Etiology — what causes it
Active injury or chronic overload occurring during a competitive season where stopping play is undesirable or impossible. Common in tendinopathy, low-grade strains, and chronic overuse presentations.
Epidemiology — who gets it
Universal across competitive sport. Decision-making depends on injury severity, sport demands, career stage, and athlete preference.
Clinical signs
Specific to the underlying diagnosis. Tools like the Acute:Chronic Workload Ratio (Gabbett, BJSM) help guide load monitoring decisions.
Symptoms
Specific to the underlying diagnosis.
Best evidence for chiropractic treatment
Load management frameworks (Gabbett ACWR, Soligard et al. BJSM consensus on training load), targeted treatment to reduce symptoms enough to bridge competitions, structured deload periods, and clear communication with coaches and athletes about risk. Symptom-tolerance frameworks (e.g., pain up to 3/10 during activity acceptable in tendinopathy) help athletes train through manageable issues.
When to seek emergency care
Some symptoms need urgent medical attention — not a chiropractic visit. Call 911 or go to the nearest emergency department for: progressive limb weakness, loss of bowel or bladder control, saddle anesthesia (numbness in the groin/inner thighs), severe unrelenting pain unrelieved by position, signs of fracture after significant trauma, chest pain, stroke-like symptoms (face drooping, arm weakness, speech changes), or any rapidly worsening or unusual symptom.
Bottom line
In-season management is about modifying load, controlling symptoms, and bridging the season — then doing the full work in the off-season.