Figure 6

®

Figure 10

Corrected Methodology

How to fix this crisis? Motion, as in regular exercise, is mandatory in keeping weight down, blood pressure down, cholesterol down, and anxieties down. Motion also tends to prove and supports the universal law that you get what you pay for. We’ve become a nation seeking comfort. We spend too much time sitting, at the computer, playing video games, shopping online, texting and emailing, and doing all of the other computer-related activities that alienate many of us from the rest of the world. Not only do these acts not require us to move more than our fingers, but I’m sure someone out there is also writing about the sociological effects that are being caused by this behavior.

We need to move our bodies and our minds. We need to move our vascular systems and tendons, muscles, and joints. We need to include motion (exercise) in our lives each and every day. A body that doesn’t move enough will become obese (see Figure 1). Likewise, a joint that becomes locked (loss of normal motion) will degenerate prematurely (see Figure 2).

The new methodology has to include keeping the body moving and keeping the joints, tendons, and muscles healthy and moving. A proactive approach is thus mandatory. This means taking positive action before illness arrives. This must include a biomechanical standard of care that ensures that all joints, tendons, and muscles are moving fully and correctly. Each of us must also assume greater responsibility to move and get enough exercise in our lives.

Case History:  Using New Proposed Guidelines


Again, let’s look at the 34-year-old male with chronic low back pain. Look again at Figure 3, Crooked Man, and notice the imbalances in that graphic. Below are the tests that can be done to demonstrate these same imbalances on any person.

Test 1: Digital Foot Scan. The normal foot scan, which shows the three arches of the feet fully supporting the weight of the patient, can be seen on the right side of Figure 4. Red represents body weight, which should be evenly distributed between the front and heel of the feet. The left side of Figure 4 shows a difference between the feet. This imbalance will affect the entire body. We can see there is a fallen outer arch on the left foot, and this imbalance translates up the entire
structure of this individual. The boxes at the top left of the figure reveal that 59.2 percent of this person’s body pressure is going through the left side of the body, while only 40.8 percent is going through the right side of the body. This is a significant imbalance. This abnormal mechanical loading is undoubtedly causing severe stresses and strains throughout the entire structure.

The Structural Management    Program

Preserving the Musculoskeletal System

Structural Management | Dr. Tim Maggs

Figure 2

Figure 8

Test 4: Center of Gravity. Center of gravity testing is done with the patient standing still on a platform for two tests of 26 seconds each. The patient must stand as still as possible, first with eyes open, then with eyes closed.

In Figure 9, we see that the patient’s center of gravity is to the right. On the actual printout from the test, red represents the test done with eyes open, blue, with eyes closed. In Figure 10, we can see that the patient’s center of gravity lies significantly behind the body. In this case, the greater sway is with eyes closed, as the eyes are critically important in the stabilization of the body. Again, the stability is reduced with eyes closed. This patient’s center of gravity is in the right-rear quadrant.


Figure 5

Figure 10

Figure 3

Figure 4

Crooked Man


Figure 3 shows the imbalances all of us live with. The Structural Fingerprint® concept states that our structure is as unique as our fingerprint. This figure shows that all imbalances begin in the feet and that there is a domino-like effect going up the structure. Now add to these imbalances the stresses of sports, hard work, bad habits, overweight, and injuries, and it’s not hard to realize why musculoskeletal imbalance is the leading cause of disability in people over the age of 50 in this country.


Case History:  Using Traditional Guidelines


A 34-year-old male goes to his primary physician with chronic low back pain. The primary physician, who lacks knowledge and experience to deal with anything musculoskeletal, does the proper thing and refers the patient to an orthopedist. The orthopedist takes some x-rays of the low back, and if they don’t reveal a fracture or a condition requiring surgery, the patient is either given an injection of cortisone or a referral to a physical therapist. Keep in mind, however, that the orthopedist often will take x-rays of the patient in the lying down position, which removes the influence of gravity. This prevents the examiner from knowing what effects gravity will have on the body, which prevents the awareness of any biomechanical information on the part of the orthopedist. If the patient elects physical therapy, health insurance guidelines allow a fixed number of visits to alleviate the symptoms. Although the patient is hopeful the orthopedist sends a multi-page report outlining what was found on exam and what treatment needs to be done, the truth is that it’s an “evaluate and treat” prescription. Nothing more, nothing less. Maybe the patient feels better with physical therapy, maybe he doesn’t. In either case, insurance coverage ends as soon as a specific, limited amount of treatment has been provided.

Test 3:  Cervical (Neck) X-Rays. Figure 7 is an open-mouth view showing the alignment of the first and second vertebrae (atlas and axis), which greatly influence the nervous system as the spinal cord exits the brain. In this case, the alignment of these two bones looks very good. In Figure 8, the side view of the neck, however, we see a severe forward lean of the neck, which can lead to all kinds of problems for the patient, including neck pain, pinched nerves, and disc injuries. The weight bearing line should be going through all of the bones of the neck for normal center of gravity of the body and normal wear and tear on the neck. In this case, however, the head is substantially forward of the body, changing the mechanical loading going through the neck. This imbalance throws off the center of gravity of the entire body.


Figure 8

Figure 9

What if a patient decides to go to a chiropractor? If this chiropractor also practices under the standard medical model (treatment to alleviate symptoms only), then insurance may pay for another brief period of time in hopes the patient will feel better. In the end, no long term plan has been given to the patient. He went through a temporary treatment program with no knowledge of what the underlying cause of his low back pain is, no guarantee of relief, and no idea what the future may have in store for him.

Consider the reactive, localized, symptomatic healthcare provided for muscular, skeletal and nervous system conditions. It’s no wonder our costs are escalating while people are degenerating at a younger age. If every person in this country were evaluated for their unique biomechanics at the age of 12, much as an orthodontist does with the teeth, long before there are any major breakdowns, then everyone would have a corrective plan to follow that would help to preserve their biomechanics and structures. Such a plan would also help to reduce the costs of healthcare.

In addition, by keeping the people’s musculoskeletal systems healthier, people would be able to be more active, which would keep heart disease, diabetes, obesity, and other degenerative diseases down, as these are often secondary conditions to a disabled musculoskeletal system.

Test 2: Low Back X-Rays. Figure 5 shows the front to back view of the patient. The vertical black lines should be centered through the spine and the front of the pelvis, which they are not. The left pelvis and the right pelvis should be level, which they are not.

Figure 6 is the side view, which also shows an abnormal weight bearing line (long vertical line), which should fall through the short black vertical line. The sacral base angle should be 36 to 42 degrees; instead, it is 24 degrees. These biomechanical imbalances shift the mechanical loading of the body, putting undue stress on specific areas of the body that were not designed for increased weight bearing. In this case, the weight is on the back of the discs, which are most vulnerable to injury. This will cause an area of the body to physiologically react with spasms, inflammation and damage to whatever structures are involved, including discs, ligaments, nerves, bones, and muscles.


Figure 2
Figure 6

The medical profession, in the U.S., has aimed our rules for healthcare in a very dramatic and polarized direction. Unfortunately, healthcare today is a profit vehicle for many, while actual good health remains an elusive goal. We’ve known the laws of good health, such as getting a good night’s sleep, eating a healthier diet, having a positive attitude, and getting enough exercise and attaining higher energy levels, for many years, yet we’ve somehow allowed the business of healthcare to replace grandma’s good sense. There’s no reason good health should cost what it does, but our corporate methodology and the promotion of artificial treatments have distracted us from practicing the simple laws of good health.

As the business of healthcare continues to grow, the motivation for good health on the part of the American public continues to decline. We’ve never been told that we have much control over our health or that discipline and sacrifice are necessary components of a long and healthy life. Merely taking a pill to treat a symptom should not be part of our long-term health plan.

Let’s consider the topic of high blood pressure, which is a common by-product of the American lifestyle. The most popular treatment recommended by physicians and endorsed by the insurance industry is medication. This should, however, be about the seventh or eighth consideration on the list of ways to approach high blood pressure, behind exercise, sleep, diet, weight-management, stress-management, family history, smoking cessation, etc. Today’s lifestyle leads to high blood pressure, yet too many people are medicated and too few learn to fix the problem. If you’ve already addressed all seven or eight of the above-listed issues, and you still have high blood pressure, then it may be time to ask your physician for a pill. Not before.

Medications have taken over our lives to the point where we believe they’re the correct— and the only—way to reach improved health. From advertising to insurance coverage, all arrows point to medicine as the safest “physician-recommended” way to get healthy. Many of us don’t realize that the AMA-approved medical practice, which is largely dependent on pharmaceuticals, is a relatively new profession. It’s only a couple hundred years old. Once physicians and others in health care realized the profit potential in pharmaceuticals and testing, and once patients saw how easy it was to feel symptomatic relief when taking a pill, medicine took off and has never looked back. The problem is that we never realized that taking pills would lead us to such a state of dependence.

Obesity is another by-product of this pill-taking mentality. In addition, the side-effect symptoms from medications that patients must live with are oftentimes worse than the original condition.

Structural Management

Figure 5

A Broader Vision


We should never accept the easiest way to remove a symptom without considering the long term effects of that removal. Instead, we must look at current healthcare practices from a broader perspective. When choosing a model of care, we must look at the long-term health of the patient and consider the long-term wellness of a society as a whole. We must look at the financial, emotional, and health outcomes from every possible angle and then decide what system is best. The artificial elimination of symptoms alone will never be the best choice when considering long-term wellness.

Good health is a lifetime process. Every year our needs vary. We can never stop working towards better health. Every person has a maximum potential in all areas of his or her life. The ultimate goal of a healthcare practitioner is to get people doing the best things to get them as close to their maximum health potential as possible. This approach is much more productive than providing reactive treatment to disease and symptoms.

To fix the healthcare crisis, we must begin by accepting the fact that every human being is also an architectural structure and the architecture of the body is influenced by gravity, age, and mechanical loading. The assumption of our traditional healthcare providers, as well as the insurance industry, is that all humans are biomechanically sound at birth and that any imperfections at any point will be fixed with a limited amount of care.

The truth, however, is that we are born with biomechanical imbalances and faults (think of the stress and rotation on the neck of the newborn who is coaxed out of the womb with forceps), and life leaves many banana peels on our sidewalks, leading to many slips, falls, and traumas during our lifetimes. These injuries add to the many imbalances we’re born with. Combine this with a lack of conditioning, increased weight, bad habits, injuries, and artificial treatments to eliminate symptoms, and you can only imagine the gravity of the problem as time goes on.

It is these structural imbalances, fixations (restricted joints), and distortion patterns (structural imbalances) that will dictate the wear and tear patterns and degeneration of our physical structure over our lifetime. All of this translates into disability and a loss in quality of life occurring at a younger age, as well as an exponential increase in costs paid to physicians and pharmacies over a lifetime. Our injuries and disabilities are born in our imbalanced biomechanics, and these imbalances are readily detectable as early as age 12 if the proper tests and interpretations are done. Corrective treatments, rehabilitation, and recommendations can be made. They can also dramatically change a person’s life and significantly reduce the cost of this person’s healthcare over his or her lifetime.

Figure 1

Figure 7

Structural Management

The Future of Sports Medicine

Dr. Tim Maggs

®

Figure 1

Figure 4

Figure 7

Figure 9

Conclusion


With the information given in these four tests, plus additional information derived from the patient’s history and the physical exam, we can see the biomechanical and neurological imbalances this patient is dealing with. A comprehensive corrective program can now be designed for patients, regardless of whether they have symptoms or not. This will make a major difference in the life of this patient, as well as in the healthcare cost paid by this patient over his lifetime.



The Four Stages of Musculoskeletal Degeneration


Musculoskeletal degeneration begins the day we’re born. This is not the actual breakdown of the muscles, tendons, and joints, but the buildup of biomechanical imbalances, fixations, and distortion patterns that lead to premature breakdown. Nowhere in our current healthcare system do we detect these imbalances, so correction programs are never recommended.

Stage 1 (birth to 20 years old). These are biomechanical faults that lie dormant and have no symptoms. In early years, we can see many of the following faults that will predictably lead to future problems.

  • Pronation and supination of the feet
  • Inward rotation of the knee(s)
  • Increased “sway back” of the low back
  • One hip higher than the other
  • Humpback in mid-back
  • One shoulder higher than the other
  • Forward leaning head carriage
  • Restriction in certain joint movements
  • Leg length difference
  • Muscular imbalances


Stage 2 (20 to 40 years old). The second stage of musculoskeletal breakdown comes in the form of pain. The following are classic Stage 2 events that garner little healthcare interest, as they are hard to diagnose and even harder to fix using modern medical approaches.

  • “My back is out”
  • Bursitis
  • Tendonitis
  • Whiplash
  • Spasms
  • Pulled muscles
  • Plantar fasciitis
  • Other inflammatory conditions
  • Loss of quality of life
  • Increased disability


Stage 3 (20 to 60 years old). After the Stage 2 symptoms have been ignored long enough, and abnormal mechanical loading has never been altered, additional physiological changes occur.

  • Bulging discs (like a bubble in a tire)
  • Herniated discs (the bubble has popped)
  • Meniscus injuries in knees
  • Ligamentous injuries throughout the body
  • Pinched nerves
  • Weakness, tingling and numbness in extremities
  • Loss of quality of life
  • Increased disability


Stage 4: (40 years old to death). When signs and symptoms have only been treated and the actual conditions have been ignored then total breakdown is the result.

  • Osteoarthritis
  • Disc injury and disease
  • Joint replacements
  • Total restriction of motion
  • Constant pain and weakness
  • Constant tingling, numbness and burning
  • Foraminal stenosis
  • Spinal stenosis
  • Increased susceptibility to other degenerative conditions (heart disease, diabetes, obesity, etc.)
  • Loss of quality of life
  • Total disability

All of these conditions can be improved when we begin looking at abnormal mechanical loading and restriction issues as part of our healthcare concerns.