Interview with Brad Farra, D.C., CCSP, CSCS. Certified Chiropractic Sports Physician. Owner of Evolution Healthcare & Fitness. By Michael Vincerra.
How did you became attracted to sports medicine?
I was in the Navy for 6 1/2 years. I was a helicopter rescue swimmer and EMT, and it definitely spurred my interest in healthcare. I felt like that was definitely a calling for me. I enjoyed every aspect of search and rescue. After I got out of the Navy, I thought "that was the intention the whole time. Let’s get in [the Navy], get an idea of what I might want to do, and earn some college money." Then I started doing my undergraduate degree as pre-med in allopathic medicine, but I quickly realized it wasn’t what I wanted to do. I was irritated when all I ever had was sports injuries, and they had no tools for me. Then somebody gave me some really good advice: "Figure out who you want to work with, what you want to treat, and decide which profession is going to help you get the right toolbox." I quickly realized the Sports Chiropractor has the best toolbox to work on sports injuries and give people tools to take care of themselves.
Your profile indicates that you specialize in “recovery and prevention strategies.” Mountaineers and climbers encounter all types of injuries. Could you explain a little about your strategies in prevention and what makes them unique?
Strictly speaking on a preventive basis, if someone comes to me with absolutely no injury, there are a lot of things that we can do to determine risk and vulnerability for injury. We do movement screens, we assess tissue quality, we do orthopedic testing, and a lot of that is looking at movement patterns and figuring where we need to go to minimize risk for injury. For a climber, I’d rather look at the way they squat, the way they move their shoulders, and how they transition from back to neck to shoulders—fundamental movement patterns.
Why look at the squat?
We use the way someone squats to determine their risk and vulnerability to injury. For example, a toddler knows exactly how to squat and it’s a perfect squat every time. But as adults in the 21st century, we sit. All the time. Sitting jacks up the post of your chain and the motor pattern, it shortens the hip flexors, and it turns off the glutes and gets our core weak. Eventually that leads to mobility problems in the upper back and the hips, not allowing us to move properly through a squat. The squat tells me about how they’re moving throughout the day. Then that tells me how they’re going to move up on the mountain for 3,000 feet, and where the breakdown is going to be. It’s amazing how much we can gather by watching somebody move and develop a set of corrective exercises.
Can you explain one of these methods in detail and the benefits it has to your patients?
“Class 4 therapeutic laser, graston technique, soft tissue manipulation, rehab, and nutrition.” A lot of people think, "I don’t need chiropractics." You’re probably thinking of a chiropractic adjustment or manipulation. Chiropractic is a profession, not a procedure. I’m looking at the research, taking all the best tools, and helping my patients with the problems they come to me with. So take Graston technique, which is basically an instrument- assisted soft-tissue mobilization technique. It does a phenomenal job of breaking up scar tissue, resetting the nervous system, and bringing fresh blood to the area. I see it being effective for my patients day in and day out. With the research they’ve done, using pre- and post-diagnostic ultrasound, they’ve demonstrated scar-tissue adhesions breaking up and lining-up of tissue fibers, which allows tissues to glide and move.
How does your chiropractic background inform what you do as a Sports Medicine Physician?
Well, that’s interesting. I have a B.S. in Human Biology. I went to a four-year professional school that mirrors medical school. You spend a couple years in basic sciences, you get into clinical sciences, and continue as your start an internship. I’m reading the same sports science research that everybody else is reading. And because of my scope of practice, I’m able to apply all those tools like another practitioner would, like a physical therapist or a physiatrist would. At this point in time, 80% of my practice is extremity sports injuries: ankle, knee, hip, wrist, elbow, and shoulders.
What is the most popular injury among climbers?
Medial and lateral epicondylopathy. Their nicknames are "golf elbow" and "tennis elbow." It tends to be a chronic condition, not an acute condition. I also see a lot of pulley and tendon injuries. On fingers, you have the pulley that holds the tendon down. Sometimes, it’s not just the tendon that gets injured from cramping but also the pulley that holds the tendon down. Sometimes both. I’m able to accelerate the healing process and guide somebody back to sport. That’s really the biggest question: ‘When can I climb again?" If we go back too soon, it’s going to prolong the healing process. Shoulder injuries is the next biggest one. Because the shoulder is such an important part in the way we move. If someone is not moving properly at the shoulder, the elbow takes more of the load, and they end up with epicondilytis. And a lot of the rehab for elbow injuries is shoulder stability and strengthening. So it depends on the specific presentation.
Especially for a lot of the Mazama climbers, it’s about their cardiovascular "motor" and that the core is strong, the hips are strong, and we’re able to deliver the climber to the mountain and not get injured. I like to say that the core allowsyou to transfer power to your extremities. Whether you’re a throwing athlete or a climber that needs to carry a 50 lb. pack up the hill, you need to have a strong core so you don’t lose energy.
Has your own experience as a mountaineer taught you how to prevent sport injuries?
As a strength coach and a climber, I feel it’s a really helpful tool to speak the language of the climber. So that when they tell me, "I was pulling this Gaston and felt a pinch in my elbow ..." I’m able to talk to a climber about what they’re doing and to help them and guide them back sport.
I definitely feel like my experience as a climber gives me a better perspective on what a climber is dealing with and their goals. I enjoy working with motivated people who just want to get back out there and do their thing.
Come and learn from Brad: Training for Alpine Climbing on Nov. 17 at Evolution Healthcare & Fitness.