About the author: Dr. Alan Palmer practices in Scottsdale, Arizona and is the cofounder of the Chiropractic Association for the Elite and Professional Athlete. An athlete himself, Dr. Palmer has won 30 first-place bodybuilding competitions, despite a 14-year hiatus from competition from 1981 to 1995. He now competes exclusively in natural bodybuilding competitions. He won the 1996 Forever Natural Championships, the 1996 United States Natural Championships, and his division at the 1996 Natural Universe.
Mark Letendre, the head athletic trainer for the San Francisco Giants of major league baseball, has incorporated chiropractic care into the Giants' system for 12 years now. He is a staunch supporter and believer in the power of chiropractic and in the power of the body to heal itself.
Mark's first experience with chiropractic came in the late '80s when the Giants' then-shortstop Robby Thompson had a low back problem. Thompson had a series of epidural shots which did nothing to resolve his condition. Mark then called Nick Athens,DC, of San Carlos, California. Dr. Athens had gained a reputation in the Bay Area for treating Joe Montana of the San Francisco 49ers and other players. Dr. Athens was able to get great results with Robby. That was the beginning of Mark's long relationship with chiropractic that lasts to this day.
Mark recognized that drugs and surgery did not provide all the answers. If he could use the benefits of chiropractic care as one of the tools in his toolbox, he could make chiropractic part of his multidisciplinary approach to care for the players. It would be a benefit for the players, the team and the trainer.
It took some time for Mark to establish chiropractic in the Giants' system, mostly because the gatekeepers were orthopedic doctors. But once Robby Thompson and Matt Williams started getting care at Dr. Athens' office, other players began following suit. Today, about 80 percent of the Giant players and 40 percent of the front office staff use chiropractic.
There are a number of challenges to incorporating chiropractic into the arena of professional sport teams. There's the issue of defining specific terminology that is comfortable and understandable to both the team's medical staff and chiropractor. Mark observes that most teams are not comfortable in immediately bringing an outside doctor into the locker room, but will send players to the chiropractor's office.
With a professional team's medical staff, there is a certain amount of protecting one's own turf. Any staff would be leery of any practitioner who claims the ability to "fix anything." When dealing with certain types of injuries (for example, grade 2 or grade 3 sprains), a manipulation would be contraindicated until there was a sufficient period of healing of the tissues.
One of the difficulties for Mark comes in locating DCs to treat the players while visiting other cities. He's had some trying experiences. At times he has resorted to looking in the phone book, which in some cases has not worked out very well. Of course Mark does get positive referrals. He recalls when the Giants were playing in Houston and the two teams were making a run for the Western Division title. Matt Williams took a ferocious swing at a ball and suffered an intercostal strain. Dr. Athens referred a chiropractor to see Matt. Two games separated the teams from first and second place, and the Giants needed Williams to play. Matt did play and the Giants won. Mark is convinced that Matt would have been unable to play without the chiropractor's care.
Mark realizes the value of chiropractic care. The challenge is to bridge the chasm that still divides athletic trainers and chiropractors. That bridge is being built. Two years ago, Mark asked Dr. Athens and myself to help him create a national network of chiropractors that would be taught the standards and protocols that the athletic trainers and team doctors want for a healthy partnership with doctors of chiropractic. The name of the organization is the Chiropractic Association for the Care of Elite and Professional Athletes (CEPA).
When it comes to player care, you're either part of the solution or part of the problem. It's our goal to make sure that chiropractic becomes part of the solution. The few chiropractors who have made it to the inside have done so by their own creativity, skills and hard work. There has been no concentrated, coordinated effort to link chiropractors and institute a game plan that will bring chiropractic into the training rooms of all the teams. Mark's goal is to see that chiropractic becomes mainstream as part of the multidisciplinary approach, instead of being an ancillary or peripheral part.
One of the barriers that has held chiropractic back is that the gatekeepers in professional sports are orthopedists. But things are changing. Head athletic trainers are acting as facilitators in creating systems of multidisciplinary care for athletes. "Many are changing their attitude toward chiropractic and others are having this change forced upon themwhen players seek out the services of chiropractors," observes Mark. "I think we can grow together, learn together and really show a unified front so that the players get the maximum use of everyone's skills."
It's my hope that Mark will become the liaison between the National Athletic Trainers Association and our profession. "It's not important that I be the lead guy," Mark explains. "I just want to be the one that gets things going and help it work properly so we can move forward and continue a quality program that we've begun."
Mark believes that developing a coordinated effort is important because the athletic trainer is going to know what the DC coming through the door will be able to offer.
I had the experience of treating Barry Bonds during spring training in 1997 after he fell down a flight of stairs. (See "Professional Athletics and Chiropractic: a Winning Combination" in the May 31, 1997 issue.) Mark asked if I would take a look at him. He had pain radiating down his low back into the hip, leg and around the groin area. I did a workup and found his pelvis and low back were rotated. I corrected the imbalance. After adjusting him I saw an incredible change. He said the pain was gone.
When Bonds left the locker room, reporters asked how he was feeling. "I feel 100 percent better. I saw my chiropractor," he explained. The story made national headlines.
That was nothing compared to the great PR of Dr. Athens adjusting San Francisco quarterback Joe Montana during the pre-game show of the 1990 Super Bowl: a free million dollars worth of advertising for chiropractic. We can create these kind of unsolicited testimonials by players that the Fortune 500 companies pay millions for.
Because there has been so much misunderstanding over the years between team athletic trainers and the chiropractic profession, realize that treating the athletes of professional teams is not a relationship that is built overnight. The relationship has to be earned and built on trust, one small step at a time.
You are asking to join their party. Show an unselfish gratitude and willingness to do whatever it takes to facilitate the highest level of care for the players. Ask nothing in return. In doing so, the law of the universe says that you will reap benefits.
My relationship with the Giants developed over four years. The first year I treated the assistant trainer for the Giants and then treated Mark and a few other players. The second year, Mark presented half a dozen players to my office. The third year he asked me down to work in the visitors' clubhouse, where he would send players over that needed chiropractic care. It wasn't until the fourth year that I was invited to come into the clubhouse on the home team's side and work side by side with the athletic trainers in the care of the players.
I have since developed other team relationships. I'm also working with the Arizona Diamondbacks and the Phoenix Coyotes.
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.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
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.
