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2 Fall 2016 | Canadian Chiropractic Association

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8 Message from the CEO

Three Decades of 12 The Learning Curve in Chiropractic Protection 5 Multidisciplinary Clinics

14 Chiropractic Care Changes Pain

26 Toward a Better Approach to Pain Management in Canada

Chiropractic and the 16 Toronto Argonauts CHECK IT OUT

Champion Profile: ObusForme 20

The CCRF Celebrates its 40th Year!

Successful Foresight: Mount Carmel 21 Clinic's Chiropractic Program 22 Champion Profile: Morneau Shepell 28 at the Ottawa Marathon Running Business: Chiropractic 29

Champion Profile: Moneris

On-Base: Working to Help 33 Chiropractors at the Olympic Games 30 Canada's Military

Fall 2016 | Canadian Chiropractic Association 3 CONTRIBUTORS

DR. PAUL F. CAREY, DC Dr. Paul Carey graduated from Canadian Memorial Chiropractic College in 1967. He resides in Stratford, Ontario and retired from active practice in 2016. He joined the Ontario Chiropractic Association Board in 1971, serving as their president from 1981 to 1983. He was president of Fall 2016 Issue 12 the Canadian Chiropractic Association in 1987, and was a founding member of the World Federation of Chiropractic, serving as president from 2002 to 2004. Dr. Carey was also instrumental in setting up Canadian Chiropractic Protective Association in 1986, serving www.chiropractic.ca as their president from 1986-2014. [email protected] DR. DWIGHT CHAPIN, DC BACK Matters™ is a publication Dr. Dwight Chapin is a chiropractor and the clinic director and co-owner of High Point Wellness of the Canadian Chiropractic Centre, a multidisciplinary health clinic in Mississauga, Ontario. In addition to his practice, his team delivers corporate wellness programs for a variety of enterprise clients including The Globe Association (CCA) and is and Mail, General Mills Canada Corporation, Bell Media, Canada Post Corporation, and the Centre published three times per year. for Health and Safety Innovation. He is also the team chiropractor for the Toronto Argonauts and a health advisor for The Globe Mail. Copyright © 2016 Canadian DR. GREG DUNN, DC Chiropractic Association. All rights reserved. The opinions Dr. Greg Dunn graduated from Canadian Memorial Chiropractic College in 1976. He had an active practice in Manitoba, mostly in the small community of Neepawa, until June 1999. Dr. Dunn expressed in this publication served on the Board of the CCPA from 1990 until his appointment of COO in September 1999. are those of the authors and Also, while serving on the CCPA Board, he became chair of the Risk Management Committee. do not necessarily reflect He is also a national and international lecturer on the topic of risk and risk management. the opinions and policies of Currently, Dr. Dunn serves as the CEO of the CCPA. He is a past president of the Manitoba the CCA. Advertisements Chiropractors’ Association and a past president of the Canadian Chiropractic Association. Dr. Dunn has also been very active in community volunteer work. He co-chaired the 1992 shall not be considered an Manitoba Summer Games, was a founding member and first chairman of the Beautiful Plains endorsement, warranty or Community Foundation Inc., and was the leading force in getting Canada Post to issue a guarantee of the product(s) or Centennial Stamp commemorating one hundred years of Chiropractic in Canada. service(s) advertised, nor an DR. FELIX LANTHIER, DC endorsement by the CCA of Dr. Felix Lanthier graduated from the Université du Québec à Trois-Rivières (UQTR) in 2013. the manufacturer, distributor, He then bought an existing practice in Gatineau, Quebec, where he is currently practicing. supplier or advertiser of such While developing his business, he enrolled in the sport chiropractic program at UQTR which he product or service. graduated from in 2015. Dr. Lanthier was very involved in chiropractic school and continues to be: he has been the regional advisor for the Association des chiropraticiens du Québec for the No part of this publication last two years. His passion right now is to continue learning by attending professional seminars. may be reprinted without the DR. FABIO LEVI, DC editor’s written permission. Dr. Fabio Levi obtained his Doctor of Chiropractic degree from the Canadian Memorial Chiropractic College with Clinical Honours. He is a diversified practitioner whose main goal is to utilize a holistic approach to help his patients reach their optimal functioning and health Published by the CCA potential. Dr. Levi has extensive experience working with a wide range of individuals from Editor: Ronda Parkes office and industry workers to fitness fanatics and professional and Olympic athletes. With special interests in biomechanics, nutrition, ergonomics, and physical fitness, Dr. Levi takes [email protected] the time to educate and empower his patients on the importance of healthy living and the benefits of chiropractic care. Tel: 416-585-7902 Toll Free: 1-877-222-9303 DR. STEVEN PASSMORE, DC, PHD Fax: 416-585-2970 Dr. Steven Passmore is an assistant professor in the Faculty of Kinesiology & Recreation Management at the University of Manitoba. He also holds adjunct appointments in the College Publications Mail of Rehabilitation Sciences at the University of Manitoba and the Research Department at New York Chiropractic College. His sub-specialization in kinesiology is human perceptual learning Agreement No. 40036842 and motor control. Dr. Passmore explores performance-based outcome measures to determine population characteristics, movement outcomes, and intervention sustainability. He practiced Return undeliverable as a chiropractor in the Buffalo Veterans Affairs Medical Center from 2007–2009 and has aided Canadian addresses to: the Mount Carmel Clinic in data collection since 2011, spawning his interest in chiropractic care 186 Spadina Ave, Suite 6, integration into publicly funded facilities. Toronto, Ontario M5T 3B2 DR. AUDREY TOTH, DC Dr. Audrey Toth, originally from Northern California, graduated from Life Chiropractic College West in 1990. She has enjoyed private practice since. Presently, she is employed as an on-staff chiropractor at the Mount Carmel Clinic in Winnipeg, Manitoba. Dr. Toth is a past registrar of the Manitoba Chiropractors Association, past acting executive director of the Manitoba Chiropractors Association, and a past chair of the Standards Committee of the Manitoba Chiropractors Association. She has also MIX Paper from served on various committees of the Manitoba Chiropractors Association including the Complaints responsible sources Committee, Examining Committee, Licensing Committee, and Legislative Review Committee. C011603 Dr. Toth served as vice president for the Canadian Federation of Chiropractic Regulatory Boards and as president of the Manitoba Chapter of the Acupuncture Foundation of Canada Institute.

4 Fall 2016 | Canadian Chiropractic Association Three Decades of Chiropractic Protection

BY DR. GREG DUNN, DC CHIEF EXECUTIVE OFFICER, CANADIAN CHIROPRACTIC PROTECTIVE ASSOCIATION

his year marks the 30th filed. This is a unique benefit to being provide that are designed to help you anniversary of the Canadian a CCPA member. Insurance companies sleep better at night. We are always T Chiropractic Protective Association typically act only when a claim has been looking for ways to enhance the quality (CCPA). Over those three decades we have filed against you. of those services. For example, all of learned how to protect chiropractors in our members now enjoy a $5 million per Canada. As a result, the chance of you facing The CCPA also works on your behalf in claim limit. That is more than double a malpractice claim are very low. Today, only regulatory matters. Be sure to call us the previous limit of $2 million. The about four chiropractors in 1,000 will be sued first if you are ever facing a complaint aggregate annual limit per member annually. That number has fallen from about or an investigation by your provincial was also increased to $5 million. 12 in 1,000 in the early 2000s. licensing board. We offer valuable advice to members who are weathering this We are proud to offer this tremendous One of the reasons that number is so low is process and will be able to refer you to a increase in protection for no additional due to the CCPA’s claims prevention service. lawyer we trust in the event that you need cost to you. Keeping the cost of CCPA We want to hear from you as soon as you one. At the conclusion of the process, you membership as low as possible has been suspect a problem might arise. Our expert may be eligible to have some of your legal a commitment we’ve stuck to for three team of chiropractors and lawyers will costs reimbursed by the CCPA. decades. In today’s money, our members immediately begin working on your behalf. now receive 10 times the protection for We get lots of calls like this and in many This diligent protection of you and your over $450 less than in 1986 when CCPA cases we are able to avoid a claim being practice is part of a suite of services we was founded.

Fall 2016 | Canadian Chiropractic Association 5 MESSAGE FROM THE CHAIR

DR. DAVID PEEACE, DC What Are We Building? Chair, CCA Board of Directors

“If I have seen further it is by standing upon the shoulders of giants.”

— Sir Isaac Newton

his quote resonated with me this I am proud to serve our Canadian chiropractic community as summer during my travels in England, Chair of the Canadian Chiropractic Association (CCA). Dr. Robert T David has passed along the torch and I feel forever indebted to where I attended a seminar. While I was there, his leadership, and the leadership that has preceded me. I have opportunities arose to chat with some of our had the honour of working with previous chairs and presidents over the last 11 years—not only during my eight years on the colleges across the pond and reflect on our CCA Board of Directors but also while I was serving as a Board profession. What I found not only made me member of the Chiropractors’ Association of Saskatchewan from appreciate some of the aspects of practice we 2005–2007. I remember coming to my first national meeting for Clinical Practice Guidelines at Saint Andrews by the Sea 14 years take for granted in Canada, but also recognize ago, and perhaps that planted the seeds for what was yet to come. the common bond we have with those in our After seeing and working with many of the profession’s national profession across the world, regardless of leaders for over a decade, I continue to be impressed by the depth of leadership in our profession. I am also fortunate enough to say which country we are from. many of these leaders have become mentors to me.

6 Fall 2016 | Canadian Chiropractic Association I am sure that most of you, like myself, entered our profession We are focusing our on lobbying for the profession and because of having met someone in the profession—as a patient, pressing forward for better care for members of the military. friend, or family member—who later became your mentor. We As you will see in this issue of BACK Matters, we are announcing owe a lot to these individuals—they have entrusted us with the the launch of a demonstration project with the Department of future of the profession that they hold so dear. With this trust Defence for on-base chiropractic care. This project offers an there is an expectation to continue to move forward, to advance our incredible opportunity for research into the musculoskeletal profession, and to keep building upon the successes of the past. health of our men and women in the Canadian Forces (see page 30). We welcome the opportunity to develop this field Early on in my practice, I attended a seminar where the presenter of research while simultaneously offering increased care to a told a story that had a profound effect on the audience and a population that suffers greatly from MSK-related ailments. lasting impact on me:

“A man came upon a construction site where three people were “After seeing and working with many of working. He asked the first, ‘What are you doing?’ and the man replied: ‘I am laying bricks.’ He asked the second, ‘What the profession’s national leaders for over a are you doing?’ and the man replied: ‘I am building a wall.’ decade, I continue to be impressed by the As he approached the third, he heard him humming a tune as he worked, and asked, ‘What are you doing?’ The man stood, depth of leadership in our profession.” looked up at the sky, and smiled, ‘I am building a cathedral!’”

This little story demonstrates the value of perspective. There are also exciting things happening with our The question, “What are you doing?” could be posed to researchers—we have a growing number of researchers all chiropractors. In fact, it can be turned around to your studying the field and bringing more and more credibility to association—you may ask, “What is the CCA doing?” Often, the the profession. As you will read more about in our column for question behind this common inquiry is, “What value is there the Canadian Chiropractic Research Foundation—which is being a part of the CCA?” I hope in the next few paragraphs I currently celebrating its 40th year—we have officially secured can answer that question and help you see the value. a research chair at a major university in every province. Our 18th research chair position has been established at In the last Message from the Chair, we informed you that we the University of New Brunswick, completing our list of are reviewing our three-year strategic plan. In 2013, we stated participating provinces. From here, there is only room to grow. our vision is that chiropractors will be an integral part of every We celebrate this accomplishment, but we also know that Canadian’s healthcare team by 2023. This was a result of a huge continued support for research is needed in order to maintain change in the governance of CCA, which brought about not only progress in the field. a new vision but also a mission and strategic plan to accomplish it. We are now one-third of the way through our 10-year plan, Finally, there have been some exciting changes to the and review is underway. Some stakeholders have suggested Canadian Chiropractic Guideline Initiative which have our vision is too lofty or too out of reach. However, it is worth peaked interest not only in Canada but also to the world noting that our profession did not start out with small goals or as a whole. These changes include new guidelines on the ideals. We have always challenged the status quo and worked treatment of neck pain associated disorders and whiplash hard, with our focus always being the improvement of our associated disorders. patient’s health. I believe we are entering some exciting times. There will This turn towards the patient is why I am very encouraged definitely be some hurdles and challenges to overcome, and proud of the work put forth by the Patient Experience however, I am confident we have the knowledge, tools, Task Force. In our surveys, we have found there are still some and tenacity to overcome them. I have confidence in the strong misconceptions about our profession that are keeping dedication and courage the Board of Directors that sit with Canadians from coming into our offices. It is concerning that me at our table and in the tireless and innovative spirit of our not all patients are completing their treatment plans and, staff who continue to amaze me as they come up with plans worse, they are often not returning after the first office visit. that bring us closer to our vision. Finally, I have confidence The task force is working with membership to examine these in our profession. We are builders; we see the bigger picture; trends—they are asking some tough questions and coming up we know that it is not only vertebrae we are adjusting, and with solutions that may be challenging, but look very closely at we know that our work is about more than simply helping the profession through the patients’ perspective. The success of someone feel better. We know we are building the health of this effort will only be attainable if we can see change through our nation and improving the lives of all Canadians. I believe the eyes of the patient—and work together on delivering viable that by standing on the shoulders of those who have gone and patient-centred solutions. before us, our vision gets clearer and clearer.

Fall 2016 | Canadian Chiropractic Association 7 MESSAGE FROM THE CEO

Motivating Canadians: ALISON DANTAS Building a Brand CEO

Pain changes everything.

Chiropractic care changes pain.

uman connections are the heart and soul of the We wanted to define the chiropractor's role as a part of profession. At the end of the day, you are dealing with every Canadian’s healthcare team in a way that has value H people. Helping Canadians seek out your expertise and for Canadians, the profession, and our members. supporting a national agenda that encourages a consistent brand position to do this is our motivation. For the profession at large, we wanted to create more meaningful cultural connections between chiropractors and Storytelling is a powerful technique for building relationships. Canadians. We wanted to convey to the public that chiropractors It’s an age-old concept that connects and engages people. are there to help the patient and that there is evidence behind Storytelling and marketing go hand-in-hand. chiropractic care.

For the first time, associations across the country united to develop For members, we wanted to create opportunities to be part of a a consistent brand position that effectively communicates our value movement—one that values chiropractic as an integral part of to Canadians and to the healthcare system from the perspective every Canadian’s healthcare team. of patients. We know that there is so much you do to help patients improve their health. We also know that pain is primarily what drives We heard what patients have said and modified our thinking to a patient’s decision to seek care. This position is based on research and address these concerns. input from patients, stakeholders, key chiropractic informants, and consultants. We are excited to deliver a clear message that clarifies THE RESEARCH what we as a profession do, why we do it, and how we change lives. This discussion around reshaping our brand identity began in the Fall of 2014. Through working groups, external consultants, Our brand galvanizes our efforts—it drives momentum for and validated public opinion research, the conversation has our patient-centred movement. But there’s more to our grown, and out of it came a professional descriptor, a national profession’s brand story. brand positioning statement, and the brand story we have today.

8 Fall 2016 | Canadian Chiropractic Association Our national brand initiative works to position the profession for greater success and foster the perception that chiropractors are spine, muscle, and nervous system experts trained to diagnose and BRAND CLARITY recommend treatment options for patients. CLARITY COLLABORATION The underlying commitment we share is towards the Leaders of the profession across the country were included in a patient—to be understandable and to be clear, in plain national agenda. We came together to discuss positioning the language about how the profession works, what its profession through the eyes of the patient, to bring everybody unique value is, and why our patients matter to us. We onto the same page and provide a consistent approach to our already have the professional descriptor, and now we individual marketing and public relations efforts. This is a have the national brand positioning statement and a precedent-setting moment for the profession as we have come corresponding brand story. together—and built the project and its parameters together— with full agreement from all the provinces. When patients know and understand that their well- being comes first and that their treatment is about Our professional descriptor may not capture the nuances of them and guided by an evidence-informed practice, it each individual practice, but what it does is touch upon what allows them to have more trust in the profession. This is the public is telling us is the main reason they would even seek fundamental to our movement. out a chiropractor. PROFESSIONAL DESCRIPTOR NATIONAL SUPPORT Canada’s chiropractors are musculoskeletal (MSK) experts, We believe that attaining full national support of this brand providing the assessment, diagnosis, treatment, and positioning statement provides an immense opportunity for the preventative care of biomechanical disorders originating profession. We are stronger together. Members and patients will from the muscular, skeletal, and nervous systems. benefit from consistent messaging across the country. A shared positioning statement increases the reach of the profession and The nuance between the brand positioning and the the public’s awareness of it—consequently opening up potential professional descriptor is that in our professional opportunities for stronger advocacy efforts. descriptor we label ourselves as MSK experts—it is used in the context of advocacy in medical fields, and UNIFIED VOICE identifying ourselves amongst our fellow healthcare Having a unified voice as a profession gives us power. It makes practitioners. Our brand statement is different. us identifiable to the public, bolsters our cultural authority, and builds trust. It is part of the movement that will allow us to attain BRAND POSITIONING our vision for every Canadian to see chiropractors as an integral For people with persistent back or neck pain, headaches or part of their healthcare team. migraines that prevent them from enjoying their everyday lives, chiropractors are spine, muscle, and nervous system Our brand story was designed to answer the question, “Why experts specifically trained to diagnose the underlying cause chiropractic?” from a patient-centred perspective. Our brand and recommend treatment options to relieve pain, restore video tells Canadians who suffer from spine, muscle, and nervous mobility, and prevent reoccurrence so that people can lead system pain that chiropractic care can help. It tells the public healthy, active lives. that chiropractors are experts trained to diagnose that pain, recommend treatment options, restore mobility, and prevent This brand positioning statement, like the professional reoccurrence so that people can lead healthy and active lives. descriptor, has been extensively researched; it represents a collaborative effort; and it is based deeply on the insights of the public into the profession of chiropractic. Our national "Why Chiropractic?" brand statement and story are predominantly public-facing. Here, we label ourselves as spine, muscle, and nervous Our Brand Story system experts. This distinction is by design—the brand You can view our brand video positioning uses language that a patient can understand and on our website here: words that can be grasped by the general public.

chirochangespain.ca Through this statement, we have created a brand story, for which we have carefully defined guidelines to surround the We would love to hear from you message. We know why we use each statement, and how it about our brand story. works to both inform and build trust.

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1609998_G0690_AD_TRYUS-8.5x11_REST_En.indd 1 06/Jul/2016 10:26 AM BUSINESSSPOTLIGHT PROFILE ON DR. FABIO LEVI The Learning Curve

Dr. Fabio Levi on the multidisciplinary clinic model changing the landscape of healthcare—and chiropractic’s role within it

“It’s been changing since I graduated. There’s a lot more is a huge advantage for successful patient care. I don’t think openness; other healthcare practitioners are starting to see that everyone will respond to one healthcare service.” the benefit of including chiropractic to manage patients,” Dr. Fabio Levi comments on the atmosphere that surrounds Working with so many other professionals in treating a patient his multidisciplinary work. He also refers to the value of starting also requires a delicate balance of trust and communication: the learning process at the school level, before entering the “At times, I have patients who see me, the physiotherapist, the workforce, and how the nature of that education has changed massage therapist and a family doctor.” Often a patient will (and continues to change) since he went to school. be co-managed by both physiotherapists and chiropractors at the clinic, “Since we work right next to each other, we have the At the time Dr. Levi was in school, he remembers that ability to collaborate and have discussions to avoid overlapping multidisciplinary learning was only just beginning to take shape: treatment—all for the benefit of the patient.” students were encouraged to communicate with medical doctors and family practitioners, “but I can’t say that there were a lot of As an associate in the clinic, he was offered a learning case studies or practical training where we were taught to put environment that has allowed his own skills as a chiropractor that into practice—even in the last internship year.” to grow and thrive. One unique aspect of the multidisciplinary environment is a collaborative approach to learning. There’s Fortunately, he found the learning environment he craved in a voluntary in-service program where various healthcare his practice. Two and a half years ago he joined a medical walk- professionals present a specific healthcare topic and explore it in clinic with multidisciplinary options available that have through the lens of their profession in collaboration with the nourished his need to work and grow with other practitioners: other attending practitioners, “most of these presentations “Though there has been progress, our profession has seen a highlight the importance of a thorough assessment by the most number of challenges in developing relationships. Maybe it’s appropriate health professional for the presenting condition,” something that I always thought was a bit of a challenge, and Dr. Levi explains, “so we can refer patients to the right healthcare I’ve been drawn to improving that.” Dr. Levi also notes that professional in the clinic.” Among the in-service sessions he having ready access to others has transformed the treatment has led are mechanical low back issues, postural dysfunction, process for the betterment of the patient: headaches, running issues, as well as assisting with a session on knee issues. As far as who decides to lead a session, “It’s initiated “Working well with your fellow medical by any one of us. I will present on the chiropractor side, one or two physiotherapists will speak, the medical doctors will provide doctors and healthcare practitioners input and ask questions, and usually we collectively come up requires understanding, and these with three to four cases to discuss,” all through demonstrations, collaborative learning sessions open the assessments, and management. “When we demonstrate a topic or case it’s not just PowerPoint slides, it’s a very interactive floor to consideration and empathy. The process and offers lots of opportunities to engage. I do my best to result is better communication between try to understand what everyone brings to the table to ultimately improve the care of our patients.” different types of therapists and doctors.”

Dr. Levi sees the structure of these in-service rounds as a positive “I like the collaborative approach versus being isolated by step for the future of healthcare clinics. Chiropractors often face chiropractic practice alone. Patients are unique and respond misunderstandings about the profession, or other practitioners differently to healthcare options. Having access to other don’t have the opportunity to sit down with the chiropractor that professionals and interventions directly within my workspace is treating their patient, however:

12 Fall 2016 | Canadian Chiropractic Association “Simply providing the opportunity to ask questions and Looking to the future of healthcare integration, in both have them answered is extremely valuable. Medical doctors, medical clinics and hospitals, Dr. Levi sees real promise in this like chiropractors and other practitioners, can be quite busy, model, particularly for the patient: “This model will allow us so the opportunity for conversation beyond electronic or to help more people, and effectively triage for patient needs. paper notes has been a very positive and beneficial experience. Chiropractors are qualified to take on cases within our scope, Since my time at the clinic, and due to the collaboration and to also refer when necessary.” Inevitably, sharing knowledge that we’ve established, I have seen more frequent and and resources serves to benefit everyone: appropriate referrals for musculoskeletal [(MSK)] issues, so patients are benefiting by receiving the care that they need “I believe that the interdisciplinary model would relieve some when they need it.” of the stress on the medical system, including medical visits, diagnostic imaging, and specialist appointments, while allowing Working well with your fellow medical doctors and healthcare chiropractors to fully participate in the management of MSK practitioners requires understanding, and these collaborative health issues. I believe this would definitely facilitate and learning sessions open the floor to consideration and empathy. improve primary contact for the patient.” The result is better communication between different types of therapists and doctors. “It’s been great. Finding the best Ultimately, multidisciplinary and interprofessional collaboration time for discussions and in-service sessions has been one starts with a shared desire to learn, listen, and grow. Hopefully, of the biggest challenges with the various schedules of each through recent changes in chiropractic curriculum alongside practitioner, but as far as the ones who do attend, it’s been shifting perceptions towards the profession, the environment a positive experience.” is primed for change. “I think that’s the way things are going. We have a role to play in facilitating better communication and When asked if he has seen this type of educational structure working together for the benefit of the patient. When resources before in other clinics, Dr. Levi says he has not, but he knows are properly utilized and patients improve, this reduces the it is more reflective of the kind of education you would see burden on the healthcare system—that is always going to be in hospitals, where doctors will do their rounds. a positive thing.”

We’ll help ecome a healthcare leader

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We prepare our students to be successful providers of highly 203.576.4552 competent patient-centered care by utilizing best practice [email protected] educational methodologies and engaging in relevant scholarly bridgeport.edu/chiro activities. Scholarships available to Canadian students

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Fall 2016 | Canadian Chiropractic Association 13 COMMUNICATIONS

Chiropractic Care RONDA PARKES DIRECTOR OF Changes Pain CORPORATE AFFAIRS

e know that as chiropractors you change people’s Our campaign, Chiropractic Care Changed My Pain—or W lives every day. You help with pain, rehabilitation, and #ChiroChangesPain—celebrates the stories of chiropractic correcting joint dysfunction, among many other ways you care for patients and doctors of chiropractic. Through this initiative, your patients over the course of their treatment. Along the path we are working to bring awareness to the different people who of your career, there are often defining moments that remind you suffer with MSK conditions, highlight the profound impact why you do what you do. Those are stories we wish to celebrate. chiropractors have on patients’ lives, and build an understanding of integrative healthcare models. Musculoskeletal (MSK) health Each year, we are excited to celebrate World Spine Day. This touches each of our lives in a different way, and sharing diverse year, we launched a new social media campaign which began stories helps to spread the message that MSK health affects in the weeks leading up to World Spine Day on October 16. everyone. Here is one patient’s story:

Meet James. An avid hockey and rugby player who Read James’ Story turned to chiropractic care to treat the wear and tear of years of contact sports.

“I played competitive hockey for over 25 years and rugby for over 15 years. While I enjoy both sports immensely, they took a toll on my body. Specifically: two degenerating spinal discs and the resulting lower back pain, two torn MCLs (medial collateral ligaments), shoulders that separated more than a few times, shin splints, and a torn meniscus. Needless to say, seeing a chiropractor has been a part of my life for many years. Chiropractic treatment has relieved much of the pain caused by my injuries and has enabled me to continue playing the sports that mean so much to me and allowed me to continue to achieve my full potential on the ice and on the field.”

14 Fall 2016 | Canadian Chiropractic Association While the #ChiroChangesPain campaign began early this Fall, it was the start of something greater—an ongoing celebration of our successes. There are many compelling stories of the burden MSK issues can have on patients as well as the great lengths chiropractors will go to treat them. Sometimes, there are complications and comorbidities that add to the challenge of Meet Your Alberta treatment, and require the work of an entire team of different healthcare professionals in order for your patient’s treatment CCGI Opinion Leaders to be successful. Other times, as doctors or patients, you are in locations so remote that it changes the way you approach your treatment. Every day, you listen and connect with your patient Opinion Leaders are and make them feel at ease and confident in your treatment individuals who are plan. These are stories that we want to share with the public— recognized by their both from within the chiropractic community and from the colleagues as excellent patients you treat. It is a project we would like to build on year- communicators, round, and we would like to call upon you, our membership, to knowledgeable practitioners share your inspiring stories with us. Dr. Phil and caring professionals. “Musculoskeletal health touches each of our Conway The Canadian Chiropractic lives in a different way, and sharing diverse Guideline Initiative is stories helps to spread the message that pleased to introduce its MSK health affects everyone.” Opinion Leaders who are helping to promote clinical We are working towards building our story for Canadians and practice guidelines and best helping Canadians choose chiropractic care. These stories and Dr. David practices across Canada. this social media campaign support not only World Spine Day Linford These inﬂuential leaders but our wider brand story and national brand positioning. It are working with patients, answers the question “Why chiropractic?” and talks about clinicians, students, policy pain and patients, in many different voices and many different ways. Our brand story video universalizes the conversation, makers and stakeholders and our #ChiroChangesPain campaign fills it with the stories of to promote and disseminate real people. The brand story video includes the national brand evidence-informed practice positioning and professional descriptor that Alison described so in their province. well in her CEO message in this issue of BACK Matters. Please view Dr. Clark it on chirochangespain.ca, and be part of the conversation. Mills Ask them what they can

You may have already noticed that these stories are being spread do to help you apply best through the Canadian Chiropractic Association’s social media practices in your practice platforms and that they are open for anyone to share. They have today—they’ll be happy another, more permanent location where you can find stories you to help. wish to revisit in the future: chirochangespain.ca. Here you can also find the submission requirements to send in your inspiring stories. We hope you had a chance to visit the World Spine Day digital toolkit in the members-only area of the CCA website to find key messages and images you can share online and posters which Connect wi� us! you can print and use in your clinic to promote the campaign. Share your stories and ask patients and other healthcare providers to share their stories about the value of chiropractic in their lives. www.chiroguidelines.org Please join us in this celebration. Submit your stories. Put up the poster in your office. Send an email to your patients for their stories as well. Join us on Facebook to share the stories of On LinkedIn others. These are our stories, and they represent how millions of Canadians are affected by the care you provide every day.

Fall 2016 | Canadian Chiropractic Association 15 FEATURE CHIROPRACTIC

AND THE TORONTO ARGONAUTS

16 Fall 2016 | Canadian Chiropractic Association BY DR. DWIGHT CHAPIN, DC when playing football at this the practice squad, it was understood level. As former Argonaut legend, that it would take a lot of hard work and n a week five matchup against Michael “Pinball” Clemons, says a little luck to close the season with a Montreal, the Toronto Argonauts to inspire players, “If what you did championship. Football is unforgiving and I (the Argonauts; the Argos) needed a yesterday still sounds good today injuries can change the direction of a season long five yards to keep a second quarter then you haven’t done much today.” in a blink of an eye. As success on the field offensive drive alive. Future Hall-of- lies in the fine details—everyone quickly fell Fame quarterback Ricky Ray dropped The preparation required each week into their roles and got to work, using the back into the pocket and threw a 17-yard to give the team the greatest chance vision as their fuel. The team united behind strike to rookie receiver Kenny Shaw for for success requires an off-field their common goal under the watchful a touchdown. Argos put seven points on sophistication that leaves little margin eye and skilled leadership of their general the board on their way to a convincing for error. Fall short, and your opponent manager, Jim Barker, and their head coach, win—a win that would give them a share will take full advantage. It is in this Scott Milanovich. of the lead in the Eastern Conference environment that chiropractic care heading into week six of the 2016 season. is a required ingredient for a winning As team chiropractor, the players have program in pro-football. made me feel like a teammate. Knowing On the sidelines, I celebrated the intimately the aches and pains and score. I was happy to see the Argonauts The 2016 campaign is an exciting one strengths and weaknesses of every player, take control of the game but, more for Toronto, namely, because the team the season is a thrill ride of emotional importantly, as team chiropractor, I liked is playing under a new ownership group highs and lows. I can demand more from the look of Ray’s throwing motion and the that is committed to winning on their these players and push the boundaries of efficiency, speed, and power of a handful recently renovated home turf at BMO their biomechanical performance farther of additional players I had my eye on. Field. The Toronto Argos are the oldest than I can with patients in my general existing professional sports team in North practice. This is clinically exciting and Football is a brutal sport that demands America—building on this history, the new has shifted my expectations of what is the best from everyone—coaches, owners have staged the team for future possible. Athletes of this calibre respond to players, trainers and medical staff. success. With Toronto hosting the Grey Cup chiropractic care in an impressive fashion. Success on the field depends on it. The this year, the Argos came into training camp Canadian Football League game is both hopeful to represent the Eastern Conference Most players specialize in a particular fast and exciting. Attention to the finest in this year’s championship on home field. position and skill, making teamwork details often makes the biggest difference From the president to the last member of and overall team talent more important

Fall 2016 | Canadian Chiropractic Association 17 Dr. Chapin treating Offensive Lineman Sean McEwen pre-game. Argonauts BMO Field Locker Room pre-game.

than the abilities of any single player. status of injured players and key details provided by Shannon and his team of It is said that football is a true team on their progress and expected return. athletic therapists. My approach integrates sport; the Argos’ medical team takes This is an essential tool used to keep manipulation, acupuncture, and various the same approach. Our ability to treat everyone on the same page and working soft tissue techniques in an effort to instill a player successfully hinges on our with the most current information. As you efficient mechanics, accelerate athletic communication and work as a cohesive can imagine, the list of potential injuries performance, and decrease the potential unit, especially on game day. in football is extensive—some weeks for injury while identifying movement and the reports read like a musculoskeletal mobility dysfunction. Some players require The medical team is led by Scott Shannon (MSK) sports injury index. Typical injuries chiropractic support for the management and Dr. Rick Zarnett: Shannon is team head include common hamstring and adductor of an acute injury, others to stay on top of a athletic therapist and is responsible for myofascial strains, lumbar and cervical chronic condition. managing the medical staff and Dr. Zarnett strains, medial collateral ligament is head team doctor and orthopaedic sprains, acromioclavicular joint sprains, Many players will seek me out to simply surgeon. Under their leadership, each anterior talofibular ligament sprains, maintain their top performance during member of the medical team is treated as metacarpophalangeal joint dislocations, the season. I asked James Yurichuk, Argos’ an equal and given every opportunity to various contusions and, yes, concussions. linebacker and special teams captain, contribute as it pertains to their individual to share his experience from a player’s scope of practice and the performance “Regardless of the perspective: “The professional football and well-being of their players. Both season is long and physically punishing— Shannon and Dr. Zarnett have established sport or level of play, inevitably there [are] going to be nicks and a collaborative environment of trust chiropractors have an bruises along the way. […] In April 2015, and accountability that the players and one month before training camp I suffered coaching staff can count on. opportunity to make a 16 mm tear in my patella tendon during a meaningful impact plyometric training. I knew the first half Rounding out the medical team is sports on athletic and team of season would be in jeopardy.” As his physician Dr. Michael Clarfield, Dr. Tim chiropractor, I quickly discovered that there Deakon (orthopaedic surgeon), Dr. Mitch performance.” was increased stress in his knee resulting Whyne (emergency-care physician), from abnormal mechanics in his hip that had Dr. Paul Eisner (team dentist), The team places a high value on likely contributed to his knee injury. Through Dr. Marty Falke and Dr. Pat Tracey (team chiropractic care and the role chiropractors active release techniques, acupuncture, optometrists), and assistant athletic play as MSK experts. I have the chiropractic, and laser treatment, we were therapists Josh Shewell, Brittney Enright- opportunity to work with players once a able to minimize the tear, address the issue Blount, and Andrew McMillan. week at the Argos’ practice facility, and with his hip and Yurichuk was able to safely Shannon queues the players with MSK return to play. “Without chiropractic care,” Every day, Shannon forwards a daily injury conditions requiring chiropractic care he says, “I fully believe playing every game report to coaches and various members leading up to my visit. My clinical efforts and coming out of the season without pain of the medical team. The reports list the are directly linked to the ongoing care would not have been possible.”

18 Fall 2016 | Canadian Chiropractic Association The pace on these treatment days at the practice facility is typically a little slower than game days, providing me with more time with each player to discuss injury management, prevention strategies, and sports performance. Players requiring additional support will come to my clinic in Mississauga. Two of my associates, Dr. Bryon Weinberg and Dr. Patrick Welsh, also assist with providing care and instructing on rehabilitation programs.

Game days, however, are a totally different experience. I work every home game along with the games that are held in Hamilton against the Tiger-Cats. Road trips for other away games are typically quite short so the team travels with a limited medical staff that does not include a chiropractor. Injured players are seen immediately on their return to Toronto by our medical staff according to their need.

Dr. Chapin in Argonauts locker room at entrance to therapy room. The home pre-game atmosphere is electric as the players prepare their Injuries that occur during the game are like making sure my hips are tracking bodies and minds for battle. On game quickly triaged on the field by Shannon correctly prior to a game. Other times day, chiropractic care is in high demand: and his team of athletic therapists. From it is loosening neck muscles after a players typically arrive at the stadium there, everyone has their role to play: big hit to allow me to look over my three to four hours prior to kick-off for Shannon decides if the issue is structural shoulder again.” treatment. Those requiring a pre-game or functional. Structural concerns go treatment record their number on a strip directly to doctors Zarnett, Deakon or As experts in MSK care and of white athletic tape that is posted next Whyne for assessment. Functional MSK biomechanics, chiropractors have to my chiropractic table, so I know who issues typically come directly to me for an important role to play in sports next to call. assessment and/or treatment, either performance and injury management. directly from Shannon or from one of the Regardless of the sport or level of play, I treat players as listed. Many times I end medical doctors. Decisions regarding the chiropractors have an opportunity to up treating members of the coaching and player’s ability to return to the field are make a meaningful impact on athletic medical staff as well. This season, typically made in collaboration between and team performance. Dr. Weinberg has provided additional Shannon and our medical staff. Shannon support on game day to be sure that then communicates all medical decisions As for the Argos, there is still a lot of everyone requiring chiropractic treatment and status updates to the coaching staff football to be played. The spirit of this is seen. I tell the players that the pre- as soon as possible. Decisions must be year’s team is different than teams game is my game time. It is an intense, made quickly and decisively as the play of the recent past: their belief in the adrenaline-packed few hours that demand continues—replacement players may potential of this season and desire to my complete attention and draw heavily on need to be subbed in. The player’s health put the Argos back on the map in a my 17 years of clinical experience. The last is a top priority at all times and is never competitive Toronto sports market is few pre-game treatments commonly take compromised. infectious. I, for one, am a believer. place just prior to the national anthem. While the risk of an injury at a key Once the game starts, Dr. Weinberg and Chris Van Zeyl, the Argos’ offensive position is ever present, both the I take a position with doctors Zarnett, lineman and offense captain, speaks depth and character of this team are Deakon, and Whyne on the sidelines at or to the value of this level of attention strong and carry great potential. The near the line of scrimmage. The gameplay in chiropractic and MSK care that the opportunity to work with the Argos as is quick and injured players are not always players receive: “They ensure that I am the team chiropractor at this point in aware of the mechanism of injury. It is at the top of my game and am capable the team’s history is a thrill. Here’s important that one of us has our eye on of reaching my potential.” he says, to being united as a team as we work the play at all times. “Sometimes it is something minor towards our goal—together.

Fall 2016 | Canadian Chiropractic Association 19 Comprehensive insurance coverage for CCA members Comprehensive insurance coverage for CCA members For over a decade, Morneau Shepell has partnered with the CCA to o er a Group Benefi t Program, which means we have CCA members covered. For over a decade, Morneau Shepell has partnered with the CCA to o er a Group Benefi t Program, which means we have CCA members covered. Morneau Shepell is Canada’s only human resources consulting and CCA-specifi c services technology company that takes an integrative approach to employee The CCRF Celebrates its 40th Year! CCA members can take advantage of assistance, health, benefi ts, and retirement needs. Morneau Shepell is Canada’s only human resources consulting and CCA-specifigroup buying cpower services to purchase a ordable, BY DR. PAUL F. CAREY, DC communications and programs implementation. We are happy technology company that takes an integrative approach to employee comprehensive insurance coverage. CHAIR, CANADIAN CHIROPRACTIC RESEARCH FOUNDATION to have them both on-board. Our clients are progressive leaders seeking to enhance the health, productivity,assistance, health, and fi nancialbenefi ts, security and retirement of their employees. needs. With approximately CCA members can take advantage of We have helped the CCA create a benefi ts 4,000 employees in o ces across North America, we apply our combined group buying power to purchase a ordable, This year, the Canadian Chiropractic Research Foundation For the past decade, a large part of the CCRF’s success has been comprehensiveprogram tailored insurance to their members’ coverage. needs by consulting,Our clients outsourcing,are progressive and leaders technology seeking expertise to enhance to help the them health, succeed. (CCRF), the only organization of its kind in Canada, celebrates a result of the hard work of Dr. Allan Gotlib and our Canadian providing the fl exibility and options they require, productivity, and fi nancial security of their employees. With approximately its 40th year! At the Canadian Chiropractic Association research chairs. Their initiative and high-quality studies Weat competitive have helped rates the usuallyCCA create o ered a benefi only tots large 4,000 employees in o ces across North America, we apply our combined (CCA) Chair Affair event this November, we will honour the continue to validate our profession’s impact on patient care. The Established in 1966, Morneau Shepell currently serves more than 20,000 programcompanies. tailored From toan their easy members’ all-in-one needsaccess by consulting, outsourcing, and technology expertise to help them succeed. accomplishments of this unique establishment and our first- other key factor to our success has been the ongoing support of clients ranging from small businesses to some of the largest organizations providingpoint that theprovides fl exibility a full and view options of options they andrequire, class researchers. We will also introduce the CCRF’s exciting our national and provincial associations who continue to make in North America and around the world. atcosts, competitive CCA members rates usually have the o eredability only to acquireto large plans for the future, which continue to focus on the expansion this important research possible. Specifically, the CCRF would Established in 1966, Morneau Shepell currently serves more than 20,000 companies.the benefi ts Fromthat produce an easy peaceall-in-one of mind access for of vital chiropractic research. like to thank the CCA for its generous backing over the years. Inclients the Canadian ranging from market small we businesses are the industry to some leader of the in alargest number organizations of areas pointthemselves that provides and their a fullfamilies. view ofCCA options members and Because of these organizations, Canadian chiropractic research includingin North America Employee and and around Family the Assistance world. Programs, integrated absence costs,and their CCA employees members can have choose the ability life, long-term to acquire When I was asked to come on board as chair of the CCRF this has now garnered global recognition. management, and technology and outsourcing solutions for retirement and thedisability, benefi professionalts that produce overhead peace ofexpense, mind for Spring, I was honoured. Having served for many years as benefiIn the Canadiant plans. We market are proud we are to bethe the industry o cial leader Mental in aHealth number Partner of areas of the themselvesAD&D, critical and illness, their families. and health CCA & membersdental founder, and then president, of the Canadian Chiropractic We must keep the momentum going and we look forward to the Canadianincluding EmployeeOlympic Team. and Family Assistance Programs, integrated absence andcoverage, their employees as well as the can specifi choose c amountlife, long-term Protective Association, I have enjoyed contributing to work ahead. In 2017, we will launch our new strategy for expanding management, and technology and outsourcing solutions for retirement and disability,they need. professional overhead expense, our profession and leading positive change for Canadian chiropractic research, and we hope that we can continue to count benefi t plans. We are proud to be the o cial Mental Health Partner of the AD&D, critical illness, and health & dental chiropractors. Retired chair, Dr. Drew Potter, left great shoes to on your support throughout this journey. There is still much to Canadian Olympic Team. coverage, as well as the specifi c amount fill. Over the past seven years, Dr. Potter played an imperative be done. It is no understatement to say that chiropractic research they need. role in the final rollout of the CCRF’s National Research is critical to our professional futures. Unlike other healthcare Chair program, an initiative that has successfully appointed professions, we are still working towards mainstream integration. As a Champion Corporate Partner, we look forward Contact us today 18 chiropractic researchers in universities across Canada. Research is our ticket to accomplishing this—in validating our to continuing to work with the CCA to make it easier benefit to patients, adding to our independent practices, and 1.866.432.8427 The CCRF added two new members this year: Dr. Kate propelling our acceptance within healthcare teams. Asand a more Champion a ordable Corporate for its Partner,members we to look protect forward their morneaushepell.comContact us today MacAdam from Halifax, Nova Scotia, joined as a Director tobusiness, continuing income, to work and with family. the CCA to make it easier [email protected] on the CCRF Board, and Nicole Henderson joined as the 1.866.432.8427 CCRF’s project manager, helping to renew the organization’s Together, weʼre on the right track. and more a ordable for its members to protect their ©2016morneaushepell.com Morneau Shepell Ltd. | MS-CCA 05-2016 business, income, and family. [email protected]

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How Quality Assurance Database Development at Mount Carmel Clinic’s Chiropractic Program Justified Our Existence By Dr. Steven Passmore, Assistant Professor, Faculty of Kinesiology & Recreation Management, University of Manitoba. With contributions by Dr. Audrey Toth, Attending Chiropractor, Mount Carmel Clinic’s Chiropractic Care Program. SUCCESSFUL FORESIGHT

22 Fall 2016 | Canadian Chiropractic Association “The future of research for healthcare lies not solely in the results from highly-controlled, and potentially highly-contrived, clinical trials, but also in the databases we can create at the front line of patient care that document what is actually happening in clinical practice.” — Dr. Gerald Olin, Manitoba Chiropractors Association’s liaison to the Mount Carmel Clinic

esearch and clinical endeavours do not have to be mutually importance of documenting and demonstrating what you have exclusive. When constructed with foresight, the two can done in a new program so that when you are under a spotlight, you R be complementary, particularly when implementing and can provide the evidence that stakeholders need to evaluate your evaluating a new clinical program. Successful foresight is achieved clinic and your contribution to the patients, facility, and healthcare when you later have minimal remorse about your decisions in team. Dr. Dunn developed a quality assurance spreadsheet that hindsight. There is always room for improvement, but the old tracked and documented the characteristics of patients that entered adage is true: failing to plan is planning to fail. Fortunately, this and exited the VA chiropractic program and their progress. After story is an example that reflects people who had the foresight to I graduated, I stayed on at the VA as a licensed chiropractor and, work together and develop a plan to advance the profession in an because of his foresight in creating a quality assurance database, interprofessional context and, more importantly, help patients in Dr. Dunn and I were able to make some contributions to research. need of clinical care to attain it. Descriptions of MCC’s chiropractic program were like I first heard about the Mount Carmel Clinic (MCC) in the first hearing about the VA facilities all over again—a publicly-funded few meetings of the University of Manitoba Chiropractic initiative providing the opportunity to integrate chiropractic Working Group—a group which I established shortly after services into a multidisciplinary healthcare setting. However, accepting my new faculty position at the University of MCC’s chiropractic program began as a three-year pilot program Manitoba (U of M). I had moved to Winnipeg to accept the of Manitoba’s Family Services Department. If stakeholders saw no Canadian Chiropractic Research Foundation Professorship in value to it at the end of the pilot, it was a project that could go away. the U of M Max Rady College of Medicine. Having previously co-founded another working group at McMaster University, I Understanding the need for the stakeholders of the MCC chiropractic understood how such meetings successfully develop a network program to see the program’s value before the end of its pilot gave of university-affiliated chiropractors to help shape chiropractic our working group a window of opportunity. In order to validate the university-based research. As I listened to the Manitoba program’s value, we need to measure it. The University of Manitoba chiropractors in the working group discuss the chiropractic unit Chiropractic Working Group became engaged in a discussion about of the MCC, I heard what sounded like a “chiropractic utopia” to the clinic, and I proposed the creation of a prospective quality me—a publicly-funded chiropractic clinic in a multidisciplinary assurance measure. My vision was to use Dr. Dunn’s quality facility focused on addressing and treating the healthcare needs assurance spreadsheet headings as a template, knowing that it of an underserved and marginalized portion of the population. would have to be modified to reflect the local population.

In 2005, I had been introduced to data collection during my work To make this quality assurance measure work, the working group in the United States Veterans Affairs (VA) hospital system. I began needed input from relevant stakeholders, on-site clinicians, the a clinical rotation with Dr. Andy Dunn—the first chiropractor to provincial governing body, and Mount Carmel administrators. deliver an adjustment in a VA hospital, and the first with student With the help of these authorities, we were able to customize the interns. Dr. Dunn’s clinic was pioneering and, determined not to spreadsheet to align with the unique elements of the Manitoba let the program fail, he literally wrote the manual on how to make population. A working group member, Dr. Greg Stewart, knew a clinic that adhered to clinical excellence and evidence-informed Dr. Gerald Olin, the MCC’s liaison to the Manitoba Chiropractors practice in that environment. He also instilled in me the vital Association (MCA), and forwarded him the draft of our discussion

Fall 2016 | Canadian Chiropractic Association 23 “The clinic has been a tremendous success, as our research/data collection has demonstrated that the chiropractic clinic is well utilized and patients are experiencing tremendous benefit from chiropractic treatment.” — Dr. Gerald Olin

explore the broader picture of the clinic on a monthly or annual basis, such as the times of the year patients have the greatest (From left) Dr. Audrey Toth, Chiropractor, Mackenzie Kein, Registered Nurse and Primary Health clinical need. We can also use the data to Services Manager, and Bobbette Shoffner, Executive Director at the Mount Carmel Health Clinic. generate a summary of clinic utilization and usefulness for our target population. notes about spreadsheet creation. Dr. Olin changes in their pain numeric scale told us that the MCC’s clinicians had a data scores) and numerous other items. Both ABOUT THE MCC’S collection form already in development. spreadsheets are de-identified so that Using elements of the VA spreadsheet patient anonymity is protected. CHIROPRACTIC CARE UNIT merged with the data collection form, I The MCC is not only the largest community was able to create two spreadsheets and Although the spreadsheets are not health centre in Manitoba, it was the present them to the MCA and gain the perfect, they seemed like a reasonable first community health centre opened in support of the president to move forward place to start our data collection. Canada. The clinic serves the Point Douglas with the initiative. The MCC administration agreed. neighbourhood in Winnipeg, which has more potentially significant socioeconomic health CLINIC DATA THE QUALITY ASSURANCE DATABASE risk factors than any other region in the Each line on the clinic spreadsheet Since the spreadsheet’s creation, data area. Results from a 2009–2010 statistical considers what happened at the clinic collected from MCC’s chiropractic study by the Winnipeg Regional Health on a given day. For example, the number program has been entered into a quality Authority showed that MCC’s clients include of patients scheduled and how many of assurance database which has served a higher proportion of seniors, a higher those were no-shows. Other track details several purposes: 1) internal report and proportion of people who have had fewer of working in an integrated clinic, like presentation generation from the on-site educational opportunities, over twice the “hallway consultations”—the five-minute chiropractor; 2) summary data generation average number of families living below the hallway chat with another clinician about for provincial government meetings; and low-income cut-off, and double the average a patient. It seems like a small thing, but it 3) for use in research (with appropriate amount of unemployed than anywhere else really lends merit to the success of patient permissions and approvals). in the entire Winnipeg Health Region. care when teams of different clinicians are under the same roof. Clinicians are able to Through data analysis, we can see the “Over our 90 years of service, we have build rapport, facilitate interprofessional success of the MCC’s integrative healthcare strived to continually respond to the trust, and help the same patients. model. We know the diagnosis, trial of needs and feedback from our community chiropractic care, and results of that trial members,” said Ms. Bobbette Shoffner, PATIENT DATA for every patient that has entered the MCC’s executive director. “This includes Each line on the other spreadsheet reflects clinic. We know where patients are coming access to chiropractic care, which is a an individual patient’s experience of the from or being referred. We know if people perfect fit for our clinic. It could not clinic, such as the length of their course are attending scheduled visits and keeping have been introduced at a better time. of care, their primary diagnosis, their appointments. We know who is coming Our motto is ‘We meet you where you’re response to care (as interpreted through to the clinic. With this data, we can then at. No judgment here.’” Ms. Shoffner

24 Fall 2016 | Canadian Chiropractic Association is passionate about chiropractic care as a vital service that “We are proud of our clinic as we have “supports community members on their health journeys.” received public acclaim not just here The Clinic’s Chiropractic Care Unit is led by Dr. Audrey Toth, who has been with the program since it began. She has been tailoring in our province, but across Canada and to the needs of the clientele, providing care without bias in a into the United States. Many view us as professionally cooperative environment. Dr. Toth has also helped the chiropractic program thrive and has encouraged a more a model for care that is responsive to successful health experience at the MCC. Ms. Shoffner believes community needs and addresses root Dr. Toth’s responsiveness as a practitioner has been fundamental to the quality chiropractic care the chiropractic care unit provides. causes of health struggles. Chiropractic “We have been very fortunate to have a chiropractor, Dr. Toth, who is very accommodating and who is approachable and very care has been a wonderful fit here.” involved.” Ms. Shoffner said. “She takes the time to listen to clients and understand their needs, without judgment.” — Executive Director Bobbette Shoffner, Mount Carmel Clinic Ms. Shoffner also points to how Dr. Toth’s fostering of relationships with the entire interprofessional healthcare team has allowed for enhanced client-centred care. “Just last week,” Ms. Shoffner remarked, “while in consultation and examination I have delivered presentations that included data on the MCC’s with a client, Dr. Toth sent an electronic task to the client’s chiropractic program to the Saskatchewan Minister of Health, physician requesting x-rays. The client did not have to wait Manitoba Public Insurance, the Association of Chiropractic and had a requisition in hand upon leaving her chiropractic Colleges Research Agenda Conference, and the Canadian appointment. This level of cooperation and responsiveness Chiropractic Association National Convention & Tradeshow, to client needs takes a dedicated team to achieve.” and, most recently, at the World Federation of Chiropractic Education meeting. As a researcher, presenting data at meetings THE FUTURE OF MEDICAL RECORD DATA that resonate with an audience allows you to identify like- In the future, our quality assurance database will allow us to consider minded individuals. One such individual I met when presenting subpopulations and how they respond to a course of management. MCC chiropractic program data is Dr. Geoff Outerbridge. For example, we could identify all of the patients with a particular Dr. Outerbridge is the clinic director for World Spine pathology, like degenerative lumbar spinal stenosis, and compare Care—a not-for-profit foundation developed to fill the gap in those who use tobacco and those who do not on their clinical musculoskeletal treatment in underserviced areas around the outcomes. There is an endless combination of questions that we world—and has been collecting database information from all can ask and utilize the information from the database to explore. the World Spine Care sites. We frequently discuss our respective We are only limited in the potential of the database exploration by successes and challenges, and teleconference regularly to our own resources, and the boundaries of our creativity. The data discuss innovative ways we can improve our methods. collected will help us to better understand our role in the healthcare community, and will enhance our ability to provide the highest To our profession’s researchers: If you think our quality quality care to our patients. If other chiropractic sites around the assurance database could add further knowledge to your world adopt quality assurance data collection, our insight into the research question, whether it is about geriatrics, pediatrics, profession would grow exponentially. or other populations seen at the MCC’s chiropractic program, please let me know and we can seek an understanding together about patient populations and their response to chiropractic care in a publicly funded environment.

To chiropractic clinicians: Thank you for your service to patients. Without your generous contributions to research, our profession would be stagnant. Every day, you are a public ambassador for our profession in your clinic.

To chiropractic students: Be excited! New clinical and research opportunities are developing every day and are expanding career options for those entering the chiropractic profession.

To reach Dr. Passmore with research inquiries, please contact [email protected].

Fall 2016 | Canadian Chiropractic Association 25 ADVOCACY

Toward a Better Approach to MICHAEL HEITSHU DIRECTOR OF GOVERNMENT Pain Management in Canada AFFAIRS & POLICY

ublic awareness of the scope of the opioid crisis has substance abuse problem and collectively we are not looking grown quickly this year. An estimated 2,000 Canadians carefully enough at the bigger issue of why opioids are being P are now dying annually from opioids.1 While many of prescribed, too many Canadians are potentially being exposed these deaths are for the illegitimate use of opioids, the truth to the risk of addiction. The solution to this crisis must have, remains that they are being prescribed far too often in Canada. at its foundation, a better approach to pain management—one We have the second highest rate of prescribed opioids per that addresses the underlying causes of pain and reduces the capita in the world.2 In addition to all the other impacts of pressure to treat that pain with opioids. This is the position of using opioids to treat pain, deaths alone are now exceeding the influential 2016 Centers for Disease Control and Prevention automobile accidents.3 guideline for prescribing opioids, which clearly emphasizes that nonpharmacological therapies should be considered first As a result, opioid overuse is rising to the top of the Canadian for treating chronic pain. Because back pain is so central to healthcare agenda. Canada’s Health Minister Dr. Jane Philpott this crisis, it is clear that chiropractic care is an important has announced an Opioid Summit in November 2016 to develop a part of the solution. new national action strategy to address this crisis. The Canadian Chiropractic Association (CCA) has been successful in securing Evidence in support of the chiropractic role is growing. A 2010 an invitation to the Summit. study found that including chiropractic in a collaborative care team reduced narcotics use by almost 60%.6 Positive results The CCA began raising concerns about this crisis early, including about collaborative care models that include chiropractors are writing to the Minister in May on the need for urgent action. If also expected from what has been seen so far in the evaluation we look at why these opioids are being prescribed for chronic of the Ontario Low Back Pain Pilot Project. South of the border, pain, it is clear that in many ways this opioid crisis is a back pain the US National Pain Strategy specifically recognizes the value crisis. Available evidence on prescribing is limited. However, of chiropractic care in pain management. Further, manipulative a British Medical Journal study found that more than 50% of therapy in conjunction with standard medical care has a much prescription opioid users in North America report back pain.4 better likelihood of decreasing pain and improving function when Back pain was also the reason for 75% of opioid prescriptions to compared to standard care.7 We also know that chiropractic care is Medicaid recipients in Tennessee.5 documented for better outcomes in the treatment of low back pain.8

Another part of the crisis is that opioids are more addictive The CCA is leading efforts to build support for a better approach than previously thought. If this issue is treated just as a to pain management. We are engaging Members of Parliament

26 Fall 2016 | Canadian Chiropractic Association and senior government officials; engaging the medical profession in building an understanding of the role of back pain in this crisis; collaborating on a common strategy with other professions that can provide alternatives to opioids; and supporting efforts of provincial chiropractic associations. This issue has highlighted the importance of taking a broader look at chiropractic’s role in the health of Canadians and re-evaluating how we deal with pain.

“The solution to this crisis must have, at its foundation, a better approach to pain management—one that addresses the FIND A CHIRO underlying causes of pain and reduces the pressure to treat that pain with opioids.”

Other CCA initiatives help to support these efforts. As you will read within this issue of BACK Matters, we are announcing our support of the Canadian Armed Forces for the first phase of a demonstration project that has been developed to explore the overall impact of integrating chiropractic within on-base healthcare teams. In addition, the CCA recently released a brand Our ‘Find a Chiro’ function story that helps inform the public on the role chiropractic can play in addressing pain. on the CCA website enables Canadians to not only find a This opioid crisis has brought to the surface many challenges in chiropractor, but also allows Canada’s current approach to pain that chiropractors have been dealing with in their clinics for years. Your support as members them to learn more about you of the CCA contributes directly to the advocacy efforts that build before they get in touch. awareness of the value of the care that chiropractors provide and to developing a better approach to pain management in Canada Log on to www.chiropractic.ca that includes a more central role for chiropractors. and update your profile to

References include your picture, bio, clinic 1. Picard A. Opioid overuse is creating “lost generation” expert says. The Globe and details, languages spoken, Mail. August, 24, 2016. http://www.theglobeandmail.com/news/national/opioid- overuse-is-creating-lost-generation-expert-says/article31547148/. Accessed on techniques, and much more. October 6, 2016.

2. Weeks C, Howlett K. Prescription of opioid drugs skyrocketing in Canada. The Globe and Mail. April 5, 2016. http://www.theglobeandmail.com/news/national/sales-of-opiod- drug-prescriptionsskyrocketing/article26008639/. Accessed on October 6, 2016. Your profile helps build visibility

3. Transport Canada. Canadian motor vehicle traffic collision statistics 2014. Collected for you and your clinic, and helps in cooperation with the Canadian Council of Motor Transport Administrators. https://www.tc.gc.ca/media/documents/roadsafety/cmvtcs2014_eng.pdf. prospective patients locate you.

4. Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain.BMJ . 2015; 350: g6380. doi: 10.1136/bmj.g6380. Visit www.chiropractic.ca 5. Ray WA, Chung CP, Murray KT, Hall K, Stein M. Prescription of long-acting opioids and mortality in patients with chronic noncancer pain. JAMA. 2016; 315(22): 2415-2423. doi:10.1001/jama.2016.7789. and select “My Account”

6. Mior S, Gamble B, Barnsley J, Côté P, Côté E. Changes in primary care physician’s and “Update Profile” from management of low back pain in a model of interprofessional collaborative care: an uncontrolled before-after study. Chiropr Man Ther. 2013; 21: 6. the toolbar at the top. doi: 10.1186/2045-709X-21-6.

7. American Chiropractic Association. What research shows about chiropractic. http://www.acatoday.org/Patients/Why-Choose-Chiropractic/What-Research-Shows. Accessed on September 30, 2016. [email protected] 8. Bishop PB, Quon JA, Fisher CG, Dvorak MF. The chiropractic hospital-based interventions research outcomes (CHIRO) study: a randomized controlled trial on the effectiveness of clinical practice guidelines in the medical and chiropractic or call 1-877-222-9303 management of patients with acute mechanical low back pain. Spine J. 2010; 10(12): 1055-64. doi: 10.1016/j.spinee.2010.08.019.

Fall 2016 | Canadian Chiropractic Association 27 RUNNING BUSINESS Chiropractic at the Ottawa Marathon (Above) Ottawa Marathon finishers (42 km) on Sunday waiting in BY DR. FELIX LANTHIER, DC line for chiropractic treatments.

hiropractic often goes hand-in-hand with some type C of physical activity. Over the years it has made great strides in supporting professional athletics, allowing the most specialized athletes to overcome their pain and maximize their performance. It is the intrinsic connection between chiropractic and athletics—and the passion and resilience athletes bring to their treatment—that motivated me to become a part of Canada’s largest marathon event, the Ottawa Marathon.

We started working on this project in April 2016, hoping to be part of the 2017 marathon. To our surprise, the medical team was very enthusiastic about adding chiropractors to their team for the 2016 marathon. This meant that we had to mobilize quickly. It was a fast-paced month of preparation and organization with only four weeks leading-up to the event. Despite the short notice, our final team was robust, with eight chiropractors from Quebec and Ontario, a student from the Canadian Memorial Chiropractic College, and a chiropractic assistant who supported the chiropractic team and helped educate new patients.

Dr. Gabrielle Pomerleau (left) and Dr. Félix Lanthier (centre) treating We had the perfect location for our two-day experience at the 42 km finishers. Ottawa Marathon: our tent faced the finish line from the recovery zone so that every runner would see it. Apart from the first aid team, there were no other healthcare practitioners present; this meant that we were an exclusive service. Needless to say, we were busy. A lot of existing chiropractic patients came for treatment, others discovered chiropractic for the first time. Our presence opened many people’s eyes to something new that could serve their needs. In total, we treated more than 170 patients in an eight- hour time frame. At one point, more than twenty people were lined up in front of the tent to seek care—we thank them for waiting! We were fortunate to have so many dedicated athletes awaiting our care and recognizing its value in their recovery.

Without the support of the Association des chiropraticiens du Québec, both financially and logistically, it would not have been possible for us to seize this opportunity and see it succeed in such a spectacular way. With so many positive comments from the medical team, the runners, and the chiropractors who (From left) Dr. Stéphanie Demers, Dr. Brigitte Pelletier, Dr. Félix volunteered, we are positive that chiropractic will be part of the Lanthier, Dr. Gabrielle Pomerleau, and Dr. Samiya Boucenna 2017 edition of the Ottawa Marathon. on Saturday after the 2 km, 5 km, and 10 km races.

28 Fall 2016 | Canadian Chiropractic Association CHAMPION PROFILE

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Fall 2016 | Canadian Chiropractic Association 29 ON-BASE Working to Help Canada’s Military: A Promising Demonstration Project

30 Fall 2016 | Canadian Chiropractic Association “Disability claims related to musculoskeletal conditions in this line of work are prevalent. We want to explore the role chiropractors can play in reducing such claims and limiting numbers discharged.”

he Canadian Chiropractic Association (CCA) is proud This project is also possible because of the considerable in- to announce that the Canadian Armed Forces have kind contribution made by the Canadian Memorial Chiropractic T approved the first phase of a demonstration project. College and the research time offered by the University of Ontario It will research the outcomes of chiropractors providing on-base Institute Of Technology and Queen’s University. care to members of the Canadian Forces. “For the chiropractic profession to see the tremendous impact “The military is unlike almost any other career that is out there. of MSK conditions on the military, it created an imperative for us When you sign up to serve, you are making a commitment to to engage in this conversation and to be raising awareness of the Canada. I think that there is a really strong recognition that as a opportunity for chiropractic to help,” Mr. Heitshu explains. “The country we have a duty to those who serve us,” says Mr. Michael evidence from research conducted in the United States suggests Heitshu, the CCA’s Director of Government Affairs & Policy. that there is a benefit when including chiropractic care in the military. We are tremendously appreciative of this opportunity Ms. Alison Dantas, Chief Executive Officer of the CCA, laments to explore similar questions within the Canadian Forces.” for how many military careers are cut short by MSK injury. “Disability claims related to musculoskeletal conditions in Dr. Silvano Mior, a Principal Investigator on the project, explains this line of work are prevalent. We want to explore the role that the study will examine the impact of care upon military chiropractors can play in reducing such claims and limiting personnel and their return to duty. “It’s about the soldiers—and numbers discharged.” trying to enhance and contribute to their care,” says Dr. Mior. He explains the imperative for recognizing this as an opportunity We also need to present critical questions regarding how to to assess the role chiropractors play in a collaborative, better serve those who serve us. multidisciplinary, team-based environment in order to optimize the health and well-being of our soldiers, “When we look to our The project is funded jointly by the CCA and the Ontario colleagues in the States, they have a longer history than we do Chiropractic Association—an important partnership that with involvement of the United States Veterans Affairs and the demonstrates recognition of this growing health concern for United States Department of Defense. There, we can see how our Canadian military, and how important it is to address. chiropractors contribute to the health and well-being of soldiers

Fall 2016 | Canadian Chiropractic Association 31 within a team-based environment. It’s more about collaboration and contributing to care.”

The actual structure of the demonstration project, and the work that will go into creating it, has tremendous value unto itself: “It will explore models that are innovative around collaborative care and how we can work with other healthcare partners to provide the best possible care for patients,” remarked Ms. Dantas.

Part of the research process is coming to understand the unique environment our soldiers are in. “We’re working closely with military colleagues to try and understand their culture and the opportunities and the challenges they face within their system—which is rather unique and becoming more demanding,” explains Dr. Mior, “It’s amazing what they can do within the constraints of what they have; so we’re really sensitive to the inherent challenges they face day-to-day.” OUR RESEARCH TEAM Why is research important? According to Dr. Mior, “Investing in research provides DC, PhD evidence to support sustainable growth.” Silvano Mior, Margareta Nordin, Models of Interprofessional Collaboration PT, Dr. Med. Sci. Research is also necessary in order to Canadian Memorial Chiropractic College Occupational Return to Duty bring about change: “If you want to New York University change policy, if you want to influence Pierre Côté, DC, PhD policy, if you want to be at the table Epidemiology; Disability Prevention Audrey Laporte, PhD where policies or decisions are made, and Rehabilitation Health Economy and Healthcare Utilization you need the evidence.” UOIT-CMCC Centre for Disability University of Toronto Prevention and Rehabilitation, University of Ontario Institute of Ellen Vogel, RD, FDC, PhD The research team for this project is Technology Qualitative Research and Policy Change diverse, “We have individuals with University of Ontario Institute of Technology amazing experience, knowledge, and Simon French, extensive track records, aside from BAppSc (Chiro), MPH, PhD Anthony J. Lisi, DC also being multidisciplinary and multi- Rehabilitation Therapy Veterans Health Administration institutional” says Dr. Mior. Ms. Dantas Queen’s University also expresses pride in the research team Deborah Sutton, BSc (OT), MEd, MSc Patrick Loisel, MD Project Management established: “We’ve got people with great Rehabilitation and Disability Prevention UOIT-CMCC Centre for Disability skills and researchers who have proven Canadian Memorial Chiropractic College Prevention and Rehabilitation themselves either as research chairs or in other capacities, so I think we’re very lucky to have the team that we have in place.” preliminary research we can move on for us is near and dear to our hearts—it to planning and implementation.” presents an opportunity for us.” She goes This two- to three-year research project on to explain the importance of empirical is currently in its recruitment phase, “The Ms. Dantas expresses that the reason evaluation of healthcare, and how first phase of the study is the qualitative this research project is so important objective data can lead to valuable insights study” Dr. Mior explains, “We’re to us is because we see the burden that into the medical needs of those who serve collecting data now, and we’re going to soldiers face, and we see how evaluating us. “At the end of the day, we want to keep be interviewing members of the military the current state of affairs is important in people in active duty and doing the thing healthcare teams. Once we collate all the order to bring about change: “This project they love to do—serve their country.”

32 Fall 2016 | Canadian Chiropractic Association CHIROPRACTORS AT THE OLYMPIC GAMES

We reached out to Team Canada’s chiropractors to talk about their experience at the Rio 2016 Olympic Games. Here are their stories.

DR. JENN TURNER, DC

This is my second time attending the Olympics as a chiropractor, athletes for which they care. It is really awesome to work with but my first time working at the Olympics with Canada’s bicycle others who have that common passion at their core. motocross (BMX) team. I have been working with the National and Development BMX teams over the last four years, and the value of For me, one of the most memorable BMX moments of the Rio chiropractic in this sport has been monumental. BMX is a high injury 2016 Olympic Games was within the first few minutes before Tory sport, but the culture of the sport has not put injury prevention or Nyhaug rode his first moto. I was so incredibly nervous for him management in the forefront. Being a developing “elite” sport, and thought about the countless hours I had spent with him over this is only the third appearance for BMX at an Olympic games. At the past four years preparing for these games. With this moment present, there is not a lot of research or innovation out there with came the realization that I had done everything I could have respect to musculoskeletal injuries in the sport. done to prepare him for this moment—now it was up to him. After coming out of the gate strong and carving the first corner As the Canadian national BMX team’s year-round chiropractor, I low to come out in front, he won the heat and eventually ended have been exposed to working with kids involved with the sport at up qualifying for the superfinal the next day. There had been a all levels. I feel that my role is multi-faceted in that I can work on number of crashes that day that had left many of the athletes injury management but also injury prevention when introduced to out with serious injuries—but not for Nyhaug. He was confident, these different groups. I have been given the opportunity to educate motivated, and uninjured. After placing fifth in the exciting BMX different grassroots-level development groups for kids, including the Olympic Final (less than one second off the gold medal!) our team Olympic prospects for 2020. I have been able to teach parents as well was ecstatic. Tory was gracious and a true winner, and of course, as kids about the benefits of chiropractic along with how to take care this became a career highlight for me as a chiropractor. of your body when involved in such a high-risk sport.

BMX injuries are more serious than the sports I have worked with in the past—namely with the national road and track cycling teams—and most definitely different than the injuries that I see in my day-to-day practice. Treating athletes in this sport makes things a lot more stressful for sure, but I enjoy being pushed past my comfort zone and learning new things, while simultaneously nurturing new strengths.

As a chiropractor travelling with a national team—not only to the Olympics but to other international competitions and events as well—I really enjoy having the opportunity to collaborate with the other health professionals and integrated support teams. I am often working alongside other amazing professionals: coaches, orthopaedic surgeons, nutritionists, and strength and conditioning professionals. Each of these professionals is at the top of their field. With athletes working at such a high level, the staff has so much to offer and to contribute not only to their sports performance but also (From left) Jacques Landry (Cycling Canada High Performance to the development of their treatment. As a result, all members Director), Dr. Jenn Turner, Tory Nyhaug (BMX), Adam Muys (BMX Canada Team Manager), PH Sauze (Tory's Personal Coach). of their healthcare teams make each other better, as well as the

Fall 2016 | Canadian Chiropractic Association 33 DR. JOHN VARGO, DC

It was an honour and a privilege to be named to the Athletics Canada Integrated Support Team (IST) as team chiropractor for the Rio 2016 Olympic Games.

Track and field athletes have long-benefited from the integration of chiropractic care into their training and post-competition recovery. Chiropractic care for the treatment and prevention of injuries—and ultimately as a performance enhancement tool—is a critical element for the world’s greatest track and field athletes. Their neuromusculoskeletal systems are extremely sensitive and as a result, their response to chiropractic treatment is magnified. They achieve results not normally seen in daily practice.

One of the more interesting things I have learned from experienced practitioners who have preceded me—and from my own experience in working with high-level athletes—is that, often times, less is more. Our natural instinct in a crisis is to (From left) Aaron Brown, Andre de Grasse, Dr. Alban Merepeza, treat with everything we have in our armamentarium. However, Brandon Rodney, Akeem Haynes. these finely-tuned athletes often respond negatively to over- treatment by feeling tired and competing flat. Chiropractic is DR. ALBAN MEREPEZA, DC definitely an art and a science. The art component is so important when treating athletes in an elite athletic setting like the Olympic My experience at the Rio 2016 Olympic Games was a fantastic Games. Ultimately, our role is to facilitate their performance. one. Although this was my fifth time attending the Olympic Games as a chiropractor, I was really excited to be part of Athletics Canada works very hard to ensure that their IST members Canada’s athletics team and what was, in my experience, the and athletes can work together throughout the year to establish best Olympic Games yet. This was the largest athletics team clinical relationships. The goal is to maximize each athlete’s response Canada has ever sent. It also included many talented athletes to treatment and ensure their needs are well-known prior to the with—in my opinion—the potential to deliver the best results time-sensitive and pressure-filled environment of the Olympic of any past Canadian Olympics athletics team. For me, the Games. Our continued goal is to optimize the dynamic interaction of most exciting part of being part of the games was that I could all of our skill sets and areas of expertise for the benefit of the athlete. follow many athletes I admired directly to their competition: Andre De Grasse, Phylicia George, Aaron Brown, and Brendon I’m proud to be a member of Olympic gold medalist high jumper Rodney. I also had the privilege of being present at their Derek Drouin’s personal support team—which also includes ultimate events. I was excited to be able to provide care for his coach, strength and conditioning specialist, massage them in Rio and support them as they reached new heights therapist, and sports psychologist. The integration of many and fulfilled their Olympic dreams. health professions and varied skill sets are all brought together and challenged to function as a unit at the Olympic Games. To The results were great for Canada as a whole with Andre be a part of the Rio 2016 Canadian Olympic team and to assist De Grasse leading the way with three medals. This was our amazing team of athletes with chiropractic care during the undoubtedly the best moment for me—to see him succeed biggest competition of their lives was truly an honour. and put Canada back on the sprinting map.

Overall, I felt that the Rio 2016 Games were a good showcase of our chiropractic profession. I had the privilege of being part of a great medical team and the great fortune of working alongside my friend and colleague Dr. John Vargo for Canada’s track and field team. I got to see Dr. Jenn Turner working with cycling Canada (whom I had not seen since London 2012 Olympic Games) and Dr. Mohsen Kazemi working with Canada’s taekwondo team (whom I had not seen since the 2011 Pan Am Games in Guadalajara, Mexico).

(From left) Dr. John Vargo with Gold medal high jumper, Derek Drouin. It was a fantastic and memorable experience.

34 Fall 2016 | Canadian Chiropractic Association OLYMPIC CONTRIBUTORS DR. ALBAN MEREPEZA, DC, MSC Dr. Alban Merepeza graduated from the Canadian Memorial Chiropractic College in 2005 and has practiced in Port Hope, Ontario since his graduation. He owns and operates Port Hope Health Centre, a multidisciplinary health team that includes audiologists, chiropractors, medical doctors, naturopaths, physical therapists, and registered massage therapists. He graduated from McMaster University in April 2016 with a master’s degree in rehabilitation sciences and is currently completing his Fellowship of Chiropractic Sports Sciences.

He has attended five Olympic Games: 2008, 2010, 2012, 2014, and 2016; the Pan Am Games in 2011 and 2015; the Mediterranean Games in 2009 and 2013; the Central American and Caribbean Games in 2014; and numerous world championships of track and field, swimming, and weightlifting. He recently attended the 2016 Canadian Olympic sprinter Andre De Grasse and Dr. Merepeza. UEFA European Championship in France.

DR. JENN TURNER, DC Dr. Jenn Turner is a graduate of the Canadian Memorial Chiropractic College in Toronto. She resides in Vancouver running her multidisciplinary clinic Moveo Sport & Rehabilitation Centre. She is currently waiting to sit the exam to accomplish her Fellowship of Chiropractic Sports Sciences. Her career highlights include working at the 2012 Olympic Games in London and most recently at the 2016 Summer Olympic Games in Rio de Janeiro. Dr. Turner has been working with Cycling Canada for the past nine years in the Track, Road and BMX programs. Currently, Dr. Turner is competing recreationally as a runner and trail runner while figuring out the work-life balance with the recent addition to her family of her first baby Olympic BMX cyclist Tory Nyhaug with Dr. Jenn Turner. Tanner in December 2013 and second baby Maddie in August 2015.

DR. JOHN VARGO, DC Dr. John Vargo received his Honours Bachelor of Science Degree in Human Kinetics from the University of Guelph and his chiropractic degree from the Canadian Memorial Chiropractic College in Toronto. He also completed a post- graduate chiropractic sports injury specialty and is a Fellow in the Royal College of Chiropractic Sports Sciences (Canada). Dr. Vargo is the team Chiropractor for the Sarnia Sting Junior A Hockey Team. He was on the medical team for the Pan American Games in 1999, the Commonwealth Games in 2014, the World Championships of Track and Field in 2015, and the Summer Olympics in 2016. In addition to his practice in Sarnia, Ontario, he also currently acts as a chiropractic sports injury consultant for many professional athletes in the NHL, NFL, and Athletics (From left) Olympic high jumper Derek Drouin, Dr. John Vargo, and Canada. He has provided sports injury coverage for numerous middle-distance runner Hilary Stellingwerff. events at the international, national, provincial, and local levels.

Fall 2016 | Canadian Chiropractic Association 35 CCA NCT’18

APRIL 27–29, 2018 Telus Convention Centre Save Calgary, Alberta thedate