Friday, January 9, 2015

Chiropractor or Certified Chiropractic Sports Physician: Does It Make A Difference For Your Sports Injury?

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 general practice chiropractor and a certified 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, DC (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 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
• Concussion Management
• 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 private consultants to coaches and athletes alike. 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.

Or, maybe take a chance on someone without the education, experience and credentials while they learn on your multi-million dollar star athlete...

If  you're here in Miami or Miami Beach, you can find more about my practice at: If you're not local to South Florida, then just visit The American Chiropractic Board of Sports Physicians-Directory . All CCSP and DACBSP that keep their education and credentials up to date are listed there. Another resource to finding a good sports chiropractor is the American Chiropractic Association's Sports Council

'nuff said

Dr. T


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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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