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Objective: The purpose of this case report is to describe and discuss the clinical diagnosis of a medial meniscus tear in an older patient using a multimodal management approach provided by a chiropractor. Clinical Features: A 60-year-old woman reported to a chiropractic clinic with left knee pain and swelling. The history and physical examination findings suggested a medial meniscus tear, which was confirmed with magnetic resonance imaging. Intervention and Outcome: Treatment consisted of therapeutic ultrasound; rest, ice, compression, and elevation protocol; soft tissue therapy using effleurage and lymphatic drainage; chiropractic mechanically assisted adjusting techniques to the left knee using a handheld mechanical thrusting instrument; sports taping applied to assist facilitation of the vastus medialis obliquus; and a specific rehabilitation program aimed at strengthening this musculature. The patient's pain was assessed using a quadruple numeric pain scale. Function of the left knee was examined using McMurray, Apley, and a variation of Helfet orthopedic tests, as well as joint line tenderness. Monitoring was done at the initial consultation and at the sixth and 12th treatments. The patient reported being able to walk, swim, and ride a bicycle asymptomatically. Her pain score at the concluding visit was 16.7%, indicating low-intensity pain. Conclusion: This case indicated that conservative management of a meniscus tear through a chiropractic multimodal treatment approach provided an alternative or adjunctive therapy to routine orthopedic surgery for this patient.

Background This paper describes the education and case management profile of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate qualification: International Chiropractic Sport Science Practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic qualification. Methods A cross-sectional survey, carried out between 22/10/2014 and 22/12/2014,was utilized with a 39-item web-based survey examining practitioner, practice and clinical management characteristics, and was distributed via email to all sports chiropractors who held an ICSSP qualification (n = 240) in 2014. Results The survey response rate was 64% (n = 154). 36% of chiropractors were aged between 31 and 40 years, just over three quarters were male, and 27% had been in practice for 5–10 years. The majority of respondents were based in North America. All sports chiropractors surveyed reported treating neuromusculoskeletal conditions outside of the spine. 91% utilized a multimodal approach in most of their treatments, prescribing rehabilitative exercises in 76% of consultations. Almost 64% of respondents reported current treatment of professional athletes, and 78% reported current treatment of semi-professional athletes, whilst the vast majority of those surveyed endorsed past treatment of professional (91%) and semi-professional (95%) athletes. All respondents reported referring to a range of conventional and allied health providers. Conclusions This study of ICSSP-qualified sports chiropractors describes a small but well-educated workforce treating high-level athletes, managing a wide range of spine and non-spinal neuromusculoskeletal conditions, utilising multimodal approaches (including active and passive strategies), and referring to and co-managing with other health practitioners.

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BACKGROUND:This paper describes the education and case management profile of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate qualification: International chiropractic sport science practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic qualification.METHODS:A 39-item web-based survey examining practitioner, practice and clinical management characteristics was distributed via email to all sports chiropractors who hold an ICSSP (n = 240) in 2015. RESULTS:The survey response rate was 64% (n = 154). The average age of the chiropractors was 31-40 years, just over three quarters were male and have been in practice for 5-10 years. The majority of respondents were based in North America.Sports chiropractors treat a wide range of musculoskeletal conditions with multimodal care (active and passive) and treat professional, semi-professional and Olympic athletes. Sports chiropractors have referral and co-management relationships with a range of conventional and allied health providers.CONCLUSIONS: There is often a lack of knowledge and misinformation about the background of sports chiropractors. This study refutes a number of commonly held misbeliefs, and describes a workforce that is well educated, treat high-level athletes, utilise a multimodal approach to management, treat a wide variety of non-spinal musculoskeletal conditions, frequently prescribe rehabilitative exercise, and refer to and co-manage with other members of the sports medicine team.Trial registration: This study was approved by the RMIT University, SEH College Human Ethics Advisory Network (ASEHAPP 52-14 AMES)