Chiropractors Cash In on Olympics.

File:Frederick Winters during 1904 Summer Olympics.jpg

The Olympics are coming to London this Summer and the presence of such a huge jamboree means it will not just be athletes and race walkers flocking in, but thousands of support staff and businesses including caterers, pole dancers, medical teams and chiropractors.

Yes, chiropractors. Apparently, a ‘Central Medical Unit’ has been appointing “doctors, chiropractors and physiotherapists” in order to treat athletes at the games. Google this ‘Central Medical Unit’ and you will see a plethora of chiropractors who are keen to announce their pride at their inclusion in the event.

We see chiropractor Richard Skippings from Thirsk say “to have been selected is a massive honour”. Chiropractor Lauren Comley from Berkhampsted says on her website  “to have been selected is a massive honour.” Tim Button from Mangotsfield also says that “to have been selected is a massive honour”. And we see Bath-based chiropractor Peter Dixon reporting to the newspapers that “to be part of the team and to have been selected is a massive honour”.

It would appear that to be selected for the “Central Medical Unit” is indeed a massive honour.

Except, I cannot find anyone else who thinks so.

Indeed, I am struggling to find any reference to the Olympic “Central Medical Unit” beyond the press releases of chiropractors and osteopaths.

The London 2012TM Olympics do indeed have an Anti-doping and Medical Sport Department. And indeed, this team is recruiting, although they only give job descriptions for physiotherapists. The Medical Services Manager tells us about her team, and highlights profiles of her physical therapists, radiologists, anaesthetists and pharmacists. No mention anywhere, as far as I can tell, of chiropractors and their “Central Medical Unit”.

I could be wrong, and I would welcome any insight in comments as to why there may be this discrepancy.

But what are chiropractors going to do at the Olympics anyway given its very limited therapeutic value and inherent risks? What evidence is there that chiropractic manipulation can either prevent or treat sports injuries?

Not a lot, as you might guess.

Last Autumn a systematic review of the evidence was published in Focus on Alternative and Complementary Therapies entitled “Chiropractic for the prevention and/or treatment of sports injuries: a systematic review of controlled clinical trials.” [full text]

The review searched databases for trials into chiropractic as it is used in sports health. The emerging studies were generally of low quality and inconclusive. Trials were not properly controlled, were too small, did not report in standard ways and did not use validated outcome measures. Thus, the authors had to come to the conclusion that,

Few rigorous trials have tested the effectiveness of chiropractic manipulation for the treatment and/or prevention of sports injuries. Thus, the therapeutic value of this approach for athletes remains uncertain.

As this is the latest review into the subject, it places the chiropractors taking part in the Olympics in a difficult ethical and professional position. As regulated chiropractors, they are expected to abide by their code of ethics that demands that the “care you select and provide must be informed by the best available evidence”. If these chiropractors were to make claims that their therapy could help athletes either prevent or treat sports injuries then they could be subject to professional disciplinary action. They might be misleading their customers if they claimed they could be of benefit.

So, unless the chiropractors are going to be part of the catering or pole dancing services, where claims made are not so stringently enforced, it is not clear what they are doing as part of the “Central Medical Unit”. So, could these chiropractors actually risk disciplinary measures?

Unlikely. I would find it difficult to believe there would be any problem here given that one of the massively honoured chiropractors, Peter Dixon, is chair of the Council of the General Chiropractic Council – the statutory body charged with upholding chiropractic standards. A body that has recently admitted that it is failing to protect the public with its complaints system.

The chiropractic trade has a big problem with evidence. Indeed, Peter Dixon has been criticised by Professor David Colquhoun of being ‘careless about evidence’. The reason is straightforward. Chiropractic is not a medical specialism but a pseudomedical belief system based on the mystical teachings of a 19th Century magnetic healer. It’s central beliefs have not held up to modern anatomical knowledge and its historical and widespread claims that diseases is caused by spinal problems are almost all bogus.

That is why the trials of chiropractic sports applications were of such poor quality. From where I sit, the utility of such research is not to discover if chiropractic can help  in a particular area, but to give a veneer of scientific plausibility over existing, questionable practices. Poor quality trials most often give spurious results. They may look positive when all you are seeing is flawed trial design. Thus, a systematic review of the evidence is so important.

As the authors of the FACT paper conclude,

Future studies of chiropractic should adhere to accepted standards of trial design and reporting (e.g. CONSORT guidelines). In particular, studies should be adequately powered, use validated outcome measures, control for non-specific effects and minimise other sources of bias. Reporting of these studies should be such that results can be independently replicated.

That sounds to me like an academic slap around the chops to the profession for producing such a substandard evidence base. Will we see improved future studies?

Don’t hold your breath. Such future studies run the risk of denying chiropractors the massive honour of being selected for the Olympic “Central Medical Unit”.

UPDATES

18th April

It really would appear as if the great and the good of the UK chiropractic trade are the ones to have reveived this ‘massive honour’.

Today we learn from the Stroud News and Journal that chiropractor, Richard ‘Plethora’ Brown, is also saying that ““To be part of this event at any level is tremendously exciting, but the chance to work with the best athletes from around the world is a once in a lifetime opportunity.” Coincidentally, exactly the same words as all the other chiropractors involved.

Richard ‘Plethora’ Brown is the President of the discredited British Chiropractic Association. Under his watch, he almost brought the entire chiroptractic trade to its knees. The BCA decided to sue science writer Simon Singh after he wrote in the Guardian that the BCA were “happily promoting bogus treatments” for children. Brown stated there was a ‘plethora’ of evidence for chiropractic for kids and sued. It took many months of repeatedly asking Brown to publish his plethora as it was doubted that it existed. When he did, bloggers and the BMJ demolished it within hours as worthless. The BCA and Richard Brown were humilated.

Their humiliation did not end their when subsequently they had to withdraw their case against Singh and pay is costs mounting to hundreds of thousands of pounds. Worse, after 600 complaints were made to the General Chiropractic Council by people objecting to chiropractors making claims without evidence, millions were spent on investigations, requiring the GCC to mortgage its premises and ensure chiropractors will be paying the highest medical registration fees for many years to come.

Still, if you get to crack the back of the odd Romanian wrestler then I guess it was all worth it.

24th April

Chiropractors who have been claiming to be “deeply involved in organizing the medical services that will be provided to Olympic athletes at this summer’s Olympic Games in London” have been caught being less than honest.

I tweeted that the business “London Chiropractor” are styling themselves as  a UCL ‘Centre of Excellence’. I did not believe this and so Professor David Colquhoun of UCL took it up with the relevant authorities and the claim  turned out to be a porky. Read about it here.

21 comments for “Chiropractors Cash In on Olympics.

  1. Mick
    April 17, 2012 at 1:10 am

    I too cannot find any mention of a ‘Central Medical Unit’ made up of a multidisciplinary team. there is a polyclinic and a designated athletes’ hospital, plus venue medical officers and paramedics. The massage therapists, physios etc will be based at the polyclinic in the Olympic Village.

    I wonder what gives with these claims?

  2. April 17, 2012 at 1:11 am

    Thanks for the laugh! Based on the experience of everyone I know who’s seen a chiro (including myself), I used to think they were just scammers; then when I observed the online behaviour of some of them, I began to think they were a really nasty bunch. Now they look more ridiculous than anything else.

  3. Brian Lang
    April 17, 2012 at 2:38 am

    Are they using the word Olympic or Olympics? If so, then you could report them to the organizing committee for the Olympics, as unauthorized use of the Olympic trademarks is diligently protected.

  4. April 17, 2012 at 10:05 am

    Let me explain how it works. If an elite athlete “believes” (he could care less about published research) that chiropractic helps performance he will have a chiropractor, a hypnotherapist or whoever in his team. They will be based outside the Olympic village during the games and the athlete will spend much time there. The medical centre is more of a political set up, to keep everybody happy very few of the elite people will use it and no one is going to “cash in” as you put it. What is your expertise in again Andy

    I doubt very much if you guys have every performed at an elite level of sport (too much time playing computer games), so if you look at my latest blog on chiropractic live the physiologist who invited me is one of Scandinavias leading sports science people. Fortunately real scientists understand the nature of evidence better than skeptics do.

    • Le Canard Noir
      April 17, 2012 at 10:57 am

      To answer your question Richard, my expertise is in exposing quacks.

    • April 17, 2012 at 11:35 am

      Richard Lanigan wrote: “If an elite athlete “believes” (he could care less about published research) that chiropractic helps performance he will have a chiropractor…”

      Indeed. Superstition is rife among athletes. If they thought a witchdoctor would boost their performance, they’d bring one in. Having a chiropractor on hand to crack a few joints could simply be another form of pulling on ‘lucky socks’.

    • Jonathan
      April 17, 2012 at 5:20 pm

      I personally am not an elite athlete but have a close family friend who would certainly fall into that category. He had a knee injury (a proper one brought on by running stupid distances every day of the week, 52 weeks a year). He initially went to a chiropractor and seemed amazed that his treatment was having no effect whatsoever. A few months with a physiotherapist sorted it out and he was soon back to full training. I know we don’t like anecdote round here but that is just a true story I have to relay. Draw your own conclusions. Mine is that chiropractors risk damaging professional athletes careers by thinking they can help and encouraging those athletes to seek their advice before that of a proper medical treatment.

    • April 18, 2012 at 11:15 am

      What a surprise! The “it works for me” argument (albeit by proxy. Maybe athletes “don’t care about published research” because they assume that research has indeed been carried out and was successful? And that anyone “chosen” by a “Central Medical Unit” is acting in good faith?

      Not impressed.

    • Muscleguy
      April 18, 2012 at 4:18 pm

      And plenty of endurance athletes, elite and otherwise used to wear those nose plasters in the erroneous belief that slightly enlarging the nostrils improves their VO2Max. I am both a long term competitive distance runner and a ‘real scientist’* and I call that physio out for being unscientific and not caring about evidence based medicine. Not like physios of my acquaintance.

      One swallow does not a summer make Richard and one physio making a bad decision is just an anecdote, it changes nothing about the reality of chiropractic because reality is not a popularity contest. That you make this argument speaks volumes of your own contact with reality and scientific evidence. But keep going, you bury your credibility with every post if only you knew it.

      *This is a One True Scotsman fallacy argument. As a Scottish Scientist Athlete I call you on it.

    • Tom Carter
      April 18, 2012 at 5:32 pm

      I thought you made a reasonable point in that athletes might want this sort of thing, in the same way as they have rituals to get their ‘head in the right place’.

      But then you went on to discredit your comment by making a personal attack on ‘you guys’ in general, and then making a nonsense point about skeptics vs. scientists (considering all the evidence is taken from a published systematic review, written by scientists if that wasn’t clear).

  5. April 17, 2012 at 11:26 am

    Seems to me that these “massively honoured” chiropractors are hinting that they were head-hunted when in reality they applied to become volunteers:
    http://www.chiropractic-ecu.org/default.asp?p=70&nid=20&sbl=58&sbr=1

    There’s also this:

    Quote
    ECU [European Chiropractors Union] chiropractor Tom Greenway is the man responsible for bringing chiropractic to London 2012…Tom is convinced that the impact of chiropractic involvement will extend long after the Games are over. “I hope that the integration we all experience at the Games will make us far more confident and aware of what exactly we need to do to get us more involved in mainstream healthcare provision in the UK”.

    What you need to do is simple, Tom. Show us your evidence.

    • Dr Richard Rawlins
      April 17, 2012 at 3:51 pm

      Tom, Glad to hear your objective is “to get more involved in mainstream healthcare provision in the UK”.

      That straightforward – All you have to do is train and qualify in one of the mainstream professions. Medicine say, or physiotherapy.

      Best of luck, but until you join us, may the woo be with you.

  6. sweetpea
    April 17, 2012 at 1:50 pm

    In March 2011, you state on your blog that you had cancer, but you are obviously now alive and well. You do not state how it was treated. Was chiropractic your chosen medication? I’m sure we would all like to know.
    As another writer states, lucky socks, witchcraft doctors are all likely items of an athletes team, but quite frankly unlikely to be much help in the event of injury.

    • April 17, 2012 at 7:57 pm

      On Friday I had my last session of chemo therapy cant feel my feet hands or dick but they tell me chemo will reduce the likelihood of a re occurrence. Not great “evidence” to tell me how long I will live , but I have had excellent medical treatment at Kingston Hospital and the Royal Marsden where you can also have acupuncture, aromatherapy, reflexology, to complement the radiation, pre surgery chemo, the surgery and six months more chemo for grade three cancer. Fortunately I dont fear death having a wonderful family around me and have led a worthwhile life, which everybody is not able to say.

      Having worked at the highest level of athletic performance, with top sports scientists can I say we have all observed some extraordinary achievements of mind over body in Sport. Witchcraft?? who cares athletes dont care as long as they win

      • April 18, 2012 at 10:22 pm

        Richard Lanigan wrote: “Having worked at the highest level of athletic performance, with top sports scientists can I say we have all observed some extraordinary achievements of mind over body in Sport. Witchcraft?? who cares athletes dont care as long as they win”

        That’s exactly my point. It’s very strange that the volunteer chiropractors at the London Olympics should feel “massively honoured” about being involved with athletes who adopt such a mindset. In other words, the volunteer chiropractors aren’t likely to be of any more help than a lucky rabbit’s foot tucked away in an athlete’s kit bag.

        There’s also this to consider: The President of the British Chiropractic Association, who will be one of the volunteer chiropractors, says that he has worked with ‘elite’ athletes in the past. See
        http://www.stroudnewsandjournal.co.uk/sport/9653498.Chiropractor_Richard_celebrates_Olympic_call/

        Well, if it’s only ‘elite’ athletes who are being seen by the volunteer chiropractors, then their success is almost a foregone conclusion due to their pre-existing physical prowess. What would really be interesting to know is if any non-elite athletes have access to the volunteer chiropractors, and, if so, how many of them end up producing unremarkable performances, e.g. fail to produce a personal best.

  7. Dr Richard Rawlins
    April 17, 2012 at 3:56 pm

    Doctors at the Games will not be paid. Nor provided with accommodation or travel expenses. A bone of contention with the BMA, but it is not for us to dictate to members who wish to excercise their altruistic sensibilities.

    They are volunteers. Unless employed by athletes on a personal basis or through their Associations.

    There is no “massive honour” involved – not even massive enough to benefit from chiropractic intervention.

  8. Mike Warren
    April 17, 2012 at 7:13 pm

    Naked opportunism by chiropractors? Who’d have thought it.

  9. nobby68
    April 17, 2012 at 7:17 pm

    if a athelete opts for chiropratic intervention does that mean they have automatically failed the dope test?

  10. John H
    April 19, 2012 at 2:10 pm

    THOSE OLYMPIC RESULTS IN FULL

    MEDAL EVENT WINNER

    Gold – Vertebral Arterial Dissection Chiropractic
    Gold – Needless Irradiation Chiropractic
    Gold – Fractures In Osteoporotics Chiropractic
    Gold – Restoration of Innate Intelligence Chiropractic
    Silver – Advising Against Vaccinnation (Gold = Homeopaths)

  11. Andrew G
    April 20, 2012 at 12:01 am

    Some stuff from the bottom of the world:

    Chiropractors have been selected as attending doctors at the Olympic Games… (from http://www.dynamicchiro.co.nz/sports-performance-and-chiropractic.html)

    Dr Greg Oke said, “I used to be the chiropractor for the last two Olympics” (from http://www.stuff.co.nz/manawatu-standard/news/6360028/Chiropractor-on-song)

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