Taking Chiropractic on Tour

Many consider the century-old Tour de France the world's greatest annual sporting event, and for good reason: The grueling 2,125-mile, 23-day cycling race challenges participants' physical and mental limits like no other competition. Only four riders had ever won this historic event five times - until July 27 of this year, when American Lance Armstrong joined the elite ranks with his fifth consecutive Tour victory.

In each of those five victories, Jeffrey Spencer, MS, DC, CCSP, treated Lance and the other members of United States Postal Service Pro Cycling Team - before, during and after each stage of the race. DC interviewed Dr. Spencer recently to learn more about his continuing role keeping Lance and the other cyclists on the team healthy for the rigors of the Tour.

Dynamic Chiropractic (DC): Hello, Dr. Spencer. Thanks for taking the time to answer a few questions. Give our readers a brief background of your training and experience as a chiropractor: the college you attended, how long you've been in practice, any specialized training, etc.

Dr. Jeffrey Spencer (JS): Prior to graduating from Cleveland Chiropractic College in Los Angeles in 1988, I received my bachelor's and master's degrees in sports science from the University of Southern California. I went on to receive my certification as a chiropractic sports physician (CCSP) from Los Angeles College of Chiropractic, and currently serve on their postgraduate faculty, where I teach the sports-injury portion of their diplomate rehabilitation program. I have been in clinical practice since 1988.

DC: How and when did you become involved with the cycling world in general, and with Lance Armstrong in particular?

JS: I began cycling in 1961 and competing nationally in 1963, which culminated in my becoming a member of the United States Olympic Cycling Team. We competed in the 1972 Olympics in Munich, Germany. After returning from the Olympics, I finished my studies at USC and became a fitness conditioning consultant to many sports teams and athletes, then entered chiropractic school in 1985.

My motivation for going into chiropractic was to develop the capacity to heal athletes in a fraction of the time of conventional delivery systems. Having been an athlete, I was all too aware that the existing protocols for injury prevention and management were far too slow for the athlete; most of the time, an injured athlete was never able to return to pre-injury function. I continued with fitness consulting while in chiropractic school, which allowed me to maintain my strong ties with the athletic world.

I met Lance in 1988 at the Tour de France through Mark Gorski, the general manager of the United States Postal Service Pro Cycling Team (of which Lance was and is a member). Early that year, Mark requested that I come to the Tour to meet Lance and begin my formal involvement with the team at its preseason training camp the following January.

DC: Have you treated Lance at other races, or just the Tour de France? Did you treat other members of his team, as well?

JS: Yes, since 1999 I've treated Lance at other races and training camps - all part of his preparation for the Tour. At the Tour, I treat every member of the nine-rider team daily.

DC: Describe a typical day at the Tour - the personal travel involved, the lodging, and your participation in the treatment program.

JS: The Tour is the most brutal experience I've ever gone through. It's so incredibly difficult - it's hard to adequately describe its complexity. The bottom line, I guess, is that it's the ultimate sleep- and food-deprivation experiment that tests the absolute limits of one's physical and mental capacity. There is no 'typical' day. It's three weeks of controlled chaos, 24/7. Every moment is spoken for at least three times over, with absolutely no margin for error.

The team is composed of nine riders; four massage therapists; four mechanics; two directors; a medical doctor; myself; a public-relations liaison; and a chef. My responsibility with the team is to ensure that each rider's body is biomechanically and energetically prepared to meet the demands of every one of the Tour's 21 stages; proactively implement injury-prevention strategies; administer injury-management protocols; and implement aggressive recovery measures.

A typical day begins at 6:30 a.m. and finishes at 1:30 a.m. There's a short breakfast, then the equipment and suitcases are readied for transport. We administer morning therapy, then load on the team bus and travel to the starting point. On the bus, I do kinesiotaping, H-wave, Erchonia laser and adjusting, right up to the start of that day's Tour stage. There's always something that needs to be done.

After the start, I ride in the bus to the finish, then wait for an hour or so until the riders finish the stage and board the bus for the trip to the hotel. On the bus, I triage the day's carnage and begin injury-management and recovery procedures immediately. As soon as we get back to the hotel (around 6 or 7 p.m.), half the riders go for massage and the other half come to me for care. We work until the 8:30 p.m. dinner. After dinner, I work on the other half of the riders, finishing at around midnight. Then I reorganize my equipment for the following morning and go to sleep by about 1:30-1:45 a.m.

DC: Can you detail any specifics of the treatment program you administered to Lance (in this year's race or previous years)? If not, give us a few hints into how you think chiropractic care helps world-class cyclists.

JS: Lance's program always entails detailed pre-race protocols designed to optimize his performance, accelerate recovery and minimize down time - exactly the same program as the rest of the team. Each session with each rider is based on [his or her] needs at the time of the session - I don't provide cookbook recipe care. My arsenal of tools includes adjusting; Erchonia cold laser; resonance testing with QXCI; postisometric stretching; "The Stick"; Rejuvenetics VE-1; kinesiotaping; H-wave; Earth Tether grounding; ELF light beam generator; and other proprietary adjuncts I'm not at liberty to discuss.* I'm also currently working with a state-of-the-art infrared thermography imaging system that allows me to detect a tendonitis or soft tissue problem well in advance of it being symptomatic. This technology will also allow me to objectively follow the course of an injury's recovery. It's incredible.

Chiropractic is an indespensible part of any athlete's career, providing it includes leading-edge manual techniques, modalities and nutrition strategies that promote prevention, performance and recovery. Athletes who don't avail themselves of these technologies will never consistently put in top performances or have long careers.

DC: Is there a difference between treating a world-class athlete and treating a "typical" chiropractic patient?

JS: For me, there's no difference whatsoever. The principles that govern anatomy, neurology, energetics and physiology are the same for everyone. There's no distinction between athlete and nonathlete. The body's the body. We're humans first and athletes second.

DC: What are the specific chiropractic needs of a professional cyclist?

JS: The most important chiropractic needs for the pro cyclist are to accurately identify and quickly resolve any neuromusculoskeletal or locomotor dysfunction, organic deficiency, hormone imbalance, nutritional need, or hidden 'drags' on the body, such as heavy-metal burden, occult microbial infection, pesticide exposure or parasitic infestation. It's extremely important to ferret out anything that's putting a load on the body. The hidden things - the things that aren't symptomatic - are the biggest problem. What riders don't know is going on inside them is what can end up really hurting them. We all think how we feel is what we are, but that's not true. How we feel is only how we feel - it doesn't reveal the hidden time bombs in our bodies that are ticking toward their detonation times, ready to kill off careers through needless injuries and illnesses.

DC: Based on your experience, what is the general overall feeling toward chiropractic from the competitors?

JS: The riders embrace the comprehensiveness of the profession. They respect my knowledge of biomechanics, nutrition, supplementation, modalities, rehabilitation, organic function and microbiology. I get asked questions every day that pertain to all of these areas.

DC: Have you treated other athletes? If so, what types of conditions do you see, and what does your general treatment program entail?

JS: I've treated professional athletes in a variety of sports, including motocross; car racing; snowmobiling; jet skiing; baseball; golf; and football. Along with Lance, Tiger Woods is probably the most well-known athlete I've treated. Conditions I've treated include almost everything, from dislocated joints to massive abrasions.

My first step with anyone is to do a workup, which includes a functional NMS examination, autonomic response testing, and if necessary, functional lab tests, doctor's data or labs, thermographic imaging and resonance testing with the QXCI. Clinical treatment protocols include all the elements I've discussed previously. Patient homework includes NMS stretching, strengthening, and coordination exercises, and "The Stick."

DC: Lance Armstrong has now won five consecutive Tour de France races - with chiropractic's assistance. What do you think this says about the power/future of chiropractic?

JS: Chiropractic is an incredibly powerful tool that has an unbelievable capacity to heal and prevent an extremely diverse range of conditions. The future of the profession rests in the hands of those who build that diversity to include the full implementation of the entire scope of biomechanical, biochemical and bioenergetic diagnostic and treatment protocols - to deliver a new paradigm of health care based on identifying and resolving bottom-line causes, not just chasing symptoms.

DC: What's your advice to other chiropractors who may want to get involved at professional sporting events and/or treat professional athletes? How can they get involved, and what are the benefits/drawbacks, in your opinion?

JS: If you want to get involved with professional athletes, start by developing relationships with the athletes. Treat them outside the team structure, then go to the teams after the athletes have experienced the power of chiropractic, and they become your greatest advocates. Most teams have a deep medical bias steeped in territorial protectionism - chiropractors are often relegated to the role of 'adjusting technicians' rather than primary diagnosticians with diverse clinical treatment skills.

I also suggest getting a postgraduate degree in sports injuries. The best way to get involved in amateur athletics is to find someone you have a personal history with and who participates in the sport; tell them what you want to do, and ask if they can pass on your inquiry or résumé to the person who sets up the relationships with the teams' health care providers.

The benefits of working with athletes are that you can help form lifetime attitudes about their health by teaching them about their bodies, so they understand what it takes to live a highly productive and long life. Developing deep human relationships that can last a lifetime is another major bonus, plus you get to see the world and work with people who want to take charge of their health. The drawbacks can include being given only limited capacity to use your entire chiropractic training to diagnose and treat; being taken for granted by the athletes and/or the team; seeing someone with whom you've developed a special relationship severely injured; or not getting just compensation for your contributions to the athlete and/or the team.

DC: Thank you, Dr. Spencer.

Editor's note: Dynamic Chiropractic does not necessarily endorse any of the specific therapeutic/diagnostic products Dr. Spencer mentions by name in the course of this interview.