Types of Sports Practices
There are two types of chiropractors who treat athletes. First, there is the chiropractor who happens to have athletes as part of their total patient base, and the athlete is treated no differently than any other patient. This does not make the chiropractor a sports chiropractor by default, nor does it warrant advertising to that effect!
Second, there is the chiropractor who treats athletes and also has been specifically trained through experience and/or postgraduate programs. This type of sports expert will undoubtedly have had some experience in on-field training of athletes. Some chiropractors focus in-office, dealing more with an athlete's individual concerns rather than serving the needs of a team or a specific sport.
The evaluation and treatment of athletes on-field is distinctly different than in-office. Some degree of experience would be a requisite for a chiropractor wishing to gain knowledge with regard to how athletes injure themselves, the rules of the game, and the psychology of the athlete in real time. Without this contextual training, it is difficult to appreciate the athlete's total frame of reference when giving advice, modifications or restrictions.
Secondly, on-field decisions are framed often in the context of immediacy not found in the office. Left without the normal tools of the trade such as a suitable table (exams are often performed on the field itself), x-ray machine, orthopedic supplies and, most importantly, time, decisions are made in the context of that moment: the needs of the athlete, the team, the coach, and possibly the parents. Also, if the event involves out-of-town athletes, it is clear that this is a one-time opportunity to evaluate and treat or recommend without the advantage of followup. It is not uncommon to have to make decisions regarding return to play without a full picture. This time-sensitive urgency is not common in office practice. As a result, the on-board skills and reflex thinking that must occur are developed as a unique set of skills.
When attending an event as part of the "medical team" or as the sole health provider, certain skills are often required. A sole provider should have:
• emergency skills including CPR and Red Cross training, and the ability to evaluate traumatic injuries and make appropriate triage decisions;
• athletic training skills such as taping, stretching and soft-tissue skills; knowledge of equipment, the rules of the game, common training regiments for the sport, etc.;
• chiropractic skills that go beyond spinal adjusting, including extremity adjusting and mobilization.
I have attended sporting events where an untrained chiropractor (uninvited) arrives with an adjustment table. The individual is clearly identified by the athletes or coaches as someone attempting to drum up patients (if, in fact, that is the individual's intent) and is not taken seriously. Unfortunately, this may have a detrimental effect on the reputation of the profession if this individual is the only one who shows up at an event.
For chiropractic students, I cannot emphasize enough the enormous advantage of connecting with your local SACA or other sports club and participating in school-sponsored sporting events. This head start puts you in a position of having had experience prior to becoming a licensed practitioner and is the best way to enter the profession as a knowledgeable sports specialist. I have known students who, after one year of on-field training, have had more experience than many chiropractors who consider themselves sports chiropractors.
Approach to Personal Development as a Sports Specialist
One can develop both general expertise in sports and also specialize in a given sport or type of sport. This is often dictated by one's past experience or recreational preferences. This self selection process is often a survival of the fittest advantage. In other words, the knowledge of a given sport with regards to rules, common problems/injuries, training approaches, psychology, etc. gives a distinct advantage in communicating with athletes or coaches of that sport. This common bond is often the initiator of a long-lasting and expanding relationship.
In addition, the interest in the sport provides an obvious reward with regard to satisfaction level when having to volunteer time at training or sporting events. Yes, I said volunteer.
Most sports chiropractors (and other health practitioners) volunteer a good part of their time and services (unless at the level of professional or high-level amateur sports). Although this may appear a selfless act to the people you are helping (or even to yourself), the returns are often exponential in developing a practice and reputation.
Academic training is necessary and may be acquired through postgraduate courses leading to sports certification through the ACA's CCSP and diplomate (DACBSP) programs or the Canadian sports program. Additional training is available through the National Strength and Conditioning Association (NSCA) and other groups. It is generally difficult in today's environment to be taken seriously without some certification. Association with the ACA's programs also makes available a resource connection to a network of coordinators throughout the country who have contacts with specific sports or sporting events looking for assistance at events. These can be accessed through Sports Talk (an ACA publication), or you can call the ACA's Sports Council at (800) 593-3222 for more information. They will ask if you are certified and what experience you have had.
Without a connection to a sport through personal experience, it is often worth volunteering at as many different types of events as possible (assisting an experienced DC, not acting as the primary provider). This gives a broad exposure to the different types of experiences available and allows a narrowing of interests based on personal likes.
Generally, it should be evident that some sports involve more trauma such as rodeo, martial arts, contact sports that do not have protective gear, etc. Some sports involve more soft tissue based injury patterns such as track and field or swimming, for example. The "immediacy" and intensity of the experience varies based on these choices. Whatever choice, it is crucial to become acquainted with the general rules, categories, equipment, etc., of the sport prior to attending the event. This allows a better appreciation of the types of injuries and allows a more intelligent questioning of athletes and coaches.
Make contacts with your local health clubs. Visit the facility to make sure that you understand what equipment is available. Know how the equipment operates, what the intended function of the equipment is and what options are available for training the same body parts or types of exercises. This will allow you to discuss training with your patients in a manner that will instill confidence because they recognize you really understand the equipment and are not speaking purely academically. If you do not know the specifics, go through a training session using the equipment and read as much as you can on the equipment. Most importantly, try out the equipment yourself. This will often raise or answer questions for you that go a long way in meeting your patient's needs.
Always read the latest developments and, if applicable, apply them. The best way to learn and remember is to read and apply. Take advantages of summaries such as those offered in the Journal of Sports Chiropractic and Rehabilitation and my own articles in Dynamic Chiropractic. Seek out hands-on types of seminars once a year nationally, and at least once a year in your area. This establishes contacts, allows the exchange of ideas, and produces the acquisition of new skills.
Taking your personal sum of experiences and certification, you may approach coaches, teams or schools with a level of confidence that will not be perceived as a desperate attempt at patient acquisition. Using the many articles found in most chiropractic journals on a chiropractor's involvement in sports, you can develop a summary flier or pamphlet to include with your personal sum when contacting these individuals or groups. The ACA and ICA also provide pamphlets for this purpose. When individuals see the extensive inroads chiropractic has throughout the sporting community and the reliance most top-level athletes have on chiropractic care, you will not have to "sell" them on the idea of chiropractic care for their athletes.
Other aspects of marketing might include the following:
• participating in or organizing preparticipation physical examinations (do not attempt this without experience);
• volunteering for either training or actual events as the team doctor;
• offering a discount team rate for the athletes you are involved with.
Finally, a caution to be patient. It takes time to develop the experience/knowledge and networking necessary to be a specialist. The road to this level of practice is exciting and rewarding. Don't sell short the fun of the learning experience, and don't sell short the human element of the process where many wonderful professional and personal relationships will be formed.