Conditions · Sport
Sports injuries,
down to fine margins.
Sport finds the weak link. A club runner and a professional golfer present very differently, but the question underneath is the same: which part of the chain stopped doing its job, and why did the tissue that hurts end up carrying the load? That is an assessment question before it is a treatment one — and in sport, the answer is usually somewhere other than where it hurts.
I have treated sportspeople for seventeen years — runners and rugby players, people who train hard in the gym, and a good number of professional golfers. The higher the level, the smaller the things that matter.
01 · The chain
Where sport actually breaks.
Most sporting injuries that arrive here are not accidents. They are overload — one structure asked to do more than its share, over and over, because something above or below it stopped contributing. The tissue that finally complains is the last link, not the first.
So the examination goes up and down the chain from the painful part, and the extremities get examined as carefully as the spine. That is what the extremity certification is for: shoulders, elbows, hips, knees and ankles assessed and adjusted as joints in their own right.
Shoulders and overhead sport
Rotator cuff and the soft tissue around the joint, in swimmers, throwers, racket players and anyone lifting overhead — examined with the shoulder blade and the neck, because that is where the load usually comes from.
Hips, knees and rotation
Rotational and change-of-direction sport loads the hip first. A hip that will not reach the end of its rotation hands the job to the knee below it or the back above it.
Ankles and feet
Short-term management of an ankle sprain once the fracture question is settled, and plantar fasciitis in runners — with the calf, the knee and the hip examined alongside the foot.
Elbows
An elbow that flares with every round or every session is often downstream of a shoulder or neck that is not moving well. That is the version of elbow pain I look at; an isolated tendon problem is one I refer on.
02 · The margins
Why serious athletes come to a chiropractor.
In elite sport the margins are small, and what a good athlete notices is rarely pain. It is availability — a hip that stops a few degrees short, a shoulder that is not quite stable through the top of a swing, a foot that will not load evenly. Small, specific, and enough to change a complex movement.
How I think about it is that a specific adjustment, and the muscle work that goes with it, changes the information the nervous system is getting from a joint. In my experience the movement then becomes more available: control first, and the athlete's own training turns that into output. I would not call it a settled science, but it is a principle I have worked to for a long time.
It also gives us something to measure. I test a muscle or a movement, treat what I think is holding it back, and test again with you watching, so you see what changed rather than take my word for it. What I am measuring is how a muscle fires and how a joint moves. What I will not claim is that treatment makes you play better. That is your training's job; mine is to remove what is in its way.
03 · Golf
Golf, specifically.
Golf asks the body to rotate hard, in one direction, thousands of times. The lead hip, the mid-back, the lead shoulder and the trail elbow take that load in sequence, and the one that hurts is rarely the one that stopped moving. Golfers make up a good part of the sporting caseload here, from weekend players to professionals.
I work alongside golf coaches and performance staff rather than around them. A swing coach or a strength coach will often send a player to me when a movement is not available, and I send them back with what I found and what changed — assessment first, treatment where it is needed, then back to the coach.
04 · The appointment
What happens, and what happens next.
A new patient appointment is 45 minutes. The history covers the sport, the training load and what changed before the problem started, and the movement that reliably provokes it. The examination covers the painful part and the chain around it — joints, muscles, orthopaedic and neurological testing where warranted — and then I explain what I have found and what I think it means.
Treatment is chosen case by case: specific adjustment, soft-tissue work, dry needling, taping, neural mobilisation where a nerve is involved. Then the part that matters more in sport than anywhere else — loading. Rehabilitation here means rebuilding capacity progressively and checking it holds up under the demands you are actually going back to, with exercise between sessions and, where you have one, your coach or physiotherapist kept in the loop. I would rather get you back to training with a plan than tell you to rest and wait.
05 · The limits
When it isn't one for me.
Some sporting injuries need imaging before anyone treats them, and some need a different clinician entirely. Where that is the case I will say so and refer — for imaging, for an orthopaedic opinion, or on to a colleague for something like shockwave therapy that I do not carry.
Urgent care, not a chiropractor
A suspected fracture or dislocation, a joint that swelled fast after impact, a tendon that went with a snap, or a limb that has gone numb, weak or cold. These need emergency assessment today.
Head injuries
Concussion is not a chiropractic problem. It needs medical assessment and your sport's own return-to-play protocol, and I will point you there rather than treat around it.
Signs that need imaging first
Significant trauma, a sudden loss of strength, or pain that does not change with position or activity. I refer rather than work around the uncertainty.
Patients who came in with this
Thanks for the brilliant tune up before I run Berlin Marathon on Sunday! Always a great experience being seen by Rich!
…had me back to training whilst doing my therapy sessions. Richard is a very experienced chiropractor … I always refer my clients to Richard when needed.
…I have been seeing Richard on and off for two years with my back essentially, (I a runner) … he has a calm professional manner & will explain in simple terms what is wrong & what he is doing treatment wise.
Often connected
Where to see me
Two London clinics, same practitioner at both. A new patient appointment is 45 minutes and includes your first treatment where that’s appropriate.