This column marks the first anniversary of the "Chiropractic Sports Physician" series in "DC." It has been an interesting challenge to bring you both practical and useful information from different voices in the field. I certainly hope that each article has been helpful in either keeping everyone up-to-date on what is happening in chiropractic sports medicine, or in providing useful information for your own involvement with the athletic community. If you have ideas for subjects to be addressed by this column, or wish to suggest a guest author, please contact me in care of Dynamic Chiropractic. We will continue to try to bring you relevant information in 1993.
While traveling around the country to teach, I'm often asked the question: "What is the best sports injuries reference I can buy for my office bookshelf?" Ah yes, we would all like to be able to get one, or maybe two (but no more) comprehensive reference books for our special interests. This would allow us to answer any question that might rear its head in our daily practice at the mere turn of a few pages. If only it were indeed possible. Unfortunately, the answer to this question is not simple. While I am only one voice in a crowd of people in the field of chiropractic sports injury management, I will try to outline some suggestions that seem to work for doctors in general practice.
Most of you have probably already noticed that sports injuries management (in all health care fields) is a remarkably dynamic subject. Because of a heavy interest in this field within the last 10 to 15 years, research has abounded; along with it, a plethora of publications -- both in book and journal form. If you are a busy practitioner, you will quickly find that it is virtually impossible to keep up with this outpouring of the written word, so it is important to become choosy about what you read, simply in order to stay relatively sane. But how do you decide what to read? Is it possible to stay reasonably informed while reading just a few journals and buying only a small fortune worth of books (as opposed to a large one)? It just might be possible.
As someone who specializes in the field and who has had the luxury of being involved with a chiropractic college, I not only have access to, but actually try to get my nose into every new book and journal that hits the market. Yet, in my dealings with patients, I have often found myself referring back to certain texts repeatedly and have also developed a favorite list of journals. My list is in no way intended to be complete, and I am sure that others in the field also have their own personal favorites, but here are a few ideas.
Journals
This should actually be the larger part of your reading effort, since it is extremely important to stay on top of current information and new ideas. Believe it or not, I've narrowed my recommended list down to four items. First of all, it is important that you find out what is going on within our profession. Therefore, a subscription to Chiropractic Sports Medicine published by Williams & Wilkins is in order. This is our journal; it publishes refereed/reviewed articles and is also indexed. Next, your best bet as a general practitioner is to focus on journals which review pertinent information from all aspects of the field of sports medicine. Mind you, these are not original research journals but rather review information previously published elsewhere. Information in these journals is usually about six months old, but you can always go back to the originally published research if the information is of particular interest to you. This type of journal is aimed at the practitioner in the field, and is focused on the practical. My two favorites are The Physician & Sports Medicine published by McGraw Hill, and Sports Medicine Digest published by PM Inc., in Van Nuys, California. Lastly, I have found that the Journal of Musculoskeletal Medicine, published by Cliggott Publishing in Greenwich, Connecticut, prints a great deal of information relevant to a sports injuries practice.
Textbooks
Unfortunately, there are very few current textbooks in this field which are written by chiropractic authors. (Look for news from Williams and Wilkins this year that will change this fact.) There are, however, several good references which will augment your library. Although Roy and Irvin's Sports Medicine (Prentice-Hall) is an old favorite, there are several newer books which are quite useful. My two current favorites on injury assessment are Practical Joint Assessment by Hartley (Mosby-Yearbook, 1990), and Athletic Injury Assessment by Booher and Thibodeau (Times-Mirror, 1989). My favorite primer in exercise physiology is still Costill's Inside Running: Basics of Sports Physiology (Benchmark, 1986). You will need to supplement this basic book with up-to-date research findings from your journals.
For setting up preparticipation physicals, the new bible is Kibler's The Sports Preparticipation Fitness Examination (Human Kinetics, 1990). For current therapy there is Torg's Current Therapy in Sports Medicine-2 (Decker -- available through Mosby, 1990), and Sports Physical Therapy by Sanders (Appleton-Lange, 1990).
And finally, there is The Team Physician's Handbook by Mellion et al. (Mosby, 1990), and Modern Principles of Athletic Training by Arnheim (Times Mirror, 1989).
Please take note that I do not favor any particular publisher and that you should always strive to further expand your library. There are numerous titles available on topics which are more specialized and there are also some older standards which are wonderful (such as Sports Medicine by Shneider, Kennedy, and Plant (Williams and Wilkins, 1985). This is just a list of some general helpful references as a starting point.
Most of the publishers listed above have 800 phone numbers. I suggest that you get on their mailing lists to be kept abreast of new publications and updated editions of older publications. With some basic references, access to a few current journals, and continuous news of new publications, you should be able to answer a lot of questions.
Don't forget though, that there is also an additional option for getting answers to questions that may arise in your athletic injury practice. There is sometimes no substitute for experience, so a phone call to a colleague who has seen a problem before may also yield valuable information. Even with all those books and journals out there, it is important to tap into the experiential knowledge, both within our profession and among our colleagues in other areas of health care to aid our quest for improved quality of care for our patients.
Marianne Gengenbach, D.C., CCSP
Crawfordville, Florida
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
