Olympic Games Inspire Optimal Athletic Care

Philip Santiago, D.C. participated in five intensive weeks of medical service during the XXV Olympics. The U.S. Olympic Committee medical team consisted of 10 doctors: four orthopedists, four internists, one chiropractor, and one sports psychologist, plus 25 athletic trainers, one for each of the U.S. teams.

To serve the 615 U.S. athletes in Barcelona, members of the U.S. sports medicine team often were required to work 16 hour days. Dr. Santiago treated a majority of the U.S. athletes. He described the experience as "a utopian working climate, where all health professionals pull together in mutual professional respect and admiration, for the common goal of enhancing each athlete's performance."

The Politics of Cooperation

The 1992 Olympics set the stage for excellence on many levels, and the U.S. sports medicine team was no exception. It was an honor to serve with the best orthopedists, internists, and athletic trainers in the country. We created a synergistic and optimal level of medical care that I will never forget.

We found that practicing a policy of inclusion allowed each professional to contribute strengths to the medical fabric of every situation. Joining forces with this diverse group of talented professionals set up the opportunity for us to see how effective cooperative practice can really be. Supporting and consulting one another in each situation provided the athletes with the ultimate in dynamic care and opened the door for unique learning experiences.

The working environment also gave MDs, some of whom had not worked hand-in-hand with chiropractors, the chance to see how chiropractic techniques and their own skills work together for the benefit of the patient. The highly skilled professional on staff were open-minded, confident in their own specialties and abilities, and unafraid to ask questions to learn more about techniques that were new to them. We worked together without any claims of superiority on anyone's part -- just a keen sense that we each came with different tools, and that every tool was necessary to the overall mission. In each case, we discussed and decided the best possible strategy to meet our mutual goal -- to help the athlete produce the best possible performance.

Maximizing Quality Care Delivery

Serving over 600 elite performers with high priority demands challenged every aspect of our professional and personal capabilities. In order to meet the gargantuan task, one key guideline prevailed: preparation. Managing the diverse duties and emergencies of running your own clinic lays the groundwork for the proficient juggling of the many intense demands faced on a daily basis at the games. For example, in addition to our duties to the athletes, we were asked to supervise medical services for the USOC support staff. My experiences as an athlete, coach, and chiropractic sports physician, coupled with my on-field experience and familiarity with the training room environment, helped prepare me for the pace and demands of serving at this largest and most prestigious world athletic event.

The responsibilities of the U.S. medical staff required peak service in what seemed to be a sea of mayhem. In retrospect, I realized that planning ahead had been a critical operating factor. For instance, the off-field prescreening evaluations prepared me for the crucial demands of returning an athlete promptly to competition. These evaluations familiarized me with the athlete's condition and later allowed for the quickest diagnosis and treatments on the field.

The state of an athlete's mind plays a tremendous role in athletic competition. The team's medical duties required attending to the whole athlete, including the psyche. Like every athlete's physical characteristics, every athlete's personality was different. Getting acquainted with the athlete and his personality became vital when competitive pressures mounted and insecurities gained momentum. Left unattended, mental issues could hinder performance capabilities. If the athletes needed psychological pampering to prevent or minimize stress, we gave it to them. The medical team existed to assist the 615 outstanding American athletes in reaching their highest potential by providing the utmost in physical and psychological care.

The Olympic Experience

Being the only chiropractor on the U.S. medical team for five weeks was exhausting. You do notice the fatigue, but the opportunity and experience were so exciting that adrenaline kept me going.

The clinic was a constant buzz of activity, and the arena was pressure-packed with supercharged athletes and short time frames for treatment. The gymnastics team required the most attention because they experienced the greatest number of injuries, mostly overuse. Their injuries resulted from intense training and usually involved the lower back and shoulders. Repetitive swinging, vaulting, and back arching caused their small, strong bodies to take a continual beating.

Runners and swimmers required frequent treatment as well. Swimmers came in often to alleviate sore muscles with massages, spinal adjustments, and soft tissue techniques. Track and field athletes developed great sensitivity to their bodies because they compete individually and must keep themselves in top competition form at all times. If they had a bad day, there was no one to substitute for them and take up the slack. Competitors like Carl Lewis, sprinter and long jumper, were quick to realize when they didn't feel well and would come in for performance enhancing treatments. Many of the runners would return to us after a practice or competition for fine tuning even if they were not experiencing pain.

Of all the medical teams represented at the Olympic Games, the U.S. medical team was unparalleled for dynamic efficiency. Athletes on many of the other national teams were forced out of competition if they got hurt. While the Unified and Japanese medical teams came closest to U.S. standards, none of the other medical squads could compare in remedying problems fast and getting athletes back in action.

When trainers brought in basketball "Dream Team" forward Charles Barkley, he could not turn his head. The medical team demonstrated how flexibility and camaraderie can result in ultimate dynamic care. While the normally accepted medical model puts the orthopedist in charge of orthopedic problems, the USOC medical team analyzed the situation, put all egos aside and decided that in this case the chiropractor should provide the primary care with other specialties providing support. With crowds of Olympic athletes-turned-basketball-fans crowding the room and cameras flashing, it turned the clinic into a circus and Barkley's treatment into a public performance. The crowd watched as Barkley responded successfully to chiropractic treatment and then observed as the trainers completed the job with soft tissue work while the MDs prescribed anti-inflammatories. I had the unusual feeling that, for a moment, doctoring had become a spectator sport and we had won a team victory. Barkley came in the next day for a pregame adjustment and went on to another basketball triumph.

The Olympic Atmosphere

As you might expect, the very nature of the work and the surroundings at the Olympics created a stimulating environment. The scene while walking through the village on our way to the clinic was always a hubbub of activity, a kind of pervasive air of intensity reigning. The village was beautiful. The romance, history, architecture, and culture of this brilliant city overlooking the azure Mediterranean sea gave the Olympic village its special European ambiance. Atlanta will have a difficult time matching the splendor of Barcelona in 1996.

After late evening events, we would walk from the clinic or the arena to catch the Metro back to the village. Our short journey would take us past the incredible National Palace and its tiers of palatial fountains. At 10:00 each night, sound, light and water fountain displays created an artistic spectacular along the descent of Montjuic. The magnificent displays were set against the backdrop of an incredible view of the city and dominated by startlingly elegant royal architecture. In these and many other ways Barcelona truly succeeded in capturing and imparting European tradition and passion for the benefit of Olympic visitors.

Everywhere you go at the Olympics, you become aware of the profound emphasis on the visual. Barcelona had been polished to a virtual gleaming shine. Every country displayed a visual image, from its selection of a flag bearer and team uniforms, to striving for a neat and photogenic appearance. The result was a cultural celebration, unsurpassed in quality and magnitude, that was shared throughout the technological world.

Presenting an Olympic Image

In surroundings and services, Olympic organizers sought to set standards that were worthy of the best athletes in the world. Most of those selected to serve on the U.S. Olympic team's medical staff were former athletes who understood the athletes, their concerns, and their injuries. All underwent an extensive application and selection process designed to organize a team that blended professional competence and personal compatibility. The medical staff went through pre-event "Olympic trials," just like the athletes, and the competition was intense. Thousands of professionals applied to the U.S. Olympic Committee in hopes of serving on the medical team.

The goal of producing a cooperative medical team was undetermined by well-meaning but inappropriate mavericks. Doctors who arrived uninvited, even with the best of intentions, were seen as lacking professional integrity. While medical professionals of all kinds tried to bypass the selection process, chiropractors had more at stake than MDs and other professionals. The Olympics provided a very worthy opportunity to raise the chiropractic profession to the stature it so well deserves by demonstrating the power of effective cooperation among various specialists. USOC teamwork allowed other medical professionals to see the success of chiropractic treatment not only to the spine, but also to kinetically-linked articulations. When physicians observed chiropractors in action, they saw the results for themselves: seeing is believing.

At the Olympics, a competent, professional image included neat and appropriate attire, but went far beyond visual appearance. It may not seem very significant on the surface, but it was important to observe the rules of considerate conduct, adhere to chiropractic credos, obey the USOC guidelines, and respect the laws and cultural customs of the hosting country. Success at the Olympics was more than victorious medical care for competing athletes. When you conduct yourself with the utmost professional dignity and integrity, you act as a worthy ambassador for the chiropractic profession.

Chiropractic Comes of Age at the Olympics

The Olympics presented a tremendous opportunity for engendering positive communication and worldwide public relations. Everyone strived to share peace, friendship, and understanding. Even medical professionals were briefed on the importance of acting in a way that demonstrated a well-vested national pride. The games gave us a chance, for five weeks, to show what kind of positive world this can be when we all pull together without prejudice or hatred.

At the Olympics, chiropractic is no longer perceived to be experimental or introduced on a trial basis. The USOC, the medical community, and the athletes view chiropractic as a valued component with a defined purpose within the medical team. Chiropractic care has been integrated into the system with total acceptance of chiropractic skills and recognition of the effect of subluxation in the athlete. The success of this integration in the environment of the Olympics speaks well for the future. It suggests that chiropractic will be more widely integrated overall; those who stand to gain most of all are the athletes.

Philip T. Santiago, D.C.
Lake Hiawatha, New Jersey

Editor's Note: We'd like to congratulate Dr. Santiago for the inroads he's made for chiropractic by being named the official chiropractor for the U.S. Olympic team by the U.S. Olympic Committee (USOC).

The article you've just read will also be published later this month in Chiropractic Sports Medicine, Vol. 6, #4.

Stephen Perle, D.C. of the Federation Internationale de Chiropratique Sportive (FICS) informs us of the following FICS members who were involved in treating athletes in Barcelona:

DCs Mike Reed (U.S. wrestling), and Dan McClure (U.S. diving); DCs providing chiropractic for other national teams included: Brian Nook (Zambia); Clive Hill (New Zealand); Joseph Albarello (Angola); Don Oyao (Seychelles); Kurt Anderson (Norway); Graham Dobson (New Zealand canoeing); Howard O'Meara (Ghana); LeRoy Perry (Unified); Mike Greenberg (British Virgin Islands); Alan Miller (Sierra Leone); Jack Scott (Antigua); and Doug Menzes (Virgin Islands). DCs Doug Greene and Clayton Heatley worked with the International Olympic Committee.