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Tactical Sports Medicine is the application of a sports medicine model to those who serve in tactical roles such as the military, law enforcement, fire fighters and emergency medical technicians. Simply stated, this population is one of first responders.
Occupational medicine serves many people who have injuries in the work environment. Often the occupational medicine model provides the same speed and method of care for an office worker with carpal tunnel syndrome as it does for a deputy sheriff or a firefighter who have very physically demanding jobs with inherent risk and dangerous conditions.
Sports medicine has to perform at a faster speed of delivery of care, provide a more accurate diagnosis sooner, and design a management plan for “return to play” to the field, track, rink or other surface. This sports medicine model of care is applicable to the tactical population as there is need for speed of care and rapid “return to play”/return to work management.
Tactical Strength and Conditioning is a branch of strength and conditioning, which focuses on the needs of the tactical population. Each population has unique needs of performance. Military personnel may have to carry heavy loads, which have increased over the decades. Law enforcement carries a smaller load, but cannot take it off or put it down during their work shifts as the military is able to do. Firefighters can carry significant loads onto unstable surfaces with limited vision due to smoke. Emergency medical technicians often have low back injuries from lifting gurneys with sick or injured patients into the ambulance. Preparing to enter these fields, or returning to work after an injury requires special attention to preparedness for the tasks involved.
The branches of the military often refer to the combined fields of tactical sports medicine and tactical strength and conditioning as Human Performance Optimization (HPO).
The birth rate has been steadily declining since 1990. The available target population to enter law enforcement, firefighting and the military is becoming smaller. Simply noted, there are fewer people to recruit. Concurrently, this same population is less active and is in poorer condition than previous generations. This has created a problem for all of the tactical environments.
The military has spent tens of millions of dollars on HPO to learn how to avoid inducing injuries as there is not a sufficient population to simply replace the injured recruit. Training methods have been studied and subsequently modified. The provision of musculoskeletal healthcare in the military is changing as well and is following a model closer to a sports medicine model.
Some fire departments have hired a certified athletic trainer to manage minor injuries and the result has been fewer injuries and claims. Australian police departments studied the impact that having department health clinics with a rapid response of care would have. Injuries were reduced and officers were returned to work faster. The financial impact was so significant that the government now helps fund these department clinics.
There are law enforcement agencies in which the deputies/officers have to work 6-8 overtime shifts per month to fill the department employee deficits. The solution to this volume of overtime work it is to reduce injuries in training, and to resolve the injuries of incumbent deputies/officers in a more efficient and timely manner.
The Southern California University of Health Sciences (SCU) is 107 years old and includes multiple colleges including the Los Angeles College of Chiropractic, College of Acupuncture and Eastern Medicine, Ayurveda, and a Physician’s Assistant Program.
The main campus has a University Health Center, a musculoskeletal urgent care center called the Ouch Clinic, Sports Medicine Department, Tactical Sports Medicine Department and Clinic, a Fitness and Human Performance Center, Diagnostic Imaging Department, and has 2-year residency programs in Diagnostic Imaging and Sports Medicine.
SCU has a premier relationship with the USOC Sports Medicine Department. As a result, the Sports Medicine residents also spend part of their residency at the US Olympic Training Centers in Colorado Springs or Chula Vista. Sports Medicine residents also rotate through the California State University Fullerton Athletic Training Room.
Interns and Attending Clinicians are also present in the Student Health Centers at California State University Fullerton, California State University Northridge, California State University Los Angeles, and Mt. San Antonio College.
The SCU Tactical Sports Medicine Department is bringing the sports medicine healthcare model to the tactical environment. The department is carefully selecting the doctors and strength and conditioning staff for the skill, knowledge and experience they bring to this endeavor to help the first responders. The program is multi-disciplinary and truly integrative health care for the benefit of the tactical patients. There is a high emphasis on accuracy of the initial diagnosis and quick delivery of care.
The Board Certified Sports Medicine Chiropractor position is uniquely qualified to lead the Tactical Sports Medicine Team. This specialty has extensive training in sports medicine, physical examination and differential diagnosis, rehabilitation and manual therapies, “return to play” criteria, diagnosis and management of concussion. This musculoskeletal skill set creates a strong vertically integrated health care delivery system and truly patient centered care.
The SCU Tactical Sports Medicine staff has a unique on-boarding process to ensure the providers understanding the culture of the patients they are serving.
Dr. Joseph Horrigan is Board-Certified in Chiropractic Sports Medicine with an extensive history in elite sports medicine in private practice, and professional sport strength and conditioning. Dr. Horrigan joined SCU on a full-time basis in 2016 to launch the Tactical Sports Medicine Program. He currently serves as the Executive Director of Tactical Sports Medicine and HPO.
Dr. Babikian is Board Certified in Chiropractic Sports Medicine and also completed a two-year residency in Primary Spine Pathways as well as serving as an attending clinician for interns. Dr. Babikian serves as lead instructor to a Sports Honors Tract and guides future sport medicine doctors. She has also presented numerous lectures. She currently serves as Clinical Staff for the SCU Tactical Sports Medicine Department.
Dr. David Velasquez brings a strong clinical skill set from 20 years in private practice in multidisciplinary clinics.Dr. Velasquez has presented eight podium and poster abstracts to the ACBSP Chiropractic Sports Science Symposia over a twelve-year period. He currently serves as Clinical Staff for the SCU Tactical Sports Medicine Department.
DC, CCSP®, CSCS
Dr. Fanning is a Board Certified in Chiropractic Sports Medicine and he is also a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA). He retired from the Air Force with 19 awards and service medals. He currently serves as Clinical Staff for the SCU Tactical Sports Medicine Department.
MS, CSCS, TSAC-F
Mr. John Hofman holds a Master’s degree in kinesiology. Mr. Hofman is also a Tactical Strength and Conditioning Facilitator with Distinction (TSAC*D) and Certified Strength and Conditioning Specialist with Distinction (CSCS*D) both from the National Strength and Conditioning Association (NSCA). He currently serves as the Director of SCU Tactical Strength and Conditioning.
Dr. Dietrich is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association (NSCA). He has earned his Functional Movement Screen FMS Level 1 & 2 certifications. He currently serves as Clinical Staff for the SCU Tactical Sports Medicine Department.
Dr. Melka completed a two-year residency in Primary Spine Pathways and is serving as an attending clinician for interns. Dr. Melka had numerous rotations in spine care throughout the Los Angeles region. Dr. Melka is the Lead Investigator in a current research project. She currently serves as Clinical Staff for the SCU Tactical Sports Medicine Department.