Tuesday, February 26, 2008

Life's Lessons

Dr. Robert Jarvik, inventor of the artificial heart, has been removed as pitchman for Lipitor, the best selling medication on the market. According to the report, Pfizer, the manufacturer of Lipitor, felt pressured to make this move as Dr. Jarvik's credentials have recently come under fire.

House Democrats said the ads could be misleading to consumers because Jarvik appeared to be giving medical advice, even though he is not licensed to practice medicine. While Jarvik holds a medical degree, he did not complete the certification requirements to practice medicine.
Democratic Reps. John Dingell and Bart Stupak said Monday the company made the right decision. "When consumers see and hear a doctor endorsing a medication, they expect the doctor is a credible individual with requisite knowledge of the drug," Stupak said.

Too frequently I read articles and get word back from patients how their therapist or health care provider warned them against some of the pro-active efforts we endorse, like flexible custom orthotics, proteolytic enzymes, chiropractic adjustments, cold laser therapy, etc.

I would like to ask Bart Stupak to tell the public that when a Dr., or any other healthcare authority voices an opinion on a possible course of action a patient is going to take, keep in mind this Dr. may not be intimately knowledgable about what they are saying. In fact, more often than not, they have little to no first hand experience regarding what they are saying.

And, as Norman Cousins said in his book, Anatomy of an Illness as Perceived by the Patient, "Be careful who you let make a proclamation of doom on you, as that may be the beginning of the end."

May all experts remain experts only in what they are experts at.

Saturday, February 23, 2008

Shortcomings of Traditional Sportsmedicine

There are 4 basic flaws with today's sportsmedicine industry.
  1. We wait until an athlete is injured before we do anything.
  2. We only look at the site of injury.
  3. Our treatment goals are "to eliminate symptoms".
  4. We allow insurance guidelines to dictate what care is provided.
As athletes, we have much greater, more demanding and continual needs that should never be based only on symptoms nor governed by the insurance industry. Structural Management® guidelines are much more suited to the needs of athletes;
  1. Examine biomechanics prior to season and make corrective recommendations.
  2. Begin taking corrective measures immediately.
  3. Never let symptoms be the call to action. The ultimate goal is maximum biomechanical improvements, and once that has been achieved, structural management and maintenance becomes a lifetime mission.
Today's message. Sleep well.

Friday, February 15, 2008

High School Athletes and Scoliosis

This past week, a female high school runner who is a patient of ours came into our office rather upset. She needed to talk. Evidently, the school nurse suggested the possibility of scoliosis, and the very thought of some deformity in her back was overwhelming to her.

Six months ago, when her mother brought her in to go through our Structural Fingerprint Exam® to uncover any structural imbalances or weaknesses, we looked at her in extreme detail to see how she faired. Look at the homepage under "Structural Fingerprint Exam®", and you'll see all the tests we put her through. This was one of those great cases where the mother "gets it", and wanted to have her daughter begin her running career safely, to see if there were any "structural issues" we should know about before she began.

For the past 6 months, we've been treating her accordingly, along with monitoring some of the other recommendations we made for her, and she has succeeded beautifully. She went to Disney in January and ran her first big race, and has continued running since. The joy her mom feels, being a marathoner herself, is, as they say, "priceless".

But, all of these successes became irrelevant, meaningless, as the school nurse examined her and said she might have scoliosis. Tears streamed down her face, and quickly, someone had to try and make sense of it all to her. "The school nurse is using very few tools to examine you, and can only screen you. When seeing so many kids, I'm sure one athlete just blends into the next, and any suggestion is only precautionary".

Within 5 minutes, we had her smiling again, because we pulled out her x-rays, and her spine was as straight as an arrow. "There is no scoliosis", I told her. I also told her I'd be happy to call the nurse and speak with her, which I did.

So, after all that, what is the moral of the story? First of all, from a structural point of view, our healthcare industry grades people as either having scoliosis or not having scoliosis. Black or white. Yet structural biomechanics is hardly black and white. There are unlimited shades of gray, but our medical model healthcare providers are thoroughly unfamiliar with the grays.

They are familiar with hearts and lungs and pancreas', but the percentage of high school kids with issues in these organs pales in comparison to the percentage of kids who have biomechanical issues at this age. The thought that so many kids have braces on their teeth, but their musculo-skeletal system is perfectly balanced is insane.

The second moral of the story is that all high school athletes are examined medically (eyes, ears, nose and throat) while their biomechanics are grossly ignored. This has to change. We know too much now to let these young kids fly without a net in life, when they could easily go through a full exam and begin to make corrections before breakdowns occur.

Like our young runner friend, who clearly can't appreciate how good she really has it. She's paying now so she can pay considerably less later. And, someday, hopefully, she'll appropriately thank her mother.

Tuesday, February 12, 2008

This week's "new pill"

We recently had an article in our local newspaper about a chiropractor using manipulation under anesthesia. He works hand in hand with a radiologist and anesthesiologist in a local hospital, and this was a grand story of patients being "put under" before being aggressively adjusted. All to relieve pain.

As I read the article, I could just feel the enthusiasm in the writer's tone, looking at this as yet another breakthrough in modern medicine. And, the thought that these medical professionals would allow a chiropractor into their sanctuary and work side-by-side with them, almost more than one could bear. Wow, chiropractic must really be excited with such acceptance.

What the story fails to recognize is the lack of foresight and efficiency in our neuro-musculo-skeletal care that is provided to members of our communities. Once again, why does someone get to the point of such chronic, severe pain? The answer is simple; we encourage nothing and provide nothing in the area of management and maintenance of people's structures. Anything proactive, like chiropractic adjustments, massage therapy, physical therapy, custom orthotics, weight management, etc., is only recommended after the fact, never before.

There is a general assumption that everyone is "okay". Their structures are"okay". Ask any M.D. who has x-rays taken on patients backs, and they'll tell you most of them are "negative", meaning, the patient is "okay". But, looking closer, you'll learn the x-ray is negative for pathology, or disease, not biomechanics. Because the truth is, everyone is not okay. In fact, no one is okay. Everyone has biomechanical imbalances and issues. and these issues are the very precursors to structural breakdowns that lead to pain and disability.

So what's the moral of the story? Well, let's first congratulate the chiropractor who is working hand in hand with the medical community. For me, I never want to work in a hospital, as the very thought of that makes me quiver. The moral of the story is that acute, crisis care will always get headlines, as there is no excitement or newsworthiness in maintenance or health. How exciting is someone who doesn't hurt and lives a normal life?

Absence the glory and spotlight, I'll continue my mission to spread the word on Structural Management®, because the more people stay proactive and follow what we're teaching, the less they'll need to hire the "A" team who'll inject, x-ray and manipulate them.

This week's pill.

Friday, February 8, 2008

Void in the system

I had a young high school athlete come into our office yesterday, his mother being an RN, and he was referred by another family we've worked with for years. He had a severe strain/sprain injury of his shoulder, and had been to his pediatrician just the day before. His season is down to 3 games, and he needs to get back asap.

No real tests had been done by the pediatrician, and the recommendations were "rest and ice". Not horrible recommendations, but not "cutting edge"either. After all, no x-rays or other biomechanical tests were performed. So the mom asked me, "What are you going to do?". I told her we'll start by taking some x-rays of his mid-back and neck, to see if there are any underlying causes.

She then wanted to tell me that the pediatricians wouldn't give her a referral to our office and said absolutely don't let her son be adjusted by a chiropractor.

The pediatricians have minimal knowledge of musculo-skeletal injuries, what influencing factors contribute to them, and what corrective therapies, treatments and recommendations are needed to accelerate this athlete back to "game ready" (proven by their exam and recommendations). Yet, they actually believe they're doing right for the patient to make proclamations as they do. And, so many patients accept this.

I'm now working with the Director of all Wellness Programs for the state of New York's state employees. She is an employee of the Department of Health. The DOH has no category for musculo-skeletal. It's not even considered on their list of diseases, conditions, etc. This possilby provides us with the reasons why traditional healthcare only recommends ice and rest. Surely, it doesn't take 12 years of higher education to learn that recommendation. This category has been neglected by main stream medicine, and we're now bringing it to the forefront.

The director and I are now in the process of developing a pilot program, using state employees and Structural Management®, to address this crisis that both industry and sports suffers with (the breakdown of the musculo-skeletal system with no intervening testing or care until after-the-fact). The interest level and acceptance level by all employees, so far, has been extraordinary. Everyone is excited with the possibilities. This void can be filled.

And, if it is filled with a program like Structural Management®, a newsletter will have to be sent out, Express Mail, to all parents of young kids who believe every word their pediatrician says, even if it has to do with conditions they know little about. Parents will need to know there are answers. Better than "ice and rest", which is actually no answer at all.

In 1975, Dr. George Sheehan, the deceased running cardiologist who was a guru in his time, said so eloquently in his Book on Running;

“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."

The mission continues.

Sunday, February 3, 2008

Broken System

Industry is a perfect controlled study that demonstrates the lunacy in our healthcare system today. Management wants to put the burden of health insurance on the workforce, while the workforce will scream eternally to keep costs on the backs of management. A modern day Hatfields and McCoys.

I've watched over the years, and have never understood why neither side will ever question the healthcare system by asking "Why do you cost so much?". It seems like an appropriate question. "Why have costs escalated so high? When might it stop? And, simply, how can they be lowered?"

This week in Sports Illustrated, this very topic jumps off the pages in Gary Smith's article Bitter Battle For The Old Guard, about Gene Upshaw, the 25 year Executive Director of the Player's Association. The flavor of this article is how retired NFL players are ignored, broken down and no one (The NFL Player's Association) cares.

The article reads, "Creeping along the sideline on a walker, bent at a 45-degree angle, was the alltime great Oilers running back Earl Campbell. Confused by foggy memory, neck locking up from damaged vertebrae, advancing on an artificial left hip was Hall of Fame Dallas Cowboys safety Mel Renfro........How had it come to this?........For three decades, from Pop Warner to retirement, they'd been groomed to spit at the pain, which was ever-increasing as the colliding bodies grew larger and faster, and they'd soldiered on in silence for years after they'd faded away. But then came the day when the consequence of all those head-ons, all that pounding on all that green pavement called astro-turf, demanded its reckoning. The mornings when they awoke and realized they could barely get up......or didn't even want to. The multiple knee and hip replacements, each one carving a year of recovery time out of their lives; the depression, vertigo, Alzheimer's and thoughts of suicide, which some doctors linked to the multiple concussions they'd suffered; the spiraling medical costs and the realization that neither their pension nor their disability plan--if they even qualified for it--could possibly keep pace, had combined to overwhelm them."

Wow. The end result of a broken system. This article wants to highlight the lack of concern the Player's Association has for it's retirees, while I only care to discuss a spoke out of that wheel, the physical condition of retired football players. Their futures have a backdrop of physical disability, pain and limitations, not the type of retirement anyone would aspire to have. The costs are overwhelming; emotional, physical, financial, relationships, employment, etc.

What is the solution? When does it begin? Success in any endeavor requires management. All athletes today, by default, learn the rules in taking care of themselves. Stretch, warm-up, lift weights and hope you don't break down. If you get hurt, well, we're not sure. Do you have a primary? Will they see you today? Or will it be the P.A.? Will they give you meds, a script for phyiscal therapy, a stint of chiropractic? No one really knows. There is no plan other than, we hope you don't get hurt. Maybe just take time off until the pain goes away.

The reason for such inefficiency and ignorance is that our injuries (Earl Campbell bent at a 45-degree angle, Mel Renfro's neck locking up from damaged vertebrae) are biomechanical injuries, yet we MUST deal with medical model healthcare providers. They don't do biomechanics. They don't know biomechanics. Even professional sports teams. And if the pros don't get it, what is the shot that our high school athletes or everyday athletes are going to get it.

Success at maintaining a healthy physical structure also requires management. It starts with a biomechanical exam and detection of the imbalances and faults. Correct those, now maintain these corrections throughout your lifetime. It's not about shots of cortisone, a short stint of physical therapy, surgeries after the injuries occur, early retirement due to broken down parts or retirements that leave you totally disabled.

The current system is broken, and the public must demand change! The answers are available, but don't call your primary and expect them to know. They, too, are victims of the problem. And certainly not the solution. We need biomechanics in our sports world to hope to help the middle and high school athletes of today not end up as a feature story in Sports Illustrated 40 years from now.

The famed comedian Lenny Bruce screamed at the judge as he was being dragged out of the courtroom, "Your honor, somebody needs to tell you when you're screwing up".