Week 6: 3/24 - 3/31
Reflection:
This week I only had one day at Evergreen Spine and Sports Medicine, and it was the last day of my mentorship. My only day was on Thursday the 27th, and we saw only a few patients. Our first patient on this day was a middle aged woman, she was a new patient on Thursday so we did a lot of testing and reviewed all of her medical history. This patient was experiencing pain in her shoulders and hips due to her past history of two shoulder surgeries, three knee surguries, double broken ankles, and tear of her gluteous maximus. She had a lot of past injuries, the most prominent of which were on the right side of her body. Maya did shoulder testing on the rotator cuff, and deltoids which are muscles around the shoulder, and did light massaging throughout the gluteous maximus and minimus to try and loosen the muscles in the area. Maya also did slight adjustments to the supper back and neck to try and releive some pressure that was building up in the upper back and around the shoulder blades which was causing the tightness, stiffness, and pain. Maya then began to work on the hips and lower back. She started with the massage gun to loosen the muscles and joints around the area, and did deep tissue massaging to the glutes and began to try and improve the range of motion that the glutes were able to reach. Maya then applied kinesio tape to the shoulder and around through the upper back to try and supply more stability to the shoulder, and scheduled this patient to come back twice next week to further assess if the taping and the massaging that was done in this session helped the pain, and what the next steps of care would be.
Our second patient of the day was an older man who was experiencing back pain, and has a history of chronic back pain for the last 10 years after being in a car crash that resulted in a herniated disk in his spine, which then led to nerve damage and a long lasting feeling of compression in the back, which led this patient to have poor posture which over time led to a rounded back and curved spine. Maya began with very light massaging through the back, and used the tiny "jack hammer" tool on the back to slightly move the joints in the spine and relieve some pressure on the spinal chord. Maya then did some stretches and excersizes with him to see if the range of motion of this patient had improved since his last visit, and then gave him an at home stretching plan to try and mannually fix his poor posture and releive the pain that was constantly shooting through his back.
Maya and I then had a long break between patients so I was shown more of the scheduling process and how the specific at home plans were made for each individual patient. Our third and final patient came slightly after this, and this was a weekly patient who comes in for back massaging and corrections so Maya began massaging his back. She then moved into the massage gun, loosening up the muscles and releiving pain throughout the whole back. And then she ended off the short session with chiropractic back corrections to the upper, lower, and middle back, and additionally did one correction to the neck to reduce the pressure that has been building up.
This was my one and only day this week, which completed my hours for my capstone mentorship. Throughout the past 6 weeks I have learned so much about the sports medicine feild, and the amount of different professions that are wrapped within it. I also learned about the diagnostic procedures, and how to treat each patient specifically to their concerns and how age can affect the type of treatment that is done.
Research:
This week I was curious on how past injuries can continue to affect the body and how they can make the body more suceptible to new injuries. When a person experiences injuries the body can fail to heal adequetly leading to weaker muscles and less function in that specific part of the body which can then lead to a higher risk of injuring that part of the body again, or causing a new injury in a related location. Specifically, "Active adults commonly present with lower extremity (LE) injuries from a variety of professional and amateur sports activities. Decreased LE function significantly alters daily life and subsequent injuries increase this impact," (Fulton). After an injury there are many people who then have less functional capacity throughout their body, meaning that once they experience an injury from a sport or every day life, they are less likely to do that again, and are more hesitant when using that part of the body which can lead to the weakening of muscles. There has been research done that shows that an ankle sprain is the most common injury which can then lead to a secondary sprain of the ipsilateral or contralateral ankle after the initial sprain. In a study involving 65 professional male football players, "the recurrence of a secondary ankle sprain following the same initial injury was 50% higher than those without a previous ankle sprain," (Fulton).
Every injury in the body can leave a mark, not just on the skin, or in a visible location, but also under the skin, deep within muscles, joints, and tissues. Previous injuries can have a lasting impact and influence on the likelihood of future injuries occuring. "The healing process is not foolproof, and scars-both visible and invisible-may persist," (Snyder). There can be a chain of injuries that can spark from one initial injury; an ankle sprain may lead to a different walking patter, and then cause unintended stress on the knee. The knee must make up for the loss of balance in the body, then putting more stress on the hip. This cycle can continue and then affect the body as a whole due to one slight injury. "During the recovery process, muscles surrounding an injured area may weaken, leading to imbalances," (Snyder). Once the biomechanicas of the body are altered then the risk of injury resulting from a prior injury can increase, and in hand increase the possibility of overuse of other body parts which can lead to strains, sprains, or tears.
This week Maya had used kinesiology tape to help provide stability to the shoulder and shoulder capsule. I became intrigued on the actual benefits of KT taping and how it actually helps the body in providing support. "Kinesiology tape is a thin, flexible tape that was developed to aid muscle movement and enhance performance," (Castro). Kinesiology taping is used to help relieve pain and in hand try and reduce the swelling and inflamation to the area which it is applied to. Kinesiology tape is used to help provide support to the joint which it is applied to, and lower the range of movement that the location has, a provide more control for muscle contractions. "When you apply the tape, the skin sends signals to the nerves to activate the muscles," (Castro). Kinesiology tape is applied in a way that then supplies more room under the skin that can then improve lymphatic flow in the area which is inflammed. Kinesiology taping is a great way to help relieve stress on a injured area, it feels natural and skin like so that you aren't feeling the treatment as intensly as other options.
Citations:
Castro, John. “Kinesiology Tape: What It Is and How to Use It.” Hospital for Special Surgery, 20 Sept. 2023, www.hss.edu/article_kinesiology-tape.asp#:~:text=It%20is%20often%20used%20to,have%20no%20stretch%20to%20them.
Fulton, Jessica, et al. “Injury Risk Is Altered by Previous Injury: A Systematic Review of the Literature and Presentation of Causative Neuromuscular Factors.” International Journal of Sports Physical Therapy, U.S. National Library of Medicine, Oct. 2014, pmc.ncbi.nlm.nih.gov/articles/PMC4196323/.
Snyder, Rocky. “The Connection between Previous Injuries and Future Risks.” Rocky Snyder - Trainer, Author, Educator, Movement Specialist, 2 Jan. 2024, www.rockysnyder.com/the-connection-between-previous-injuries-and-future-risks/.
Week 5: 3/10 - 3/17
Reflection:
I started this week off on Monday the 10th, we only saw 1 patient today, and we also ended early due to Maya's very empty schedule for the time that I was here. Our only patient today was a younger woman who came in because she was experiencing a great amount of pain in her knee. Initially Maya had thought it could be one of three things, either a slight sprain to her meniscuis, something going on with her IT band, or there was something strained revolving her popliteous muscle. Maya did a lot of massaging and different stretching techniques that helped to loosen the knee, and then came to the conclusion that it was the IT band.
Tuesday was a very busy day, we saw a total of five patients in the first hour and a half of me being there, and then I left early because there were no more patients until after noon. The first patient on Tuesday was a quick appointment with just slight back corrections and chiropractic spinal corrections. This patient comes in every week so Maya just did some simply back and neck corrections and then had her scheduled for the same time next week. Our second patient was also a short appointment, with just simple deep back massaging and back corrections. This was also a patient who comes every Tuesday so Maya helped them schedule their appointment for next week.
Our third patient on Tuesday was more interesting for sure, she was a younger woman who was experiencing extreme tenderness from up high in her shoulder blades down through her lower back. Maya gentely massaged the whole area to loosen up the muscles, and then used the massage gun on the upper and lower back, and through the shoulders. Additionally, Maya used the small "jack hammer" to slightly move the vertebrae ever so slightly to then help the tenderness along the spine. She then massaged again throughout the whole back and upper shoulders loosening the back again, and did chiropractic back corrections to relieve any tension and pressure that was still in the back. Our fourth patient of the day was a younger woman who was experiencing shoulder pain in her left shoulder, from the patients initial complaints, Maya beleived that it could be a problem with her shoulder capsule. Maya began with gently massaging and stretching the shoulder and attempting to bring more flexibility back to the shoulder capsule. Maya used many different tequniques to loosen the joint, and by using these different stretches and excersizes she was able to identify what was going on with the shoulder, and which specific muscles were inflammed and causing the lack of movement and pain in the joint.
Friday was also a slow day, and we only saw two patients. This first of which was an older women who came in with complaints of pain in the back of her right leg and some pain in her lower back on the right side aswell. Maya initially did massage work on the hips and lower back to loosen the muscles which she thought were injured, and based on the mobility and what hurt the patient, Maya had concluded that the injury was based on the sciatic nerve. This nerve runs from the lower back and then through the backs of the legs and down through the legs. Maya used the massage gun throughout the lower back and hip and did a slight pelvic realignment and then did the normal work of neck and back corrections and deep tissue massaging throughout the whole back. After this appointment Maya suggested that this patient come back twice every week for the next few weeks to see what helps the injury progression and what was not helping this injury.
The second patient that we saw had previously been diagnosed with spinal stenosis. This is when the spinal cord cavity becomes narrow and there is less space for the spine to move, causing for lack of mobility involving the spinal region. This patient was an older man who has been experiencing great amount of back pain for this injury, and who did not want to resort to surgery to cure this injury. Maya helped to deeply and gently massage the spinal area to provide looser muscles and possibly more mobility, however at the end of the session she had come to the conclusion that the only long term treatment for this injury would be surgery.
Research:
This week we had a lot of patient who were complaining of lower back problems, but the one that stood out to me the most that I wanted to research was the spinal stenosis. "Spinal stenosis happens when the space inside the backbone is too small. This can put pressure on the spinal chord and nerves that travel through the spine," (Mayo Clinic Staff). If a patient were to get surgery for spinal stenosis then the surgeon would then open the cavity that the spine lays and create more space for the spine. I found that there is often no symptoms that are shown to indicate spinal stenosis, however when symptoms do appear, like stiffness, pain, or lack of mobility, they rapidly increase in prevelence and will continue to get worse over time. Spinal stenosis only mainly appears in two places, the lower back and the neck. In the lower back spinal stenosis would cause pain in the back and possibly cause cramping in one or both of the legs while walking or standing for a long period of time. In the neck there can be many different indicating factors, these include, numbness, trouble keeping balance while walking, neck pain, or tingling down extremities. The main cause for spinal stenosis is a herniated disk or bone spurs on the spine. There are also thick ligaments which can push into the spinal chord if they become thick and stiff over time. Spinal stenosis primarily appears in people who are over the age of 50, and it can appear in younger patients if they have a history of scoliosis or other spinal problems.
When we saw the patient with the sciatic nerve problems, I became intrigued on what the nerve is and what it does for the body. The sciatic nerve is a nerve that has roots that start in the lower back ans then run down the back of each leg. "Sciatica is the pain or discomfort of your sciatic nerve when it gets compressed or pinched," (Cleveland Clinic). The sciatic nerve is a mixed nerve which means that it has both motor and sensory fibers. Motor function helps the muscles in your legs and feet move, and the sensory function helps you feel any sensation in your legs. This nerve is what allowes the ability to walk, run, and stand. When there is damage to the nerve it is considered sciatica. Sciatic is when something is causing significant irritation to the sciatic nerve which results in extreme pain throughout one or both of the legs. "The pain most often occurs on one side. Some people have sharp pain in one part of the leg or hip and numbness in other parts," (Ma). The sciatic nerve have three roots, two that start in your lower back, the lumbar spine, and three that start at the bottom of your spine, the sacrum. There are all of these nerves on the right and left side of your body. Around your knees the sciatic nerve splits into two main branches. The common perineal nerve, and the tibial nerve. The common perineal nerve runs throughout the outs part of your knee to the outer part of your foot, and the tibial nerve runs down the back of the calf, going down through the heel to the sole of the foot. To prevent any injury from occuring to the sciatic nerve, it is recommended to stretch frequently, and keep yourself active as to not weaken the nerve.
Citations:
Cleveland Clinic medical. “Sciatic Nerve: What Is, Anatomy, Function & Conditions.” Cleveland Clinic, 15 June 2021, my.clevelandclinic.org/health/body/21618-sciatic-nerve.
Ma, Benjamin. “Sciatica.” Pennmedicine.Org, 20 Sept. 2022, www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/sciatica.
Mayo Clinic Staff. “Spinal Stenosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 27 June 2024, www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961.
Week 4: 3/03 - 3/09
Reflection:
I started my week on Monday the 3rd, we saw two patients on Monday. The first one was a younger woman who had been experiencing great pain throughout her lower back and in her piriformis muscle in her lower back. She experienced the worst pain when she was sitting for a long amount of time and then got up and moved around. She described this pain as excruciating and when Maya tried to massage it she said it wasn't like a "good sore type of pain" but much more of a discomfort and hurtful pain. We then decided that it would be best if we do an SMFA, which is a selective functional movement assessment. This assessment tests all of the joints and muscles in the body, and checks their flexibility and movement and is then put into an online database which sorts out what muscles, joints, or ligaments need work. These assessments are used to assist doctors in finding a diagnosis for patients who they are not fully sure how to treat right away. When we were doing this assessment, we found that this woman was experiencing most of her pain and weakness in her right side around her hip, lower back, and glute. After the exam Maya set her up to come and see a corrective exercise specialist who works at ESSM twice a week and come in for sports medicine chiropractors appointments once a week.
Our second patient for Monday was an older woman who had been diagnosed with CRPS after being in a car accident when she was younger. CRPS is complex regional pain syndrome, the general description of this syndrome is that your body may heal injuries, but your brain keeps sending the pain receptors to the area that you had previously experienced pain in, leading to "phantom pain", a pain that is really there and that you can feel, but there is nothing medically wrong with you. This patient had taken a big fall when walking her dog and landed straight on her right side. She had broken many ribs in the crash as well, which then caused Maya to not be able to massage as thoroughly because the ribs are very delicate and injuries could result from intense massaging to the area. When she broke her ribs she developed osteoporosis which then led to her bones becoming very weak and brittle which leads to a higher chance of a small incident breaking them again. She had also developed a large hematoma on the right glute which made it extremely painful for her to sit down, so Maya recommended that she not only apply heat to the area, but also ice it to ease pressure and attempt to start massaging the muscle lightly so that blood can start flowing more to the area. Once Maya had gotten a close look at the glutes it was evident that there was a sacroiliac ligament sprain, which is a sprain on one or both sides of a patient, with pain showing primarily in the joint around the glutes. Maya did slight realignments with this joint and gave her a few mobility exercises to keep up with to hopefully reduce pain and increase the ability to move the joint. Maya suggested that she come back one more time this week, and twice weekly for the foreseeable future.
Tuesday was my second day of my mentorship and was filled with a bunch of our normal weekly patients. First was an older woman who comes in weekly for massage therapy and chiropractors for her upper back, shoulders, and neck. She is a very active woman who is always messing around with her grandkids which aggravates the muscles in her upper body. First, Maya started of with just simple massaging, and due to this woman's age, Maya does not do spinal corrections in a chiropractic way, she uses the mini "jack hammer" tool to help move the joints and muscles in a very small and delicate manner as to not injure the patient. Then Maya finished off with light massaging throughout the muscles of her shoulders and neck to help relieve pain and stiffness that has developed over the past week. Maya officially took this patient out of the books because she had become much more mobile, and has a physical trainer who can help her with her muscle specific tightness and soreness. Our second patient today was also a weekly patient who we always see on Tuesdays. She experiences pain throughout her whole back so Maya began with deep massaging throughout her back and down into her glutes. This patient also experiences pain along her piriformis muscle that runs horizontally along the glute. Maya did extensive light massaging in the area, and gave her many different at-home exercises to do daily so that she doesn't feel as much stiffness and pain after sitting for a long time.
Research:
After my mentorship on Monday I became more interested in what a selective functional movement assessment actually was, how it is used, and what the overall goal of one is. I read a short article from the House of Bones Chiropractic, which is a chiropractic office located in Texas. This article states that "The SMFA is a series of multiple full body movement tests which are designed to assess fundamental patterns of movement such as bending and squatting in those with known musculoskeletal pain" (House of Bones Chiropractic). These assessments are used to identify other meaningful impairments to the patient that aren't directly related to the musculoskeletal complaints, but which may also add additional pain to the patient. These assessments are rated either dysfunctional non-painful, dysfunctional painful, functional painful, or functional non-painful, this is modeled after Cyriax's selective tissue testing. These four levels categorize the patient's symptoms and sort everything into different folders for the doctor to then assess and see which muscles are aggravated, and what different movements make the pain worse. Once the SFMA is completed then the doctor is able to specialize an individual exercise plan which is specific to each patient and their complaints. When doing an SFMA you must also consider the patterns of movement within the patient's body. "Normal movement is achieved through the integration of fundamental movement patterns with an adequate balance of mobility and stability to meet the demands of the task at hand," (House of Bones Chiropractic), this can be changed if a patient is experiencing pain the musculoskeletal areas which can lead to inadequate mobility anywhere in the body. The SFMA ultimately provides feedback for the effectiveness of the therapeutic exercise program, which in all targets dysfunctional movement patterns and related impairments.
The second patient that we saw today had developed CRPS years ago, and I have become interested in many aspects of it: how it develops, why it does not go away once an injury has healed, and how CRPS is treated in the long run. CRPS stands for complex regional pain syndrome, which is a form of chronic pain. CRPS is when the pain of an injury is out of proportion to the actual severity of the initial injury, and once that injury has healed there is pain residing in the patient where they had experienced that past injury. There are many symptoms of CRPS, however they can vary from person to person. "Pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch) usually occur first," (Mayo Clinic Staff). The condition can be treated, but once the affected limb or part of the body becomes cold or pale, the condition is often irreversible. The cause of CRPS is not fully understood by doctors. CRPS only occurs in two types, these both have similar signs and symptoms, but have different causes. Type 1, often referred to as reflex sympathetic dystrophy (RSD), occurs after an illness or injury that didn't directly damage any nerves in the affected limb. "About 90% of people with CRPS have type 1," (Mayo Clinic Staff". Type 2, which has been referred to as causalgia, has similar symptoms as type 1 however type 2 CRPS occurs after distinct nerve injury.
There are also a few complications that can occur if CRPS is not treated in the early stages. The first of which being tissue wasting, which is called atrophy. This is when the skin, bones, and muscles may begin to deteriorate and weaken, leading to trouble lifting arms or moving legs. There can also be muscle tightening, which is called contracture. This is when there would be extreme tightening of the muscles, this can lead to a condition in which the hands/fingers or feet/toes are stuck in one position, and attempting to move them causes pain, or when there is no movement when attempting to change the position of these limbs.
I also noticed this week that many patients that I have seen have been experiencing pain, tightness, or stiffness in their piriformis muscles. I found that there is a syndrome that can relate to this, called Piriformis Syndrome. "Piriformis syndrome is compression of the sciatic nerve by the piriformis muscle in the posterior pelvis, causing pain in the buttocks and occasionally sciatica," (Liebert). The piriformis muscle extends from around the surface of the pelvis to the upper border of the femur. While running or sitting this muscle can become compressed and compress on the sciatic nerve. There are many symptoms of piriformis syndrome these can include a prolonged pain or ache, or tingling or numbness throughout the buttocks and back of thigh. There are treatment options for this condition including modification of activities, or stretches to help loosen the piriformis muscle and create a greater range of motion of the muscle. It is also recommended that patients who are diagnosed with piriformis syndrome stop running, bicycling, or doing any activity that can elevate the level of pain that they are experiencing, and if their pain is aggravated when they are sitting or standing, that they try and find a different position to do so to relieve pressure and pain to the area.
Citations:
Liebert, Paul L. “Piriformis Syndrome - Injuries; Poisoning.” Merck Manual Professional Edition, Nov. 2023, www.merckmanuals.com/professional/injuries-poisoning/sports-injury/piriformis-syndrome.
Mayo Clinic Staff. “Complex Regional Pain Syndrome.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 10 May 2022, www.mayoclinic.org/diseases-conditions/crps-complex-regional-pain-syndrome/symptoms-causes/syc-20371151.
“Selective Functional Movement Assessment (SFMA) – House of Bones Chiropractic.” House of Bones Chiropractic –, 18 Aug. 2023, www.houseofboneschiro.com/our-services/selective-functional-movement-assessment-sfma/#:~:text=The%20Selective%20Functional%20Movement%20Assessment,those%20with%20known%20musculoskeletal%20pain.
Week 3: 2/24 - 3/02
Reflection:
This week I started my mentorship on Monday the 24th. I walked into the office this week and we immediately saw our first patient. This patient was an older man who had a history of back pains and 24 years ago had a bad ski crash which led to a hematoma in his glutes on his left side. This weekend he had gone skiing and had another, smaller, crash. He was experiencing great amounts of pain throughout his lower back and through his glutes. Maya did some examination of where he was feeling tenderness and discovered that he had extreme internal bruising on his piriformis which is a muscle that runs horizontally throughout your glute. Maya recommended to him that he get massage therapy primarily on his lower back, glutes, and lower extremities with one of the massage therapists who work at ESSM, to help loosen and relax his muscles that he tends to aggravate when doing sports like skiing. Our second patient on Monday was a former employee at Evergreen Spine and Sports Medicine and had also been coming here for physical therapy and chiropractors. She was experiencing severe tenderness and tightness in her neck area and lower back. She assumed from shoveling the many inches of show that we got late last week. Maya had concluded that she had a minor muscle strain running through her neck and back from poor posture when shoveling and lifting heavy things with her back instead of her legs. This was an easy fix with lots of massaging to the neck area.
Our last patient for the day was a woman who is a pilot, and experiences a lot of back and neck pains. This mostly happens when she takes long flights, and is sitting in the cockpit flying the plane for countless hours on end. Maya had mostly focused on her neck which was incredibly stiff, and wanted to massage and loosen the muscles before her next flight to Germany on Thursday. We also use the massage gun on her upper back to help to loosen the muscles around her vertebrae and give her more movement and ability to move her head around.
On Tuesday we saw our first patient, she was an older woman who has been experiencing neck pain which has been getting progressively worse as she ages. This session was short because Maya had already seen her multiple times, but she was experiencing tightness in her neck through her shoulder which is the trapezius muscle. Maya massaged that muscle on both right and left sides. Maya then scheduled another session with her for later in the week. The second patient that I saw on Tuesday was a younger man who had crashed on his skis and hyperextended his knee, had a mild lumbar strain, and had a slight cervical spine sprain. To treat the knee Maya began slowly moving the knee around in the socket, attempting to loosen the muscles and tendons in the knee to get more motion and less pain. She did this for a while and also added light massaging to the sides and back of the knee, and to finish off she used kinesiology taping to try and supply more support to the patella and tendons in the back of the knee which had been strained. For the neck and back strains, Maya did the usual massaging and stretching to try and loosen the muscles, relieve at least some of the pain, and improve range of motion. Maya did all of this and sent the patient home with a stretching plan which is custom made to his injuries to help him build back strength again.
Maya and I also dove more into the difference between a sports medicine chiropractor and a physical therapist, and the benefits that each of them can have for different patients. She then gave me the idea to dive more into the differences in the schooling process and what types of certification each different doctor must get in order to become a certified specialist in the feild. We talked about the difference in salary and how much school it takes, and how Maya chose sports medicine chiropractics to be her main feild rather than physical therapy.
Research:
This week I had more interest in finding out how many people actually utilize chiropractic care, why people search for sports medicine chiropractors or physical therapists, what type of people do see chiropractors and what care is provided to these patients. Through the article The Chiropractic Profession: A Scoping Review of Utilization Rates, Reasons for Seeking Care, Patient Profiles, and Care Provided they discuss all of the points that I was interested in. Chiropractic care is utilized world wide, however the rates of usage do vary between each country. In the U.S. and Canada "approximately 6-12% of the population seeks chiropractic services. While Alberta and Canada report higher usage rates of around 20% in 2006," (Beliveau). Chiropractic sports medicine care has become more popular over the past 19 years, however it was rapidly growing back in 2006 which led to the expanding of the practice. Majoring of patients commonly visit their chiropractors for musculoskeletal issues which primarily include back pain, neck pain, extremity issues, wellness/maintenance, hip pain, and headaches. It has also been found that nationwide "Chiropractic patients are predominantly female, with a median age of 43.4 years," (Beliveau) this is showing that once women are getting older then are more prone to joint pains which would then lead them to seeing a sports medicine chiropractor or physical therapist. There are a lot of different types of care that can be provided to patients through this field of medicine. These include spinal manipulation, soft-tissue therapy, patient education, nutritional supplements, and exercise instruction.
I also have had the general question of how much a sports medicine chiropractor makes annually, especially if compared to a physical therapist. On average a Sports Chiropractors salary changes based on state, but in Colorado, Sports Chiropractors make on average $86,046 annually, (What Is Sports Chiropractor Salary by State?). Compared to physical therapists who make on average $101,676 (Salary: Entry Level Physical Therapist in Colorado (Feb 25) ). This is due to the popularity of the different practices, physical therapy being more popular with a higher demand than chiropractors, the difference in education levels, the amount of schooling necessary for a license, the different benefits that come with the jobs such as a 401(k), medical insurance, paid time off, tuition reimbursement, and license reimbursement.
"Professionals who wish to become chiropractors must first complete a doctorate program. This can take between six to eight years to achieve... Physical therapists complete a doctor of physical therapy (DPT) after earning their undergraduate degrees. These professionals can spend between six to eight years in post-secondary school. Physical therapists must pass a certification exam..." (Indeed Editorial Team). There are many different aspects that either a physical therapist or sports medicine chiropractor has to take to complete their schooling which can lead to higher salaries or difference in pay. Physical therapists additionally, after earning their DPT have to complete one year of residency with an already certified physical therapist. This helps them gain hands-on experience and then can further help them decide which specific field of physical therapy to go into. Chiropractors are chiropractic doctors, instead of doctors of medicine, however they still have to retain extensive levels of knowledge of general medicine, neurology and other medical fields. Due to this, they have to complete a certification program through the American Board of Chiropractic Specialties (ABCS) to ensure that their skills meet the criteria of what is expected of a certified sports medicine chiropractor. The ABCS is a council filled with certified specialty chiropractors that promotes and ensures the quality and efficiency in the process of evaluating and certifying doctors of chiropractors.
Citations:
Beliveau, Peter JH, et al. “The Chiropractic Profession: A Scoping Review of Utilization Rates, Reasons for Seeking Care, Patient Profiles, and Care Provided.” Chiropractic & Manual Therapies, U.S. National Library of Medicine, 22 Nov. 2017, pmc.ncbi.nlm.nih.gov/articles/PMC5698931/.
What Is Sports Chiropractor Salary by State?, www.ziprecruiter.com/Salaries/What-Is-the-Average-Sports-Chiropractor-Salary-by-State. Accessed 3 Mar. 2025.
Salary: Entry Level Physical Therapist in Colorado (Feb 25), www.ziprecruiter.com/Salaries/Entry-Level-Physical-Therapist-Salary--in-Colorado. Accessed 3 Mar. 2025.
Indeed Editorial Team. Chiropractor vs. Physical Therapist: Salaries and Tips to Improve Pay | Indeed.Com, 2 July 2024, www.indeed.com/career-advice/pay-salary/chiropractor-salary-vs-pt-salary.
Week 2: (2/17 - 2/23)
Reflection:
This week my mentorship started on Tuesday the 18th. First, we saw a patient who we saw last week. She is an older woman who has been experiencing back pain since her initial compression fracture which occurred in her middle to lower back, which did occur a while ago, and since then she has also experienced pain in her upper back between her shoulder blades. Maya did lots of deep tissue massaging to loosen up the tissue that was surrounding her back pain in her back, and also used a tool which is like a "tiny jack hammer" which can then loosen the joints around her back and relieve stress and tightness which is causing her pain.
The second patient we saw today was a woman with extreme scoliosis who sees treatment multiple times a week. There is a lot of different treatments for scoliosis and today Maya just did lots of massaging to her back in an attempt to loosen the muscles that are surrounding her spine, and also did lots of stretching to her neck because she had tweaked her neck a few weeks ago which caused lots of swelling and inflammation around the spine and scapula bones. We only saw two patients today, however, I was introduced more to their social media platforms and how they promote themselves as a business, and how there is more to the programming than I thought. The way that they use the different types of social media and how they represent themselves as a business is more in depth and takes more time and effort than I had thought.
I had already seen the platform that they use to schedule and create their social media presence, however, Maya has shown me more of how they create these posts and what they post and when to make the most sense for how the business is running. This week she scheduled a few posts about how the use of kinesiotaping can help patients maintain support for their injuries while playing sports, and even in their everyday lives! There are different prompts which are then put into Chat GPT which then generates different social media posts that can then be inserted into the platform and then have the posts to be scheduled when Maya, or whoever is creating the posts, feels necessary. Posting this information not only informs the followers of the platforms, but can also boost the businesses in the search engines and when someone looks up "What are the primary uses of kinesio taping?" then the social media posts will pop up, promoting Evergreen Spine and Sports Medicine, and then lead them to the social media platforms.
This week I only went to mentor Maya once. Which wasn't the initial plan but we got a lot of snow overnight before Friday morning, so I wasn't able to get out to my mentor Friday morning. I am excited, as always, for next week's mentorships, and to continue to learn more as I gain more experience, hands on or just watching, and learn more about sports medicine as a whole.
Research:
This week Maya helped me find a few different sources that would be reliable and which are good sources of information for me to read. The first of them being Patterns of initial treatment and subsequent care escalation among medicare beneficiaries with neck pain: a retrospective cohort study which was published by the National Library of Medicine. This article talks a lot about the difference in patients between what part of Medicare these older patients have and what types of treatment comes from them when they are experiencing lots of back pain. There are four different types of Medicare: A, B, C, and D. These four different types of Medicare provide different types of care for each person. Type A provides inpatient/hospital coverage, type B provides outpatient/medical coverage, type C provides an alternate way to receive Medicare benefits, and type D provides prescription drug coverage. These four different types of Medicare can then provide the patients of chiropractic care with different types of coverage for what Medicare will cover. These different types then lead to different care being provided to the patients, and their age additionally affects the type of Medicare which they are able to acquire.
Additionally, I read the online article Why Do Athletes Often Rely on Chiropractic Care? which outlines the benefits of chiropractic care for athletes. "The common injuries suffered in many sports can knock the spine out of alignment, causing stress on its pain-sensitive joints, muscles, nerves, discs and ligaments. In study after study, chiropractic care outperforms other medical options at reducing pain and restoring normal function," (Tisinger). Chiropractic care can provide a drug and surgery free option for athletes who are wanting to reduce pain but also stay playing their sports. This care can range from tennis elbow to back pain in elders to groin pain in soccer players. Additionally, it has been studied and proven that about 90% of athletes see a sports medicine chiropractor on a regular basis to help heal or prevent injuries, or boost their physical performance. This outlines how chiropractic care and physical therapy can improve athletes performance.
This week I read more of my book Built From Broken: A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body and this week I read Chapter 2: The Anatomy of Pain. This chapter heavily dives into how you can manage your pain, the purpose of pain, the different types of pain, and pain sensitivity. "It (pain) is not only a tissue-specific sensation, it's the product of neurological wiring and has a clear psychological component," (Hogan 26). Pain within the body can mostly be placed into one of two categories, nociceptive pain or neuropathic pain. The primary difference between the two is that nociceptive pain is caused by direct tissue damage, and neuropathic pain is caused by a disease state or nervous system dysfunction. "Nociceptive pain is what you experience when you break a bone, twist an ankle, or smash your thumb with a hammer... Neuropathic pain is markedly different in its mechanism. Neuropathic pain is described as shooting, tingling, stabbing, or burning," (Hogan 27), which shows how pain within the body can be placed into two main categories. There is a third type of pain which is called centralized pain, this occurs when your nervous system amplifies the volume of pain signals in only one location within the body. This type of pain often lingers long after the original tissue damage has already healed. There are many different subtypes of pain which are prevalent with different injuries, however these two (or three) types are the primary categories of pain, which can hold many different types of smaller or less prevalent pains in the body.
Citations:
Anderson, Brain R, et al. “Patterns of Initial Treatment and Subsequent Care Escalation among Medicare Beneficiaries with Neck Pain: A Retrospective Cohort Study.” European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, U.S. National Library of Medicine, 26 Dec. 2024, pubmed.ncbi.nlm.nih.gov/39722095/.
Tisinger, Sarah. “Why Do Athletes Often Rely on Chiropractic Care?” Palmer College of Chiropractic, 21 May 2024, www.palmer.edu/palmer-blog/why-do-athletes-often-rely-on-chiropractic-care/.
Hogan, Scott. Built from Broken: A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body. Salt Wrap, 2021.
Week 1: (2/10 - 2/16)
Reflection:
This past week was my first week doing my mentorship. I arrived at Evergreen Spine and Sports Medicine on Tuesday, February 11, and I started off by meeting with Maya, my mentor, and we initially talked about the scheduling process, and the website that they had created to then create prognosis pages for each patient and then have the ability to send it to the patients. There is a website which they created to help organize their patients and have the ability to schedule patients when they think it is necessary. There are a lot of different aspects that go into
I only went to my mentorship once this week, but I did see 4 different patients with Maya. There were a few times that I was able to actually come in contact with these patients. Most of the patients were older women, experiencing back pain, specifically osteoporosis in their lower backs. There was tightness in their backs, which was primarily caused by small things that "tweaked" their backs. I also saw one patient who had wrist pain. Maya suggested she get an MRI to see if there was simply deep tissue damage, or if it was a fractured scaphoid bone. With a fractured scaphoid bone, Maya explained to me that the scaphoid bone only has one vein leading to it, and the location where fractures primarily occur, the blood circulation to the bone can be cut off, and the bone can slowly die.
I expected the workplace to be very straightforward and uniform. Once I stepped foot into the office, I could tell it was different from all of the other offices I looked into. There are the physicians dogs running around the office, and everyone who works there seems to be good friends. It was a fun and lively community which I loved. All of the doctors seemed very nice, it was a good way to start my mentorship and learn the lay of the land on my first day.
I have now purchased the book Built from Broken: A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body. This book outlines the ways that you can build your body back up once you experience an injury. I haven't read much of it, however, from what I have seen from taking a brief glance at it, it does seem very interesting. This book talks a lot about the human body and how physical therapy and seeing a chiropractor and doing exercises yourself can help rehabilitate you and bring you back to your state prior to injury at a quicker rate.
I also went into the office on Friday the 14th. We saw quite a few patients that day. We saw a young girl, she was having knee pain and ankle pains and she plays basketball and volleyball and runs track. Based on her symptoms, Maya did many tests and decided that she had plantar fasciitis in her left foot and experienced a slight hyperextension in her left knee. We treated her with some massage therapy and also taped her knee to add more support, and suggested she get orthotics for her shoes to give her more arch support. We additionally saw a patient who just needed a sports physical which I was able to help out with. We measured her, weighed her, tested her blood pressure and oxygen levels, and also tested her vision, balance, and joints. This was good for me because I am currently taking pathophysiology and one of our previous units was vital signs and doing all of those tests so I already knew a lot about what we were doing for the physical. Lastly, I was introduced to the program they use to schedule social media posts to boost their social media presence and promote their business. Maya said that next week I will be able to work on the program myself and schedule social media posts.
Research:
Initially with this capstone project I had the large question of what does it mean to be a sports medicine chiropractor? According to the National Library of Medicine, "It is a specialized approach that combines the principles of chiropractic care with an understanding of the unique demands placed on the bodies of athletes, thereby facilitating injury prevention, rehabilitation, and overall performance enhancement" (Fu Chieh Lin). Sports medicine chiropractors focus primarily on the neuromuscular issues mostly in the back, or along other nerves within the body. Wrapped in chiropractics there is also a time when physical therapy is used, when attempting to rehabilitate the body prior to injury.
Additionally, I have read the blog page Why Should I See a Sports Chiropractor, written by Matt Lowe. Lowe states that chiropractic care can allow athletes to return back to their sports faster and more efficiently than if they were to just see a normal doctor for their injuries. There are many different types of rehab therapies that sports medicine chiropractors can utilize when treating patients, these include; cold therapy, massage, taping, manual manipulation and stretch and strengthening exercises, and others. "Sports account for an average of 8.6 million injuries every single year in the United States. Meanwhile, athletes, and even those who simply value consistent physical activity, look for ways to push themselves farther and perform better. Although not always at the top of an athlete’s to-do list, visiting a sports chiropractor can often help with achieving both goals. Here is a look at how sports medicine, when applied correctly, can help you stay active," (Lowe). There are millions of injuries in the United States which can be brought up via sports or activities, which can easily be prevented and treated with the help of a sports medicine chiropractor.
I just read an article posted by Reagan Integrated Sports Medicine which talked a lot about how seeing a sports medicine chiropractor can help and benefit your strength and range of motion. "Spinal adjustments not only fix misalignments and relieve pain in the spine but also improve blood flow" (Rojas). Improving the blood flow within the body can help to loosen tight muscles which can lead to an increase in flexibility. There can also be a benefit to your muscle function. "Sports chiropractors not only concern themselves with musculoskeletal treatment, but they can also assess the body’s overall condition and detect muscle imbalances. Muscle imbalances can lead to chronic pain or increased susceptibility to injuries" (Rojas). Sports medicine chiropractors can specifically create a physical therapy plan for patients with specific exercise and stretches to help improve each person's muscle function. How A Sports Chiropractor Can Help You Stay Healthy and Energized was a very interesting read, which continues to bring countless different perspectives on sports medicine chiropractors and physical therapy benefits.
Citations:
Fu Cheih Lin, Andy, et al. “Unlocking Athletic Potential: The Integration of Chiropractic Care into the Sports Industry and Its Impact on the Performance and Health of Athletes and Economic Growth in China and Hong Kong.” Cureus, U.S. National Library of Medicine, 5 Apr. 2023, pmc.ncbi.nlm.nih.gov/articles/PMC10075015/#:~:text=It%20is%20a%20specialized%20approach,overall%20performance%20enhancement%20%5B2%5D.
Lowe, Matt. “How Sports Chiropractors Help in Preventing Injuries.” Dynamic Sports Medicine, 5 May 2023, dynamicsportsmedicine.com/blog/why-a-sports-chiropractor/.
Rojas, Yenny. “How a Sports Chiropractor Can Help You Stay Healthy and Energized.” Reagan Integrated Sports Medicine, 16 Sept. 2024, www.reagansportsmed.com/2021/09/03/how-a-sports-chiropractor-can-help-you-stay-healthy-and-energized/.