look at how all professions have their place yet often overlap. Knowing which professions overlap will allow you to make the best decision when choosing treatment.
Sports Chiropractors versus Physical Therapists (PTs)
There are many similarities between sports chiropractors and physical therapists both from a standpoint of treatment and philosophy.
A physical therapist’s education starts with a bachelor’s degree in kinesiology with an emphasis on exercise science or another related field. Application to a university providing a doctorate of physical therapy is now the norm. Long gone are the days when only a master’s degree was required. Following a 3-year program, a physical therapist too may specialize in areas of care by completing residency programs.
Practice methods are similar. Evidence-based guidelines dictate how a sports chiropractor and physical therapist will approach treatment. These guidelines are based on decades of research from recognized universities and organizations. The research produces a rationale behind the methods of rehab.
While PTs are not trained in “chiropractic adjustments,” they are trained in spinal manipulation to reintroduce normal motion into the spine.
From an educational perspective, sports chiropractors and physical therapists are trained in biomechanics, movement assessments, exercise rehabilitation, physiotherapy, stretching, and passive modalities. Both have advanced knowledge of neurology as it relates to the structure and function of the body. While neurology is a subspecialty of physical therapy, the chiropractic neurology diplomate program is unmatched.
As far as injury rehabilitation, both PTs and sports chiropractors are excellent choices. Both treat chronic and acute injuries related to work, trauma, and sports. Both physical therapists and sports chiropractors can recommend sport-specific strength and conditioning techniques to augment and enhance training.
Sports chiropractors go through extensive biochemical and nutrition education which may help augment patient care and sports performance.
Sports Chiropractors vs. Massage Therapists
Sports chiropractors don’t have much in common with massage therapists, but they incorporate some of their skills to help with patient care. Massage therapists may even be on staff with a sports chiropractor to enhance the patient experience.
Massage therapists are not able to diagnose musculoskeletal disorders and are not able to be primary treating physicians. Massage therapist education is provided by either a certification program or an accredited massage therapy school. Licensing is not required in all states, but it is recommended.
Sports massage and deep tissue massage are the preferred massage treatment methods of athletes. These two methods help break up scar tissue, relieve spasms, and heal injuries.
Sports chiropractors are not massage therapists but are often trained in and use deep tissue massage and sports massage to help increase range of motion, increase flexibility, break up scar tissue, and eliminate spasms.
Active Release Techniques® and Graston Technique may also be employed by sports chiropractors as a more advanced form of sports massage that requires extensive training. These differ from massage in that they emphasize the prevention of scar tissue buildup in muscles.
While sports chiropractors do use massage therapy techniques, they are not massage therapists. Rather, they provide athletes with a well-rounded approach to pain and injuries.
Sports Chiropractors vs. Medical Doctors (MD and DO)
First, let’s discuss the differences between medical doctors.
In reality, both are medical doctors. Both have national board certifications and both apply for residency programs.
MDs represent a larger organization and they can specialize in vast areas of sports medicine, family medicine, oncology, and internal medicine. A doctor of osteopathic medicine’s training is strikingly similar to that of an MD with the exception that their curriculum also includes spinal manipulation. DOs can be thought of as hybrids of chiropractors and MDs.
Chiropractors and medical doctors have a vastly different approach to treating injury. Medical doctors are frequently the dictator of patient care for the rehab team. Chiropractors are part of that rehab team and take a holistic, drug-free, and non-invasive approach. Many MDs are great at diagnosing, but when it comes to non-emergency, medical doctors take a hands-off approach.
An MD’s education is rooted in pharmacology and can heavily rely on medication, injections, and surgery as a treatment approach.
It’s not that medical doctors are unaware of soft tissue techniques; they simply stick to their training. They may recommend a massage or treatment by a sports chiropractor or physical therapist, but they themselves do not practice this method.
Sports medicine is a specialization within the MD realm. There is a 1-2 year fellowship program in which the MD receives further training and experience with sports-related injuries. These MDs come from orthopedic surgery residencies or family medicine residencies.
Primary family medicine MDs are trained to evaluate and treat sports injuries, while their counterparts that focus on orthopedic surgeries do not. The surgical sports medicine physicians training emphasizes repair of specific sports-related injuries (e.g. ACL tear, Labrum tear, etc.)
Athletic organizations utilize medical doctors, sports chiropractors, and massage therapists as complementary sources of care.
Sports Chiropractors vs. Chiropractors
Chiropractors generally fall into two categories: straights or mixers. Think, conservative vs. liberal. Straight chiropractors are considered conservative and mixer chiropractors are considered liberal.
Conservative chiropractic providers tend to focus their treatment methods around subluxation theory and spinal manipulation. This group of chiropractors is often criticized by the scientific community. They are scrutinized because the vertebral subluxation theory that defines the chiropractic profession is often rejected by the scientific community.
They believe that spinal subluxation is the sole cause of disease and dysfunction. They think that fixing the subluxations by taking pressure off of a nerve will yield the best form of treatment and prevention. The problem that arises is that while spinal manipulation has value in helping to restore a normal range of motion in spinal segments, practitioners don’t utilize the full scope of treatment.
Liberal chiropractic providers utilize all of their education and use an array of diagnostic tools to aid in the evaluation and care of their patients. They are skilled at utilizing tools such as X-rays and MSK ultrasound to help diagnose, treat and reevaluate a patient’s condition as they go through a treatment program.
They may work alone or in a multi-disciplinary setting, working with MDs, DOs, DPTs, and massage therapists. They may also work with PTs and athletic trainers and recommend exercise as part of their treatment program. Spinal manipulation is still part of their practice, but they follow mainstream medical research when considering treatment and evaluating patients.
A sports Chiropractor is very much a mixer and falls into the far end of the mixer spectrum, making up approximately 5-10% of the chiropractic profession. These practitioners are highly integrated into the modern healthcare system. They are seen as complementary, yet an alternative to modern medicine.
By incorporating basic chiropractic principles into evidence-based practice methods such as exercise physiology, strength and conditioning, exercise rehabilitation, and sports medicine, sports chiropractors have deeper knowledge that blends many professions together. They use modern, non-invasive treatments for pain, sports injuries, and personal injuries.
How do I know If I should visit a sports chiropractor?
First, you have to ask yourself the following questions:
- What do I want from a chiropractic experience?
- Do I want an adjustment?
- Do I want Active Release Technique or other manual therapies?
- Do I want a massage as well?
- Do I want someone to listen to my problems?
- How many doctors and chiropractors have I seen so far with little to no improvement?
- Am I an athlete? And what kind? A professional, amateur, or weekend warrior?
- Was my pain preventable?
- Is my current chiropractor, physical therapist, physiotherapist, or trainer helping my current problem?
- Has my treatment plan plateaued with my current health care professional?
Sports Chiropractors have the advantage over traditional chiropractors in that they add value to the patient experience. Sports Chiropractors evaluate the entire body for strength, posture, and mobility imbalances.
In truth, anyone can visit a sports chiropractor—from an everyday Joe to a recreational athlete to amateurs and pros. Maybe you need a strength and conditioning coach with a medical background for safety and advanced knowledge. Or, you might be looking for someone who has extensive knowledge of your particular sport and can help fix problems before they start.
If you have asked yourself any of the above questions, a sports chiropractor is a proper fit for you.
Now, you have the tools you need to find the right sports chiropractor.
Remember, use your goals to formulate questions for yourself and your treatment provider. This will help you determine which sports chiropractor you want to see.
Give us a call. We can help guide you if you are having any trouble finding treatment. If you have any other questions, we are always here to offer our professional advice and support.