Frequently Asked Questions

About Performance Sport Care

What is Performance Sport Care, and what makes it different?

Performance Sport Care combines chiropractic and manual care with supervised progressive strength rehabilitation in one practice, under one individualized, coordinated plan. You can read more about Our Approach and see Inside Performance Sport Care.

When pain or restricted movement is getting in the way, treatment can help you move more comfortably. When the problem has also affected strength, control, confidence, or your ability to tolerate work, exercise, or sport, rehabilitation can help rebuild what is missing.

Care can include chiropractic treatment, manual therapy, assisted stretching, specific exercise, training modification, nutritional guidance to support recovery and repair, supervised progressive strength rehabilitation, and follow-up examinations to monitor progress, reassess findings, and keep you informed about how your recovery is progressing.

The treatment room and the strength-rehabilitation facility are part of the same practice, so what we learn during treatment can influence rehabilitation, and what we observe during rehabilitation can influence what happens next.

The goal is practical: help you hurt less, move better, get stronger when strength is needed, and return to the work, training, sport, or everyday activity that matters to you.

Who does Dr. Cancel treat?

People across a wide range of activity levels.

That includes active professionals, older adults, desk workers, recreational athletes, runners, golfers, bodybuilders, powerlifters, weightlifters, CrossFit athletes, and people returning to activity after an injury or surgery.

For one person, the goal may be getting through a workday without back pain. For another, it may be walking, gardening, traveling, sleeping comfortably, returning to the gym, playing a sport, or lifting heavy again.

You do not need to be an athlete to be cared for like one.

I have already tried chiropractic care, physical therapy, injections, or other treatment without getting the result I hoped for. Is it still worth being evaluated?

Yes. Previous treatment not producing the result you hoped for does not, by itself, tell us why the problem remains.

Dr. Cancel starts fresh. He reviews what has already been tried, considers relevant records or imaging, examines what is limiting you now, and looks at what you are trying to get back to.

Sometimes a different treatment or rehabilitation approach makes sense. Sometimes additional information can clarify the problem.

The purpose is not to decide that somebody else was wrong. It is to determine what the current findings support and what makes sense now.

Does Dr. Cancel treat bodybuilders, powerlifters, and other strength athletes?

Yes. Strength athletes are a particular area of experience within the practice.

Dr. Cancel is a former national-level competitive bodybuilder and a lifelong strength athlete who still trains. He understands exercise selection, training volume, fatigue, recovery, progressive resistance, and the demands involved in returning an injured area to serious training.

That experience is especially useful when the goal is not simply to make something hurt less, but to determine what you can keep doing, what may need to change temporarily, and what the injured area must eventually be able to tolerate again.

Is Performance Sport Care a subluxation-based or adjustment-only chiropractic practice?

No.

Chiropractic manipulation is one treatment option, not the organizing principle of every visit.

Depending on your findings and goals, care may include manipulation or mobilization, manual treatment, assisted stretching, specific exercise, movement work, training modification, nutritional guidance, follow-up examination, and supervised progressive strength rehabilitation.

There is no requirement that every patient be adjusted at every visit or remain on an ongoing maintenance schedule of adjustments.

Services, Treatment, and Rehabilitation

What kinds of problems does Performance Sport Care evaluate and treat?

Dr. Cancel evaluates and treats many musculoskeletal problems involving the spine and extremities, including:

• Back and neck pain
• Sciatica and other forms of radiating pain
• Shoulder, elbow, hip, knee, foot, ankle, and leg problems
• Muscle strains and many sports injuries
• Tendon and repetitive-stress problems
• Headaches when the findings support a musculoskeletal source
• Training-related pain in lifters, runners, and other athletes
• Rehabilitation following injury or surgery when conservative care is appropriate
• Persistent or recurring musculoskeletal pain

You do not need to arrive knowing exactly what the problem is. Tell Dr. Cancel what hurts, what you can no longer do comfortably, what you have already tried, and what you want to get back to.

What treatment methods does Dr. Cancel use?

Treatment is individualized.

Depending on the problem, care can include chiropractic manipulation or mobilization, myofascial and other manual techniques, instrument-assisted soft-tissue treatment, assisted stretching, movement work, specific exercise, training modification, nutritional guidance to support recovery and repair, and supervised progressive strength rehabilitation.

Follow-up examinations may also be used to monitor progress, reassess findings, and keep you informed about how your recovery is progressing.

Not every patient needs every method. The mix can change as you change.

Do you treat both new injuries and long-standing problems?

Yes.

A recent muscle or joint injury may need a very different approach from pain that has been present for months or years.

Dr. Cancel considers how the problem began, what aggravates or relieves it, what you have already tried, what the examination shows, and what your body needs to be able to do again.

Some problems improve relatively quickly. Others require more time and progressive rehabilitation.

My MRI looks normal, but I am still in pain. How is that possible?

Imaging is useful, but it does not explain every source of pain or every limitation in function.

A normal or reassuring MRI can make some structural explanations less likely. At the same time, findings such as disc degeneration, bulges, or arthritis can appear on scans in people who are not experiencing symptoms.

Imaging also has to be interpreted in the context of what condition is suspected and when in the course of an injury the study was performed. In adolescent athletes with suspected spondylolysis, for example, an early pars stress reaction can appear on MRI before a fracture line is visible on X-ray. See Persistent Low Back Pain in Teenage Athletes for a practical example.

That is why Dr. Cancel considers imaging alongside your history, orthopedic and neurological findings, movement, strength, symptoms, and your response to applied stresses or mechanical tests.

The scan is part of the clinical picture. It is not the entire picture.

For more on this subject, read When Your MRI Looks “Normal” But You Still Hurt.

Tell me about the strength-rehabilitation facility.

Performance Sport Care has a small, private, purpose-built facility for supervised progressive strength rehabilitation.

It includes commercial-grade equipment from manufacturers such as Atlantis, Sorinex, Cybex, and Arsenal Strength, along with dumbbells, kettlebells, barbells, racks, and other equipment that allows rehabilitation to progress across a broad range of ability.

The equipment was selected not simply for quality, but for stability, safety, comfort, adjustability, and biofidelity.

By biofidelity, we mean that the machine works in harmony with the body rather than forcing the body to accommodate the machine. Some exercise machines are uncomfortable or do not adjust well for smaller individuals, including many women and shorter patients. That can make an otherwise appropriate exercise awkward or painful.

Dr. Cancel selected the equipment specifically to accommodate a broad range of body sizes and proportions comfortably while allowing exercise to be performed through a natural and controlled path of motion.

For one person, rehabilitation may begin with a two-pound weight and a precise shoulder movement. For another, it may eventually involve a loaded barbell.

The goal is not to make everyone train heavily. The goal is to make the exercise fit the person and the job it needs to do.

Why do you supervise rehabilitation instead of simply giving patients exercises to do at home?

In Dr. Cancel’s experience, simply handing patients a list of exercises to perform at home has not been a satisfactory way to manage progressive rehabilitation.

Even with good instructions, exercise technique can drift. Tempo may change. The resistance may be too light or too heavy. People can become distracted, rush through the work, or continue performing an exercise incorrectly without realizing it. Those problems can slow progress and, in some circumstances, increase the risk of aggravating the injury.

That is one of the reasons Performance Sport Care created a dedicated strength-rehabilitation facility.

It allows patients to learn and perform their rehabilitation on commercial-grade exercise equipment selected specifically for stability, safety, comfort, adjustability, and biofidelity.

More importantly, the work is supervised. We can watch how you perform an exercise, correct technique and tempo, select an appropriate resistance, and change the exercise or resistance as your ability improves.

Every supervised rehabilitation session is recorded, including the exercises, resistance, sets, and repetitions, so progression is based on what you actually did and how you responded.

The goal is not simply to give you exercises.

The goal is to make rehabilitation a controlled, progressive part of your recovery.

Who conducts the supervised strength rehabilitation?

Dr. Cancel performs the evaluation, establishes the rehabilitation plan, and directs its progression.

Most supervised exercise sessions are conducted by Dana K. McDaniel Cancel, Lead Supervised Exercise Trainer, under Dr. Cancel’s planning, direction, and on-site supervision.

Dr. Cancel remains responsible for the clinical plan and can reassess or modify it as needed.

Can chiropractic care improve athletic performance?

Routine spinal manipulation does not enhance athletic capabilities, but it can offer certain benefits to athletes.

When pain, stiffness, restricted movement, or reduced tolerance to training is interfering with performance, chiropractic care may help address those limitations. Rehabilitation can then be used to restore strength, movement, and capacity for the demands of the athlete’s sport or training.

At Performance Sport Care, spinal manipulation is not used as a performance enhancer. It is one treatment option within a broader plan aimed at helping an athlete move more comfortably, train more effectively, and return to the level of activity their condition allows.

Do you recommend ongoing maintenance chiropractic care?

Not as a uniform recommendation for everyone.

Some patients may find periodic care useful based on their history, activity demands, recurring symptoms, or personal preference. Others may not need ongoing care at all.

At Performance Sport Care, maintenance care is not imposed as a standard requirement. Care is individualized, tied to the patient’s goals and response, and adjusted according to what is actually useful.

Your First Visit

What happens at my first appointment?

Your first visit is designed to move you forward.

Dr. Cancel takes time to understand how the problem began, what makes it better or worse, what you have already tried, and what you are trying to get back to.

He then performs an appropriate functional, orthopedic, and neurological examination. Depending on the problem, that may include assessment of motion, strength, movement, and response to applied stresses or mechanical tests.

Relevant records or imaging you bring are reviewed and are always useful. If you have them, we encourage you to bring them to your appointment.

By the end of the evaluation, our goal is to solidify our understanding of your problem, answer your questions, and provide workable first steps toward recovery and better performance.

Will I be treated at the first visit?

Often, when the findings support beginning treatment that day.

If Dr. Cancel believes imaging or additional medical information would meaningfully affect what should be done, he will explain that before proceeding.

The purpose is not to delay care. It is to make sure the care has a reasonable likelihood of success.

What is the Clinical Evaluation Report?

Every new patient receives a written Clinical Evaluation Report within 24 hours of the initial visit, at no additional charge.

The report records the relevant history, examination findings, diagnostic impressions, and recommendations.

It is yours to keep and share with your spouse, doctor, or anyone else you choose.

Can Dr. Cancel order X-rays, MRI, or other imaging?

Yes.

When imaging would help clarify the problem or materially change the plan, Dr. Cancel can order the appropriate study.

Imaging is not automatically required for every patient.

How long does the first appointment take?

One hour is scheduled for the initial visit.

Straightforward cases may require less time. More complicated problems sometimes require additional time or more than one visit to complete the evaluation properly.

Follow-up treatment appointments are scheduled for at least 30 minutes when appropriate.

The practice is intentionally not built around rapid, high-volume visits.

Do I need a physician referral to see Dr. Cancel?

No medical referral is required simply to schedule an appointment or to choose from among the care options available at Performance Sport Care.

Some insurance plans, however, may require a primary-care referral before they provide out-of-network reimbursement. If insurance reimbursement is important to you, check your plan’s requirements.

If Dr. Cancel is uncertain of the diagnosis, believes additional medical evaluation is needed, or determines that medical treatment is the better choice for your situation, he will recommend that promptly and help arrange the appropriate referral.

What should I bring to my first appointment?

Bring:

• Photo identification
• Your current insurance card if you plan to submit claims
• Relevant imaging or imaging reports
• Records that may help explain previous evaluation or treatment

If you have relevant records or imaging, we encourage you to bring them. They are always useful and will be reviewed.

Be sure to list your medications on our online new patient registration form.

Wear clothing that allows the involved area to be examined and makes basic movement testing practical.

Recovery and Returning to Activity

How many visits will I need?

There is no predetermined number of visits.

We will always try to obtain the best possible results in the shortest reasonable period of time. But healthcare problems are not always predictable.

The amount of care depends on the problem, its severity and duration, your objectives, your individual response, your level of participation in the recommended homework, and whether progressive rehabilitation is needed.

We will keep you informed every step of the way. We will be honest and truthful. We will be accountable for what we do and recommend. And we will not sugarcoat anything.

How long will recovery take?

That depends on the problem and the destination.

A mild recent injury should not be given the same timeline as a problem that has been present for years. Likewise, returning to comfortable walking is different from preparing an injured area for heavy competition-level lifting.

After evaluating you, Dr. Cancel can give you the most reasonable estimate the findings allow. That estimate can become more precise as your response becomes clearer.

Will I need to do anything between appointments?

Often.

Depending on the problem, Dr. Cancel may recommend specific homework, movement practice, temporary activity changes, nutritional or recovery guidance, or other steps between visits.

Those recommendations should have a purpose and relate directly to what the plan is trying to accomplish.

Progressive rehabilitation that requires close attention to technique, resistance, tempo, or progression is generally better suited to supervised sessions in the rehabilitation facility than to a handout alone.

Will I have to stop lifting, running, working out, or playing my sport while I recover?

Whenever possible, we try to avoid an unnecessary loss of fitness during recovery.

That often means being creative and finding workarounds, modified workouts, or other ways for you to maintain some part of your usual exercise program, activity, or sport while the injured area recovers.

Sometimes that is not possible. Certain injuries require more substantial restrictions, and occasionally complete rest from a particular activity is necessary to provide the best opportunity for healing and recovery.

Our goal is to preserve as much safe activity and conditioning as we reasonably can without compromising recovery.

How do you know when care should end?

Sometimes you will already know.

You have regained pain-free function. Your muscles are relaxed and flexible. You have full, pain-free range of motion. You have regained the strength and endurance needed to return fully to your sport, exercise program, work, or daily activities without aching or premature fatigue.

Other times, recovery is not so clear-cut. That is when experienced, expert, and truthful guidance becomes especially important in helping you reach your goals.

Active care typically ends when you have reached an appropriate functional standard for your situation and can manage without depending on us, or when you have reached a point at which further care is unlikely to materially improve your condition beyond its current state.

In some medicolegal settings, that latter point may be described as a permanent and stationary status.

In short, care ends when the job is done. But we will be here when you need us again.

Treatment and Safety

Will treatment hurt?

Sometimes it does.

We do not seek to make treatment painful. Pain is not the objective, and pain does not equal results.

But pain is sometimes difficult to avoid. A muscle may have been shortened, tight, stiff, or relatively inelastic for months or years. A severe muscle spasm may prevent you from standing upright or moving normally. A joint may have been arthritic, restricted, or painful for a long period of time. Restoring movement to tissues like these can sometimes be painful.

When that happens, the important question is whether a temporary increase in pain is reasonable in relation to the expected benefit. We will explain what we are trying to accomplish, monitor your response, and modify the treatment when appropriate.

Most treatment situations are not nearly that dramatic. In the majority of cases, any pain associated with manual treatment, stretching, or therapeutic exercise is minimal and short-lived.

Unfortunately, those routine experiences are rarely the ones people talk about. The unusually painful treatment experience is much more memorable, and that can create the impression that effective treatment is supposed to hurt.

It is not.

Pain is sometimes encountered during treatment. It is never the measure of whether the treatment is working.

Is chiropractic care safe?

There is no chiropractic or medical treatment that is completely risk-free. Serious reported adverse events are rare.

One advantage of the range of care available at Performance Sport Care is that treatment does not depend on a single technique. If one method is inappropriate, poorly tolerated, or simply not indicated, we can often choose another approach and still work toward the same clinical objective.

Safety begins with selecting treatment that fits the patient and the findings. Dr. Cancel reviews the history and examination, considers whether a particular method is appropriate, and can modify the technique or choose another form of care when needed.

You do not need a medical referral to schedule an appointment or to choose from among the care options we offer. If Dr. Cancel is uncertain of the diagnosis, believes additional medical evaluation is needed, or determines that medical treatment is the better choice for your situation, he will recommend that promptly and help arrange the appropriate referral.

What does current research say about neck manipulation and cervical artery dissection?

Recent evidence is reassuring, but it should be described accurately.

A large 2026 matched retrospective cohort study examined 862,984 adults seeking care for a new episode of neck pain or headache. It found no increased 30-day risk of cervical artery dissection after chiropractor-administered cervical spinal manipulation compared with matched patients receiving medical care and an ibuprofen prescription.

This was an observational study. It does not prove that the risk is zero, nor can it establish what caused an event in an individual patient.

An important clinical issue is that a developing cervical artery dissection can itself begin with neck pain or headache before the condition is recognized.

That is one reason unusual symptoms, neurological findings, or other warning signs deserve careful evaluation before neck treatment.

What if I do not want my neck adjusted?

You do not have to.

Performance Sport Care offers a range of treatment options that can accommodate different people, preferences, and clinical situations. Cervical manipulation is only one possible treatment method.

If you are uncomfortable with a neck adjustment, tell Dr. Cancel. He can explain why he is recommending it, what he hopes to accomplish, and what reasonable alternatives may be available.

The goal is not to make every patient accept the same treatment. The goal is to choose an approach that is appropriate for your condition and acceptable to you.

Does every chiropractic adjustment make a popping sound?

No.

The sound sometimes heard during an adjustment is called joint cavitation and is associated with a rapid pressure change within the joint.

A sound is not required for treatment to be useful, and the absence of a pop does not mean the treatment failed. Dr. Cancel does not repeat an adjustment simply to produce a sound.

For a more detailed explanation of what causes the sound and what it means, read What the Popping Sound Actually Tells You — and What It Doesn’t.

Insurance and Billing

Does Performance Sport Care accept insurance?

Performance Sport Care is an out-of-network provider. Payment is due in full at the time of service. As a courtesy, we prepare and electronically submit a claim to your insurer within 24 hours of your visit, so any out-of-network reimbursement available under your benefits is paid directly to you.

Coverage, deductibles, referral requirements, and reimbursement vary by plan. Performance Sport Care is not contracted with managed-care or HMO plans, including Kaiser, and is not currently contracted with Medicare.

If reimbursement is important to you, confirm your out-of-network benefits directly with your insurance carrier before your first visit.

Why do I pay at the time of service if you submit an insurance claim?

Because Performance Sport Care is out of network, payment for the service is the patient’s responsibility when the service is provided. Electronic claim submission is offered as a courtesy to make obtaining any available out-of-network reimbursement easier.

Submitting a claim does not guarantee that your insurance company will reimburse you.

How can I pay?

We accept cash, check, HSA payments, major credit cards, and Zelle. We do not extend services on credit or accept attorney liens.

How does Performance Sport Care approach the cost of care?

Care should have a purpose, and cost should be understandable. Performance Sport Care does not use preset treatment schedules, require indefinite maintenance visits, or ask patients to enter long-term treatment contracts.

Progress is reassessed, recommendations can change as your condition changes, and the current episode of care should end when the job is done. The office can explain current fees before your first appointment so that you know what to expect.

Our aim is to resolve the problem, not to manage it indefinitely. When care succeeds at that, the total cost of getting better — counting your time and the life impact of a problem that drags on, not just the visit fees — may be lower than open-ended treatment that never quite resolves it.

What if I have limited insurance benefits or no insurance?

You can still be evaluated and treated on a self-pay basis. Contact the office for current fees. If cost is an important consideration, tell us before your appointment so you understand the financial side of care before making a decision.

Scheduling and Getting Started

What if I am not sure whether chiropractic care is what I need?

You do not need to arrive knowing exactly what kind of treatment you need.

Start by explaining what hurts, what you cannot do comfortably, what you have already tried, and what you want to get back to.

Dr. Cancel’s job is to evaluate the problem and recommend what makes sense based on the findings.

Performance Sport Care offers a range of care options, so the answer does not have to be the same treatment for every person. When treatment and rehabilitation here make sense, Dr. Cancel can explain how they can be used. If additional diagnostic information or medical care is the better choice, he can help you take that next step.

How do I schedule an appointment?

Call (925) 945-1155 or use the online Request an Appointment form.

Dr. Cancel personally calls every new appointment request within 24 hours.

That conversation gives you an opportunity to tell him briefly what is going on before the first visit.

Where is Performance Sport Care located?

Performance Sport Care is located at:

1776 Ygnacio Valley Road, Suite 106
Walnut Creek, CA 94598

The office serves Walnut Creek, Lafayette, Danville, Alamo, Concord, Pleasant Hill, and greater Contra Costa County.

It is a short walk from John Muir Medical Center, next door to the Walnut Creek Tennis Club, and steps from Heather Farm Park. On-site parking is available.

Ygnacio Plaza and Sports Basement are across the street.