Two patients came in within the same month with the same specific fear: that the window they had been working toward was about to close.

One was a professional tennis player. Six weeks into the early-career tournament season, ranked, with a specific US event that mattered for trajectory. He had been through dry needling, cupping, massage, rest, and a full course of oral prednisone. An MRI showed a disc protrusion. Everyone had been treating the disc. His clinical assessment pointed somewhere else entirely, a facet-mediated presentation that had been misidentified by the imaging. When we treated the correct structure, he responded.

The other was a young woman training for her first half marathon. She had hip pain six weeks before race day. She had lost her senior track season in high school to the same hip on the opposite side. She already knew how this story ended if she did not get the right help. “I’ve always been running my whole life, and I don’t want this to stop me from being able to do that.”

What these two patients had in common was not just their sport, it was their relationship to it. The pain was not the problem. What the pain was taking was the problem. That distinction shapes how we think about sports injury care.

 

What Makes Sports Chiropractic Different

A sports injury presentation is not just a musculoskeletal complaint with a training history attached. The athlete has a timeline, a season, a performance demand, and a level of physical conditioning that changes both the assessment and the treatment plan.

The goals are also different. For the general population patient, the goal of care is pain-free function in daily life. For the athlete, the goal is return to full performance, which is a different threshold and requires a different endpoint for treatment.

Here is what that means practically:

The assessment has to include performance demands. I need to know what the athlete actually does. A swimmer, a tennis player, a runner, and a football player with hip pain are assessed differently. The movements that load the structure, the positions of vulnerability, and the tissue requirements are sport-specific.

The treatment has to allow continued training where possible. The worst outcome for most athletes (worse, in their experience, than the injury itself) is being told to stop entirely. The Traffic Light System I use with athlete patients governs this: green (0-3/10 pain), train normally; yellow (4-6/10), modify; red (7+/10 or neurological signs), stop. Most athletes can continue a significant portion of their training with appropriate modification even during active treatment. The goal is to keep them moving toward their performance demands, not away from them.

The timeline is real. Tournament windows, race dates, seasons, these are not arbitrary pressure points. They are legitimate parameters that shape treatment sequencing. Getting a professional tennis player functional for a specific tournament means different pacing than preparing a recreational golfer for a June trip.

 

Common Sports Presentations We Treat at COSJ

Hip and groin pain in runners. Hip flexor and groin strain, labral irritation, and IT band syndrome are the most common presentations I see in runners. Many are managed with rest, which provides temporary relief but does not address the capacity deficit that produced the injury. Building hip extension and posterior chain strength is almost always the missing piece.

Shoulder pain in overhead athletes. Rotator cuff tendinopathy, AC joint dysfunction, and cervicogenic referral to the shoulder are common in swimmers, tennis players, volleyball players, and CrossFit athletes. The approach combines shoulder mobilization, dry needling, shockwave where indicated, and rotator cuff loading in the sport-specific planes of motion.

Low back pain in throwing and rotational athletes. The lumbar spine is under significant compressive and rotational loading in throwing, swinging, and racquet sports. Facet joint irritation, disc involvement, and soft tissue injury are all common, and distinguishing between them changes the treatment significantly.

Acute lower extremity injuries. Ankle sprains, hamstring strains, calf tears, and knee ligament sprains are addressed with the same framework, reduce the acute tissue insult in the Repair phase, restore full range and motor control in the Retrain phase, rebuild the loading capacity above the sport demand in the Reinforce phase.

 

The Capacity Conversation Every Athlete Needs

The runner who lost her senior track season already knew the pattern. She had not built the hip capacity for the volume she was running. Neither had she rehabilitated the prior hip injury on the other side, the tissue healed, but the capacity never returned to match the demand. Six weeks before the half marathon, her current hip was doing what her previous one had done.

This is the conversation worth having before the injury happens again. Not “are you good to run” but “is your capacity above your training demand.” Not just now, but across a full training season.

The athletes who stay healthy are not the ones who are lucky. They are the ones who have built and maintained a capacity that consistently exceeds what they ask of their bodies. Building that capacity (particularly in the posterior chain, hip stabilizers, and the segments most vulnerable to sport-specific loading) is the Reinforce phase of every sports injury treatment we deliver.

 

FAQ

Can I train while being treated for a sports injury?

In most cases, yes. The modification depends on the presentation. The Traffic Light System guides athlete patients in maintaining training through symptoms when it is appropriate to do so. Complete rest is rarely the right call.

How quickly can you get me back to my sport?

Timeline depends entirely on the presentation. Acute tendinopathies and mild joint irritations often respond within two to four weeks. Significant structural injuries, nerve involvement, or chronic presentations require longer. I give every athlete an honest timeline after the first evaluation, not the answer they want to hear, but the accurate one.

Do you work with youth athletes?

Yes. Youth athletes, particularly multi-sport kids in high-volume training periods, are a significant part of our patient population. The presentation is often a capacity gap, volume has outpaced the body’s ability to adapt. Building that baseline capacity is the intervention.

 

If You Are Dealing with a Sports Injury in Westerville or Central Ohio

Come in for an evaluation. We will assess what is generating the pain, what your performance demands are, and how to get you back to your sport as quickly and as completely as possible.

The window is not closed. Let’s work with the timeline you have.

Schedule at cospineandjoint.com/schedule-appointment

Committed to your strength,
Dr. Blake Richard, DC
Central Ohio Spine and Joint | Westerville, OH
cospineandjoint.com/schedule-appointment