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Our team of certified sports specialist doctors are at the forefront of the current research regarding health care and injury management. Many of them are active researchers themselves in the field of manual medicine, as well as instructors, and/or lecturers at their respective educational institutions.
What is the difference between a Sports Chiropractor and a regular Chiropractor?
This question was sent to us from Mississauga, Ontario:
“What is the difference between a Sports Chiropractor and a regular
Sport Chiropractors are becoming core members of many athletic teams due to their distinct education and clinical skills in
areas fundamental to the prevention and management of sports injuries as well as the enhancement of sport performance.
In fact, due to their additional training, expertise, and skills set, Canada sent seven Sport Chiropractors to work
with its athletes at this summer’s Olympic Games in Beijing.
Currently, regular Chiropractic education is a comprehensive, integrative, and outcomes-based program.
Chiropractic students undergo rigorous training similar to that of other health care professionals. In
Canada, students are required to complete a minimum of three years of university education prior to being eligible
for admission to a Chiropractic accredited program. The current four-year Chiropractic program focuses
primarily on human anatomy, biochemistry, physiology, radiology, pathology and clinical courses aimed
at the diagnosis and managment of disorders arising from the neuromusculoskeletal system.
A Sports Chiropractor receives intensive education supplementing their four year
This is accomplished either through the completion of a masters program through an accredited university or
the completion of a rigorous two-year residency program at the Canadian Memorial Chiropractic College (CMCC)
Sports Chiropractor receives additional training specific to the diagnosis and management of
sports injuries, sport biomechanics, and advanced diagnostic imaging. Many of the skills Sports Chiropractors
possess are cultivated during the hundreds of hours spent working alongside orthopaedic surgeons,
doctors, and professional and amateur athletes in a multitude of sports.
Sport Chiropractors also enhance the
skill of spinal manipulation they learned in
Chiropractic college with additional training or certification in a variety
of treatment techniques including
Active Release Techniques (ART), Graston Technique, Contemporary Medical Acupuncture,
Kinesiotaping, rehabilitative exercise prescription, custom orthotic fitting and core training, to name a few. In Canada,
Chiropractors that specialize in the management of sport-related injuries also belong to the Canadian College of Sport Sciences
(Canada) [CCSS(C)] which is the national governing organization of Sports Chiropractic in Canada. Members of CCSS(C) have
worked with Canada’s elite athletes for over two decades.
So stop playing, start competing and go see a Sport Chiropractor at Sports Performance Centres in the Greater Toronto Area (Thornhill & Mississauga).
Answer provided by:
Dr. Kevin Sims
Sports Sciences Resident
How Can Lactate Testing Help Me In My Training?
This question was sent to us from Oakville, Ontario:
“I am a beginner tri athlete and I was wondering
how Lactate testing might help me in my training?”
Knowing your lactate balance point (LBP) can be the single most important training tool you possess. Whether you’re a beginner or
pro tri-athlete this information can make the difference between crashing halfway and winning the race.
Blood Lactate measurement is used by the
training specialists at SPC to accurately
determine Heart Rate
training zones, recovery and much more. Lactate is a metabolic product that can be measured by taking a drop
of blood at a finger tip the same way diabetics monitor their blood sugar level. The blood lactate level
increases with exercise intensity and shows clearly the transition from aerobic to anaerobic activity. In
other words, it can determine the exact point when the body transitions from utilizing its aerobic system
which is the most important system utilized during a triathlon (and therefore during
to using its
anaerobic system, which is more useful for activities requiring short bursts of power. Thus, the testing can be used
to specifically set your exercise intensity to stress, and thus improve, the body system that is most important for
successful performance during a triathlon race. Since the measurement is completely individual it gives a precise
method for testing and monitoring training intensity and recovery.
Blood Lactate testing is far more precise than the
outdated and inaccurate method of using percentages of maximum heart rate to set training zones. Because heart rate is an
individual response, heart rate training zones need to be determined by measurement of physiological variables not set by
mathematical formulas. Furthermore, the relationship between exercise intensity and heart rate is different for different
exercises, e.g. heart rates for running will not be the same as heart rates for cycling for any given intensity. Training
programs should not be based on general heart rate guidelines rather they should be based on individual responses. This can
be achieved through
To learn more about SPC’s training systems, and about
high performance testing, visit the conditioning section of our website.
Answer provided by:
Mr. Jeff Ransome
Sports Performance Centres Mississauga
What’s the difference between your sports conditioning centre and others in Mississauga?
This question came to us from Mississauga, Ontario:
What’s the difference between your sports conditioning centre and others in Mississauga?”
This is an excellent question and I thank who ever sent it in! There are many things that ‘gyms’ and so called ‘sports conditioning centres’ or ‘sports specific training centres’ claim to have that set them above the rest. Many of them speak of their modern and fancy equipment, others show video’s and pictures on their website of clients performing “sports specific” exercises (which in most cases are random exercises with a hockey stick, or a golf club in their hands). At SPC, we don’t claim to have the fanciest equipment, nor the largest facilities…nor do we put our clients on top of a bosu ball and call it “sports conditioning.” What sets SPC Mississauga sports specific training apart from the rest (and SPC Thornhill as well….although you only asked about the one facility) are 2 things: 1. the credentials, and experience of the Strength and Conditioning staff, and 2. the training itself.
It is not common knowledge to everyone, but what sets you apart from being a “personal trainer” is a weekend course! The Strength and Conditioning staff at Sports Performance Centres are specialists in the field of Sports Conditioning and we have the credentials to prove it. I invite you to follow this link to our ‘About Us’ page to read some of the bio’s of our staff. You will be impressed to see that many members of our training staff are not only trainers…but high level athletes themselves! In addition, many are actively involved in Strength and Conditioning Research and Development; and many teach these concepts to other trainers, and sports organizations. Thus, SPC offers some of the most knowledgeable Strength and Conditioning Specialists in Mississauga.
Many people claim to be ‘Sports Specialist Trainers’…but few have the credentials to prove it.
The world of Sports Conditioning is full of people who use buzz words, and follow the new ‘sexy’ training trends. However it is very rare to find Strength and Conditioning Specialists who actually know what it takes to build better athletes. At SPC, we have the knowledge, and experience it takes to take athletes to the next level. Our training relies on scientifically proven principles and techniques that have stood the test of time…you will not see the recent training trends and gimmicks being used at an SPC Mississauga sports specific training session (nor at SPC Thornhill….just can’t leave them out!). What you will see is fundamental, HARDCORE sports conditioning at its best. We will make you stronger…we will make you faster…we will make you more agile…and we will make you a better athlete…period.
To sign up for Sports Specific Training in Mississauga click here.
Answer provided by:
Mr. Jeff Ransome
Sports Performance Centres Mississauga
What is Active Release Techniques (A. R. T.)?
This question was sent to us from Richmond Hill, Ontario:
“A triathlete friend of mine has suggested to me that I try Active Release Techniques for a chronic groin injury that I have been suffering from. I am a 43-year-old recreational runner, and former “wanna-be-pro” hockey player. Can you explain what Active Release Techniques are and what it does?”
Answer: Active Release Techniques ®, or ART, is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia, joints and nerves. Headaches, back pain, neck pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciosis (plantar fasciitis), knee problems, and tennis elbow are just a few of the many conditions that can be successfully treated with ART as part of the overall treatment plan.
This form of soft tissue therapy is utilized to remove restrictive scar tissue, or “adhesions” that accumulate in tissue such as muscles and tendons, as a result of acute conditions (pulls, tears, collisions, etc.), accumulation of small tears (micro-trauma), or over use injuries. Each of these types of injury lead to scar tissue development in different complex ways; the description of which are very complex.
One of the more common causes occurs with repetitive use of tissues (muscles, ligaments, tendons, etc) which puts the tissues in a state of oxygen deprivation, or hypoxia. This particular scenario is explained below.
One of the functions of the circulatory system is to act as a delivery system for oxygen (O2), which is carried by the blood. Tissues such as muscle, ligaments, bone, and nerves utilize this oxygen in order to produce energy with which they carry out their daily functions. The circulation of blood is also used in order to remove waste products created by the tissues as they perform their tasks.
When a tissue is kept in a tightened or stressed position for a prolonged period of time, the blood supply to that tissue becomes compromised. Some examples in which this may occur is during prolonged endurance sports where the muscles are constantly being used; during repetitive tasks at work; or with poor posture where muscles are constantly being stressed. When an oxygen dependant tissue (such as muscle) does not receive enough oxygen (and thus energy) to function, this is referred to as “tissue hypoxia”. If presented with this situation, your body will begin to replace oxygen dependant tissue with tissue that doesn’t require as much oxygen to function…this tissue is called “Fibrotic tissue” or “Scar tissue”. As scar tissue is deposited into the tissue, the function of the tissue is severely hindered. Using the example of muscle tissue, a scarred or fibrotic muscle will be unable to contract properly, and thus will be unable to carry out its desired function. Therefore your body will begin recruiting (or “call into action”) other muscles to compensate for the injured muscle. As these muscles begin to do the job of two muscles, then they become tight, become hypoxic, develop scar tissue…etc. This leads to a dangerous cycle of scar tissue accumulation and dysfunction.
Scar tissue (also known as adhesions):
- Limits the available range of motion in the tissue.
- Is a high friction substance. Thus it irritates nerves and causes pain.
- Has the ability to cause tissues to “stick” (or adhere) to each other thus resulting in increased friction between tissues.
The explanation of the effects of Active Release Techniques on soft tissue mechanics is a highly complex topic. There are in fact various effects on the tissues histo-patho-mechanics. However in simpler terms, the effects of Active Release Techniques soft tissue therapy can be explained as such:
Certified A. R. T. practitioners are able to locate areas of fibrosis development in the body’s tissue. Using a combination of digital pressure and tissue motion, the ART practitioner is able to selectively “stretch” specific soft tissue structures which “breaks-up” adhesions both within and between tissues. Following this, specific exercises and stretches are prescribed which influence the body to repair and replace the formerly fibrotic tissue with healthy tissue.
When used in combination with a specifically tailored rehabilitation program, Active Release Techniques (A.R.T.) can help the body regenerate new tissues and correct biomechanical faults cause by adhesion development.
SPC Thornhill and Mississauga have numerous certified ART practitioners. Please visit our about us page to read about their credentials.
Answer provided by:
Dr. Andreo Spina
Sport Specialist Chiropractor, Medical Acupuncturist, Certified Personal Training Specialist
Dr. Jason Pajaczkowski
Sport Specialist Chiropractor, Medical Acupuncturist, Rehabilitation Specialist
How should you treat an athlete with a first-time dislocation of the shoulder?
This question comes to us from San Diego California:
“My 16 year-old son is a competitive baseball player who has recently dislocated his shoulder after a fall. I have had conflicting advice concerning the best way to go in terms of treatment. What do you think is the best course of action?”
Answer: The proper treatment for anterior shoulder dislocation has been long debated in the literature. The answer depends on several factors, the most important being the age of the patient when the first dislocation occurred. It may be surprising to hear that an increased recurrence rate of shoulder dislocation has been identified in younger patients. This means that the older you are when the dislocation occurs, the less chance you have of re-injury. It is also known that there is an increased incidence with participation in contact sports.
There are two main paths to take with managing this injury. The first is conservative treatment which consists of pain control and rehabilitation; the second is surgery. Recent literature states that the risk of recurrence of dislocation is 5 times greater when treated conservatively. It is also known that in young, highly active patients not treated with surgery initially, between 25 & 45% will require subsequent surgery. Therefore it would be safe to say that for a young, active/athletic person who wishes to continue sports participation, surgery is most likely the way to go. This of course must be a case by case decision between the athlete, guardian, therapist, and surgeon.
Answer provided by:
SPC Thornhill location
How should you treat Iliotibial Band Syndrome?
A Massage therapist from Richmond Hill asked:
“I have a patient with a very “stubborn” case of Iliotibial Band Friction Syndrome. She has had it for approximately 4-5 months now, and my treatment does not seem to be getting to the root of the problem. In fact, often she describes an increase in symptoms following my treatments. What do you think?”
Answer: This is actually a common problem amongst my students who also struggle with treating cases of the so called Iliotibial Band “Friction” Syndrome. For those who are not in the medical field, the Iliotibial Band, or ITB, is a fibrous structure which starts at the lateral aspect of your pelvis, and inserts into the lateral (outside) and anterior (front) aspect of your knee. It is a common cause of lateral knee pain in runners and it was believed that the cause of the pain was due to the fact that the ITB “rubbed” along the outside of the femoral condyle (the thigh) during running (with the knee at the 30 degree range); hence the term “friction”. A recent study however has demonstrated that this is in fact not the case, and that the problem is not one of increased friction at all. Fairclough et al. (2006) published a study in the Journal of Anatomy which demonstrated that the ITB does not rub along the outside of the knee at all. It is actually tightly adhered to the lateral aspect of the femur. Thus the assumption that friction is the root of the problem is in fact incorrect. What they found is that deep to the ITB in the area of the knee, there is a prominent fat pad. When the knee is at the 30 degree range, the ITB actually compresses tightly along the femur thus irritating the fat pad in symptomatic patients. Thus the problem is not one of friction, but one of inflammation. Therefore treatments, such as aggressive massage, in the area of the fat pad will only serve to irritate the condition. Therefore my advice would be to aggressively treat/stretch the entire ITB except for the area where the symptoms are. This will serve to “loosen” the structure thus decreasing the amount of compression experienced at the 30 degree range. The actual area of pain should be treated as an inflammatory condition requiring ice, anti-inflammatory meds, and other anti-inflammatory modalities. In terms of rehab, Fredricson published a paper outlining the importance of strengthening the hip abductors for resolving this condition (which would improve the lateral stability of the patient).
Answer provided by:
Dr. Andreo A. Spina
Sports Specialist Chiropractor, Medical Acupuncturist, Personal Training Specialist
What is the optimal treatment for Anterior Cruciate Ligament Injury?
This question was submitted by a Chiropractic Student:
“I have a friend who plays college football in the US; he has asked me to offer an opinion on how to properly manage his ACL tear (complete). The coaching and training staff at the college has advised that he should keep playing following conservative therapy. He wants to know if there are any long term implications of continuing high level activity on an ACL-deficient knee.”
Answer: The proper management of ACL ruptures has long been debated in the scientific literature. Current research allows us to make evidence based recommendations on the most appropriate course of action, however the most “appropriate” action will differ depending on the expectations of the individual. A summary of the current evidence-based recommendations is as follows:
- The initial management (4-6 weeks) of an acutely injured ACL in not debated. Conservative, “first-aid” treatment should be done in the first 4-6 weeks in order to allow the hemarthrosis (bleeding within the joint) to settle and allow restoration of the range of movement.
- After this, successful reconstructive surgery in the patient with an isolated ACL injury reduces the rate of subsequent meniscal damage, and may reduce future arthritic/degenerative changes in the joint.
- Reconstruction of the ACL should be done by replacing the damaged ligament with a piece of the patient’s patellar tendon (“bone-patellar tendon-bone graft”), or with a piece of the patient’s hamstring muscle. Literature has shown both to provide excellent clinical results in ACL reconstruction, thus the decision is based on the preference of the patient and surgeon.
- ****After isolated ACL reconstruction, approximately 90% of patients can return to their previous activity level.
- If conservative management is selected, patients must be counseled against high-risk activities to prevent recurrent injury (ie. If a very competitive athlete would like to continue to compete at a high level, conservative management may not be the best option).
Therefore, conservative management may be recommended for those who will eliminate “knee-strenuous” exercise and activity from their lives. For those who cannot, surgical options should be explored. The patient either has to modify activity to suit the knee, or modify the knee to suit activity.
Answer provided by:
Dr. Ian MacIntyre
Sports Specialist Chiropractor, Medical Acupuncturist, Certified Strength and Conditioning Specialist