The Use of Spinal Manipulation to Treat an Acute on Field Athletic Injury: A Case Report
Sean A. Duquette, BA, DC and
Mohsen Kazemi, RN, DC, MSc., FRCCSS(C), FCCPOR(C),
Canadian Memorial Chiropractic College.
This case describes the utilization of spinal manipulative therapy for an acute athletic injury during a Taekwondo competition. During the tournament, an athlete had a sudden, non-traumatic, ballistic movement of the cervical spine. This resulted in the patient having a locked cervical spine with limited active motion in all directions. The attending chiropractor assessed the athlete, and deemed manipulation was appropriate. After the manipulation, the athlete’s range of motion was returned and was able to finish the match. Spinal manipulation has multiple positive outcomes for an athlete with an acute injury including the increase of range of motion, decrease in pain and the relaxation of hypertonic muscles. However, there should be some caution when utilizing manipulation during an event.
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In the article the authors propose four criteria that should be met before utilizing manipulation for an acute, in competition, athletic injury. These include the lack of red flags, limited time for the intervention, preexisting doctor-patient relationship and the athlete has experience receiving spinal manipulation. Clinicians should be aware that manipulation may be an effective tool to treat an acute in competition athletic injury. The criteria set out in the article may help a practitioner decide if manipulation is a good option for them.
Key indexing terms: chiropractic, spinal manipulation, athlete, competition, sideline
From the FULL TEXT Article:
Spinal manipulative therapy (SMT) is a treatment modality that has been utilized for centuries with written explanations dating as far back as 460–385 BCE by Hippocrates.  There are numerous theoretical mechanisms of action for SMT. [2–4] These theories are based around three major concepts: the biomechanical effects, the muscular reflexogenic effects and the neurophysiological effects.  In addition, SMT also appears to have systemic effects on the body.  SMT have been demonstrated to be effective for the treatment of numerous conditions; research has consistently demonstrated its effectiveness for neck and low back pain. [6, 7] It has also been shown that SMT may have positive effects on pain and injury in the extremities. [8, 9] However, with this knowledge, there is limited evidence of the use of SMT during a sporting event to treat an acute injury.
Taekwondo is a martial art originating from Korea. Currently it is practiced throughout the world and has been an Olympic sport since 2000. Taekwondo competition is divided into two different categories: Poomsae (patterns) and sparring. At the highest levels sparring contests consist of three two-minute rounds with a one minute rest period between. Points are accrued through landing punches to the trunk or kicks to the trunk and head. If an injury is sustained during the competition the referee must suspend the match to allow the athlete’s doctor to treat the issue. If the athlete cannot return to the match within one minute; the opposing athlete is declared the winner. 
The goal of this case study is to demonstrate the utilization of SMT during competition and to discuss the times when it may be appropriate.