Jan 29, 2015
Perfect Alignment

Chiropractic care has come a long way in recent years, and athletes aren’t missing out on its benefits. Dr. Nick Athens answers why here.

By R.J. Anderson

R.J. Anderson is an Assistant Editor at Training & Conditioning. He can be reached at [email protected]

The day after making a last-second game-winning catch against the New Orleans Saints in the 2012 NFL playoffs, San Francisco 49ers All-Pro tight end Vernon Davis was battling soreness and tightness in his neck and shoulders. So he called Nicholas Athens, DC, a chiropractor in San Carlos, Calif., who regularly works with 49ers players. That afternoon, Davis was in Athens’s office finding relief through a series of twists, pulls, and adjustments.

Sporting a client list that has included Joe Montana, Jerry Rice, Tom Brady, and many current 49ers, Athens has spent the last 30 years adjusting necks, spines, and various extremities on professional and everyday athletes. His goal is to bring his clients acute and long-term relief and help fine-tune their bodies. Athens sees chiropractic care as another key component in the comprehensive fitness and health wellness regimens that today’s elite athletes subscribe to.

Athens’s work with professional athletes began as soon as he entered the field. After graduating from Palmer College of Chiropractic in Davenport, Iowa in 1982, Athens headed west and opened his practice in the spring of 1983. Soon after, he encountered the first of many NFL patients. Since then, he has worked diligently to build both his practice and the reputation of his profession.

Though Athens has attended more Super Bowls than most NFL coaches and has appeared on a number of national TV broadcasts, he admits that it can be an uphill battle to justify the role of chiropractic care in the sports medicine world.

We recently talked to Athens about his profession and the 30 years he’s spent working with professional athletes. He also shares his thoughts on why some people doubt the effectiveness of chiropractic care and addresses some common misconceptions he’s encountered along the way.

T&C: Why is chiropractic care appropriate for athletes? Athens: The whole premise of this profession is that the brain and nervous system run the body. If the spinal vertebrae are misaligned they can impinge the nerves, which can not only cause discomfort, pain, and stiffness, but also cut off power to muscles and organs and reduce their output. When I check if a player’s spine is out of alignment, I also check their extremities. But I only work on areas that they need help with. I won’t just adjust something that’s already stable and in alignment.

As chiropractors, we correct subluxations, which is when a bone is out of alignment and impinging the nervous system. By using my hands to mechanically readjust a joint and/or the spine, I can reduce subluxations and return the athlete to proper alignment, which improves the function of the body from the inside out.

Football players take a lot of compressing hits during a game and getting adjusted allows the vertebrae to properly reset and their central nervous system to reboot. Getting adjusted on a weekly basis keeps small subluxation injuries from accumulating and becoming a larger problem. If you take care of these injuries as they happen, they’re more apt to go away faster. For example, if you have an impinged shoulder and you don’t do anything about it, it’s going to get worse and worse, and it may eventually become arthritic and shorten your career. The average NFL player’s career only lasts three and half years as it is.

What are some of the more common injuries you see in professional football players? I see a lot of stingers in the neck and shoulder area, sometimes with pain radiating down the arms. Hip and shoulder issues are also common. And we see a lot of tight hamstrings that result from a player’s hips and back being out of alignment.

What’s the most unique injury situation you’ve encountered when working with athletes?

Former 49ers running back Roger Craig had a hip injury in the mid-80s and was told by team doctors that he would be out a few weeks. The injury occurred when he planted his knee in the ground just as he was being tackled, and a player hit him from another angle. The contact forced his hip out of alignment due to the awkward rotation it made while his knee was planted. Nothing was damaged structurally, but since he couldn’t move his hip, the doctors said he would probably need to sit out a few games. I worked on him a couple of days in a row to push and pull his spine, hip, and leg back into alignment, and the injury responded pretty quickly to the treatment. He played the following week and didn’t miss a single game.

When do you typically work with the 49ers players? During training camp, I’ll work with players on their off days. I set up a table at the team hotel and they come in one after another. During the season, it depends on how they’re feeling. Sometimes I work with them before a game to reduce any discomfort and sometimes after–and sometimes before and after. As the season goes on, their bodies really start to break down, so I like to get them adjusted and back into alignment once a week.

How long is a typical session with an athlete? About 10 minutes. I have an assistant who does some soft tissue work first, then the athlete comes to my table and I do the necessary exam and adjustment. Relief typically sets in within 10 to 15 minutes. The soft tissue work and adjustment work improve the function of the body and the flow of muscle fibers almost immediately.

How did your education prepare you to work with athletes? In addition to learning how to do spinal adjustments, I took classes at Palmer on how to adjust extremities from Dr. Mitch Mally. He taught me how to work on the feet, knees, hips, shoulders, wrists, and ankles. I use those skills quite a bit with my professional and everyday athlete clients.

When did you first get involved with professional athletes?

When I started my practice in 1983, I thought I’d just work on weekend warriors and the general public. Then one of Dr. Mally’s patients, Roger Craig, from the University of Nebraska, was selected in the second round of the NFL draft by the 49ers. Roger wanted to continue receiving chiropractic care and because my office was located near the 49ers’ training facility, Dr. Mally recommended that Roger come see me when he got to California, which he did.

Roger was just my 10th patient. He liked how he felt after seeing me, and soon, four or five more guys from the team came in for treatment. They had never been to a chiropractor before and were very happy with how they felt after being adjusted.

How did the team’s medical staff feel about you working on their players? After working with those four or five players, I saw one of the team doctors at the gym and said, “I’d like to work with you guys because a lot of your players want and need chiropractic care.” The doctor nodded his head and said, “Fine, if anybody needs it we’ll send them to you.” However, shortly afterward, I received a letter from the team physician that said if players saw me, it wouldn’t be by referral because they would never send anyone to a chiropractor.

What was your response?

I decided that if I couldn’t go through the organization to work with players who need the care, I would go to the players themselves. So I started setting up shop at the team hotel and more and more players started coming to me via word of mouth.

Eventually, I was working with over 30 players, including some of the biggest names on the team. Jerry Rice and others got on the bandwagon. Their mindset was, “If this is making me feel better and prolonging my career, why shouldn’t I continue it?”

Then, in 1990, a big moment for both the profession and me arrived when CBS Sports did a Super Bowl pregame show segment on my work with Joe Montana, who had been battling back issues for a number of years. That segment was seen by 90 million people and really opened up some eyes about the legitimacy of chiropractic care.

How did that publicity help others in the profession? It opened up the door for teams to hire chiropractors, which is quite common today. I think doctors began realizing that chiropractors are not trying to take over medical care. We just want to be a spoke in the wheel in addition to athletic trainers, massage therapists, nutritionists, and everybody else working to get and keep players healthy.

What is your relationship like with athletic trainers and team physicians now? It’s much more positive. I still work with the players independently and go to the team hotel and have a room I work out of but nobody gives me a hard time about being there. There is much less resistance than in the old days.

Why do you think some doctors discount the effectiveness of chiropractic care? I think there’s a simple lack of understanding about what we actually do. Sometimes skepticism comes from a lack of knowledge. I feel like a lot of doctors’ opinions of this profession are passed down from generation to generation without anyone doing their own research to see if chiropractic care can benefit an athlete’s health.

There are articles all over the Internet about the effectiveness of chiropractic care and its effects on the nervous system. The Journal of the American Medical Association has a lot of articles on chiropractic research. They even have articles on how chiropractic care can help alleviate headaches.

I would prefer that doctors approach it by wondering what is drawing people to us and keeping them coming back. Maybe they should ask themselves, “Why is this profession growing?”

What’s your biggest frustration about the perception of your profession?

If a patient has an unproductive chiropractic experience, they are apt to say, “I went to a chiropractor and it didn’t work,” not realizing that they might have just gone to a bad chiropractor. There is good and bad in any profession, and you simply have to find a good chiropractor.

I know that when I work on patients, I’m usually giving them their first exposure to our profession. If I give them good results, I’m representing my profession at the highest standard, and they’ll recommend chiropractic care to others.

What are some other common misconceptions you hear? “I heard that if you go to a chiropractor once, you have to keep going in order for it to work.” In actuality, you don’t have to do anything. You don’t have to eat right, you don’t have to work out, and you don’t have to get massages or do any of those healthy things. But they’re probably good for you, especially if you keep doing them. It’s a good idea to work out and eat right on a regular basis, and it’s a good idea to see a chiropractor regularly. It’s recommended, but it’s not mandatory to be effective–it’s a lot like taking a car in for regular tune-ups.

A couple more misconceptions are that an adjustment can hurt you or cause a stroke. If that’s the case, why is our malpractice insurance so low? I think that’s a very revealing fact about our profession. Our malpractice insurance premium is $2,000 to $2,500 a year. A doctor who prescribes medication has a malpractice insurance rate of $10,000 to $20,000 a year and orthopedic surgeons pay about $50,000 a year.

To tell you the truth, I hear most of those skepticisms from doctors, not the public. It’s not unusual for me to save two to three people a week from having to undergo spinal surgery because of successful chiropractic treatment.

What I’ve found is that I can either help someone or have no effect–but I don’t ever make them worse. So what’s the harm in trying it, especially if surgery is the alternative?

How has your profession evolved over the last few years? A lot of today’s chiropractors do a lot more soft tissue work, stretching, and laser work. I’m more from the old school as far as concentrating on adjusting the vertebrae and extremities to take pressure off the nerves. There are several different techniques used by chiropractors nowadays, but I’m still more of a hands-on practitioner. The players seem to respond well to my techniques.

Also, the perception of what we do is changing. Players see chiropractic care as a way to take care of their bodies and they’re not afraid to go outside the team to find healthcare providers. For example, [49ers All-Pro linebacker] Patrick Willis has his own nutritionist, massage therapist, and chiropractor. The team has all that stuff, but the players can choose to go elsewhere if they prefer.

I see a lot of older players using chiropractic care to help them prolong their careers by preventing surgeries through regular maintenance. Takeo Spikes is a good example of that. He flies me down to work on him and other San Diego players between games. Takeo is 34 years old and has made a lot of tackles and is still going strong after an already long career.

Where do you see the profession going in the next five to 10 years? I see us facing even less resistance than we do now. I think people will realize there is good and bad in the profession. Instead of saying chiropractic care didn’t help the players, a team might say that they had a bad chiropractor and will find a better one instead.

The reason I was able to get to the level I’m at with these athletes is because I’m a good and focused chiropractor. You need to go with somebody you’ve been referred to or somebody with a good reputation for working with athletes. That information is out there. You can look on the Internet and find plenty of testimonials from patients.

This profession is growing all the time. People are getting less closed-minded and forming more educated opinions. People are realizing that getting a tune-up and rebooting their system is good for them.

FEEDBACK As a practicing sports chiropractor I wanted to thank you for printing the article on Perfect Alignment. It sometimes becomes frustrating when athletes and support staff do not understand the benefits of chiropractor. Articles like this will help educate them.

– Dr. Robert J. Haley


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