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.

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