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Integrative Sports Performance

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DISCLAIMER

• This presentation and the accompanying materials are intended to provide current and accurate information about the subjects covered and is designed to help maintain professional expertise. This publication and accompanying program are offered with the understanding that neither the presenters, speakers nor sponsoring organizations are rendering any therapeutic or other professional services. Healthcare providers using this publication or orally conveyed information in dealing with a patient's care should also fully research original and current sources of authority.

• All opinions, viewpoints and recommendations contained in this presentation represent those of the author alone and do not represent the opinions, viewpoints or recommendations of any organization with which the author may be affiliated, including, without limitation, the USOC.

Integrative Healthcare

Integrative Sports Performance at the USOC

Role of a Chiropractor as Part of a Integrative Sports Performance Team

Role of a TCM Practitioner as Part of a Integrative Sports Performance Team

Role as a Integrative Health Care Provider - Traveling with a Team

Case Examples – Making a Difference in Performance

Getting Involved with Sport

Questions

Conventional Healthcare ◦ Strengths◦ Weaknesses

Complementary and Alternative Healthcare◦ Strengths◦ Weaknesses

Integrative Healthcare

Integrative Healthcare The Future of Healthcare

Organized Peer Reviewed Research

Standard of Training and Care

Technologically Advanced

Conventional healthcare in the U.S. is a sickness care system

Conventional medicine in the U.S. does not always adequately taking into consideration the following aspects of human health◦ stress and how it adversely affects

the immune system and life processes

◦ insufficient exercise◦ excessive caloric intake◦ highly-processed and denatured

foods grown in denatured and chemically-damaged soil

◦ exposure to tens of thousands of environmental toxins

◦ Human biomechanics and its effects on health

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Strengths◦ Typically focuses on

whole body, mind wellness◦ Relatively safe◦ Complimentary

healthcare used together with conventional health care

Weaknesses◦ Standard of care can

be an issue◦ Lacks large body of

peer reviewed evidence in many areas◦ Alternative healthcare

used in place of conventional medicine◦

Combines treatments from conventional medicine and CAM for which there is high-quality scientific evidence of safety and effectiveness

More and more evidence available to promote a preventive and wellness based healthcare system

Sports Medicine Chiropractic Acupuncture Physical Therapy Emergency Medicine Strength and Conditioning Sports Nutrition Sports Psychology Family Practice Orthopedic Specialist

Chula Vista, CA Lake Placid, NY

Colorado Springs, CO

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Chula Vista, CA

THE OLYMPIC TRAINING CENTER

• 155 acre complex• 133 dorms• Dining hall• Sports Performance clinic• Training facilities• Transportation• Athlete services• Campus-like• Year around training

SPORTS

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OPTIMAL PERFORMANCE

Optimal Performance

Optimal Performance

NutritionNutrition

Sports Psychology

Sports Psychology

InjuryPrevention / Management

InjuryPrevention / Management

General HealthGeneral Health

CoachingCoaching

Strength &

Conditioning

Strength &

Conditioning

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OPTIMAL PERFORMANCE

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MULTIDISCIPLINARY Performance Services TEAM

Athlete

Physical Therapist

Athletic Trainer

MD

ChiropractorAcupuncturist

Massage Therapist

Sports Psychologist

Biomechanist

Nutritionist

History Physical Lab work Cardiac Exam Clinical Orthopedic

Evaluation Functional Movement

Evaluation Biomechanical

Assessment

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MULTIDISCIPLINARY Performance Services TEAM

Athlete

Physical Therapist

Athletic Trainer

MD

ChiropractorAcupuncturist

Massage Therapist

Sports Psychologist

Biomechanist

Nutritionist

Posture Analysis Posture syndromes and

Adaptation to Sport

Gait Analysis symmetry, balance, motion,

center of gravity

Movement Patterns

Muscle length and Strength Assessment

Functional Screenings

Combined Analysis is one of the powerful and effective ways to identify musculoskeletal imbalances that lead to injury and performance problems This analysis dictates treatment plan and function rehab exercise prescription

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Muscular imbalance◦ Weak muscles◦ Strong muscles◦ Over trained muscles◦ Muscles and

ligamentous structures that have adapted over time.

Assessment, Diagnosis and Patient Management

Wellness, Maintenance and Injury Prevention

Injury Diagnosis and Management

Illness Diagnosis and Management

Trauma and Sport Coverage

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• Diagnostic• Clinical Interpretation • Musculoskeletal• Neurology• Cardiopulmonary• Biomechanics• Emergency Medicine• Manual Therapy• Taping Skills• Active Care• Strength and Conditioning

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Investigation of the most commonly treated areas of chief complaint by Sports Medicine Chiropractors treating athletes in a multidisciplinary healthcare clinic

• Results: • 6,410 Chiropractic visits recorded

• 118 were for illness and not musculoskeletal related

• 97 did not indicate area of chief complaint

• 410 reported two simultaneous areas of chief complaint

• Total of 6,723 reported areas of chief complaint and 118 visits for illness

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Investigation of the most commonly treated areas of chief complaint by Sports Medicine Chiropractors treating athletes in a multidisciplinary healthcare clinic

• Objective: • To investigate the most commonly treated areas of chief complaint by Sports Medicine

Chiropractors for elite athletes in a multidisciplinary healthcare clinic

• Methods: • During a 12 month period of time 6,410 Chiropractic patient visits by elite athletes in a

multidisciplinary healthcare clinic were recorded

• Using a medical injury tracking system the area of chief complaint by body region was tracked for each athlete visit and treatment

• Area of chief complaint for each athlete visit was divided into four main body regions each with multiple sub-regions to more precisely determine the athlete’s area of chief complaint

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6,723 total reported areas of chief complaint

REPORTED AREAS OF CHIEF COMPLAINT

Head/Neck 1,096

Torso 2,662

Upper Extremities

830

Lower Extremities

2,135

Head/Neck 1,096

Torso 2,662

Upper Extremities830Lower Extremities2,135

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Extra-spinal injuries and conditions are treated nearly as much (47%) as spinal related complaints and conditions (53%)

INVESTIGATION OF THE MOST COMMONLY TREATED AREAS OF CHIEF COMPLAINT BY SPORTS MEDICINE CHIROPRACTORS TREATING ATHLETES IN A MULTIDISCIPLINARY HEALTHCARE CLINIC

3,613 (53%) 3,228 (47%)

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Purpose:

To identify the number and type of sports medicine services utilized by Doctors of Chiropractic at the United States Olympic Training Centers Sports Medicine Clinics

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6410 Patient Encounters

9183 Individual Treatments Reported

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Most commonly reported treatment types by percentage of patient visits

1. Manual Therapy 86.4%2. Therapeutic Exercise 40.1%3. Thermal Modalities 6.6%4. Passive Modalities 4.2%

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1. Soft tissue 62.6%2. Manipulation 46.7%3. Mobilization 40.7%

Results

• Soft Tissue Techniques in Sports Medicine- Myofasial Release- Fascial Decompression/Cupping- Instrument Assisted Soft Tissue

Mobilization

Muscle Energy Techniques

Muscle Energy Techniques- Post-Isometric Relaxation (PIR)- Proprioceptive Neuromuscular Facilitation

(PNF)- Reciprocal Inhibition (RI)

Mobilization

Manipulation

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Acupuncture

Acupuncture: A modality of Traditional Chinese Medicine

(TCM) which originated more than 2,000 years ago and is one of the oldest and most commonly used therapeutic procedures in existence today.

It’s background is rooted in philosophy, logic, and observation developed over 2 millennia as a result of continuous processes of critical thinking, clinical observation, and testing.

The aim of Acupuncture is to encourage balance within the body to promote natural healing to treat a large variety of conditions and improve function at a systemic level.

The needles are inserted in precise acupuncture points along meridians and pathways or inserted into palpated Ashi points (altered or dysfunctional tissue)

Dry Needling: Called “dry” because it does not involve

injection of a “wet” substance into the tissue.

Dry needling has been used for approximately 30 years as a procedure which is similar to acupuncture in that the same sterile fine filament needles are used; however, the main treatment focus is on active and latent trigger points or dysfunctional neuromuscular junctions.

Dry needling is based on clinical reasoning and research with an overall musculoskeletal management approach

The needles are inserted directly or indirectly into altered or dysfunctional tissues.

Until about 40 years ago the practice of Acupuncture in the U.S. was largely limited to Asian ethnic groups.

1972, President Nixon’s visit to

China was a seminal event

opening the door to Chinese

medical practices in the U.S.

1992, Congress established the

Office of Alternative Medicine

1997, based upon the results of well

designed and appropriately

controlled clinical trials the NIH

issued a statement that supported the

efficacy of acupuncture for

specific conditions

1998, Acupuncture

became the most popular

complementary and alternative

medicine modality prescribed by

Western Physicians

1999, The National Center

for Complementary and Alternative Medicine was

established within the NIH. More graduate level

University in the study of TCM

2010, a Acupuncturist

was hired as one of the primary

health care providers at the

U.S. Olympic Training Center

Research Sports Performance

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Why is acupuncture such an effective Analgesia◦ pituitary hypothalamic system◦ endorphins◦ opioid, antiopioid peptides ◦ monoamines◦ afferent and efferent pathways◦ PET, SPECT, fMRI

Do Acupuncture Points Really Exist◦ Comparing the effects of needling true point vs sham points◦ By studying unique anatomical structures at acupuncture points◦ By studying the electrical properties of skin at acupuncture points◦ By studying nerves being activated by acupuncture points

Acupuncture effectiveness for a wide range of medical conditions

Analgesia Nausea and Vomiting Addiction Stroke Recovery Wound

Healing/Tissue Repair

Asthma Reproductive Health Mental Health Endocrine Disorders Immunological

Disorders Auto Immune

Disorders

The integration of Traditional Chinese and Western medicine are now being evaluated

Often show that by using a combination of both of these health care systems resulted in better outcomes than using only one of them

Acupuncture and Manuel Techniques

Acupuncture and Active Care

Acupuncture and Other Therapeutic Modalities

Acupuncture and Medications

Musculoskeletal Injuries1. Chronic Tendonopathy2. Myospasm/Pain3. Maintenance

Regulating structure and function

4. OveruseTibia stress syndrome, exertional compartment syndrome, epicondalitis, etc.

5. Post Surgical6. Acute Inflammatory

Sleep Irregularity 1. Insomnia2. Jet Lag3. Pre-Competition Stress/Anxiety

Headaches1. Tension2. Migraine

Overtraining Syndrome

1. Fatigue2. DOMS3. Illness

Gua Sha

Fascia Mobilization Techniques

Tui Na

Mobilization, Manipulation, Cross Friction, Etc….

Jing Jin

Myofascial Lines

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Cupping

Myofascial Decompression

TCM Herbs and Formulas

OTC Meds Supplements

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Role as a Integrative Health Care Provider - Traveling with a Team

PARALYMPIC TRACK AND FIELD

• Amputees• Dwarfism• Spina bifida• Cerebral palsy• Visual impairment• Spinal cord injuries• Traumatic brain injury• Cerebral vascular injury

Integrative Case Management Integrative Case Management

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Integrative Case Management

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MEDICAL VOLUNTEER PROGRAM• DC ,ATC, PT, MD, DO, MT

• 2 week rotation

• 3 Olympic training centers

• Tiered progression

REQUIREMENTS

• Application

• Letter of recommendation

• Min 3 to 5 yrs of clinical experience

• 2 yrs sports medicine experience

• Discipline-specific requirements (ex: DACBSP)

www.teamusa.org

Getting InvolvedOlympic and Paralympic Movement

Inspire and Excite the World Through Sport

www.google.com/images

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