Friday, June 29, 2012

The Joint Commission Now Recognizes Chiropractors as Physicians

Reprinted from the American Chiropractic Association 

The Joint Commission Now Recognizes Chiropractors as Physicians 

By William Morgan, DC 

The Joint Commission, the largest credentialing body for hospitals and health care organizations in North America, has recently changed its stance on the recognition of chiropractors. This organization now recognizes chiropractors as physicians.¹-² This is a major policy change from decades ago, when the commission published an article entitled “The Right and Duty of Hospitals to Exclude Doctors of Chiropractic.”³ 

The Joint Commission (JC) was one of the organizations named in the Wilk antitrust lawsuit for allegedly restricting the profession of chiropractic. It has grown in maturity since those days and is now a major force for good in the provision of health care in the United States and in Department of Defense (DOD) medical facilities worldwide. JC is no longer simply a private policeman for the health care industry; it now considers itself a partner in health care. This is evident in its new motto: Helping Health Care Organizations Help Patients.4 

The current list of JC-recognized physicians includes medical doctors, dentists, podiatrists, optometrists and chiropractors. Chiropractors and optometrists are recent additions. 

What Is the Joint Commission? The Joint Commission, formerly the Joint Commission on Accreditation of Health Care Organizations (JCAHO, pronounced jay-co), is a non-profit private organization that accredits health care organizations. JC credentials 17,000 different health care entities. It provides a fee-based credentialing process, in which hospitals participate. Even though submitting an application to this private organization for credentialing is technically voluntary, from a practical perspective, failure to have JC accreditation would very likely lead to the closure of a hospital. Joint Commission credentialing is the standard that all successful hospitals, including government facilities, attain. 

JC has changed in recent years from being an inspection and credentialing institution to being a proactive partner in improving health care. The new JC identifies particular patient safety needs and educates participating organizations about how to optimize treatment and to prevent sentinel events, prescription errors, wrong-side surgeries, nosocomial infections and a variety of patient safety concerns. It now provides leadership, guidance and education to the hospitals it credentials. 

Every hospital-based chiropractor can tell you about the impact that JC has on clinic standards, record keeping and policy. Hospital-based chiropractic clinics write their policy with JC in mind. Fortunately, JC values interdisciplinary collaboration greatly and likes to see evidence of patient-focused teamwork. 

Not Everyone Is Happy With This Change Even though JC clearly stated this change will in no way diminish the authority of medical doctors, there has still been an outcry from certain medical organizations5 that do not want chiropractors (and optometrists) added to the list of physicians. These organizations are lobbying JC in an attempt to have DCs and optometrists removed from physician status. 

Why Is Physician Status Important? The reason that we should be concerned about JC’s physician designation is the wide-sweeping impact JC has on health care in North America. JC influences Medicare, Medicaid, the DOD, the Veterans Administration, the Public Health Service and virtually every hospital in the United States. This private organization will have a monumental impact on how all of the other players in health care perceive and treat chiropractors in the future. Being designated as a physician by a prestigious organization lends far more credibility to chiropractic than being categorized as technicians. 

Dr. Morgan splits his clinical time between a hospital-based chiropractic clinic and two Washington, D.C., executive health clinics. He is adjunct faculty for F. Edward H├ębert School of Medicine, Uniformed Services University of the Health Sciences and New York College of Chiropractic. He can be reached through his Web site, www.drmorgan.info. 

References: 
1. Joint Commission Perspectives, June 2009. Volume 28, Issue 6. 
2. www.jointcommission.org/NR/rdonlyres/434D5A76-42F7-4782-8CA4-7CD018D05A67/0/06_09_jconline.pdf. 
3. http://biotech.law.lsu.edu/cases/antitrust/wilk_v_ama.htm#S*fn10. 
4. www.jointcommission.org/. 
5. www.asahq.org/news/asanews041610a.htm 

© 2012 Copyright American Chiropractic Association

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic

Thursday, June 28, 2012

Chiropractor or Certified Sports Chiropractor: Is There A Difference?

By Miami Beach Chiropractor | Chiropractic Sports Medicine Specialist Dr Todd Narson
So, you’re an athlete of some kind and you now find yourself in need of a chiropractor for your sports injury. You do a Google search or check Yelp for some guidance. There are ‘lots’ of chiropractic physicians listed and most seem to have pretty good reviews. But, being an athlete you want someone that understands you better and you think going to a sports chiropractor is the way to go. But is there really a difference between a standard chiropractor and a sports chiropractor? 

The short answer is yes. Although many chiropractors will list “athletic injuries” or “sports injuries” on their long list of conditions treated, there is an actual post graduate specialty in chiropractic sports medicine. And no, having been an athlete in high school, or college, or even the pros doesn't qualify you as a "sports chiropractor". You can't just have played sports, there's a lot of education required too.

1930s NY Yankees Spring Training, St. Petersburg, FL. with Dr. Erle V. Painter (Far Right)
Prior to the development of a formal chiropractic sports medicine education programs, “sports chiropractic” dates back to the 1930s. Sports chiropractic was born during the World Champion New York Yankees Babe Ruth-Lou Gehrig era. Dr. Erle V Painter is the first known sports chiropractor. He was the NY Yankees athletic trainer. Combining his knowledge and experience of athletic training with that of chiropractic medicine, he took care of the most famous players the game of baseball has ever known. And if history tells us nothing else, we know they performed very well.

As a base education, both chiropractic physicians and medical physicians education is more similar than you may have been led to understand. A September 1998 study revealed that of the core curriculum (physiology, pathology, chemistry, biochemistry, microbiology, diagnosis, neurology, psychology, psychiatry, OB/GYN, x-ray and orthopedics) and clinical sciences, that chiropractic students spend 3790 hours for these basic sciences and clinical sciences vs 2648 for medical students; and 1405 hours of clinic experience  for chiropractic students vs 5227 hours for medical students (which includes their 3-year medical residency) (1). Medical students then go on to their specialty training.

What the general public (and the medical profession for that matter) doesn't know, is that like medicine, the chiropractic profession has many post graduate specialties as well. The oldest (formal) post graduate specialty is radiology and requires a 3 year residency. There’s also orthopedics, sports medicine, neurology, internal medicine, rehabilitation, functional medicine and more. Some of these specialties have more than 1 level of proficiency, such as the sports medicine program. These programs are post graduate study, 1-year for the base level certification and 3-years for the “diplomate” level. It is the "diplomates" that are the specialists of a particular discipline of study of post graduate study. 

In the United States, the American Chiropractic Board of Sports Physicians is the certifying organization for the chiropractic sports medicine educational programs, examination process, credentialing and for the ongoing re-credentialing for year to year re-certification. 

To get your specialty certification in chiropractic sports medicine, you must attend 300+ classroom hours in the areas of:

• Advanced Assessment of the Athlete
• Rehabilitation of the Spine and Extremities
• Biomechanical Analysis of the Upper Extremity
• Biomechanical Analysis of the Lower Extremity
• Strength Training and Conditioning
• Soft Tissue Techniques for the Spine and Extremities
• Advanced Emergency Procedures
• Advanced Case Correlations
• Analysis of Literature
• Sports Nutrition
• Strength Training and Conditioning for the Athlete
• Special Populations in Sport
• Radiology
• Emergency Procedures
• Applications of Technology
• Soft Tissues
• Epidemiology of Spinal Trauma
• Adjunctive Therapies
• Foundations of Sport and Exercise Psychology
• Rehabilitation of the Athlete
• Taping and Bracing

Within each of these base subjects come the specifics associated with athletes of different sports & different populations (gender, age, special needs, etc). Within the chiropractic sports medicine specialty after completing your first 100-hours of study, you must pass a national board examination. Once successfully passed you are now a “Certified Chiropractic Sports Physician®” and can go on and complete the remaining hours for specialty status. You’ll complete the coursework and take a second national board examination. Once successfully passed, you then sit for a multi-station practical examination where you are put in front of live patients in simulated game and emergency situations as well as radiology, athletic taping & head trauma/concussion management. There is no curve on the practical exam. You pass or you fail. Each exam is filmed and proctored. Miss more than 2 sections and you take the entire practical exam over again. Miss 1 or 2 sections, and you can re-take those 1 or 2 sections.

 But that’s not all folks, in addition to passing the 2 national board written exams, the multi-station practical hands on examination, you must have completed at least 200 hours working with athletes in an “on field” situation. So, practical experience is also a requirement. However by this time, it’s not uncommon for diplomate candidates to have in excess of 500 to 1000 hours of experience working with athletes outside their normal office hours. If you put this in context of getting a bachelor’s degree (60 hours) or a master’s degree (120 hours) and the practical experience requirement takes on a whole new context.

Finally, each diplomate candidate must meet a sports medicine related publishing requirement and either publish or have their abstract accepted for publication in a scientific journal.

You must maintain an active healthcare practitioners CPR/BLS card as well. 

After all this, you are now given the privilege and honor of being a Diplomate of the American Chiropractic Board of Sports Physicians®

So building on the base that Dr. Erle V Painter started, combining the professions of athletic training and chiropractic, the education of a certified sports chiropractor (CCSP) and the chiropractic sports diplomate (DACBSP) now combines elements of emergency medicine, radiology, nutrition, athletic training, physical therapy, neurology, soft tissue mobilization, chiropractic, orthopedics and much more.

It is specifically because of this kind of formal knowledge and practical experience that sports chiropractors are sought out by top professional teams, Pan American & Olympic athletes as part of their sports medicine team and as consultants. But you don’t have to be a top Olympian or professional athlete to get that same level of care. If you're training for a 5k, half marathon or an Ironman Triathlon, or play pickup basketball in the park, now that you know the difference, you can find a “sports chiropractor” for yourself and your team. There's a reason the pros and the Olympics all have a sports chiropractor part of their team.

If  you're here in Miami or Miami Beach, you can find more about my practice at: www.NaturalSportsMedicine.com. If you're not local to South Florida, then just visit the American Chiropractic Board of Sports Physician's web site directory and put in the specifics for your state and city. All CCSP and DACBSP that keep their education and credentials up to date are listed there.

'nuff said

Dr. T

References


Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic

Wednesday, June 20, 2012

LeBron James | Miami Heat | What To Do Next Time You Have Cramps


by Miami Beach Chiropractic | Sports Medicine Specialist Dr. Todd Narson

Those of us sitting on the edge of our seats last night as the 4th quarter of game 4 of the NBA finals was winding down gasped when LeBron James got tripped up and fell (at least those of us who are Miami Heat fans gasped). When he had difficulty getting back up and then had a noticeable limp as he ran across the court, we started hearing about muscle cramps and were starting to get seriously worried about our impending win.  You were able to see Miami Heat head trainer Jay Triano applying ice-massage with a bag of ice on LeBron's thigh and taking him through a series of stretches and some muscle work to break the cycle of cramping/spasm. Luckily Chalmers stepped up to the plate and invoked the spirit of LeBron 2012 and Wade 2006 to help us secure the win.

In my career as a sports chiropractor I’ve had the opportunity to work with athletes from most every sport. Over the past 3 years I had some interesting incidents occur involving 2 of my athlete patients and muscle cramps.  Since both patients have publicly described the stories, I can tell you specifics. Shawn was doing his first Boston Marathon as part of the Livestrong team.  At the same time I was sitting in my office in Miami Beach when I get this phone call. “Hey Doc, It’s Shawn”… and the conversation continued with him telling me he was on mile 17 of the Boston Marathon when his right quads cramped and he was going to have to drop out of the race..."was there anything I could do?"

E.T. was doing the Ragner Relay from Miami to Key West when he suffered the same fate. He and several other team mates share different legs of the marathon. On his second leg of the race, cramps started that he couldn’t break. He also called me when he was back in the van.

In both cases I knew the racers were well hydrated and with appropriate electrolytes, so that wasn’t the problem. They are both accomplished athletes. It wasn’t as simple are replacing some electrolytes and walking it off and then they're back in action. Earlier in my career studying sports medicine I learned about this concept called Reciprocal Inhibition.  Reciprocal inhibition very basically means that when one muscle is contracting, it’s opposing muscle be inhibited from contracting. In other words, when one muscle contracts, the other must relax.  So, during the phone call with Shawn in Boston and E.T. somewhere between Miami & Key West, I guided them on how to do reciprocal inhibition themselves. Within a couple minutes, Shawn was able to go on and conquer heartbreak hill and finish his first Boston Marathon and E.T. was able to complete his marathon relay to Key West.

Joints are controlled by two opposing sets of muscles. In LeBron's case, the knee being controlled by the quadriceps and hamstrings. They are the muscles that extend and flex the knee. They must synchronized in order to work properly. When a little organ called the muscle spindle is stretched (or in LeBron's case, overstretched), the “stretch reflex” is automatically engaged as a protective measure. As a result, the opposing muscle group is inhibited (relaxed) to prevent it from working against the contracting muscle.  Just think, how would it be if your biceps and triceps could contract at the same time? It just wouldn't work. So you're nervous system is wired in such a way that this doesn't happen. 

Therefore we can use this to our advantage to break the cycle a muscle spasm (aka cramp). In LeBron James’ case, it seemed to be his quadriceps that cramped and also seems to be what is being reported. So contracting his hamstrings would neurologically inhibit the cramping quadriceps. The same thing that was happening to Shawn in the Boston Marathon. E.T. was the opposite, his hamstrings were cramping and I had him do several contractions of his quads to neurologically inhibit/relax his hammies.

So next time cramps stop you in your tracks, try this neurological inhibition technique to break the cycle of cramps. Hopefully it will work wonders like it did for my two runners. And Lebron, you’ve got the heart of a Lion to play through those cramps the way you did. You made us proud and next time, feel free to try this technique like Shawn and E.T. did. Yes they were sore, but they were able to finish miles of more running after their cramps had them on the ground.

It's not fool proof, but it worked great with Shawn, E.T. and personally in my last triathlon. When a title is on the line, it helps to have all the tools possible in your tool bag. Hope this one works for you too!

Go Heat!

‘nuff said

Dr. T

ADDENDUM If you're an athlete, there's more that you need to know about muscle cramps. I even played into the common thoughts on muscle cramping in the above article. But, cramping during athletic activity that is not due to an injury IS NOT due to an electrolyte imbalance or dehydration, but rather muscle that has been pushed beyond its level of training. Or course a strain could push it over the edge, which is what I feel brought on LeBron's cramps, however for those that get muscle cramps during training or during their "event", you've exceeded your level of training. Here are two references to prove my point: 

© 2012 Dr. Todd M. Narson. All rights reserved



_______________
Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

Friday, June 15, 2012

Graston Technique®, ASTYM, FAKTR, SASTM, Gua Sha | Experience Matters

By Miami Beach Chiropractor - Chiropractic Sports Medicine Specialist Dr. Todd Narson
Graston Technique®, ASTYM, FAKTR, SASTM, Gua Sha and others are all forms of IASTM (Instrument Assisted Soft Tissue Mobilization). The purpose of which is to break down scar tissue and adhesions that are causing multi-layered soft tissue restriction and adversely affecting the dynamic function of the underlying muscles, tendons, fascia, ligaments, etc. There are some minor difference between the techniques however ultimately, all are effective.  However effectiveness doesn't depend so much on the original coursework or specific technique, but the experience of the practitioner. 

One thing I want to "get off my chest" is that Graston Technique® & ASTYM aren't new techniques. Your doctor or therapist may have just learned it and is all excited about it, but these techniques have been around for over 20 years with the original research being done at Ball State University. Gua Sha dates back to the 5th &; 7th centuries( roughly 700-BC to 500-AD). FAKTR & SASTM have been around since the mid to early 2000s. 

Another thing is that IASTM techniques are not simply the use of instruments to loosen or remove adhesions, but it’s the follow up treatment, stretching, therapies, rehab & anti-inflammatory nutrition that completes the techniques. Otherwise, you're simply doing Gua-Sha/Instrument Massage.

Having become certified in Graston Technique® M1 & M2 in 2002 and several years ago, trained in FAKTR-PM (now known simply as FAKTR), 10 years of the last 20 years using IASTM full time in my practice, weekend excursions as a member of the sports medicine team at local sporting events, a 10 day rotation at the 2006 Central American & All Caribbean Games and at the 2011 Pan American Games, all gives me a unique experience and perspective in the practical application of IASTM. You’ll find many others with varied but similar experience. 

Some of the most important factors for providing good IASTM are: 
1. A good physical exam
2. Sports specific examination of their injury
3. Creativity -Thinking outside the box (and sometimes outside the walls of your clinic)

US Patient Pending-N6 Narson Body Mechanic
As a result of my experience with Graston Technique®, FAKTR and IASTM in general, I developed my own instrument design known as the Narson Body Mechanic N6. The design is now patented in Canada and we are currently “patent pending” here in the US and expecting the patent within the next few months. The reason I designed this instrument was out of my constant need to be more efficient. The design affords me the ability to carry all of the most useful IASTM instruments with me in one convenient tool. No longer do I have to carry a kit of tools with me. No longer do I have to clean multiple instruments between patients. I have everything in one hand at all times. I’ve added a non-slip gripping surface which reduces tool slippage and reduces finger/hand fatigue which, the longer you do IASTM with real stainless steel instruments, you’ll come to appreciate. The other thing most of us in the USA can appreciate is that it’s the only “multi-tool” for IASTM that is made from 100% U.S. steel and made 100% by hand right here in the U.S.A. 

But when it comes to giving effective IASTM, the most important thing to remember is after a good base education, it’s the wealth of experience along with the doctor’s (or therapist) ability to be creative. From my experience, it's thinking outside the box that matters most. Couple that with a good nutrition plan, rehab and anti-inflammatory therapies and the results will astound you. It’s very possible with IASTM to take long time chronic injuries-treat them with IASTM and have the athlete back out playing the same day or the next day. 

This year I have helped 2 triathletes get back into their training to complete in their first Ironman triathlon, 3 people are back training to complete 26.2 distance marathons, 10 people back into running half marathons, 70.3 distance Half Ironman, and dozens back to competing in sprint and Olympic distance triathlons. Those are just the athlete patients. 

Often you’ll find me at the pool, the track or simply running on the sidewalk with a patient working with them while they do their sport. For me, it’s sometimes the only way to resolve an athlete’s problem. Just like anything else in life, experience matters. Even with IASTM.

'nuff said

Dr. T

© 2012 Todd M. Narson, DC, DACBSP, ICSSD

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic

Monday, June 11, 2012

Sports Injury? Try A Sports Specific Exam



So, you’re an athletes and you get this annoying pain when you’re working out or playing your game. You go to the doctor and-nothing! No matter what test the doctor does, it doesn't seem to reproduce the pain. It’s just like when you take your car to the mechanic and it suddenly stops making that ‘noise’ - Now what? 

Athletes and those of us trying to be athletes and training our way back into shape are doing something not often seen in a typical doctor’s office - that being "moving around".  Most examinations are done statically. In other words, you sit on the exam table and the doctor does stuff to you to try an provoke your symptoms. This classic, tried and true exam technique may be great for your typical patient, however often fails to uncover the nature of a sports injury or athletic relating training injury. Why? Because the system isn’t being stressed the same way.
Shoulder evaluation following MMA Injury

Being a triathlete myself, I often see patients who complain of injuries from training. The dilemma is that many of these aches and pains don’t come out until they are 3, 5 or 10 miles into their training. So how do you examine something properly and efficiently if you can’t provoke the patient’s symptoms? You get out of your office and into their training environment. It’s the only way.

I have triathletes and cyclists bring in their bikes and we set them up on the indoor trainer and start them pedaling. I have runners come dressed to run and we take them outside to assess their run. With enough resistance bands and balls and balance pads in the office, I can re-create many if not most sporting environments. For those I cannot duplicate, we go to their home turf with all my exam tools in hand. If their symptoms aren't provoked until a considerable amount of time or distance, then I’ll have them workout until they’re at about at that point, at which time I show up, evaluate their biomechanics, take pictures or shoot video and once the pain shows up, it’s work time. 

Assessing Achilles Pain Following Tennis Match
Does your pain only show up on when following through on a serve? Or when cocking your arm back or accelerating as you’re about to throw a ball? How about when you are at the heel strike or toe off phase of running? Maybe it’s half-way through the club acceleration on your golf swing? How about shoulder pain at the entry or late recovery phase of freestyle swimming? Or does your pain hurt simply when gripping a racquet or gasping a doorknob? Maybe it’s simply painful after you’ve been sitting at your desk working on the computer for a few hours? Each scenario provides its own set of clues and requires its own special set of circumstances to properly evaluate it.

One more thing. The sports specific exam doesn't replace the classic physical exam, it's in addition to it.  Sports specific exams are the foundation of what I do and will be the staple of any good sports physician "tool box".

If you or your team are looking for a well trained, board certified chiropractic sports physician, I suggest starting your search at the source. The American Chiropractic Board of Sports Physicians is the academic and credentialing organization for those who hold the basic CCSP (certified chiropractic sports physician) credential, or the sports medicine specialist DACBSP (Diplomate of the American Chiropractic Board of Sports Physicians) certification. The ACBSP requires years continuing education specifically in sports medicine and related topics, maintaining a healthcare level CPR card and confirmation of continuing hours of on field sports medicine work. You can start your search for a great sports physician by clicking here

Train Smart-Play Hard

Dr. Todd M. Narson
Diplomate of the American Chiropractic Board of Sports Physicians

© 2012 Todd M. Narson, DC, DACBSP, ICSSD

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine. www.NaturalSportsMedicine.com

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