Monday, August 1, 2016

What is Your Child's Foot Type?

Our sports medicine society puts far too little importance on the issue of foot-type. Each and every foot has a unique personality, and can be defined in one of 3 categories; pronator, neutral (normal) or supinator. The running shoe industry has created shoes specifically for each foot type, and it should be part of every young athlete’s examination profile to know what shoe type is appropriate for the best injury prevention program possible.

Figure 1
Figure 2
In an effort to improve our “reactive” sports medicine industry (only treating athletes after they become injured), it’s important to look at all athletes, regardless of age, from a biomechanical perspective and make corrective recommendations in an effort
to reduce future injuries.

Each foot has 3 arches (Fig. 1). If one or more of these arches have “fallen”, or are not doing their job, there will be a domino-like effect up the entire structure (Fig. 2) producing increased demands on one or more areas of the body (muscle, tendon &/or joint). Secondly, the standing foot type can be different than the dynamic foot type (running), therefore, it’s important for a trained shoe specialist to determine what the dynamic foot type is so that the proper shoes can be recommended.

The standing foot type can be determined through digital scanning (Fig. 3) and appropriate recommendations will be made with regard to custom orthotics. As you can see in (Fig. 4), there is a difference between optimal foot support (strong arches) as compared to a foot with one or more weakened arches. In almost all people, there will also be a difference and imbalance between the left and right foot.




Standing foot type can be addressed and corrected rather easily. As we can see, there is a tremendous difference in full body alignment once custom orthotics are recommended. There is a mere 2 minute difference between picture one (without orthotics) and picture 2 (with orthotics).

CONCLUSION

Understand the importance of a full biomechanical exam (including foot type) on all athletes, regardless of age. Biomechanical x-rays are recommended for those 12 and older, but custom orthotics are recommended for those 7 and older. Specific shoe types should be considered for all athletes 7 and older, and bring custom orthotics to specialty shoe store when purchasing shoes (running, basketball, soccer, etc.).



Monday, January 26, 2015

Well, we've made it to 2015. New opportunities, new "issues". But, that's what keeps the heart beating and the mind active. Best of luck to all, and please keep your sense of humor, because without that, nothing's worth anything.

Wednesday, June 11, 2014

The Healthcare Crisis

The healthcare crisis is not due to a lack of answers. And we don’t need more research. It’s due to a loss of logic, a lack of discipline, and too many people more concerned with the profits of healthcare at the expense of human quality of life.

Health insurance governs most of our decisions and actions. We know this because the first question most people ask once they’ve decided to take action is “Is this covered by my health insurance?” Subsequent actions are typically determined by the answer they receive as deductibles and co-pays continue rising to unaffordable levels. But treatment that is covered by our insurance is consistently diminishing.

If we continue to allow health insurance guidelines to lead us in our quest to be healthy, we’re going to lose—physically, emotionally and financially. Our bodies are going to degenerate prematurely and we’ll spend a whole lot more on ourselves over the course of our lifetime. Instead of continuing to contribute to the root cause of this crisis, we must adopt a new game plan, a new set of guidelines that will help us enjoy the rest of our lives.

Each person must cost less over the course of their lifetime. If every person had this as a goal, and was willing to do whatever it takes to reach the goal of reducing their cost for staying healthy, the financial burden of our current healthcare system would disappear. But for many, the medical industry is a for-profit industry. Change will not come without a fight. Unfortunately, things probably will have to get worse before they get better.

If we look at the auto industry, we see that change has already taken place. New standards in gas mileage and emission controls have to be met. The energy industry has known for years that we need alternative sources of renewable and cleaner energy. In both cases, change continues to take place.

In the healthcare industry, we’re merely shifting economic responsibility. Who’s going to pay the bills? Not once have we heard that all Americans need to improve their health as a solution to this crisis. The health insurance industry, the pharmaceutical industry, and the medical industry all make huge profits from our broken system. In order to be profitable, these industries need acutely ill people. It’s going to take improved education and disciplined positive action from all of us to fix this crisis. Many hands will make light work.

The Journey to Crisis

There are simple reasons why this crisis is full blown. First of all, our system is based on three basic tenets:
  • We teach people to react instead of act. We teach them to basically do nothing until they’re broken. With a shrinking reimbursement allowance to cover healthcare costs, human nature is to wait longer and hope their symptoms will miraculously disappear. The more time that goes by, the more wear and tear and degenerative changes take place in our bodies. This creates an irreversible scenario.
  • We look only at the site of the injury. Treating symptoms first has become more and more the norm, so we’ve fragmented the body into parts. In the orthopedic world, I often hear statements like “He’s the best hand guy” or “He’s the best shoulder guy.” He may be good with hands or shoulders, but all parts of the body are interconnected. Every part has some global influence over the other parts of the body. To only look at the site of injury is near-sighted and contributes greatly to long-term, increased costs.
  • Our only goal is to eliminate symptoms. Whether we receive an injection, a bottle of ibuprofen, a small number of visits with the chiropractor or physical therapist, or any other palliative treatment, we’re taught that once the symptoms are gone, we should be “good to go.” This belief is so flawed. It should never have to be mentioned. However, everything in our society pushes this reactive, symptom-only approach, from advertising and marketing that reminds us “You haven’t got time for the pain” to physicians who only know what to do when you’re broken. We have an insurance system that will pay only after we’re broken, which encourages us to react after we’re hurt instead of acting to stay healthy.
But change is inevitable. People want to stay healthier longer. We know that smoking is bad for us. We know that we must exercise. We’ve learned that diet and nutrition are not only important, but mandatory for good health. We know that sugar and sugar products are detrimental to good health. Now we know that we must teach the rules for good health and the rule for cost containment in our healthcare system.

One means of addressing our healthcare crisis is to look at a system of the body that, if not maintained, can lead to the premature breakdown of other systems. This is our musculoskeletal system. The architecture of the human body plays an important role in the degenerative diseases that people are afflicted with in their lifetime. But because the preservation of the musculoskeletal system inspires little enthusiasm with fundraisers and researchers, unless we keep people active, exercising and moving without pain longer during their lifetime, many other degenerative conditions, such as obesity, heart disease, arthritis, osteoporosis, and diabetes, are inevitable and will continue costing more and more each year.

The Greatest Cost

In March 2002, President George W. Bush declared the years 2002-2011 the National Bone and Joint Decade. The mission of the U.S. Bone and Joint Decade was to “promote and facilitate collaboration among organizations committed to improving bone and joint health through education and research.”

Musculoskeletal disorders and diseases are the leading cause of disability in the United States and account for more than one-half of all chronic conditions in people over 50 years of age in developed countries. The economic impact of these conditions is also staggering. In 2004, the sum of the direct expenditures in health care costs and the indirect expenditures in lost wages for persons with musculoskeletal disease diagnosis has been estimated to be $849 billion, or 7.7 percent of the national gross domestic product.

Beyond these statistics, the human toll in terms of the diminished quality of life is immeasurable. This situation is unlikely to improve in the foreseeable future and will likely be intensified by current demographic trends, including the graying of the baby boomer population, the epidemic of morbid obesity, and the higher recreational activity levels of our elderly population.

Despite these compelling facts, the investment in musculoskeletal research in the United States lags behind other chronic conditions. While musculoskeletal diseases are common, disabling, and costly, they remain under-appreciated, under-recognized, and under-resourced by our national policy-makers.

These data should stimulate increased investment in basic, translational, clinical, and health policy research to delineate the underlying mechanisms of these diseases and their response to treatment. Through such research, novel preventive and therapeutic approaches with potential to mitigate the societal and personal impact of musculoskeletal disease will emerge.
De-emphasis and Lack of Knowledge

Most of our doctors and healthcare providers are not adequately educated in human biomechanics. Physicians may know some anatomy and how to diagnose some injuries, but they don’t know how the nervous system, the muscular system, and the skeletal system interact as a unit. Medical schools have de-emphasized the teaching of anatomy and physiology, and now focus more on pharmacology, high tech testing, and specialization. The majority of physicians in practice today wouldn’t know what to do with a healthy 15-year-old athlete whose parents just want to know what they can do to help keep this kid from being injured.

Human biomechanics is the application of the principles of mechanics to living systems, in this
case, the human body. Much like the orthodontist, who evaluates the alignment of teeth, it is also possible for someone trained in biomechanics to evaluate the human body, whether or not symptoms are present. The muscular system, the skeletal system and the nervous system all interact with each other, and their alignment, balance, organization and function are of paramount importance to people who want to live a long and fruitful life. Imbalances, fixations, and distortion patterns of the human structure will lead to a premature breakdown of joints, tendons, and muscles, which will ultimately affect the nervous system. But there are no physicians looking at the biomechanics of the human body. There is no insurance coverage for the detection and correction of biomechanical faults when there are no symptoms.

Our middle school and high school athletes, for example, must undergo physical examinations before the season begins, but the examiners are medical examiners looking at the eyes, ears, nose, and throat. The only biomechanical test these examiners do is for scoliosis. Because this exam is more of a scan and lacks proper imaging, it’s very difficult for it to be accurate. During these mandatory examinations, no one ever looks at the interrelationship of the muscular systems, the skeletal systems, and the nervous systems of our young athletes. No one is looking at the systems that are the leading cause of disabilities over the age of 50. Might there be a correlation between this gross omission and premature degeneration? Of course there is.

With the increasingly long seasons in high school sports, weight room training, the increased use of technology, like computers, video games, and mobile devices, plus the obesity epidemic in our youth, we can’t even begin to imagine what this world will look like in 25 years if we don’t address the critically important musculoskeletal system. We must become proactive and abandon the reactive-only approach. We need to take action, get biomechanical exams at a young age and work to correct and improve the many postural and biomechanical faults that are found. We must do this long before symptoms and injuries begin.

The greatest resource being overlooked in the journey to “fix” our healthcare system is the energy that lies within each and every one of us. We all have a responsibility to each other to do our part, live a little healthier and strive to cost less during our lifetimes. Paying now instead of paying later is always less costly.

Musculoskeletal Research—NOT

In 2002, when I was doing my radio show, The Sports Medicine Hour, at Rensselaer Polytechnic Institute (RPI), a top engineering school in upstate New York, I had an idea to visit Dr. Robert Spiller, the head of the biomedical engineering department there. I asked if the biomedical engineering department at RPI was in the process of doing any research on the preservation of the human structure. Dr. Spiller said no, but added that he believed that other biomechanical research centers attached to some of the bigger universities were doing some of that research. I told him I’d not been able to identify any schools that were looking at the preservation of the human structure and asked if he could point me in the right direction.

Approximately two weeks later, I received an e mail from Dr. Spiller telling me that, to his surprise, he couldn’t find any current studies. To the best of my knowledge, that sad truth still prevails today. Common biomechanical research studies focus on topics such as materials for prosthetics and robotics, but to the best of my knowledge, they ignore the preservation of the human structure.

I remember a couple years ago when my brother-in-law, a physician, gave me a promotional letter from an orthopedic group on their latest technology with regard to knee replacements. This group stressed the fact that they used advanced technology to insure proper alignment of the new knee and how this helped to ensure longevity in the replacement. My simple question was, Wouldn’t that same logic apply to the knee long before the replacement? If we can help to align knees and pelvises and spines before they break down, preservation of the human structure will have begun.
Early Detection Exams

Colonoscopies, mammograms, stress tests, eye exams, dental exams, yearly gynecological exams, and other physical exams can detect problems before they become serious. The concept is correct, and many physicians now make a living by performing these early detection exams.

But there is nothing even remotely close to such exams in the musculoskeletal world. There are no professions that recommend musculoskeletal exams. In fact, no exams have been developed in this country to look at a healthy person’s musculoskeletal system. On this page we describe and review the Structural Fingerprint® Exam, which is a comprehensive biomechanical exam that identifies biomechanical imbalances, weaknesses, sites of wear and tear, restrictions and other biomechanical defects. An examiner can determine the detailed status of a patient’s postural biomechanics by performing this exam. Then a proactive, corrective set of recommendations can be made.

The goal for every patient, regardless of condition or age, should be to strive to reach his or her maximum biomechanical potential. Once these biomechanical faults are identified, a customized corrective program can be designed to strive for improved postural balance, increased range of motion and improved flexibility. This will give the best chance for long-term musculoskeletal functioning.

I often joke with my elderly patients and say, “They can’t throw dirt on you as long as you’re moving, so keep going”. This truth rings louder and deeper than any of us can imagine. Movement is the key to preserve the ability to move.

How many times have you heard people say, “I’d love to exercise, but I have a bad back,” or, “I used to love to play tennis, but this knee just can’t handle it anymore”? These comments are all too common. As soon as we begin to lose our ability to move and participate in the activities and sports we enjoy, negative (and costly) physiological changes begin to take place.

Weight gain and obesity are the most obvious changes, but diabetes, cancer, and heart disease are not far behind. Combined with our bad habits of eating and celebrating more than we should, the loss of motion in our body is the beginning of the end. The law of life—“If you don’t use it, you lose it”—cannot be seen any more clearly than in the case of the prematurely arthritic American. We’re gaining epidemic status.

When an injury or disability enters your life, our healthcare system is not set up to analyze why you have it and or help you learn what you need to do to restore your body back to normal. Our system merely wants to get you out of the severe state, as quickly and cheaply as possible. If I’ve heard it once, I’ve heard it a thousand times from patients: Wouldn’t the insurance companies save money if they fixed you rather than paying for ultimate surgery? The answer is simple. Of course they would.

When you look at the effect musculoskeletal disease has on other health-related issues, the costs of testing, treatment and disability become exponential. Even though musculoskeletal disease is not a morbidity disease, meaning you don’t directly die from it, the potential for morbidity becomes a much bigger issue because the conditions that cause death dramatically increase when someone loses motion, exercise, and activity. A simple example is the 49-year-old male with a bad back who can’t exercise and is on disability from work. Over time, weight gain, diabetes, and arthritis become a much greater possibility.

Alternatives

Just as the energy industry continues looking for alternative fuel sources, so should the healthcare industry be looking for alternative sources. Here is a list of specializations that demand more interest:
  • Acupuncture
  • Chiropractic
  • Massage
  • Nutrition
  • Homeopathy
  • Naturopathy
  • Reflexology
  • Auricular Therapy
But our political system gets in the way. Because the lobbyists with the most money have the loudest voices, no alternative healthcare provider can come close to spending the money that the medical and pharmaceutical interest groups have to spend. The money is in acute care, not corrective or preventive care. The solution to the healthcare crisis in the U.S. lies in corrective and preventive efforts. Therein also lies the conflict.

Approximately eight years ago, I met with the chief of medicine and the CEO of our local hospital to discuss the possibility of moving my office into the hospital. Both officials were looking at the potential merger solely from an economic perspective. I met with them on several occasions to discuss the goals and protocols that we used in my office. I told them how we change people’s lives. After several weeks of negotiations, however, the hospital executives decided that the model of healthcare that I practice was not complementary with the model they were looking for. “We need to expand our acute care model”, they said. “That’s where the money is.”

Lesson learned.

Three Stages of Degeneration

Dr. William Kirkaldy-Willis, a world-renowned orthopedic surgeon, wrote an excellent book, The Management of Low Back Pain, in which he discusses in detail the three stages of spinal degeneration (see Figure 1). The first stage typically occurs during the first 25 years of life and is called dysfunction. Dysfunction includes the typical injuries and physiological responses that occur from injuries, stresses, physical activity, poor postural habits, etc. The body naturally responds to all of the above, and there are specific treatments, exercises, and preventive measures that will help to reduce our dysfunctions. In addition, there are specific treatments and exercises we can do to arrest the destructive physiological changes.


If we ignore dysfunction, the second stage of degeneration arrives prematurely. This is called instability, and it occurs significantly between the ages of 25 and 55. This is the time when many would-be athletes or exercisers bow out of specific sports or activities because of a bad knee, a bad hip, a bad low back, etc. They say, “I used to be able to do that.” This is also when costs begin to soar. Because pain meds and treatments are more expensive than they need to be, activities and exercises begin to seem harder on the aging body, and all of the other costs of healthcare take a major upswing. People begin to gain weight, and diseases and conditions like heart disease, diabetes, obesity, arthritis, increased cholesterol, high blood pressure, anxieties, and sleep disorders begin to increase.

The third stage of degeneration is to be expected after the age of 50, as nothing corrective has been done during the first or second stages. The third stage, stabilization, is inevitable. We might also call this the “rusted up” or “degenerated” stage, or use any other phrase that describes mechanical negligence under long- term stress. The body’s natural response is to break down, rust up, stop moving properly, and lock up. What causes these things? They’re just what happens to the human body. As we age, we move less freely. Our joints become fixed. We lose mobility. The loss of mobility in a joint creates an irreversible situation. But the goal in our society that sees only symptoms is merely to relieve pain, so doctors prescribe joint replacement surgeries, daily pharmaceuticals, palliative (and limited) care with the physical therapists or chiropractors. What we get is an extreme loss in the quality of life.

This is what occurs in the profit-based, medical model system we’re living with.

Ironically, according to Kirkaldy-Willis, during this degeneration process, the symptomatic picture doesn’t mirror the degeneration process (see Figure 2). We can see, especially during the first two stages of degeneration, that the symptoms are minimal or absent much of the time. But we have a healthcare system that addresses only symptoms, and insurance reimbursements are shrinking, yet the degeneration of the human body is continuous and doesn’t take periods of rest as the symptoms appear to. Our system will only pay while the patient is symptomatic, so by the time the symptoms have been treated and the patient is released from care, with or without improvement, technically speaking, he is more degenerated than when he started treatment.


Wednesday, June 4, 2014

16 Principles of Structural Management® As Related to Spinal/Pelvic Biomechanics

Copyright Dr. Tim Maggs
  1. Any joint under an elevated stress over some period of time will produce a restrictive response from the body, including some or all of the following; muscle tension adaptations, joint capsule changes, neurological irritations, bone growth changes and compensatory positioning by surrounding joints and muscles. 
  2. Elevated stress can be due to architectural, biochemical, emotional or  biomechanical imbalances, producing micro­stresses over time.  It can also be due to a macro­stress, such as a slip or fall, auto accident or any other traumatic injury.
  3. Any joint under increased micro­ or macro­ stresses, if left unattended, will at some point become “fixed” relative to the normal mobility that occurs in a normal functioning motor unit of the spine. 
  4. This fixation of a joint will produce a physiological change in that joint over time, including one or more of the following; joint degeneration, restricted range of  motion, neurological irritation and a compensatory response from surrounding joints and muscles. 
  5. Much research has been done on “pain” associated with regions of fixation and degenerative changes.  There is no direct correlation between fixation or  degeneration of a joint and pain. 
  6. However, fixation and degeneration of joints are the precursors to tissue adaptations in the body, and a restricted range of motion, shortening of involved muscles, reduced neuro­musculo­skeletal function and ultimately, symptoms  predictably will result from joint fixation and degeneration. 
  7. The symmetry of the feet, primarily the medial arches, is critically important in producing a biomechanically balanced structure. 
  8. Joint function can be impaired, or compromised, with imbalances in one or both
    feet, relative to a foot with normal and healthy medial, lateral and transverse
    arches. 
  9. Center of gravity of the structure is a critical standard of measurement when
    predicting potential of fixation and degeneration of joints.
  10. Center of gravity is influenced primarily by the eyes, the feet and the biomechanics of the structure, including joint and muscle weakness and joint fixation/degeneration. 
  11. If joint fixation and structural center of gravity are left unattended, there will be
    an acceleration of breakdown and loss of function, as well as a cascade­like
    “breakdown” effect throughout surrounding joints, nerves and muscles over time. 
  12. The compensatory effect throughout an entire structure can produce elevated joint
    stress in non­contiguous regions, or regions not immediately surrounding the
    primary sight of fixation. 
  13. A chiropractic adjustment is a passive mobilization of a joint producing minimal
    to maximal physiological benefits. 
  14. A mobilized joint has the ability to absorb and disperse stress more efficiently
    than a fixated or degenerated joint. 
  15. A fixated or degenerated joint has a reduced ability to disperse stresses, producing
    an adaptive response (accumulation of stresses) from the surrounding tissues. 
  16. Acute injuries of the neck and low back are more closely associated with fixated
    or degenerated joints, and will require a longer recovery time than an injury to
    joints with good mobility

Tuesday, May 27, 2014

ATTENTION: How to Fix Our Broken Healthcare System


It is possible to “fix” our healthcare system. The laws for good health have been known for hundreds of years. Our broken healthcare system is due to the “business” of healthcare (reactive care), while ignoring much of the science & art of healthcare (proactive care).

To fix this system, we must take decisive steps. Each and everyone of us. First, we must take responsibility for ourselves. Quit asking, “Does my health insurance cover this?”. The correct question to ask is, “What must I do to improve my health?”. Secondly, we must “Get Moving”. Motion is the key to improve our health and reduce costs. When we begin regular, controlled motion, we maintain a better weight, we manage our blood pressure, cholesterol, anxieties and more, without the use of drugs. In addition, momentum breeds momentum, and we’ll now have a higher level of motivation to improve our diets, sleep habits and overall attitudes.

This will make a huge impact on reducing healthcare costs. Not just a little, but drastically. All while our quality of life improves. Not just a little, but drastically. So, the mission is to get moving and get our kids moving. Adults must show by example that movement is the key to fixing this overwhelming problem.

The importance in taking action at this point in time cannot be overstated. Changes for tomorrow must begin with actions today. Only through taking full responsibility to solve this crisis can any of us hope for a better life for future generations.

100% of My Patients Get Custom Orthotics What about Yours?



https://nebula.wsimg.com/a18be2a31ed23db9bf5b1c0975c5f618?AccessKeyId=B0E91AC9216F5A9C2646&disposition=0&alloworigin=1

Click here to read this article that was published in the American Chiropractor August 2011.

Practice Profile: Under Structural Management®

by Rich Smith
Issue: September 2004
Chiropractic Products

This Upstate New York chiropractor creates the ultimate new patient exam and education model

Chiropractic care focused on treating symptoms alone amounts to a waste of time and expense, and represents a disservice to patients.

So believes Tim Maggs, DC, a solo practitioner in Schenectady, NY, who is making it his mission to harken the profession back to an embrace of the model it used in the days before chiropractors started patterning their thinking in the fashion of medical physicians and allowing themselves to be pushed around by insurance companies.

“With the way things are nowadays, if someone comes in for care without actual pain being present, the typical chiropractor more than likely doesn’t know what to do anymore,” Maggs asserts. “He’s been taught by the insurance industry and the medical community to use

Timothy J. Maggs, DC, explains the process of digital scanning to his patients.only the medical model, which entails diagnosing and treating based on symptoms.”

Not only that, says Maggs, but this is what patients themselves have been taught to expect. It is wrong, and needs to be corrected, he insists. “Consumers are of the understanding that they must ask for guidance regarding their health from their insurance company,” Maggs laments. “The insurance company never should be allowed to have a say in what a person does for his or her own health. Unfortunately, because the insurance company controls the money, that’s where people go for guidance. But what they’re taught is to not do anything about their health until after they’ve crashed. If you stop and think about it, you realize there’s no other aspect of life in which people function with that kind of self-imposed constraint.”

Use the Pyramid System

Both saddened and alarmed by all this, Maggs some years back put into motion a plan to recalibrate the thinking of the profession and the community. The centerpiece of that plan is his development of an approach to chiropractic care he calls Structural Management®.

“This is a program organized in the form of a pyramid,” he explains. “At the base of the pyramid is the Structural Fingerprint® exam. Above that are the familiar interventions of chiropractic along with a muscle management program and, further up, nutritional support.”

Climbing that pyramid, reaching the apex, patients find—at least in theory—that they have achieved optimal structural performance. In other words, they will have attained truly good health, Maggs suggests.

“My message, which I’m taking to sports, to industry, to the general population, and to the chiropractic profession is this: We can’t know what needs to be done for the individual until we first know where we’re starting from,” he says. “The only way we can learn what his or her structural distortions are is to take, if you will, a Structural Fingerprint® of the patient. This has nothing to do with symptoms, but everything to do with the ability to extract structural information to know where that person is relative to normal.

“Having that information, we can then create a proactive plan to work that individual toward normal. If the plan that is developed is a good one, after so many months the individual should be at a much more efficient—and far less vulnerable—state of health.”

The process of Structural Fingerprint®ing begins with the compilation of a thorough health history, followed by an evaluation of the feet.

“I also check the q-angles of the knees, range of motion, muscle tension, balance, imbalance, and leg length,” he adds. “Seventy-five percent of the information acquired during this Structural Fingerprint®ing process comes from a set of four standing x-rays we take. No other equipment is needed.”

The hardest part of the process is interpretation of the findings. “Many chiropractors have difficulty with this step because of their embrace of the medical model,” he says. “Rather than looking for symptoms, they have to instead look at things through the prism of what they learned in school—Ferguson’s gravity line, sacral base angle, and so forth.”

Explaining the findings in a cogent, impact-making manner to the patient is no less crucial because doing so then opens the door to the next step, the treatment phase, and induces in the patient a delightfully high level of compliance.

“Let’s say the patient is 42 years old,” Maggs hypothesizes. “Predictably, this person has another 43 to 48 years left on this planet. What’s he going to do to preserve and protect himself when he’s already starting to break down? If you tell the correct story to the patient, using the right terminologies and the simplest presentation, he is going to ask what can be done to preserve and protect himself. Once the patient asks that kind of question, you can correct his entire thinking about health,” shaking him loose of the indoctrination he’s received at the hands of the insurance industry all those years prior.

From there, the patient is primed to begin advanced conditioning, Maggs’s term for conventional chiropractic adjustment, rehabilitative exercises, orthotics, and more.

Get With the Program
The process of formulating this Structural Management® program spanned most of Maggs’s career as a chiropractor. “I started the process with a question: how do you articulate to the public the need for chiropractic care and for management of the entire structural system? When I entered practice in 1978, I believed that chiropractic was hugely valuable to people from all walks of life and at all ages. The problem was, I didn’t know how to articulate what I believed. It was extremely frustrating.”

His awareness of the problem became particularly acute after spending 4 years working with the New York Giants football team. It occurred to him in the course of that relationship that “almost no one involved in the players’ well-being truly understood the details of their structural needs,” he says.

At about this same time, Maggs took his nephew to meet the head strength coach of the Chicago Bulls basketball team, so that a conditioning program could be developed for the athletically gifted lad. “The coach spent an hour going through range-of-motion and various other details, in essence conducting a structural evaluation,” Maggs remembers witnessing. “It then really hit home to me that, as chiropractors, we have far more tools available to do exactly this kind of thing than does a professional strength-and-conditioning coach, and yet we’re not utilizing them.”

Soon afterward, Maggs began constructing a chiropractic version of that coach’s process. It took a number of years of experimentation and refinement, but eventually Maggs came up with what he is convinced amounts to a winning methodology.

“It’s now a program that would be perfectly appropriate in every chiropractic office in the world, and is something critically needed by sports, industry, an aging population, the pediatric population, and everything in between.”

Each year, Maggs conducts 25 seminars on Structural Management® to help colleagues learn how to integrate it within their own practices. However, there are some who find converting fully in one giant leap a sometimes impossibly daunting process because of its revolutionary nature, Maggs warns.

“It’s easy to be in your practice and stay within your comfort zone,” he says. “Structural Management® on the other hand requires you to get out of your comfort zone. Because it can be so hard to exit that comfort zone, I’ve designed Structural Management® in a programmatic form that can be adopted in easy steps. You can take certain aspects of it and implement those immediately, then add the others later as your confidence grows.”

In the program, a favorite therapy equipment to use is the stick-like object for improving warm-up prior to activity and accelerating recovery once the activity is completed. The application for this program is in sports, industry, and the general population. Maggs first used it on the New York Giants while also teaching them how to use it on themselves for all types of reasons. “This program works on repetitively used muscles that accumulate toxins and become shortened and vulnerable to injury due to excess use,” Maggs says. “Two hours of my 12-hour seminar are on this program, and DC’s are absolutely thrilled once they begin using it in their offices.”

Stripped of the Structural Management® component, Maggs’s Schenectady practice (50% cash based, 30% insurance, and the remainder a mix of workers’ compensation and the New York state version of personal injury) is pretty much a plain-vanilla operation. His office is relatively small, about 800 sq ft, into which are packed a pair of adjusting rooms, an x-ray suite, and a reception area.

However, Maggs has found the somewhat cramped quarters much to his liking. He says a compact facility abets efficiency and, if nothing else, his is an ultraefficient office.

“People very seldom wait to get into the adjusting rooms because we’re so on top of things,” he notes. It’s also a less expensive office to run. “Small size means small overhead,” he offers. “These days, given the market realities, you have to be conservative in what you spend every month.”

Even so, Maggs finds his practice outgrowing its current digs. A move to a larger site appears inevitable.

“I want to work with major employers,” he says. “To do that, I’m going to have to take on one or two associates. That, in turn, will make it necessary to have a larger office. Nothing’s firm on this yet, but one of the hospitals in this area has asked me to consider moving in with them. They don’t have programs for industrial injury and sports injury, but are of the belief that chiropractic would be ideal as the basis for those particular offerings. They see how well chiropractic is accepted by the medical community out on the West Coast, so they think the time is right to do the same here on the East Coast.”

Market My Words
As for marketing, Maggs is no fan of advertising in outlets such as newspapers and phone books. “That type of advertising motivates a response only from those people with a preconceived and completely misinformed notion of what’s going to happen when they visit a chiropractor,” he grouses.

The preferred form of marketing for Maggs is lecturing at local hospitals and service clubs, as well as getting involved one-on-one with sports coaches and corporate human-resources managers. “My most effective marketing tool is talk,” he tells. “All I need to make it work is access to people.”

For a stretch of 3 years that ended in 2003, Maggs had exactly that—access to people and the ability to talk to them via radio. “I did a Thursday afternoon show called Sports Medicine Hour. It was broadcast from a local college station that could be heard over the air and on the Internet, so it had a pretty sizable audience. I had to quit the show because I became so busy with my practice and all the things related to community health reeducation.”

Another outlet Maggs has for his message is consumer magazines. Each month, he writes a sports medicine column for about a dozen regional publications catering to runners.

“The most recent piece I wrote was about Structural Management®,” he says. “Within a matter of just a day or two after the column was published and began hitting subscribers’ mailboxes, I’d already received 35 inquiries from around the country, readers wanting to know who in their locales could perform a structural evaluation.”

Maggs says he plans to continue refining his Structural Management® program and, at the same time, build a national network of doctors trained in its use.

“My goal is for every community to one day have someone there who performs structural evaluations,” he says. “The participants in this network will be equipped to educate their communities and motivate them to take action with regard to their personal health.

“Don’t tell me there’s no market for this kind of network. There most certainly is. You go out to any company, have the right presentation, have the right program in place to be able to process people, and you can be busier than you’d ever want to be the rest of your life. I know I am.”
Born to Run

Tim Maggs, DC, is a natural-born optimist. That, however, puts him in the minority, since most people are innately the opposite.

Still, in his view, chiropractors not prone to an upbeat outlook can nonetheless learn to adopt that frame of mind.


“It takes work, but it’s worth the effort,” he assures. “Patients love to be in an office where the chiropractor has a positive view. And you’ll be able to accomplish a lot more in life while enjoying yourself along the way.”

Optimism lies at the heart of a chiropractic methodology for which the Schenectady, NY, practitioner has garnered considerable renown in recent years.

Most of that approach to care, called Structural Management®, concerns itself with the health of the body. Now, Maggs is toiling on an extension of it to address the health of the emotions.

“We know that we have to exercise to get physically in shape, but hardly anyone really talks about conditioning and strengthening our mental attitudes,” he says.

A great way to strengthen the mind while doing the same for the body is the sport of running, suggests Maggs, himself an enthusiast since his youth.

But it was in 1976, an Olympics year, that Maggs’s current keen interest in serious amateur running bolted out of the starting block. By 1987, Maggs had competed in 13 major events, including the Boston Marathon.

Then, tragedy. A day after his run through historic Beantown, Maggs developed a problem with calf pulls. “For the next 8 years, I couldn’t handle anything longer than a 3-mile run,” he says.

His running days were anything but over, though. Using a muscle management program he and two other practitioners developed (and which today is a component of his Structural Management® approach to chiropractic), Maggs restored himself to a level of functionality sufficiently high that he was once more able to run marathons.

In 2001, Maggs again qualified for the Boston Marathon. He’s run two more long-distance events since then. Maggs—married and the father of four sons who range in age from 15 to 1—hopes to run in many more contests yet to come, and more than likely will. —RS




Failure Equals Victory



A title such as this is always risky, as a writer can either immediately lose a reader or hook them for the entire section, regardless of the content. The title is an off shoot from the bible- you know, "the last becomes first and first becomes last", or "extreme bad equals good and extreme good equals bad". No matter how you, the reader, looks at it, there is something eccentric in the meaning of the title, and that's the reason you should read this article. Who knows, you may even enjoy it.

Around 1990 I wrote and published a book titled Problemology: The Science of Dealing With Problems. The premise of the book was that most people are not equipped emotionally to handle problems when they arise. Most people "hope" problems don't come (which is hardly a fool-proof strategy). When a major problem arises, these people have no game plan to fall back on. All decisions now become emotional in nature, rather than logical and strategized. As always, when your emotions are in the drivers seat, watch out.

Anyway, I feel that human beings need to mentally exercise as well as physically exercise to become totally strong (both mental and physical strength). This book teaches mental exercises that allow a person to "prepare" for problems. For example, if you walk out of your house on a rainy Monday morning, late for work, and you see you have a flat tire, the typical response would be to cuss, kick and swear. You'd yell at your spouse, hurt yourself while trying to change the tire, argue with fellow employees all day, etc. Now, for long term wellness, the correct way to handle this would be the following: always identify the problem, (the car has a flat tire), remember that life is an imperfect journey and that misfortunes will always pop up when least expected, correct the problem (change the tire) and thank God that your misfortune on this day was not more catastrophic. The way to get good at developing this mindset is to approach every problem you face, starting right now, with this attitude. Believe me, it takes practice. It's always easier to "react", but as the book explains, far less productive.

So now, admitting that life is a rocky journey and our goal is to have the most enjoyable, stress free trip we can have, how on earth does "failure equal victory"?.

In our competitive society, we are continuously encouraged to win at all costs and look for immediate gratification. Combining these objectives, you could say we're encouraged to win in the short term. Such as today, not tomorrow. So if you lose today, some may perceive this as failing. Failing, (or perceived failing), like rejection, is more apt to keep people from going after their dreams than even a severe physical disability would in many cases.

This is exactly why we need to turn the kaleidoscope of life and view this picture differently. Winning should never be only in the short term, it should be desired in the long term. And the best way to win in the long term is to be willing to fail in the short term. After all, there is no better teacher than experience. While most are taught to hang their heads because of defeat, a more productive response would be to rush home to the drawing board and plan the next strategy. Now you have more information to plug into the computer. You're an expert at what didn't work.

This approach, plus persistence is the old tried and true recipe for long term success. Persistence will win. Most people don't have the ability to be persistent due to boredom, distractions or fear of failing. But, long term victory is far superior to short term victory and defeats will always help to teach the necessary tools and techniques to enjoy victory in the long term.

In conclusion, life is a continual series of victories and defeats. The mere fact that you breathe means you are a prime candidate to fail at something somewhere along the way. He who can develop the ability "act" instead of "react" will stand a much greater chance of having a smooth and enjoyable trip through life. Winning is simply the ability to smile, care about others, help others, maintain persistence in your goals and keep things in perspective.

This is why running is the greatest activity in the world. It simulates real life in so many ways. Even if you're in the Achilles Track Club or wheelchair bound, anyone can relatively improve to feel better about themselves. You can set your own rules to the game. You don't have to win the race, you only have to win your race. Any failure, which is really just a stepping stone to long term victory, is only failure if you quit.

As comedian Jim Belushi said in one of his illustrious roles, "Never, never, never lose your sense of humor". Keep running and enjoy every day. After all, just like the marathon, it's only mental!

Psychology of Recovery From Injuries



Injuries are inevitable. For any runner who as been at it long enough, becoming injured is only a matter of time. "How can I eliminate the likelihood of injury?", you ask. There is only one answer that can't fail: "Quit running!"

But the desire to run is infectious, and when your running is threatened because of injury, the desire becomes magnified. After all, humans have always had cravings for things they can have, but have been known to kill for those things they can't have. And when running is not in a runner's itinerary, the emotional controversy that takes place rock's the senses. "I've just got to run....".

Now, we all know, for every injury out there, there are inner-circle "surgeons general" who quickly and confidently diagnose the condition, outlining the do's and don'ts they'd recommend. From your neighbor to your brother-in-law to your therapist and spouse, everyone's an authority. The runner continues to hear all of these priceless (worthless?) recommendations, but still has to deal with that little voice in the back of the mind screaming to run. "Come on. Don't be a baby. Run through the pain. If it hurts, just stop. What do they know anyways? None of them even run!"

Six weeks of mild running (which the runner will tell you was total rest), and the injury is still there. More relatives and fellow employees have joined the list of "specialists" voicing their opinion and the hope for a future on the roads now seems near impossible. But before all hope is gone, STOP and LISTEN! There is a way. There are simple means which will get you back. Just as nature provides guidelines to live by, nature also provides guidelines to heal by. You just have to Follow The Rules! (that little clause in the contract we never see). Now they may sound simple, but the difficult part comes in applying them.

Rule #1

Ask yourself clearly - "What is my objective?". The answer, for most, is generally the same and pretty simple. "To get from point A (injured) to point B (able to run safely) as fast and inexpensively as possible".

Now, the most common reason runner's fail at the above rule is because they try to answer 2 objectives at once. They want to do as stated above, point A to point B, but they also want to run everyday to not lose their conditioning. "But, I go crazy if I don't run". Don't worry, that's only mental and you'll learn to get over it.

Keep in mind, nature usually doesn't give us the opportunity to have two wishes at the same time. If you want two, you usually end up without any. (You can't run comfortably or as much as you want, and you don't heal). This is when you start looking to pay money to that great specialist from afar. Believe me, keep your money. Most injuries are cumulative and no specialist can do any more than you can do, if you are disciplined.

Rule #2

At this time, sit down and re-define your goals. You may need to forget the marathon you've been training for. You may need to give up that "favorite" race this year if your body is not healthy. Nature doesn't care about your wants, so don't act totally robotic with your schedule. The only thing that stays the same is that everything is always changing. You may need to change your wish list to be more realistic.

Rule #3

Decide what you need to do to get from point A to point B the quickest and most cost effective. Generally, allowing the injured area the necessary time to heal is a good place to start. This doesn't mean minimal running or cross training, this means quality healing time. Again, keep in mind, the more you use an injured area, the longer the healing time takes. It is far wiser to do it right the first time, if your true objective is to get back to running pain free and safely. Ice, heat, massage (The Stick®) , rest, anti-inflammatories (Rehab-Plus), etc. are some of the complements you should use.

Rule #4

Understand, this is not supposed to be fun. Runners say, "This isn't what I want to do, I want to run". Hey, dying isn't fun either, but it happens. Show an ounce of discipline and intelligence. Quit whining. Shift your mindset during this period. As long as you pressure yourself mentally, your only setting yourself up to come back too soon. Relax and do something you never have time to do because of your running. Soon enough, you'll be back, so don't drive yourself crazy.

Rule #5

The lack of pain and swelling does not mean an injury is totally healed. Read that sentence again. Don't "attack" the first day you feel good. The longer you have had to lay off, the slower your comeback should be. Be willing to come back slowly enough. Write the word "RELAPSE" all around the house and office. Imagine going back to square one and starting over. Remember, do it right the first time.

Rule #6

Last but not least, keep in mind that being frustrated, yelling or screaming or even whining or complaining is wasted energy. As I said in the beginning, if you run, you will be injured. Save the theatrics. Immediately alter your mindset and go into the healing mode. Ask yourself, "What do I have to do to get back to running the quickest?". I'll guarantee you the answer does not include kicking the dog or yelling at your spouse. Conserve your energy for something worthwhile and have the discipline to correct the condition. It's really not that big a deal.

Now, once you've done the above, and you're still not better, look for the specialist who can help. But don't be weak in your discipline and think that if you pay money you'll get some magical cure. Somewhere along the way, you have to pay the price. These guidelines, hopefully, will keep you from paying double. Good luck.

The Intent Theory



Friendships come and go throughout life and the objective is to keep as many as you can as long as you can. Many friendships disintegrate because the normal human brain is continually measuring the wrong information. We measure actions rather than intent.

The actions of other people leaves too much to be judged. Many actions occur because someone doesn't know how to act in a certain situation. Others act improperly as a reaction. No matter what, people's actions sometimes don't fit what their intent.

In an effort to better judge who should remain your friend and who should get crossed off the Christmas list, judge a person's intent. The intent is what really matters as the actual actions are merely a disguised version of what a person is feeling, and maybe the exact opposite of what a person is feeling.

For example, I remember the Thanksgiving I came home from my annual Turkey Day 10k to my wife who was excited that she baked special pumpkin muffins for me and my friends. She was so excited and I was so thankful that someone on this planet was actually going out of their way to attempt to make me happy.

Lo and behold, the muffins never rose, my wife felt like committing suicide, and all we had for breakfast was 1" slabs that were supposed to be muffins.

Many would have been ungrateful. Ah... not I. I knew that I didn't have enough people in my life who truly cared about giving to me, so this particular situation didn't register as a negative in any way, but a positive. Here was a situation of someone going out of their way to make my life better, and I could have cared less if they rose or not. I had someone who cared, and that's worth millions. The intent prevailed. The action didn't matter.

Next time you don't know whether you should be upset or not, judge the intent. Your job of figuring out whether you should ever talk or not in the future will become much easier.

The 5-minute Theory



If everyone were willing to put aside their emotional switch in their brain in an effort to gain more knowledge and experience, the 5-minute theory would not be necessary. However, such is not the case. Most people are more concerned with maintaining their image at all costs, thus eliminating many opportunities to learn and earn for the future.

When standing in a crowd of "knowledgeable" people who are discussing an intellectual topic (such as the economic swirl in the Greek Islands), and all of a sudden the spotlight is put on you, how do you respond? This theory encourages you to quickly and immediately admit a lack of knowledge and hand the torch off to others who may know more.

In many cases, someone put in this position would probably go home and commit suicide because of the humiliation they've just experienced. This theory strongly encourages us to remember, we can't be an expert at everything and people respect those who quickly admit what they know and what they don't know. It is far wiser to admit that you don't know and spend 5-minutes learning new information than it is to fake knowledge and spend the next 3 months humiliated over the fact that you didn't know what they were talking about. Gain confidence in what you do know and don't worry about what you don't know. Be willing to admit it and learn, learn, learn.

Five minutes of embarrassment and humiliation will give you a lifetime of new knowledge. And the truth is, the 5-minutes of embarrassment is only there if you let it be. Forget it as quickly as possible for everyone else has forgotten it much quicker. You can be assured of that.

The Boomerang Theory


Just like a boomerang, life will give back what you put out. So many complain about how others are selfish, mean, disrespectful and down right ugly. Learn to put out happiness, respect, kindness and honor. You will get it back by the bushel. The key is----don't stop. Putting out good is like a savings account, you never know when you're going to benefit from your discipline. Even though you may not know how or where you're going to spend what you're saving today, you are greatly increasing your odds at having a better future.

The boomerang theory will do the same.

The Circle Around the Feet Theory


We are taught to keep up with the Jones'. Marketing, advertising, peer pressure and vanity make all of us fight to "look" successful and happy, but not necessarily to be successful and happy. Despite the fact that most of us know that money doesn't buy happiness and enough never seems to be enough, we still get caught in the trap of "keeping up", and this venture makes us all fall short of the illusive dream.

Will we ever be able to say that we have enough?

Regardless of who we are or how we've been raised, the human spirit gains comfort and happiness via certain criteria that has nothing to do with materialisms. The soul needs the basics, but the basics somehow get stepped over on the trip to happiness and no one really sees them until it's too late to get back to them. So let's teach you how to turn the trip around and begin immediately to get back to what matters most in life, your happiness.

Get a piece of chalk and go out to your nearest street or sidewalk. While standing still, draw a circle around your feet so that you are standing completely in the circle. Now get ready for the wisdom you've waited years to hear:

All you'll ever own in life lies inside that circle.

Any job, spouse, child, house, car, boat, friend, etc. is merely borrowed for some period of time. We do not control any of these "luxuries" of life and are vulnerable to lose them at any time. A spouse through divorce or death. A child through running away, drugs, death, college or marriage. A boat through theft. A car through an accident or repossession. A house through sale or repossession.

You may think you have some control over these assets, and the truth is you do have some, but most people lose sight and begin to think they "own" all of them and control the destiny that lies ahead. This is where the realities of life and the hopes and dreams of life separate drastically, and this now becomes the material that causes depressions, suicides, divorces, etc.

If you can believe that every gift you have is borrowed at best, two things will happen. You will work very hard to keep these gifts. Instead of a young husband out making eyes at some young girl he may work with, he will realize that the reality of losing his wife is always very high and he might better work to keep her happy. Secondly, with this approach to life, you will have a better understanding when you do lose. You will be thankful for the time you were able to borrow whatever it was and move forward with the joy and humility that is necessary to succeed in life.

So, do away with the Jones' and go buy a piece of chalk. Quit taking anything for granted, as you are owed nothing and anything you now have you must continue to work hard to keep. If you lose it, don't think you're alone. The world loses everyday. Just don't quit. You'll learn and appreciate more next time.

The Action/Reaction Theory




If you knew you had the remote control on everyone elses personality and decisions, you'd think you died and went to heaven. Think of all the benefits you'd quickly gain if you could control the answer of everyone you come into contact with. The job you want, the mate you want, the salary you want, all at your fingertips.

Well, the truth is, it isn't quite that easy. But it's pretty darned close. Most people spend their lives "reacting" to what society happens to throw at you on any given day. If your boss is mad, you "react". If your spouse is upset, you "react". If there is a traffic jam on your way to work making you late for a very important meeting, you "react".

Your days are spent "reacting" to everyone and everything. Who's doing the acting? Who's the one having it his/her way? From this point on, it's got to be YOU!

Design your day, your week, your life, and follow that design. If you get yelled at, don't bail on your schedule. For example, if your boss yells and demands a better report, smile, thank them and get it done as quickly as possible. If you get into a traffic jam on your way to an important meeting, relax. You have a limited set of options at this point and it's the perfect time to "exercise" your mind by learning how to relax at a time when most would be going crazy. When you get to work, simply explain what happened and then go about your day doing what can be done from this point on. Quit acting like a meteorite is coming at your head.

Regardless of all of the distractions, set your objectives. Make others realize that you are a do-er of life and that you and your schedule are important. Don't be the first to say, "I'll give up what I do to make your life better". ACT!, and the world will support you.

Secondly, treat others with respect and they will "react" accordingly. Treat others with a happy demeanor, a positive personality, and you will receive the same. When someone is upset at you, simply apologize and ask them how you can avoid doing it again. What can you do to help them at this point. As soon as they see you are changing the rules of the argument (by giving kindness), they will follow. No one can be mad at someone apologizing and being kind to them.

Learn to act instead of react, and your life will all of a sudden become "your" life again.

The Shelf Theory



Our lives are filled with problems. As soon as one ends, another begins. Sometimes on a really bad day, they even overlap. Usually we're overwhelmed with yesterday's problems and in fear of tomorrow's. The mind becomes a mud puddle of stress and it truly becomes hard to ever enjoy life.

There has to become some method to be able to shield yourself from yesterday's problems, delay tomorrow's problems until tomorrow and have an up-beat and iron clad system for coping with today's problems, and then maybe, just maybe life will be fun again.

Well, the shelf theory gives the brain a visual of how this can happen. Under the premises that the mind can truly only handle one problem at a time efficiently, we're going to envision many boxes on a shelf, all titled with a different problem. Each and every problem sits in a box on a shelf, much like our collection of books in our library. The key here is that the problems are not sitting in our mind, they're in the boxes on the shelf.

When the time comes and you can work on a problem, pull the box off the shelf and give it 100% of you efforts. Not only will the problem be handled much more efficiently, but it will also receive the time and concentration it deserves. When you have worked as much as you want, put the problem back into the box and put the box back on the shelf.

Now this may seem like a simpleton exercise, but true success is not difficult, it is only the ability to control your emotions. In order to be efficient in solving problems, you need to dedicate yourself to one problem at a time. In order to be efficient at happiness, you can't have a brain swimming in a mud puddle of problems. You're not solving any problems while at the movies, but many people can't enjoy the movie because they are constantly thinking of their problems. You can't solve your problems when you are visiting friends, but many people can't enjoy themselves while visiting friends because of "all their problems".

Learn how to "put them in a box on the shelf", and you'll find that life becomes much simpler.

The Next Bite Theory


The pace of life is so fast, we miss 80% of what we pass. We get so caught up in the problems that hit us yesterday and the problems that are coming tomorrow, we hardly have time to realize the experience we are feeling at the moment.

When eating, the typical cycle of each bite goes something like this; insert fork into piece of food. Place fork in mouth. While chewing, the eyes roam the plate determining which piece of food will be the next victim. Despite the fact that the only piece of food we can really taste and enjoy at any moment in time is the one in our mouth, we still let our focus be on "the next bite", drastically reducing the joy of this bite.

We say: Carpe Chew-em!

This becomes a habit of life and the only way to change the habit, the only way to learn to enjoy NOW is to practice. This takes years of constant effort to master this concept, but the upside of it is that you'll truly enjoy more of life and stop missing the scenery you're passing on this journey.

Running—the Cure for All Ills It’s all about motion



By Dr. Tim Maggs

Those who don’t run can’t understand the big fuss. “Why would anyone run?”. Those who do run protect it like a fortune. “It’s the most important thing in my life.” And those poor souls who are former runners due to injury live on a pilgrimage back to youth. Their undying hope is “maybe, just maybe...”.

What is it that turns normal people into cult-like members once they learn what it’s like to finish their first 5k or do a long group run on a Saturday morning? What makes them convert into a “runner”?

I’ve pondered this question for years, and interestingly enough, my answer has evolved over time. I initially thought it was the joy of competition, the thrill of training to beat that nameless person you see at every race who always seems to outrun you at the end. As time passed, I saw running as a therapy, something to help me get through the tough times. And, as I’ve grown older, I now see it as a much bigger piece of the puzzle. My impression goes something like this;

Life is all about motion. In fact, I’m currently reading Robert Ringer’s new book Nothing Happens Until Something Moves. Great book. Ringer deals with the very basic universal laws of life, the laws that, if adhered to, would turn this crazy world into a balanced, respectful territory. But, the key to his entire message is motion. Motion is the very essence of life--the key to happiness & the ultimate therapy for the masses.

Running takes this message to a whole new level. Running is an organized, planned approach to insure that your life includes motion. It allows you to spend time with others who are important in your life. Without running, you’d hardly ever see such people.

Motionless


This is where everything starts getting sour on you. We have so many patients who are unable to move, with sprains, strains, arthritis and bloated schedules. I’ve come to the conclusion that lack of motion in your life is the beginning of the downhill. Think about it; weight gain, something in epidemic proportion in this country and getting worse, increased blood pressure, which should be treated with increased “motion” long before any prescription is recommended, blood sugar problems, as a result of weight gain, and most importantly, a frazzled psyche.

The psychological component is without a doubt the biggest reason people get hooked on running. Running is such an appropriate therapy for all of us, as most people have very little margin in their psychological world for any types of stresses. Yet, as we’ve written about so many times in the past, expect problems, as they are a constant part of life. Running seems to reduce the size of problems, but more importantly, gives us a quiet time to think them through and come up with better answers. I’m amazed how often I leave the house with “issues”, and come home with simple solutions. I can’t imagine how much it would have cost had I asked a professional to listen to me and then tell me what to do. Not to mention the fact, their answer could never be as valuable as mine.

Wisdom with Aging


As we get older, all of us truly recognize that mobility is so much better than immobility. I tell my geriatric patients “Keep going, as they can’t throw dirt on you as long as you’re moving”. They laugh, but they know I’m serious.

When younger, we feel like we’re bullet proof, and that youth will always be there. As we begin reaching middle age, we realize, aging happens to all of us. The aging process slows down the more active you are, not to mention the fact that life just seems to be a little less chaotic if we can include motion in our daily life.

I encourage all patients to increase their daily motion. If you can run, run. If you can’t run, walk. Combine the two. Jeff Galloway has done a phenomenal job of converting people into marathoners with the inclusion of walking. Die hard runners have a hard time walking during any training or racing event, but for those who wish to make it a lifetime activity, it only makes sense to do what you have to do to stay out on the road.

Conclusion


I was going through some old magazines the other day, when I came upon an article by the George Sheehan. It was in his later years, and he was telling the story of him out running, when some young runner approached him and asked him what his pace was. Sheehan always had a way of keeping everything in perspective. His response to the young man was “comfortable”, as he claimed he no longer checked for distance and time.

His joy of running was now at a different level, but one he felt was the best he’d ever experienced. Mimic Sheehan. Keep the fire burning by staying out there. Never give up, as any motion outdoors is mandatory for all of us. And, if you’re dream is anything like mine, you’ll also want to run to your funeral at the age of 105. I’ll drink to that.

Have a great month.

Fixing the Health Care System



By Dr. Tim Maggs

I was recently on a flight, and next to me sat a 40 some year old fellow. I usually avoid conversation with people who sit next to me, as I hate to sit with my head turned for long periods of time participating in conversations I’d rather not be in.

“So, where you heading?”, he asks.
“ I’m off to a seminar in Omaha” I tell him.
“Really, what’s it on?”.
“Sports biomechanics”.

His eyes light up. People love talking about themselves.

He’s a tennis player, and about 2 months ago, he pulled a calf muscle. He’s been to multiple docs and therapists, and he’s still injured, and doesn’t know how to fix it, or who to go to. Well, not only do I know how to fix it, but I also know that I must be the leading authority in the country on calf pulls, not because I’m smart, but because I had an 8 year period in my life where I couldn’t run beyond 3 miles without pulling a calf. I estimate I pulled my calf muscles 60-70 times over that period. Ultimately (after figuring out the answer), I made it back to marathoning, a mere 14 years after my prior marathon. So I was intimately aware of the emotionally frustrating journey this poor guy was on.

But, the clincher was this, and even he was upset over it; his primary took his blood pressure as part of the exam on his calf (I guess you always revert back to what you know), and found his blood pressure was a tad high. The guy tells me it’s high because he’s gained 15 pounds in the past 2 months since he can’t exercise. So, the primary writes a prescription for high blood pressure medication and sends him on his way. Not wanting to waste any more of my valuable word allotment for this article, I’ll assume you see the problem here.

Other Broken Industries


The auto industry collapsed. New laws have been created to demand better gas mileage and less pollution. The energy crisis continues to look for more efficient, alternative, re-usable energy sources. The healthcare system, which is leading all the crises in this country, is seeking alternative payment
responsibility, without any effort to fix this incredibly broken system.

If you think about it, the laws for good health have never, ever changed. We know what it takes to stay healthy. So why on earth are we in any kind of crisis? Well, the most obvious reason is that we have become a totally “reactive” system. We do nothing until we break, then we go through unlimited
tests, we’re referred to many specialists, and in the end, never learn how to “fix” our problem. We get a prescription to block our body’s warning signals (some call them symptoms) or ultimately have surgery to remove such a troublesome organ, gland or joint. And we ask, “Why didn’t anyone ever teach me how to keep my gall bladder healthy?”. We’re not a healthcare industry that teaches and educates, we’re a healthcare business that profits from society’s illnesses and maladies. And, reacting produces higher profits than acting. It’s called managed care.

The Fix


We know the obvious ways to stay healthier; eat better, exercise more, have a good spirit towards ourselves and others, get a good night’s sleep, and do whatever is necessary to have good energy (like running). But, that’s too easy. To get out of this crisis, here is my prescription;

It all falls under the word “MOTION”. As in, moving. If all of us were in training for a marathon, the healthcare debt would go down. Motion, or daily exercise, keeps your weight down, your anxieties down, your blood pressure down, your cholesterol down, as well as the need to continue buying bigger clothes. All runners have learned this.

But, many people will respond, “Yes, but every time I try to exercise, my hip/back/knee/or whatever goes out, and I’m injured. It’s just too frustrating. And, I don’t know how to get over that hump”.

In response to that issue, I’ll once again say, it’s all about “MOTION”. But, in this case, we’re talking, motion of the joints. When you have joints that have full mobility, particularly in the spine and pelvis, there is an increased tolerance to stress, as compared to a joint that has lost mobility. As we age, we lose mobility. When we’re injured, we lose mobility. As we gain weight, we lose mobility. So, how do we keep mobility, or get back mobility in all of our joints? See your chiropractor on a regular basis. Or, your osteopath, if they will adjust you that frequently. Every American should be adjusted (have joints mobilized) head to toe at least once a week throughout their lifetime in an effort to allow their body to tolerate the stresses of motion/exercise/life in order to keep their structures as healthy as possible. This will allow people to move, which is the key. Maybe then, you won’t need to see your primary who thinks the answer is a high blood pressure prescription.

Have a great month.

High School Athletes The new injury prevention plan



By Dr. Tim Maggs

32 years ago, when just starting in practice, I contacted our local high school football coach and offered my services to his team. A couple times a week I would work on any players who asked for help. As great as the job seemed, it was short lived. As soon as the school physician got wind of my involvement, I was introduced to the politics of sports. The athletic director informed me I was not to come onto the campus again.

So, my simple goal was to get back onto campus, and through the front door this time, not some side door where no one knew I was there. Along the way, I’ve learned a lot. We live with a broken sporstmedicine system, and this age group is all but ignored.

Here’s the deal;


  • Just about all healthcare decisions are based upon health insurance guidelines. Most high school athlete’s care will depend upon what their insurance covers. So, they have to be injured before they can do anything. Anyone in the healthcare delivery industry knows that health insurance coerage is shrinking at a severe rate (increased co-pays and deductibles with decreased coverage), and unfortunately, the care of high school athletes is jammed underneath this broken healthcare system umbrella. Athletes, especially middle and high school athletes, have needs that are much different and far greater than the needs of the general population. These needs are ignored. 
  • All middle and high school athletes receive a physical prior to the season beginning, but the majority of this examination is a medical exam, i.e. eyes, ears, nose and throat. Yes, these tests are needed, but the biomechanical exam, which checks the muscular, neurological and skeletal systems, is absent. The examiner will perform a scoliosis screening. (This is like saying the absence of terminal cancer means you’re healthy). As in, there’s a lot more to biomechanics than a scoliosis screening. 
  • We live in a reactive healthcare system dictated by economics. These kids are never looked at until they’re hurt. Secondly, our front line docs (primaries) are not trained in biomechanics, therefore, are not qualified to accurately diagnose or treat these injuries. The “System” then kicks into a costly referral system, going from the primary to the orthopedist to the physical therapist or chiropractor, and the treatment goal is to get rid of the pain/injury. No biomechanics involved. 
  • The New York Giants and Chicago Bulls used a conditioning pyramid, with the base of that pyramid containing 6 categories; aerobic capacity, body composition, joint mobility, strength endurance, core strength and anaerobic capacity. These professional athletes needed to pass tests in all 6 categories before they could enter the weight room. In almost every high school in this country, kids begin aggressively working out with weights with questionable supervision and absolutely no biomechanical evaluations. This egregious omission WILL produce devastating long term detrimental effects. 
  • When an athlete becomes injured, the goal is to reduce the symptoms, but never correct the underlying problem. Fig. 1 shows an example of the biomechanical imbalances that exist in all of us, and it is these imbalances that lead to the majority of injuries in athletes. These imbalances originate in the feet (our foundation), and if this imbalance is not addressed, we have a limited potential in balancing the rest of the structure. 
  • We’re sitting on a ticking time bomb. Many of these kids suffer with low level injuries that don’t meet the criteria for taking action. But, all of these kids have mild to extreme biomechanical faults, and our current sportsmedicine system prefers to perform joint replacements and prescribe a lifetime of pharmaceuticals later rather than address the issues now.

Possible solutions;


Chiropractors and Physical Therapists—you’re the biomechanical providers out there, so you need to step up. The first step is to get to the schools and educate the families and coaches. Then offer your services for a complete biomechanical exam for all athletes, not just those injured. This should take place before the season begins. A biomechanical exam can be found at www.StructuralManagement.com. Prescribe flexible custom orthotics as a first step in balancing their biomechanics.

Family Drs.—admit this isn’t your specialty, and work with the families to find a chiropractor or physical therapist who will help with the biomechanical needs of the athlete.

Athletic Directors—realize you are the lynchpin to all parents and athletes in your school district. Your role is critical. Work with those who are capable of providing more biomechanical information to this group. Don’t settle for that age old response, “We’ve done fine without this so why do we need it now”.

Coaches—you’re the ones who have the most contact with these athletes. Teach them about prevention and the importance of being disciplined in taking care of themselves. Help to build the bridge between families and biomechanical providers in your communities. Small injuries are warning signals. Please don’t promote the “No Pain, No Gain” mantra. Realize that pain is a warning signal for underlying biomechanical imbalances.

Parents—don’t stop until you find someone who will perform a biomechanical exam on your child. It will help detect the predictable sights of injuries, and will uncover the reasons why chronic injuries persist. And, encourage corrective recommendations.

Other than that, have a great month.