by Dr. Tim Maggs, © March 2000
For those with a chronic bad neck, low back, hip or leg problems, this article is for you. Many of you are probably part of that massive group who have contributed millions and millions of dollars to the "sportsmedicine specialists" for a solution to your problem, but never received any form of a biomechanical exam. The likely treatment; a medication with some physical therapy. Probably more telling, however, are the number of athletes whose careers have been cut short and their quantitative emotions affected by this less than adequate evaluation of classic biomechanical injuries.
The sportsmedicine market today is made up of the do's and the don'ts. The do's understand biomechanics, such as leg length, pelvic angle, lumbar lordosis, cervical lordosis, joint mobility, muscle balance, etc., know how to recognize both normal and abnormal structure, and know how to correct the defects. The don'ts are those sports doctors who do a limited exam, consider an MRI, inject cortisone, recommend anti-inflammatories, prescribe "quit running" or 2 weeks of physiotherapy, and basically scratch their head when the athlete leaves their office.
One day while on a run, which is where most of my pearls of wisdom arise, I thought about the uniqueness of each and everyone of us. There are no two people alike, and that includes our structures. But, when attempting to explain this concept to patients, for some, a period of de-programming is needed, as they thought some generic information would be more than adequate.
As often happens, a lightning bolt struck me, and the phrase "Structural FingerprintT" came to mind. This said it all. I've since used this phrase in many of my talks, and everyone understands without further explanation. We're all different. We all need to be evaluated to determine the many specifics of our structure which make up our total fingerprint. Very seldom do we hear about our body mechanics and the need to understand who we are and what unique structural defects exist, but this article is here to scream out loud the importance of knowing the specifics of your structure. It's more than critical, it's mandatory.
Many of us have learned you shouldn't see a doctor until you're unable to walk, breathe, function or exist. This approach, needless to say, is the most expensive approach. The preferred approach is to call today. Learn what specifics make up your structure, and just as the Fram Oil Filter commercial states, "Pay today, or pay tomorrow". Regardless of your choice, you will pay. Either with work and rehabilitation, or with pain and suffering.
A complete "structural fingerprint" is made up of many different factors in our lives. Genetics is where we all began, and just as blue eyes or brown hair are hand me downs from our parents, so are spinal curves and pelvic rotations. We're all imperfect, and genetics is the first contributor to this pool of influence. We also need to consider habits, prior traumas, exercises, conditioning, weight, height, sleeping surface, shoes, orthotics and many other possible considerations.
This exam could and should be done on all athletes. The most critical needs are for those who currently suffer with conditions such as low back pain, neck pain, stiffness, hip pains, ilio-tibial band syndrome, sciatica, tingling or numbness down the arms or legs, headaches, plantar fascitis, hamstring injuries, calf injuries, achilles injuries and many more conditions.
For those who don't quite have any of the above conditions, keep in mind that aging is an unkind process, and any continual stress through the structure, such as running, should require a biomechanical exam to locate defects, imbalances and sites of increased stresses.
The exam should include all ranges of motions of joints, muscle strengths, right vs. left and front vs. back, a measurement of both legs to determine if there is a structural or anatomical leg length difference, standing x-rays of at least the low back and the neck and other orthopedic and neurological tests which are appropriate.
Most corrective programs cannot begin until a patient is out of pain, or the symptoms they're suffering with are significantly reduced. Once improved symptomatically, a corrective, or rehabilitative program, should begin. The key is to restore normal motion back to all joints, increase flexibility, improve balance with muscle strengths and leg lengths, correct pelvic angle defects and gravity line defects. These changes make a dramatic difference in injury frequency, intensity and duration. Without the biomechanical influence, injuries will continue to exist and active participation will continue to decline.
So, next time you hear someone complain about their back, neck, hip or legs, think "structural fingerprint"!