By William R. Moyal, D.C.
Managing sports injuries is, by far, one of the most promising niches in chiropractic, yet most chiropractors feel uncomfortable and even inadequately trained to comprehend problems and handle cases in this rapidly expanding area.
The acceptance of chiropractic in the sports arena has grown to the point where professional teams, Olympic athletes and coaches are seeking sports chiropractors to provide care or at least they are seeking access to D.C.s. They have seen examples of improved performance and decreased injuries with a D.C.’s presence.
How do you put yourself in that position? The first step is to accept that just because you have the title D.C. doesn’t mean that you have the necessary talent or skills—although the desire may exist—to launch a sports injury practice.
This is not meant to offend, but rather it illustrates that sports injuries are a different species to learn to handle, if you really want to stand out in the community. This is also why there are so few chiropractic offices that thrive and are sought out to care for sports injuries.
As I always say, the proof is in the pudding! Prove that you can measure up beyond their expectations, especially with the cases they haven’t had any success with, and you will become indispensable.
To achieve this, you must know what you’re doing and be ready to prove it anywhere, at any time. However, can you, with total confidence, find and specifically correct a problem—at any time, on any athlete—with a single adjustment and instantly see demonstrable changes, no matter if they had several complaints?
It can be done. I have been doing it for more than 15 years with athletes from many sports and at every level of competition.
It’s a matter of having an analytical program or procedure that tells you everything about the athletes in front of you and being able to use the information they share with you about how their injuries took place. While you re-create the mechanism in your mind, you can use the following six rules to analyze the entire spine and extremities in a matter of seconds.
Then, you can determine the area of primary involvement in need of adjustment, which may be away from the initial site of impact or complaint, in order to correct the problem and get the athlete back in action very quickly.
Six Rules For Injury Analysis
Obviously, you must know the mechanisms for injuries and be able to recognize which stage in the process you are confronting. Every injury follows a specific set of rules:
Rule No. 1: All injuries contain a certain amount of force that the body is forced to absorb. When this force is met with acceptance, the injury is minimal or non-existent. If the body is not ready to accept this force or is caught off-guard (causes of joint dysfunction), an injury results. The extent of the injury will depend upon the amount of force, the direction of the force, the integrity of the tissues involved, position, alignment, resilience and other factors (the law of adaptation).
Rule No. 2: The body is always trying to protect itself. Therefore, it will share that force throughout the body to minimize the initial site of impact (the dispersive factor).
Rule No. 3: This, in turn, creates predictable patterns (patterns of injuries) that we can follow and solve step-by-step to resolve the problem.
Rule No. 4: The body will also compensate (the law of compensatory mechanism and the torsion/countertorsion principle) during this protective phase of the injury process.
Rule No. 5 The body will develop the initial injury into many different injury sites (the dispersive factor and the law of compensatory mechanism). The result is that even a single small injury now affects many other joints, muscles, ligaments and other tissues in and away from the spine or the site of initial trauma (the law of compensatory mechanism).
Rule No. 6: This is critically important to understand: Never, ever stop at where the complaint or the painful area is, or you’ll be missing 90 percent or more of the remainder of the injury. This is the reason the injury can keep coming back and often keeps getting aggravated with little or no improvement (a common source of frustration for the patient and the practitioner).
In order to totally assess an injury and properly correct it to the full extent, you must check every major joint in the patient.
You must follow a specific, complete evaluation method, and it must take very little time, while yielding a massive amount of information necessary to analyze, understand and eliminate the present problem while working with the natural laws of healing (time).
This process must provide you the plan of action and, with tremendous accuracy, what to expect with each adjustment you are about to make (even before you make each one).
Two Quick Evaluation Tests
You can add two quick tests to your arsenal when you check your patients on each visit.
The first is the shoulder abduction test, for which you are behind the patient, whose arms and rest by their side. Slowly raise the patient’s arms into abduction (holding their elbows from underneath)—to horizontal, near horizontal or above horizontal—and notice if one side feels more restricted than the other. If so, then that restricted side is a faulty shoulder that needs to be adjusted.
The importance of checking this is that the dysfunctional shoulder is a common cause of recurring neck, mid-back and low back pain (and potential headache source). Also, if present, the elbow, wrist and especially the thumb on that side must be evaluated and released, too.
The next quick test is to check the feet for extension (dorsiflexion). Have your patient lie on their back. While holding both feet at the toes and forefoot with your fingers pointing toward their talus, dorsiflex the foot/toes toward their tibias and check for which foot is restricted. Again, if one foot is restricted, then that is the faulty foot, which must be released at the talus. When you recheck, you will instantly see an improvement in the range of motion of the foot.
The importance of this is locating the common involvement and cause of low back pain and shoulder involvement and restriction, which will very often release the shoulder and low back even without ever having to adjust those areas at all (if that is the primary cause to begin with). This may be the answer you’ve been looking for in solving chronic recurring low back and shoulder cases.
One of my primary findings in almost every single sports injury I’ve checked in the last 15 years—the reason why injuries will respond quickly or not at all—is that the primary holding element is the psoas muscle.
The psoas is perhaps the single most involved muscle and the cause of loss of range of motion in the low back, neck, shoulders and especially hip joint (often the patient will complain of feeling like they have a groin pull).
It decreases performance in every athlete I’ve checked. When released, though, it causes the most relief, restores range of motion, improves function and gait and delivers a sense of freedom, like a heavy weight has been removed from the hip joint and lower back.
This release alone has improved the performance of many athletes, no matter what sport, and it causes a quick and dramatic change.
Knowing these rules and using these tests have helped me in managing sports injuries, and I know they can help you in your work with athletes.
About the author: William R. Moyal, D.C., a 1985 Life Chiropractic College graduate, is a noted author, seminar lecturer and consultant with expertise in advanced motion palpation and sports injury extremity adjusting. Inquiries should be directed to him at 940 Lincoln Rd., Suite 311, Miami Beach, FL 33139; call (305) 531-2933 or e-mail DrmKiro4u2@aol.com. For information on technique/analysis instruction manuals, call (888) 343-5024, or visit www.chiropractic4dummies.com.