Wednesday, January 1, 2003

Sciatic Pain - No Cure? Please!

© 2003 By Dr. Tim Maggs

I recently spoke with a runner who’s suffering with a severe case of sciatica. The pain got so bad she couldn’t sleep at night. I asked my usual question, “So what’s causing it and what are you doing for it?”, but her response was one I hadn’t heard yet. “I looked up a bunch of info on the internet, and evidently there is no cure for it”.

What is Sciatica

This misunderstood condition is proven by her finding that there is no cure. To understand sciatica, it’s important to understand some simple anatomy. The sciatic nerve exits the low back and travels down through the butt and down the back of the thigh. It continues down to the lower leg, but for the most part, all symptoms remain in the butt and back of the thigh. It is the largest nerve of the body, approximately the size of one’s little finger.

When that nerve gets pinched or becomes inflamed, it hurts. And, although I’ve never had the condition myself, I can only tell you it’s one of the more painful conditions that patients come in with. The first goal for anyone suffering with this condition is to locate the sight of irritation on the nerve. So, to ever say there is no cure for the condition borders on lunacy, since there are so many different causes.

The most common cause of inflammation of the sciatic nerve is due to injuries, restricted motion in the lumbar spine or abnormal weight-bearing, or weight distribution, in the low back (detected on standing, low back x-ray). This will produce an added stress on the sciatic nerve causing the pain. The second most obvious cause of the condition is tightening of the piriformis muscle, which is a muscle that runs straight across the butt. All of us have 2 piriformis muscles, and usually only one will go into a spastic state at a time. If you think of your muscles in the low back and butt as wires holding up a flag pole, when the pole leans one way, the wire on the opposite side tightens, and that’s what happens to us.

Now, there are other causes for this condition, but none are as common as the two causes above. Despite that fact, I had a patient come in about 15 years ago with sciatic pain, and on x-raying the low back, we found an abdominal aortic aneurysm that put him into surgery within 2 days. Whether the aneurysm was in any way directly or indirectly causing the sciatic pain is unknown, but doing a thorough work-up saved this patient’s life.

Determining the Cause

Most sciatic conditions are due to long term conditions. Structural imbalances place too much stress for too long a time on one or more areas of the low back, and the sciatic nerve gets pinched. The easiest way to find out what’s causing it is to have a structural, or biomechanical exam done. This consists of a foot exam, leg lengths, low back range of motion and a variety of other structural tests. The most conclusive test is the standing low back x-ray (front and side-view), because that shows the unique structural positioning and condition of the vertebrae and disc spaces. The most important findings are the sacral base angle, the weight bearing gravity line and the quality of the disc spaces. (For more information on any of these, feel free to e mail me).


In most cases, once the exact cause is learned, proper treatment, home recommendations and exercises can be determined. Since most of us stand or walk or run a lot of the time, symptoms may take longer than normal unless we eliminate the majority of these from our schedule.

In the case of a degenerative joint, the condition may take a little longer, since the inflammation is due to a lack of motion within the joint as well as a compromise of the amount of space for the nerve to exit the joint. But, with proper treatment and home recommendations, symptoms and the condition can be improved greatly.


A good approach to treating all conditions would start with ice treatments to the low back, since the majority of sciatic problems originate there. Secondly, the tennis ball technique on the hip muscles will greatly help to relax the piriformis muscle, thus reducing the stress on the sciatic nerve. Stretching this area could also help to take pressure off the nerve.

If custom orthotics are needed, they almost become a must, since the imbalance in the feet will continue the stress on the low back until corrected. And, as written about in prior articles, the orthotic should be flexible for the foot and fitted in a standing position.

Finally, with regard to training, running should only resume once all symptoms are gone. This may sound harsh, but sciatic problems can last a lifetime, and the only way to get rid of them and keep them gone is to “get rid of them” before you run. So, ice, treatment if needed, orthotics if needed and patience will get most runners back the soonest and keep them back the longest.

Dr. George Sheehan The Greatest Visionary Ever

© 2003 Dr. Tim Maggs

Many runners have gruesome stories of injuries and their nasty “quest back” to running. Me included. It took me 8 years to solve my condition, and I’m supposedly a specialist in sports injuries. Getting injured is one thing, but trying to find a doctor who knows about the injury is another. Today’s industry is so focused on illness, pathology and disease that it’s virtually impossible to find a doctor who understands the importance of structure and the architecture of an athlete. Yet, structure is the key when talking about most running injuries. Just yesterday, I had a runner with low back pain come in and tell me he’s been to 2 chiropractors and 4 orthopedists over the past 6 years, and none of them have yet to tell him what his injury is. Well, none of them have done a structural exam on him either, and he’s still injured. What a surprise.

In 2001, the New England Journal of Medicine published an article on low back pain, stating that 85% of the time it was near impossible to detect the exact cause of low back pain. Therefore, pain killers and anti-inflammatories were the best that could be done. In 2002, the Annals of Internal Medicine did another story on low back pain and imaging, and stated that less than 3% of all low back pains were due to pathology (disease), and 97% were due to mechanical distortions.

Well, if this is the case, (and it is), then why are our pathological doctors suggesting they are the experts on mechanical disorders, which they know nothing about? The very thought that 28 years ago, Dr. George Sheehan wrote his thoughts on running injuries loud and clear in his book, Dr. Sheehan on Running, pleases me to no end.

Over 2 years ago, I wrote an article on building a national sports doctor network. That dream is becoming more of a reality everyday. My vision of having a structural specialist in every community in this country is getting closer. When this day arrives, the overwhelming incidence of injury in runners will go down drastically, as well as the costs that are spent on needless tests looking for pathology and symptomatic treatments that hide the real cause. Race directors, get ready. When this day arrives, you’re the ones who will have to handle the massive crowds. What a great day that will be.

And, to think, Sheehan knew all of this back then. What a genius.

“When I began running, I was an educated specialist who concentrated on one area of the body. I was an expert who relied on other experts for advice. I soon needed it. Although my ancestors could run forever, my limits were quickly reached. Serious running led swiftly to a series of foot, leg, knee and low back injuries that threatened to end my new found happiness on the roads.

I went dutifully to my specialist friends and found to my surprise that they were of little help. They were pre-occupied with giving relief to my aching foot, my swollen knee and my throbbing sciatic nerve. They treated the effect, not the cause. And, when I resumed running, back came my misery and pain. Clearly, I needed someone more sophisticated, some super-specialist.

I had not gone high enough on the specialist ladder to find the wise man to help me. I soon discovered, there was no such wise man.”

“I am a cardiologist, but my relationship to sportsmedicine has been as an athlete rather than a doctor. What I have experienced as a runner-and what judgment I have been able to bring to this experience as a physician-has convinced me that traditional medicine isn’t dealing adequately with athlete problems.

In more than 10 years as a distance runner, I have experienced almost every injury of the foot, leg, knee, thigh and back. During this time, the medical profession has only been able to provide me with symptomatic relief.

It wasn’t until I came under the care of a podiatrist that I was able to run for prolonged periods and be free of foot, leg, and knee difficulties.”

“This convinced me that no matter what an athlete’s problem is, we should look first to the feet as the source of the problem. The foot is an architectural marvel-an engineering masterpiece that has 26 bones, four times as many ligaments, and an intricate number of tendons that act as guy ropes or slings for the arches.

When these components are perfectly balanced, the foot can handle almost any amount of work. However, even a minute deviation from normal can cause adjustments that will eventually produce injury either in the foot, or in its supporting muscles and tendons, or even in the structures above.”

“The human body is a marvelous instrument. When in perfect alignment and balance, there is almost no feat of endurance the body cannot handle even on a regular basis. However, structural imbalance of even minor degrees can result in incapacitating injuries and persistent disabilities.

Prevention and treatment of musculo-skeletal injuries in the athlete, therefore, rests in the establishment of the structural balance and architectural integrity of the body-and its re-establishment should injury occur.”

 “I cannot emphasize too strongly that most athletic injuries are structural, almost architectural, not medical. You would almost be better off in the hands of an engineer than a medical doctor when this type of injury occurs.

At least you would not have your problem complicated by medication that in the long run will do no good. What the runner needs is to be restored to structural balance.”

If George were here today, I’d assure him his vision is alive and well.

Are You Centered? (Physically, that is)

© 2003 by Dr. Tim Maggs

Who would ever think you'd waste your time reading an article on you and your "center of gravity"? I ask you as I ask myself, who'd ever think I'd spend time writing an article on "center of gravity"?

Well, the more I travel in life, the more I try to hone in on those issues that really, really make a difference. You know, the one's that you really have to pay attention to. Not some of those worthless laws or rules that have no value in life. There comes a time in life when you want to focus on those rules that matter. And, after all is said and done, this is one of them.


In a December issue of Time Magazine, the cover story was all about arthritis, the new epidemic and how it's being recognized earlier in people. Of all the arthritis' out there, osteoarthritis, or wear and tear arthritis, is the most prevalent. The story went into detail about the new and advanced treatments available today. In order of usage, the list went from drugs to surgery to exercise to alternatives. You can only imagine the short list provided under exercise (if you move your arthritic joint, it will hurt less---PLEASE!!) and alternatives.

What the list failed to address at all was the importance of posture, balance, gravity and structural defects. As with any structure, imbalances accelerate degeneration or wear and tear. But, in our pathology-based world that treats everything pharmaceutically, "posture" has no shot of making the short list of treatments. But, let me tell you why it should be number 1.

Pay Now or Pay Later

How on earth can the industry sell the package that we don't have to do anything about potential degeneration until we've begun to degenerate. You mean to tell me, there's NOTHING we can do to prevent it. Time Magazine didn't give anything preventative, but I can assure you of this, there is a ton we can do.

Let's look at the simple issue---What causes osteoarthritis? It's the fixation or locking of a joint put under abnormal stress for a prolonged period of time, and then Wolf's Law kicks in. Wolf's Law simply states that any bone under stress, given time, attracts calcium salts to innately fuse it to the surrounding bones as a protective measure to resolve the weakness or stress. So, whatever part of your structure is the recipient of abnormal stress, due to an imbalanced center of gravity, will be the site of attraction for calcium salts, or..osteoarthritis.

This is not a pathological or pharmaceutical issue. People with osteoarthritis should not be going to their doctors to get drugs or look for a miracle cure. It's a biomechanical issue that will require a re-education of the body to re-establish mobility in the joints and balance in the structure. And, this takes time. In my office, we usually consider a period of 6-9-12 months, depending on the age, condition and status of the patient.

The Structural Fingerprint® Exam

It all begins with a status report of the structure. Center of gravity is a finding on the visual standing test as well as the standing x-rays, both front to back and side to side. Center of gravity is critical for normal function and normal wear and tear of the musculo-skeletal system. With imbalances, there will always be an accelerated degeneration. So, the first step is to locate sites of imbalances, fixation or weakness.

This is done through a series of physical tests, such as range of motion of a specific area, muscle tightness in that area and ultimately, standing x-rays, which provide 75% of all biomechanical information needed. The first x-ray shown is the front to back view of the low back, and shows the alignment of the spine with the pubic joint (lies in the front of the pelvis). The second x-ray shows the center of gravity from the side view. A line drawn from the center of the 3rd bone in your low back (lumbar spine) down to the front 1/3 of your sacral base will show you if your weight bearing is ahead of or behind the area designed to handle the weight in your body.

If either of these gravity lines are off center, you know there will be an increased stress and an acceleration of breakdown in whatever joints are under the most stress. So, with running, it's an easy formula----balance and correct centers of gravity make it the perfect sport. But, with imbalances, running slowly adds to the degenerative process that is taking place.

Simple Answer

The simple solution is to go through a complete biomechanical exam, and then be willing to do the corrective measures recommended. To ignore this approach and subscribe to the current system of waiting until the degeneration produces symptoms is insane. We've come too far as a society to allow such lunacy.

It may be difficult to find the person to perform this exam, but in time, each and every community will have someone you can look to. Until then, feel free to contact my office for some suggestions.

Early Detection of Your Child's Postural Imbalances

© 2003 by Dr. Tim Maggs

Back to school usually involves a check-list; books, supplies, clothes, new sneaks, a school physical, etc. Unfortunately, what doesn't make the list is a structural exam for your growing child.

Structural exams, consisting of detailed back, neck, shoulder, hips, legs, ankles and feet exam, are not part of the standard back to school physical provided to our kids. The standard exams check eyes, ears, nose and throat, with possibly a cursory scoliosis screening. More structural emphasis should be considered on the standard exam.

Musculo-skeletal imbalances and fixations are the cause of the majority of injuries that occur in grade school and high school students. Currently, there is no structural prevention, evaluation or improvement program made available to the masses even though neck, back, shoulder, hip, knee and foot problems are near epidemic proportion. With all of the specialization available today, what's the deal?

In the eyes of the public, structure falls into the hands of orthopedists, physical therapists or chiropractors. Unfortunately, most of these professionals have geared their practices towards treating symptoms and not evaluating on a structural or architectural basis. Unless someone is hurting, most doctors wouldn't know what to do. However, with the proper testing, a tremendous amount of information can be detected, and a pro-active program can be designed, consisting of corrective treatment, exercise, lifestyle changes, etc. It is this author's opinion that very few professionals are fully qualified to structurally examine a young student, especially in the absence of symptoms. It's just not considered in today's complicated health care industry.

The Structural Fingerprint® Exam

The physical demand on kids today is great. Many participate in school sports, and a percentage of these kids play multiple sports. The backpack syndrome is also to blame for many emergency room and doctor visits, as the weight of the backpack far exceeds the ratio of student to backpack weight ratio that is recommended.

In spite of these demands, a comprehensive structural exam is still not routinely performed on our growing children. Consider that all people have unique structural characteristics, and just as the orthodontist recognizes the value in proper alignment and positioning of the teeth, so, too will the human structure last longer and perform better if there is balance and mobility in all of the joints and muscles. I pose the question-"Does everyone just assume that all kids have a balanced muscle system, skeletal system and nervous system? So many kids today need braces to correct the alignment of their teeth, yet teeth are not weight bearing nor do they have movable joints. To assume that these three delicate and critically important systems of the body seamlessly interact with no imbalances or abnormal stresses borders on insanity."

What modern healthcare has failed to provide is a comprehensive structural exam before injuries occur. It should be mandatory for all back-to-school exams to also address the many structural issues that can produce weaknesses and imbalances. These tests consist of range of motion of all joints, leg length measurements, a complete foot exam, muscle tests and most importantly, standing structural x-rays. The value of the x-rays cannot be emphasized enough, because with proper interpretation of biomechanical information found on the x-rays, corrective recommendations, including exercise, proper athletic shoes, treatment, etc., can be made. The recommendations should play a dramatic role in preventing many future injuries, thus reducing the number of future x-rays a student will go through over the course of their lifetime.

Valuable Information

The information found on this exam includes the determination of possible pronation (flat-footedness) of a child, or the exact opposite, supination (excessively high arches). Both can contribute to long-term structural problems and would benefit from custom orthotic support. This not only helps the feet, but helps to balance the entire human frame while also providing shock absorption benefits. If ignored, the center of gravity of all joints above the ankles may be imbalanced, leading to both acute injuries as well as long-term wear and tear type injuries.

Range of motion tests will show if there is any restriction in either muscles or joints. If found, normal mobility of the joint should become the goal, as restrictions of muscles and joints predispose these structures to future injuries. The structural x-rays show a wealth of information. Oftentimes, the doctor will tell you the x-rays are "negative", in spite of pain, stiffness and swelling. Keep in mind most doctors are looking for pathology and disease on an x-ray. Just as structural exams are not done, biomechanical information on an x-ray is not seen by most doctors. This can be proven by the fact that many doctors take x-rays with the patient lying down, removing gravity from the equation. This is because they are looking for disease, and if disease is not present, then they say the x-rays are negative. The truth is that x-rays are negative for pathology 99% of the time, but biomechanically, will never be negative. There will always be useful information.

Biomechanics looks at the human structure as an architectural structure, and the x-rays show in detail the many unique variables each of us have. This information plays a major role in recommendations, as specific exercises, corrective treatments, habits, weight control, etc. will help someone improve their imbalances rather than just waiting for an injury, and then treating the symptoms.

Early Detection

Colonel Deborah Campbell of the New York State Police has been a long time vocal advocate for fitness and conditioning. This year she has already completed the Covered Bridges Half Marathon in Vermont and The Boilermaker 15k in Utica.

Her two children, Kelsey, 11 and Chris, 8, are following in her athletic footsteps. Colonel Campbell has long understood the importance of posture and structural balance as she has had her share of low back and neck problems in her lifetime. The very thought that she would ignore her kids and wait until an injury occurs just didn't make sense to her. That's why both Kelsey and Chris recently went through a Structural Fingerprint® Exam. These evaluations provided early detection in structural imbalances allowing her kids to work pro-actively in an effort to prevent injuries and have them enjoy exercise and sports more.

"It only makes sense to have your kids examined early, with or without symptoms, rather than just waiting for a breakdown", says Colonel Campbell. "The current approach makes no sense to a parent who wants her children to enjoy sports, fitness and life as much as possible".

Pay Now or Pay Later

Our entire healthcare industry, as well as insurance guidelines, work to provide care after injury occurs. With a little foresight and effort, all kids should be examined immediately with corrective measures provided. The cost of musculo-skeletal breakdown over the life of a person, in both industry and sports, is costing billions of dollars per year, not to mention needless suffering.

Parents should take note; early detection and active participation on the part of the patient will drastically reduce these costs. And, along the way, provide a more enjoyable and active life. Isn't that what it's all about?

Osteoarthritis, Wolfe's Law and Orthotics

© 2003 by Dr. Tim Maggs

In December, 2002, a red-hot, swollen arthritic knee donned the cover of Time Magazine. The caption read, The Coming Epidemic of Arthritis-The bad news, research shows the disease starts attacking your joints long before middle age; The good news, the latest treatments are more effective than ever.

With great interest, I thumbed to the article, only to find the same old, same old. The first set of "more effective treatments" was a list of different types of medications. From anti-inflammatories to cortisone injections. This list was followed by the different surgical procedures now available, from arthroscopy to joint replacement to bone fusion. And then, "Exercise". "It is advisable to exercise an arthritic joint, as it may freeze if you don't". I ask the question one more time. Why doesn't the industry instruct and encourage us to keep mobility in all the joints of the body as part of the prevention of arthritis, rather than wait until it hits, and then give a crisis call for joint exercise?

Glaring Omission

What the article fails to discuss is Wolfe's Law. In fact, all of modern healthcare, although very familiar with Wolfe's Law, ignores it's very existence. Wolfe's Law states that any bone or joint, under abnormal stress, attracts calcium salts to defend and protect the stressed area. Calcium salts means "bone", and additional bone means arthritis. As in osteoarthritis, the leading type of arthritis today.

So, the point here is this----any imbalances in our human structure, or any abnormal locking of joints due to stess, will lead to and contribute to the development of osteoarthritis. Life itself and heredity weaknesses produce continual imbalances and locking of joints, meaning most of us are pre-destined for osteoarthritic changes "long before middle age", as Time Magazine so aptly puts it.

These joint lockings and early degenerative changes can be detected in their earliest stages on a biomechanical exam, which I've discussed in prior articles. I've also admitted that it's difficult to find someone to perform such an exam. But, not impossible. Regardless of the difficulty, all runners must develop their marathon mentality when looking for someone to do this exam, and not stop until it's been done.

Running has the potential to aggravate joints and accelerate degenerative changes, especially when there are significant imbalances present. Any repetitive activity (such as running), especially with it's up and down compression, can certainly increase the stresses that Wolfe's Law talks about. So, balance and joint mobility is the goal, but learning your imbalances and fixation of joints is the starting point we should all seek.

Wolfe's Law and Orthotics

This is history in the making. Wolfe's Law and orthotics have probably never before appeared in the same subtitle. Why, I can't imagine. It seems like a no-brainer to me, but many don't understand Wolfe's Law, as well as not understanding the many benefits of orthotics today.

With higher quality orthotics that are available today, there is enhanced shock absorption in the heels. If more of the shock that occurs from running and the many other stresses of life is absorbed in the orthotic, then wouldn't that suggest that a reduced level of stress ends up going through the body? And, wouldn't that suggest that the structure might not degenerate as quickly? I know I'm not the surgeon general, but I've always had a pretty good sense of logic, and that's exactly what it suggests to me, as well as Wolfe's Law---less stress, less "bone" production for the support of weakned joints. Now, if this is true, why then isn't Wolfe's Law and orthotics on the cover of Time Magazine? I'm really beginning to feel like Columbo here.

Modern Healthcare

Especially when speaking of the human structure, there is a huge void in our present system. Modern healthcare has migrated so far towards disease and pharmaceuticals, that no one out there is looking after the preservation of the human structure. So, the response you'll get from all doctors out there when you begin to suffer with degenerative changes is,"hey, it's arthritis. We all have it". If you ask me, that's a pathetic response, and isn't that why we're out there running. To preserve and improve our wellness and longevity?

The insurance industry is out there forcing most of us on our choices of healthcare. Try calling your insurance company and asking where you might get a biomechanical exam, and they'll probably laugh you right off the phone. "Not a part of your policy", they'll most likely say. And, so, the saga of following the current rules and ignoring the real issues continues.

The Solution

80% of all patients in my practice are fitted with custom orthotics. If you do anything more than spend the day in bed, it is money well spent. The next step is to keep mobility in all joints and muscles of the body. Flexibility exercises are a good start, but for joint mobility, it may involve help. The chiropractic profession is the most likely source for keeping and maintaining good joint mobility. The osteopathic profession is another source, but many of them have succumbed to just writing prescriptions, so you have to make sure that adjustments or manipulation is part of their protocol.

Now, go out and run and enjoy yourself for the rest of your life. This is how it was meant to be, but don't look for advice or support from the masses. Too many people think Time Magazine is a great source of advice. Me, I think it makes good starter for a bonfire.

Redefining Sports Chiropractic What is our role?

© 2003 by Dr. Tim Maggs

With the popularity of sports in this country today, more chiropractors are staking their claim as sports injury experts. Even if only for marketing purposes, these "specialists" are growing in numbers.

For those who actually participate with teams or are attempting to become part of a team's medical staff, job description at some point becomes a key issue. The diversity between technique, philosophy, adjunctive therapies and sports knowledge, although an issue within the profession, has less meaning when determining how to fit into an existing staff.

On many pro teams, a chiropractor will visit the locker room on a certain day each week and adjust those players who want to be adjusted. In other situations, a chiropractor will work only in his/her office, and players will call and make appointments to be treated there. In both cases, the option is up to the player and typically the reason for the appointment is to relieve some pain, stiffness or symptom the athlete is experiencing. This also leaves the entire decision making process up to the athlete, which is usually due to some prior experiences with chiropractic.

In other instances, and usually in lower level sports, like high schools and smaller colleges, the chiropractor is encouraged or forced to take on a more expanded role, like taping and working the sidelines of games to handle many of the crisis oriented injuries. This opportunity, unfortunately, furthers the confusion to everyone as to exactly what the role of a chiropractor could and should be.

This author, for one, believes we should leave the sideline duties, as well as taping and other locker room responsibilities, to others. The role the sports chiropractor should play is so time consuming and critically important and currently not performed by any other specialist. To spend our time performing tasks that can be handled by others reduces our value and continues the ongoing ignorance in the sports community as to what chiropractic is all about. It also puts us in a continual competition with other professions, increasing their ongoing efforts to keep us out of the locker rooms. Chiropractors should never have to compete with the trainer, physical therapist or team medical doctor. Our roles and value should make everyone, from players to medical staff to owners or administrators, beg for our involvement.

The Chiropractor's Role

In the most sophisticated sports conditioning programs today, the best that happens is that the strength coach evaluates players for body structure, strengths and weaknesses. This information is then translated into a conditioning program. However, less sophisticated programs (and majority) put athletes on strength and conditioning programs based on their sport or position. Very few base the program on the athlete's specific structural needs. The reason for this is that no member of the team's medical staff knows how to structurally evaluate an athlete. This type of evaluation, if ever done, is only done after an athlete is injured, and the goal is to heal injuries. Any structural information gotten on the exam, however, is never used to improve conditioning.

The new role of the chiropractor is to provide structural management to athletes and teams. This program begins with a complete structural evaluation, learning quantifiable information that can educate the athlete as to the specific imbalances, distortion patterns and weaknesses that need to be addressed. These evaluations should be done pre-season. In most situations, medical exams are done pre-season. These exams, for the most part, do not include any structural testing. Since most sports injuries are mechanical, or structural in nature, it makes sense that someone perform structural evaluations before the season begins. Corrections should not be based only on symptomatic involvement. Since structural imbalances can accelerate degeneration and increase the likelihood of injury, they should be immediately addressed with treatment, supports, nutrition and exercises as soon as they're found.

The Structural Management® Program

The Structural Management® Program begins with the premise that each and every athlete has a totally unique structure. The only way we can ever know the specific needs of that structure is to perform an examination highlighting weaknesses, imbalances and distortion patterns. The Structural Fingerprint® Exam is done for that purpose. Many college and pro athletes who utilize chiropractic use the adjustment for relief of some form of symptoms. Very few of them have been educated to use chiropractic for the correction of structural distortions, and with this exam, quantifiable evidence can be shown to the athlete and become the basis for setting up a corrective structural management, and strength and conditioning, program.

The Structural Fingerprint® Exam

As structural specialists, we need to begin looking at the athlete as an architectural structure. If the athlete were a building, balance would be important. In the athlete, this translates into reduced likelihood of injury and increased endurance. Improved balance and joint mobility would improve performance, as the athlete's structure would better tolerate increased stress loads from both competition and conditioning.

This exam begins with a visual exam of the athlete in the standing position. Postural information should be noted, such as high shoulders and hips, internal or external rotation of the knees and feet, increased or decreased lordotic and kyphotic curves, etc.

It is then followed up with a complete foot exam (Fig. 1), which includes checking the medial arches of the feet and the Q angle of the knees. Full range of motion of all key joints, as well as muscle tests, leg length measurements and basic orthopedic testing, such as Lasegue's, Bilateral Leg Lowering, Patrick-Fabere and Gaenslen's will provide valuable information. Palpation of the entire para-spinal regions will show muscle tension imbalances and subluxations.

The most important testing in this exam is the standing x-ray. This provides the unique information that becomes a reference point for beginning structural correction. Most patients have never been evaluated from a biomechanical point of view, nor have they learned quantifiable information about their structures. Standing x-rays will give 75% of the information needed to determine an athlete's structural fingerprint. This information also puts chiropractors head and shoulders above all physical therapists, massage therapists, strength coaches, medical personnel, trainers, etc. We become THE authority for structural management.

The basic x-ray series should include an A-P open mouth and lateral cervical as well as an A-P and lateral L-S X-ray. These should always be done in the standing position with shoes off. On the normal open mouth view (Fig. 2), there are some basic findings that should be measured. The alignment of the odontoid process with the SP of C2 should line up. Any non-alignment is suggestive of a rotation of C2. The atlanto-axial and atlanto-odontoid spaces should be equal in size. Finally, the occiput should sit evenly on the spine. On the normal lateral x-ray (Fig. 3), the important biomechanical findings are the lordotic curve, the disc spaces and the gravity line, which should go through all cervical vertebrae. If the gravity line is ahead of or behind the cervical spine, then the abnormal weight bearing will produce an acceleration of degenerative changes as well as an increase in potential injuries in the cervical spine. If injured, the degree of injury can be greater and the time needed for recovery can be prolonged. With all abnormal findings, a corrective program becomes critical, and chiropractors are the most viable candidates for diagnosing and treating these imbalances.

X-rays of the L-S spine should be A-P and lateral. On the normal A-P (Fig. 4), the iliac crests are level, the spine is straight and in alignment with the pubic symphisis. The obturator foramen are equal in size. And, obviously, no pathologies are present. On the normal lateral L-S (Fig. 5), the disc spaces should be well maintained, the sacral base angle should be 36°-42° and Ferguson's gravity line should bisect the anterior third of the sacral base. Again, any abnormalities should become the starting point and reason for a corrective program.

The Advanced Conditioning™ Program (ACP)

Under the assumption that all people, including athletes, have never been thoroughly structurally evaluated and biomechanically corrected, it is assumed that the individual is living in a "deferred maintenance" state. Correction is mandatory to reduce the likelihood of injury and allow the athlete to tolerate a greater capacity of structural stress. The program is most effective in the absence of symptoms. If symptoms are present, it is better to eliminate them first.

The goal of the ACP is to improve balance, joint mobility and muscular flexibility. If these three objectives can be met, the amount of stress an athlete's structure can tolerate before breaking down increases exponentially. In the world of sports, this service provided to a team can become the most important service that team has available to it.

The corrective program is a 6 month program. Prior to the first adjustment, custom fitted orthotics are recommended if any of the following were positive on the exam; pronation of either foot, supination of either foot, a difference between the right and left arch, foot flare, an increased Q angle, an abnormal sacral base angle or an abnormal Ferguson's gravity line. Chiropractic adjustments start at 3x's/week for 6 weeks, then the frequency is reduced to 2x's/week for another 6 weeks. Treatments then go to once/week for 14 weeks. Any complimentary physical therapy can be used. The purpose of the adjustments is to re-educate the joints and supportive structures of the normal motion that should be within each and every joint of the body. With normal joint mobility, again, there is an increase capacity of stress that will be tolerated much better before injury occurs.

In addition to the adjustments, a specific exercise program is set up to attempt to improve any abnormal structural findings, such as an abnormal Ferguson's line or sacral base angle. Muscle imbalances are a key part of structural imbalances, and cannot be ignored when attempting to correct the structure.

The Maggs Muscle Management™ Program

This is the final component of The Structural Management® Program. This program allows each and every athlete to manage their own muscle system multiple times per day. Ideally, this should be done prior to working out and after working out. It can be done during a work-out or a game as well.

The objective is for the athlete to encourage blood to all major muscle groups while helping to eliminate harmful toxins from the muscles (Fig. 6). The Intracell Stick® is the tool of choice in allowing an athlete to treat themself. Blood carries food and oxygen, and will support the muscle for better performance. Also, when blood is encouraged into a muscle, stretching will have a much greater benefit, as the muscle is now warm. Greater flexibility of a muscle will also allow reduced injury potential as well as improved performance potential. This aspect of the program now provides the chiropractor with an extremely beneficial means for addressing muscle injuries, as well as an advanced method for preventing injuries and accelerating recovery.


Chiropractic has fought for years to be accepted, yet we currently treat 10-12% of the population. We fight to get into locker rooms, and once in, we assume the role allowed as a small part of the existing medical model that currently doesn't know how to diagnose or treat mechanical injuries. Or, we try to mimic our medical colleagues, as though that's what a good sports doctor does.

With The Structural Management® Program, every chiropractor has the opportunity to become the sports expert in their community. No other profession remotely compares to performing any of the above listed duties that are so critically needed by every athlete alive. With a willingness to look at the athlete from an architectural point of view, this program allows for a more comprehensive and marketable approach for all chiropractors in their community. This is also the beginning of finding common ground for all chiropractors to subscribe to in an effort to unify our profession. It is then we will begin to see an abundance of patients far greater than 10-12% of the population.

Repetitive Motion Injuries in Sports and Industry Prevention and Management Program

© 2003 by Dr. Tim Maggs

Repetitive activity is the breeding ground for many injuries in both the sports world as well as the workplace. Much research has been conducted in an effort to find better postures, ergonomic strategies, exercises and more effective supports. Despite the benefits to date, much more can be done.

Understanding basic muscular physiology will suggest that more attention needs to be paid to the warm-up, recovery and conditioning of repetitively used muscles. Most muscular injuries are a result of under-recovery of muscles, and these injuries consist of many of the low-back, neck, hip, carpal tunnel and other injuries we see everyday in our offices. By applying a consistent muscle management program, prevention and recovery of these over-used muscles can be improved greatly.

Basic Physiology

Regardless of the muscles that are repetitively used, the physiological process is the same. Increased muscular use increases the production of harmful toxins that will accumulate in the fibers of involved muscles. With this accumulation, a domino-like effect takes over. The blood flow is decreased, the fibers shorten, and the muscle now becomes as effective as the shortest fibers, thus increasing the potential for injury and reducing the performance potential of the muscle. If accumulation of these harmful toxins could be addressed and managed earlier and on a more frequent basis, a reduction in the time frame and incidence of these injuries will occur.

The Maggs Muscle Management™ Program (MMMP)

The application of deep pressure over a muscle multiple times per day will produce two results; the first is and influx of nutrient and oxygen-rich blood to the treated muscle. Secondly, harmful toxins will be broken up and flushed out of the muscle and back into the system. This is the first step in aiding a muscle to recovery. The use of the Intracell Stick® (Fig. 1) is one means to address these muscles. The rolling pin-like device is rolled over an entire muscle, in both directions, 20-30 times. The pressure is to tolerance, and this exercise can be performed by individuals on themselves.

Fig. 1

Preparing a Muscle for Activity-Warming Up

Once rolled, a muscle is now better prepared for stretching (Fig. 2) as the muscle is passively warmed. Flexibility exercises become more beneficial once a muscle is warmed, and this passive warming of a muscle reduces the risk of injury while maximizing the benefits to the muscle. The muscle should then be put into a mild, static stretch for 5-7 seconds. If time allows, each muscle should be rolled and stretched 2 times. There is a technique for all major muscle groups, and should be encouraged both before and after activity. If used in the workplace, this exercise could and should be performed at respective workstations.
Fig. 2

Enhanced Recovery

Under-recovery is the usual cause of most muscle pulls, tendonitis' and other related syndromes. Under-recovery is usually the result of increased muscle activity with minimum muscle management. Accumulated toxins produce shortened fibers predisposing an individual to injuries. Rest will allow injuries to symptomatically heal, however, the muscle will become injured again once activity resumes. Until full and complete recovery can occur in a muscle, there will always be a limited potential of that muscle. These are the injuries that keep individuals on full disability, keep surgeons busy and keep costs soaring in both sports and industry.

Once a muscle has been exercised, either in a practice, a game or in the workplace, the muscle now resembles a clenched fist, making it difficult for blood to enter for recovery purposes. Using Mother Nature's time frame for recovery, the time frame is longer and far less complete. The greater the activity and accumulation of harmful toxins, the longer a muscle will take to recover. Unfortunately, game schedules and work schedules are more demanding than what many muscles can handle. This lack of recovery ultimately leads to injury.

With the application of the MMMP, blood is encouraged back into a muscle, increasing the recovery nutrients needed, as well as eliminating harmful toxins before they can accumulate, increasing the rate of recovery in the muscle. The application is the same as the warm-up recommendation---roll the muscle 20-30 times, to tolerance, and then gently stretch the muscle for 5-7 seconds.

Research has shown that a muscle has a "recovery window" that ranges from 15-30 minutes after a muscle is exercised. It is during this window of time that a muscle is most hungry for recovery nutrients (that are carried to it by the blood) and will produce best results when attempting to get a muscle to recover, whether it be from exercise or injury.

Muscle Injuries

The same recipe for muscle care applies to all muscles, but the actual exercise and tool used may vary depending upon where the injury is. For example, plantar fascitis occurs on the base of the foot. These tendons and muscles are highly vulnerable to injury and inflammation for a variety of reasons. The first and most obvious reason is the amount of stress they endure during a typical day. For athletes and employees alike, the amount of force that goes through the feet is the very reason so many end up with injury. Secondly, the footwear may not be adequate from a support point of view. Thirdly, most athletes and employees have never had a thorough foot evaluation to determine foot type, proper shoes and if custom-fitted orthotics are indicated. Without these supports for those who need them, injuries are typically just a matter of time before they become evident. Finally, the muscles and tendons of the feet are not managed correctly, and when this can be implemented into an individual's schedule, proper blood flow and improved recoverability will take place. As seen in (Fig. 3) the Foot Wheel? is an ideal tool to address trigger point accumulation in the feet.
Fig. 3

Carpal tunnel syndrome costs industry millions and millions of dollars per year. As stated earlier, the same physiological changes cause the many symptoms experienced by a huge percentage of our workforce. Repetitive activity leads to shortening of fibers, and these changes produce pain and fatigue in the forearm, tingling and numbness in their hands and weakness in their grip. The Trigger Wheel? (Fig. 4) is highly effective in addressing the primary sites of trigger point accumulation. The proximal posterior forearm (Fig. 5) is a well-established site for trigger point accumulation that has a direct relationship with the incidence of carpal tunnel symptoms.
Fig. 4

Injuries such as low back, calf and hamstring pulls, as well as many other common injuries, respond well with the use of the Intracell Stick®. The advantage with using a tool such as the Intracell Stick® is merely that a larger area of the body can be addressed in a reasonably short period of time, and people have the ability to perform these exercises multiple times on a daily basis. Much of the research that has been done with regard to trigger points never considered the ability for multiple applications per day. But, with this new, self-applied program, results are superior to any prior recommendations. The combination of rolling and stretching the muscle produces a far greater effect than just doing trigger point work on a patient.


The entire neuro-musculo-skeletal industry under-serves the public. The very fact that treatment is only considered once an injury occurs should awaken all of us to the need for management and prevention. In industry, key boards are split in half and work-stations are rearranged, but no one ever talks about physiologically altering the very muscles that are repetitively used and under-recovered. Until we begin to address these muscles, limited benefits will be the best we can hope for.

Secondly, the public needs to learn that treatment for injuries is the most elementary approach to keeping costs down and employees and athletes well. Prevention through pro-active involvement is the only way we can really begin to make improvements in the current state of affairs. Keeping muscles clean, well-circulated and flexible would make a magnanimous difference in the amount of money saved vs. the cost of providing for the injury, disability, worker replacement costs, etc.

In a recent Newsweek article, new general manager Theo Epstein of the Boston Red Sox states, "If we can make our pitchers 25% healthier, that's worth tens of millions of dollars and is a huge competitive advantage". These are words of a visionary, and this muscle management program provides the very difference that Epstein is talking about. How do you make a muscle work longer with less likelihood of injury? It's simple, keep it clean on a daily basis and encourage a continual flow of food and oxygen to keep it at it's healthiest state.

What industries will benefit the most from this program? Sports and industry. Immediately, they will recognize improvements. But, it's up to the chiropractic profession to grasp onto a program such as this, and then begin the laborious process of educating our communities to a new and better way. With a growth of chiropractors subscribing to this approach, momentum will eventually turn in our favor. For, it's been far too long since a revolutionary approach has been handed to our communities, and chiropractic has the opportunity to become this messenger.

The Sacral Base Angle (SBA) Verifying Data To Prove Chiropractic

© 2003 by Dr. Tim Maggs

Chiropractic has built a reputation on the chiropractor's ability to both locate and eliminate spinal subluxations. While this claim makes our profession unique, we also must respect the fact that there are many different methods used to both locate and correct these spinal distortions.

Just as chiropractic throughout the years has fought for the privilege to be different from the mainstream, it seems necessary at this time of diversity in our profession to allow all clinically acceptable methods and let each and every chiropractor choose the method most suited for them.

The downside in this effort, however, is with the educational and marketing of our profession to the mis-informed public. We live in a society that is subtly educated through many marketing and advertising means, societal pressures and quick and easy, palliative methods. For chiropractic to ever become a force in the healthcare community, it seems imperative for us to find common ground with sound clinical evidence-based protocols that all chiropractors use to educate their patients and their communities. When this can be achieved, a powerful momentum will help to elevate our message in a very positive way.

Currently, our profession has practitioner's who use muscle testing to locate subluxations. Others use x-rays, while still others use palpation. Some prefer leg-length checks while others base their decision on location of pain. There are still more means used today, but the point is that we have no uniformity. We'd impress ourselves if we could ever get 10 random chiropractors to agree on what constitutes a subluxation on an x-ray. And, until we find this uniformity, we will continue to be our worst enemies in helping our profession to grow.

The Sacral Base Angle

Standing x-rays provide a wealth of information for both diagnostic and educational purposes. One of the more important measurements a chiropractor can use in their practice is the sacral base angle. This is the angle formed with a line drawn along the top of the sacrum and intersecting with another line parallel to the ground (Fig. 1). A normal sacral base angle is 36°-42°. Of course, this should only be measured when the subject is x-rayed in the standing position with shoes off.

The importance of the sacral base angle is huge when considering your patient from an engineering, or architectural perspective. When the angle is increased or decreased from normal, there will be a significantly reduced capacity of the low back over the life of that patient. Secondly, imbalances and abnormal weight distribution have been shown to accelerate degenerative changes in the over-burdened joints. The sacral base angle is also important when determining the extent of work needed on a patient. Regardless of the location of the spinal condition a patient is suffering with, the sacral base angle will play an important role in insuring maximum recovery for the patient. If this angle doesn't become part of the initial examination, it's impossible to know what the accurate prognosis and recommendations should be. Thirdly, it's critically important to collect data for the verification of the benefits of chiropractic care, and this measurement provides a solid reference point to measure benefits of treatment. If an abnormal sacral base angle can be found on the initial exam and the patient is put through a corrective treatment/conditioning program and improvements can be seen on re-x-rays, that becomes powerful evidence-based protocols that will get the attention of the medical community. And if this protocol can be duplicated and shown to be directly associated with pain relief and improved capacity, then chiropractic will have a much stronger stance in the medical community, as well as with the eyes of the general public.

What Influences the Sacral Base Angle

First of all, there are many, many factors that influence the exact angle of a person's sacral base. What we now know is that the efficiency of the low back architecture in a person is much greater from an engineering point of view when the sacral base falls between 36°-42°. If the angle is outside this range, the efficiency of the supportive joints and tissues goes down proportionately, and increases the vulnerability of the individual with regard to injury and degenerative potentials in their life.

The most influencing factors affecting the sacral base angle are heredity, prior injuries, poor conditioning, foot imbalances, leg length differences, weight problems, bad habits, poor posture, job, mattress, shoe style and quality, diet and frequency of getting adjusted. There certainly are many other influencing factors, but from a practical point of view, we must efficiently work with those we know and can improve upon.

One of the greatest influences of the sacral base angle is the biomechanics of the feet. If there is bilateral pronation, bilateral supination or imbalances in the arches of the feet, then correction of an abnormal sacral base angle becomes more difficult. A thorough foot evaluation (Fig. 2) will highlight any of the possible contributing factors from the feet. If an abnormal sacral base angle is present, any abnormal findings found on the foot exam would indicate the need for custom-fitted orthotics. These will allow the foundation of the body, the feet, to provide a balanced support for the re-education and improvement of the supportive structures that will encourage improvement in the sacral base angle.

Further evaluation would consist of a visual exam in the standing position, active range of motion of the lumbo-sacral spine, muscle testing for strength and flexibility, Lasegue's, Bilateral Leg Lowering, Patrick-Fabere, Gaenslen's and leg length measurement. Of all tests performed, the most valuable is the standing x-ray. The lateral view will provide the exact measurement we're looking for. This measurement becomes impossible to determine when there is a sacralization or lumbarization present.

Abnormal Sacral Base Angle

When an abnormal sacral base angle is found on x-ray, it usually accompanies some low back symptoms. The correction of this condition, not just the elimination of symptoms, becomes the objective. As seen in (Fig. 3), there is a 56° angle. This young athlete went through a 6 month corrective program, consisting of 40 chiropractic adjustments, a detailed strength and flexibility program, a muscle management program allowing him to increase blood flow to involved muscles with the Intracell Stick® (Fig. 4) and was fitted for custom-fitted orthotics, which he wore full time. The result is a significant improvement in his follow-up x-ray 6 months after beginning the program. The sacral base angle was reduced to 43° (Fig. 5) and the patient improved greatly from a symptomatic and functional point of view.

Medical Research

The importance and value of the SBA might be seen in a medical study1 performed on 40 members of a cycling club who had experienced low back pain. Serial fluoroscopic studies were performed on the lumbo-sacral region of 30 club cyclists who did not have back pain to assess baseline parameters while they cycled on different types of bicycles.

Forty members (both male and female with no ages given) with intermediate intensity low-back pain were divided into 2 groups (20 members each) and cycled with seats that had an anterior angle of inclination of between 10°-15°. (An angle of greater than 15° caused discomfort and slipping from the seat). The cyclists were seen again after 6 months of cycling and questioned about back pain.

72% reported improvement in the incidence and magnitude of pain, and 20% reported major improvement. No statistically significant correlation was found in the type of bicycle, gender, age, distance cycled per week or the angle of the inclination. The authors of this study claim that anterior angling of the saddle represents one step that the general public can take to reduce the incidence and severity of low-back pain.

Comment on the study from medical authority

"The authors devote relatively little explanation to why depressing (or, for that matter, elevating) the seat angle takes pressure off the sacral promontory, and why decreased pressure should benefit nonspecific low-back pain. Thus assessing the plausibility and validity of the results is difficult. Given the study's lack of blinding or a control, the results should be viewed as preliminary; however, they do provide some concrete advice for physicians to prescribe for recreational cyclists with back pain: Depress the front edge of the seat 10°-15° from the level position. Explaining to the patient why this works is another matter. In addition, the authors note the inevitable trade-off between comfort and performance: Although an anterior tilt may not be optimal for performance, it may offer relief for cyclists with back pain. This study provides an intriguing clinical observation with a potential biomechanical explanation and is worthy of further study and preliminary clinical use."

Thomas Schwenk, M.D.
Ann Arbor, Michigan


It's important to recognize that no other healthcare profession uses biomechanical information, such as the SBA, to assess patient status or to use the information in constructing a corrective program. Chiropractors would do well to standardize the use of this finding on all exams, as this finding provides valuable architectural information when talking about protecting a structure over the life of any patient. It also becomes a starting point that can be measured against in the future.

The above medical study is almost in conflict with the body of knowledge that medicine lives by, as they primarily look for pathology and treat pharmaceutically or surgically. Nowhere in their procedures do they look for structural imbalances or do they allow for structural rehabilitation, while that is exactly what chiropractic professes. With these types of findings, chiropractors can begin the process of standardizing the tests that we use and the findings we get in an effort to educate and help many more people. This is just the beginning.

1Salia M., Brosh T, Blankstein A, et al; Effect of changing the saddle angle on the incidence of low back pain in recreational bicyclists. Br J Sports Med 1999; 33(5): 398-400

We’re Going Back to Boston…..Again!

By Dr. Tim Maggs

In April, 1982, I sat in an Orlando restaurant, hoping my Boston Celtics would survive a playoff game against the Philadelphia 76’ers. The game wasn’t on television back then, so the best you could do was sit and hope. At about 10:30 pm, over the loud speakers, I heard, “For all you Philly fans, pack your bags, we’re going back to Boston”. As a lifetime Celtic fan, these words and those thrilling moments have never left me.

Fast forward 20 years (April, 2002), and here I am preparing to run my 3rd marathon since coming back from my 14 year, injury-laden hiatus. The Vermont City Marathon, held in late May, would allow me to continue my new quest of 2 marathons per year. It was a perfect day for a marathon. I finished in a comfortable 3:30:10. My objective, the same as my 2 marathons of 2001, was to finish and enjoy myself along the way. And, that I did.

But, along the way, a funny thing happened. The Boston Athletic Association changed their qualifying times for the Boston Marathon, and for my age group, the time was now 3:30. Oooh, so close I thought. I wondered if a few Our Father’s and a couple Hail Mary’s might encourage someone to forgive me 10 seconds, as the thought of running Boston again was a goal way beyond what I ever imagined. Knowing I may never get back to this point again, I had to do everything in my power to figure out how to get qualified. So, I called over to the BAA, and to my surprise, 3:30 means anything under 3:30:59. I couldn’t believe it. I qualified!

The Sky’s The Limit

Much to my amazement, I’m now qualified for the 2003 Boston Marathon. What a gift, since for so many years I couldn’t fathom running more than 5 miles at any one time. If all goes as planned, I hope to find myself at the finish line of the Boston Marathon at about 3:15pm on April 21, 2003. I’ve actually set my goal at sub-3:10. So, I’m really putting myself out there with this one.

What I learned through this entire process is that anything is possible. Anything at all. Many people never get to realize their potentials in life because either they never knew or somewhere along the way they forgot that life holds limitless opportunities for all of us. Every action starts with a thought, and every success requires action. All of us need to continually be reminded that we need to dream. We need to take the lid off our stagnant, robotic thinking, infuse some passion into our blood stream and write down a goal that is above our normal thinking and beyond our wildest dreams. Running the Boston Marathon again for me always seemed like a fools wish, but subscribing to the theory that anything is possible now has me on the brink of attempting it again.

For 2003, I’m now encouraging, even challenging, everyone I meet to dream bigger next year. Pick and write down a goal that is outside of your normal comfort zone. Pick something that you would never have considered, if not for reading this article. You’ve now been shaken into dreaming again. Once you decide, make it real and commit to it by writing it down and telling someone you trust what you intend to do. If you’d like me to put it on my master list, just e mail it to me. Once you’ve committed, now list the action steps needed to reach your goal. And, read it everyday and DO those things needed to get you there. If coaching or guidance is needed to help you reach it, then find someone who has the knowledge and get them to help you.

The goal here is to get and keep all of us pushing our envelopes in life so that comfort never becomes part of our vocabulary. Comfort equals weakness, and when I’m sitting in my rocking chair talking with my great-grandkids someday, I want to have enough stories to tell. The only way that can happen is to continue striving big, and to live in a world of discomfort, for that’s the only way to get there.

God Help the Masses

Statistics show that 70% of the population doesn’t exercise. Sit in a bus station or an airport someday, and look at the prevalence of obesity. At 160 pounds, I wake up some days feeling like a slug. What does a 5’8”, 270 pound person feel like? Are they reaching their optimum goals? Probably not. And, feeling good about yourself is the very beginning of helping others, and helping others is what this life is all about.

So, regardless of where you're starting from, subscribe to this program to reach your unreachable goal in 2003. Join our "Going Back To Boston" team, and all of us can celebrate next December 31st, on me, for making our life, as well as so many others, that much better. Let me know your goal and I'll let you know our site for celebration.