Coming out to play

There is no longer any doubt that in the sporting world, chiropractic has become part of the medical structure that supports athletes in competition. Athletes are increasingly seeking chiropractic care and see them as a vital component of their strength training, conditioning and even injury management.

The 2015 Pan Am/Parapan Am Games being hosted by Toronto this summer is another opportunity to demonstrate the value of chiropractic care to an athlete’s optimum performance. Not only is a chiropractor officially working once again for the health sciences team of Team Canada, more than 100 DCs across Canada are also heading to Toronto between July and August to participate in the host medical team for both Pan Am and Parapan Am Games, deployed at various sporting venues to provide on-site health care for participants.

“The last time that we had a chiropractor on the core medical team (for Team Canada) was in Vancouver 2010 Olympics,” explained Dr. Scott Howitt, director at Sports Performance Centres, a multidisciplinary health and wellness clinic with specialty in sports medicine and injury rehabilitation, based in Thornhill, Ont.

Howitt is part of the 17-member core medical team handpicked by the Canadian Olympic Committee (COC) to provide health care to Team Canada athletes at this year’s Pan Am Games. He has a sports sciences fellowship from the Royal College of Chiropractic Sports Sciences (RCCSS), where he is also first vice-president.

The Team Canada medical crew, who will be stationed at the Athlete’s Village, consists of a chief medical officer, clinic manager, chief doctor, chief therapist, physicians, athletic therapists, physiotherapists, a massage therapist and a chiropractor. Their task: look after the health care of Canadian athletes, attend to their injuries, if any, and get them back in the game, if possible.

Howitt explains the presence of Team Canada core medical does not necessarily preclude individual sports teams from bringing their own therapists or medical practitioners, even chiropractors. Core medical will serve teams and athletes that don’t have their own therapists, as well as collaborate with health practitioners who came with a team.

Howitt and his fellow practitioners in the core medical team are required to be at the Athletes’ Village a few days before the Pan Am Games officially kicks off, and a few days after it officially concludes. This allows them to be available to athletes during training and preparations for game day, and help with teardown and post-event duties after the event.

Once the event begins, Howitt expects very little downtime, as the entire medical team will be virtually on call 24 hours a day. Hence, they will all be living in the Athlete’s Village for the duration of their core medical duty.

For the love of sport
Unless the health practitioner is travelling with and employed by a sports team as a medical provider, participation as medical practitioner in major sporting events is typically an unpaid volunteer gig.

“Finding out that I was selected, I was thrilled,” Howitt recalls. “At the same time, in the back of my mind I was saying to myself, ‘I have to figure out what I’m going to do with my clinic, what I’m going to do with my responsibilities at the CMCC, and of course to get my wife to give it a thumbs-up’. I have a three-year-old and a six-year-old.”

There is a lot that a clinical practitioner would have to consider before applying to and accepting a role at a big event such as the Pan Am Games. In Howitt’s case, living in the Athlete’s Village for a few weeks means he is unable to provide patient care in his clinic for the duration of the Games. He is also taking a leave of absence at the Canadian Memorial Chiropractic College (CMCC), where he is currently a member of the faculty. And, perhaps more importantly, he will not be available to do his regular Dad duties around the house during those times – cut the grass, drive the kids to where they need to be, pick up groceries on the way home… you get the picture.

But with enough preparation, Howitt says, all will be fine. “It’s just actually taking the time to really think about that and plan that.”

Dr. Tony Varsalona, chiropractor from Grimsby, Ont., is undergoing the same preparations. He is volunteering as part of host medical services, a multidisciplinary team of health practitioners providing support for all athletes as well as staff and volunteers at the Pan Am and Parapan Am Games.

A graduate of New York Chiropractic College (NYCC), Varsalona has been in practice for 15 years. He and his wife, Dr. Megan West who is also a chiropractor, run the West Niagara Chiropractic and Wellness Centre in Grimsby, Ont.

Varsalona is not new to sporting events, but the Pan Am and Parapan Am are the biggest events he has ever been to date. Ever since he learned his application to volunteer was accepted, the Grimsby chiropractor has been informing his patients about potential disruptions in his schedule in the summer – and all were generally happy for him and are willing to accept the scheduling changes.

Unlike Howitt, host medical team volunteers are only required to show up at specific events and work at specific shifts. They are not required to live in the Athlete’s Village. This means Varsalona does not have to be away from his clinic for long periods of time.

“Once I got my schedule for the Pan Am and Parapan Am Games I adjusted my clinic schedule to the Pan Am schedule,” Varsalona explains. He also has a reliable partner at the clinic, his wife, whom he trusts his patients with – and his patients know her as well.

Preparations for the Games get even trickier when the volunteer health-care practitioner is coming from outside the province – adding cost of airfare and accommodations to things that need to be considered.

Dr. Jennifer Forbes, who owns Heritage Chiropractic and Laser Therapy in Chilliwack, B.C., is also volunteering with host medical at the Toronto Pan Am Games. She has been preparing her clinic and her patients in anticipation of her absence.

“(Pan Am organizers) didn’t release the schedule until April so it was a challenge for any chiro or anybody coming from Western Canada to find flights,” Forbes says.

Of course, flights from B.C. to Toronto get more expensive the closer to the date it gets. Even more so for Forbes who plans to bring her entire family to Toronto with her, including her two girls who are nine and 11 years old.

“I am flying my entire family out there not because they necessarily want to see the Pan Am Games, but because I’m going to be there for a pretty large chunk of time and that is too long for me to be away from my girls,” Forbes explained. She will be doing eight shifts over 12 days.

Another expense to consider when volunteering from out of province is accommodation for the duration of the volunteer shift. Forbes is fortunate she has a relative who lives in Etobicoke, Ont., whom she and her family will be staying with during their time in Toronto.

For out-of-town medical volunteers who are not as fortunate, other options and assistance are being offered by the various chiropractic professional associations. The Ontario Chiropractic Association (OCA), for instance, has teamed up with the Ontario Physiotherapy Association and the Registered Massage Therapists’ Association of Ontario,  to offer a billeting program for medical team volunteers from these three professions coming from across the country who need a place to stay. Some members of these associations are offering up their places for out-of-town volunteers to stay for the duration of their shift during the Games, free of charge. The OCA estimates about 130 DCs will be volunteering at the Pan Am Games this year.

In partnership with the Canadian Chiropractic Association and RCCSS, the OCA also hosted a “Getting Ready for the Games” panel in early June to offer some tips and best practice information for medical volunteers.

“It can be an expensive endeavor for anybody who is volunteering, but it is a great experience so I am looking forward to it,” Forbes says.

As a 14-year-veteran in chiropractic, Forbes recognizes the benefits she will gain from participating in such a huge event. She recently completed her masters in sports medicine at University of Western States in Portland, Oregon, which is also where she finished her degree in chiropractic.

She believes the education she got from her masters program and the experience of working with elite athletes at Pan Am will arm her with considerable tools to help her patients in her practice.

Forbes hopes to take back whatever she learns from the Pan Am experience to her practice. She happily notes her patients are all excited for her upon learning of her Pan Am participation. And it’s not only because they are genuinely happy for their doc; it’s also because they realize their chiropractor is investing in their care.

Patient first
Varsalona believes participating in the Games is a huge advantage to his patients. Coming from a small town, he does not see a lot of elite, high-level athletes or big sports teams in his clinic – or in his town, for that matter. But he enjoys providing care for kids of all ages and all levels of sports, providing chiropractic care at the grassroots level.

“They have somebody who can give them attention through chiropractic. It’s not just for elite athletes. I see a big need for it in all levels of sports and all levels of skills,” says Varsalona, who is also a certified chiropractic sports physician.

Volunteering for the Parapan Am Games also brings unique opportunities for learning, says Varsalona. “The Parapan Am is going to be a great experience because the type of sports they are playing are not sports that we usually are familiar with.”

He is doing some extra preparations for the Parapan Am, researching the types of injuries that typically occur at Parapan Am competitions. “It’s going to be totally different types of injuries and totally different types of sports. For example, with wheelchair rugby, you’re dealing with wheelchairs as a variable and there are injuries that can occur related to that.”

For Forbes, working alongside other health-care practitioners at the Games is also something she looks forward to.

“I just think that it’s fantastic that you have a health-care team and you can work within each other’s skillsets and you can augment that,” she says.

Forbes sports specialty came later on in her career, but it is something she finds she enjoys doing and plan to do so for the duration of her practice. The experience she gained from the sports medicine program at UWS further honed her collaborative skills. “It’s such a neat symbiotic relationship when you get to know people that you can work with and trust.”

Professional pride
Part of the reason Howitt decided to pursue a chiropractic sports specialty is to some day have the opportunity to be part of a major sporting event.

“To be selected to Team Canada is a substantial honour,” Howitt says. “I do feel a responsibility to do an absolute bang-up job. Don’t get me wrong, there’s been others before me – Greg Uchacz and Brian Seaman – but I do feel like I have an obligation to make sure that I do a great job so other people can be invited to future games for the chiropractic profession.”

The multidisciplinary nature of the medical services at the Games offers an opportunity for chiropractors to demonstrate their value to the health-care team. Pan Am is just one event. There are plenty of opportunities, sports or otherwise, big and small, that chiropractors can get involved in to increase positive public perception of the profession.

Every opportunity where a chiropractor can be part of a group and show the community “how smart we are and how hardworking we are and how diligent we are at trying to bring something productive to the table” is a big boost to the profession, Howitt says.

As an avid sports enthusiast, being part of Team Canada is a dream come true for Howitt. “I would have done anything to go to the Olympics or the Pan Am Games as an athlete. But I’m simply not good enough to go to a major game as an athlete… The only way that I could really find myself on a Pan Am Games team and representing my country is to do so as a medical professional.”

Pan Am Torch
Burlington, Ont., chiropractor Dr. Ashley Worobec was chosen as a Toronto 2015 Pan Am community torchbearer. Worobec, who works at the Burlington Sports and Spine Clinic, received the most votes from residents to bear the Pan Am torch when it passed through Burlington on June 19.

“Pan Am is such a celebration of athletes and sports and athletics, and that’s a huge part of my life and my practice as well,” Worobec says.

The Pan Am Games Torch relay is a 41-day journey through 130 communities involving 3,000 torchbearers. The torch makes its final stop on July 10, 2015 at the opening ceremony of the Toronto 2015 Pan Am Games.

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Mari-Len De Guzman is editor of Canadian Chiropractor and Massage Therapy Canada magazines. Contact her at mdeguzman@annexweb.com.