M ANY OF US TRI-AT A LOT Ol athletes-everyone from the adolescent athlete, weekend warrior, striving junior high or high school student athlete, to the athlete training for a marathon. Some of us are even lucky enough to treat a college or professional athlete at one time or another. Often we question whether their present condition is due to improper biomechanics. training errors, previous injuries, improper fitting or use of equipment. Often the patient is of little help in identifying the causative factor: "I don't know why I hurt. I haven't done anything different in my training than I have always done." Sound familiar? A thorough consultation involving questions about our patient's training habits is very important: "How many days a week do you work out? What does your workout involve? Have you noticed any changes in your ability to complete your normal workout? Has your level of performance changed?" Even to these specific questions they often do not provide you with a possible "key" to what may have caused their present injury. But the real question you must also ask is, "What specific moves or activities do you do that arc repetitive?" We know repetitive microtrauma is one of the leading causes of neuro-musculo-skeletal breakdown. Let's look at a common scenario that you have probably seen in your office on numerous occasions. Maybe we can provide some other thought processes for the next time you have a similar encounter with an athlete in pain. Effective Stretching Technique "Billy Bob" is a golfer who presents with low back pain that has been three weeks in duration and is progressively getting worse. The pain worsens with activity, and it is accompanied by on-and-off stiffness that usually eases after stretching. Many times in sports that involve repetitive movement patterns, the biomechanics or technique of the sport can be a primary contributing factor. If you are not familiar with the mechanics of the golf swing, you can always research the internet or call a golf professional. The good thing for us is often we can help our patients by just having an understanding of how they prepare for their game of golf. Ask them questions on their stretching routine before they golf. Another important question that is usually not asked is, "Do you stretch out while you are playing, or after you have completed a round?" Keep in mind that golf is a very repetitive sport. Most golfers will do some routine of stretching to warm up before they begin, but usually never while playing. Consider the right-handed golfer who has an 18 handicap. If the course is a 72 par score for 18 holes, then that golfer is usually swinging 90 times, minimum. This does not count warm-up swings, mulligans, do overs, etc. Now we are approaching more like 200 swings per round. If this golfer is right handed, then he has rotated 200 times in one direction. True, the golfer will rotate to the right side, but most of the force or energy is created as the golfer unwinds, shifts his weight, and finishes on the left side. One thing I always instruct my golfers to do is to stretch between every one-to-two holes. Most importantly, I tell them to minor their swing in the opposite direction so they can loosen the muscles that have been used in rotating with their normal swing—in a sense, to "unwind" from rotating in one direction all the time. This simple move has helped many golfers complete their rounds of golf with less pain and stiffness. I cannot guarantee that it helps lower their handicap. Once we have addressed repetitive stresses that are caused because of a specific technique or activity like the golf swing, we must consider other care options to assist in stabilizing resultant subluxation complexes following the chiropractic adjustment. Nutritional support helps with inflammation and healing in tissue. Additional strengthening exercises, with an emphasis on core strengthening, can be accomplished through the use of a properly fitted exercise ball or the use of an at-home elastic exercise band system. It's also a good idea to take a scan of our patient's feet to see if they are a candidate for flexible, custom-made orthotics which will add support to the foot, which, in turn, will provide support for the entire musculoskeletal chain. A 1980 graduate of Palmer College of Chiropractic, Dr. Kirk Lee is a member of the Palmer College of Chiropractic Post Graduate Faculty and Parker College of Chiropractic Post Graduate Faculty. He has lectured nationwide on sports injuries and the adolescent athlete, and currently practices in Albion, Michigan. If this golfer is right handed, then he has rotated 200 times in one direction.
