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| Transcript Cape Town, South Africa January 2007 Workshop |
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Workshop: Abnormal Biomechanics and the Aging Process, Diagnosis, Treatment and Prevention
First African International Anti-Aging and Aesthetic Congress and Exhibition
January 27-28, 2007
Cape Town, South Africa
Workshop by Dr. James Stoxen DC
Team Doctors
Treatment and Training Center of Champions
6432 S Pulaski, Chicago Il 60629
To contact Dr James Stoxen DC
teamdoctors@aol.com
(773) 735-5200
It’s interesting because as a chiropractor I’m the only being invited to these international conferences. Part of the reason is because we’re not going to really talk about chiropractic today.
What I’m going to talk about is basically aging. I’m going to give you many tips today that you can use on Monday yourselves as well as on your patients. I’m going to give you a little bit of background about myself, but I don’t want to get into too many details. In Chicago, I work in the sports and the entertainment industry.
In 1991, I was the first chiropractor to put a medical doctor, chiropractors and athletic trainers together in one center as a one stop shop sort of a multi-discipline practice. I had a full training center installed in my office in 1991. The reason I did it was because I got frustrated because I was telling the patients that they needed to do certain exercises that I knew about. Because at that time I was on the editorial advisory Board for Muscle and Fitness Magazine and had several 200 or 300 national World Champions that I consulted with already by that time. But to tell someone you need to do this, and then they go to the health club or they're afraid because their back hurts and they just got out of pain and they're afraid to really get in there to transitioning into getting into a training program. So I thought what the heck, I’ll buy out the front office, and I’ll gut my whole place and put in a training center and I’ll do it myself.
So that’s what I did. It was kind of interesting. You know how medicine is scientific; however, it also has economic issues like insurance companies and so forth. Also, I found very unusual codes on my billings codes for kinetic activities and therapeutic exercises. However, you know what was so funny was that the patients were so excited. At that time we were seeing around 5,000 new patients per year, or approximately 5,000 times 20; 100,000 office visits per year in a small clinic, or some crazy amount like that. I had 9 chiropractors working for me and 2 medical physicians, 2 athletic trainers and we had 65 full time staff members. So it was quite a busy place. What I liked about it was that the people really enjoyed coming. The doctors’ office is where all the good information about health, vitamins and staying healthy. When they leave, you get the commercials for the Burger Kings and the McDonalds that are the devil and the angel that is the good and the bad. So I figured the more time they spent in my office, the healthier they would be. And they liked it too. Because when you walk in our office, we don’t have a small little window where you peer through and you have to sit for a while. You walk right in and we start training you right away. You start feeling the benefits of the exercise with people that you trust.
People worry about whether people are going to get hurt in your facility. And since 1991, where’s the wood, I have not had a person even stub their toe in my training center. What you're going to get into is very interesting is that I train my patients without their shoes on. And there’s a reason for that which we’re going to get into that in a minute. I’m going to talk about barefoot training which is something you're going to want to get into. And that’s how we’re going to reduce aging. The practice grew quite a bit and then I decided you know I want to get to my roots and start to publish. So I opened up Team Doctors which is more of a deep style clinic and I’m overseeing everything.
All of a sudden this treatment technique where what I do basically is regardless of where your pains are, I go right down to the bottom – to the foundation and I look to the way that your foot plants on the ground and how it articulates through the gait cycle – to the walking cycle and how the body moves through the study of the walking and the movement patterns of the body to determine how I’m going to correct the frame.
See what we found is that, like I said this morning, I found that through evaluation of athletes, my meticulous detail to making the body as close to perfect as possible. So therefore my athletes will win gold medals, or will win world records; that’s the level we’re working with. I went through their body like fine tooth combs. Through every single little muscle between their toes with my hands, feeing around for tender spots in areas that were sore or stiff or hurting the patient beyond the symptoms – the symptoms were usually the last thing to show up. So we were finding areas that were signs of strain before the pain even showed up in those areas.
So if you want to talk about prevention and the early detection and prevention of age related diseases, this is by far the earliest detection, the most detailed and the most comprehensive approach that you could possibly have through reducing the stress and strain on the frame. The wear and tear on the frame. This is the most detailed approach. This is the most anti-aging minded concept that you can employ, I think. At least nobody I know is doing it with as much detail.
So as things went on, things became kind of exciting. Athletes switched over. You know how athletes, movie stars and recording stars are. Some athletes and movie stars come around. So all of a sudden we started seeing more Broadway performers. So I hired an agent in New York City. Her name is Heidi. She negotiates all my contracts with all these top recording artists. If you really want to stand out in your community, and you want to attract the more interesting clients that will be willing to spend the time and effort and funds to take on an anti-aging approach, well then you need to seek them out. You must have a treatment that is different and way above the standard of care. The standard of care is what everybody practices. That’s not where people of this caliber want to go. They want to go somewhere special. They want to go somewhere they are treated as close to perfect as possible. This is what’s demanded in an anti-aging type of center.
I’m just going to whip through some of the groups that we’ve been hired by to work by. Don’t know if you know Dirks Bentley, the Mariah Carey Tour, Sean Paul Tour, Paul Simon Tour, Iron Maiden tour, the Justin Timberlake tour, Back Street Boys tour, Aerosmith tour, Motley Tour, Kanye West Tour, John Fogerty, Willie Nelson Tour, Back Street Boys Tour again, Michael Bolton, Luis Miguel Tour, Cold Play. As you can see, American Idols, KEM, Kanye West, Aerosmith again, Mobey, and Alicia Keys, the Wiggles, Ozzie Osburn, Marilyn Manson. The list goes on and on.
So once you’ve figured out something that’s special, that exceeds the standard of care, then you have something really marketable to the people. Anti-aging medicine is something hat exceeds the standard of care. So therefore, when you’ve been given as a doctor, you have some limits on the policy benefits; your treatment exceeds the benefits of the insurance policy or may not be covered under insurance policies.
Current lab testing for inflammation: some of it is not covered by insurance. But everyone knows that the risk factors for disease processes are directly related and more strongly related to the levels of the C-reactive proteins and the cytokines. We all know that because we hear it over and over again. There are 87,000 articles on inflammation and the billion dollar pathway that these drug companies are looking for the magic bullet to shoot down that inflammation, the next big drug that’s going to kill the pain. That’s going to reduce that inflammation and as you know, I don’t know if you know this, each drug has receptor drugs to one kind of leukotrienes, then the problem is that if that’s the only one it attaches to, that that’s the only problem you’re going to get.
The other factor is even if you take medication, if you understand how biomechanics work, that medication by itself does not correct the stress and strain on the body that makes you tired that creates the inflammation that is going to make you fatigued as well as have the accelerated disease of aging. The stress and strain also takes its toll on your hip joints, your knee joints and more and more people. Over 400,000 in the United States, and I know for a fact have had hip and knee replacements. I don’t know if you know of anybody in India, but it’s almost unheard of there. Why? - Because of the fact that we’re going to talk about that in a minute.
Most of the people in India and other countries, don’t wear restricted footwear like we do in America. Some of these third world countries do not have as much arthritis as we do.
So let’s look at what a typical chiropractor looks at. I am not going to talk about chiropractic. You got that? We are going to talk about the science of biomechanics and how we can do certain things for ourselves and our patients – tips that will help them to feel better and also reduce the effects of aging.
As you can see, this is an MRI scan of a herniated disc. This is so funny. Patients come into my office and this is their package of MRI scans and they're holding on to them like their life depends upon them. I sit down and I say what are those? And they say these are MRI scans and I immediately throw them over here. I say “We’ll get to those later. Those are not important right now. What were going to talk about is why you're still in pain. Because you have an injury to your joints which should have healed by now and because herniated discs do heal without care. Did you know that? They seem to get better magically without treatment. And so why is your herniated disc not getting better as opposed to others that are getting better?”
Before herniated discs, my father who is 81 and who practiced as a chiropractor for 50 years, said, “Well, all these MRI scans scare the patients and they confuse them. Before we had MRI scans, we just treated them and they got better.” You know I have to agree with him. Sometimes the patient sees that they have an MRI scan with a herniated disc. How are we to know whether or not it happened when they pulled the groceries out of the back of the car or whether it happened when they were 14 playing football and it healed up already. That herniation does not mean that’s the herniation side. Sometimes it can throw a very respectable doctor off track. As a matter of fact, I've had at least 10 or 12 patients in the last year who have had validated through the medical radiologist spinal stenosis and miraculously they got better.
Here’s a perfect example. The patient goes to lift some groceries out of the back of the truck and then their back freezes up on them. They have screaming pain down their leg, they’re not getting better; they go to get the injections, they get the treatment, the physical therapy, nothing helps them. Then they walk into my office and they tell me that according to their doctor, the radiologist found that they had spinal stenosis which is a narrowing of the spinal canal which as you know, happens over years. It does not happen from lifting groceries out of the back of the car. So what happens is that the patient has been told by the doctor that they must have the surgery because the narrowing cannot be corrected with adjustments.
Certainly that’s true, but what I decided to do was: “I said, well your clinical history does not really match that of spinal stenosis which is a very slow and progressive narrowing. It came from your lifting the groceries out of the back of the truck.”
So it does not match. From what I can see, it appears to be a mirage or something to throw me off of my track which we we’re not going to let happen. I’m going to look at other factors like how do you walk and what’s happening to the floors beneath the spine.
You know so many people are focusing on this area and they stick their face right into it, and look at it and they're so focused that they miss the big picture. For instance, the big picture is if you hurt your back and we have to strengthen the back. That’s completely off. Then they say they have to strengthen the stomach muscles because that’s the core muscles. If you have a collapsed arch on your right side of your leg, on your foot, you can do all the stomach exercises you want, you are not going to relieve the stress and strain on a herniated disc if you have a collapsed arch on one side of your body. Its just not going to happen it’s foolishness to even think you're going to get anywhere with that. It’s just not going to happen. I don’t care how many sit-ups or crunches or upside down, or hanging from the ceiling or chandelier you do, you are not going to get better. And the people get frustrated and they say ‘Well I guess I need surgery I’ve tried everything.’ Well that’s not the case. There are 5 floors beneath the spine that must be leveled off and moving properly.
So many times you see doctors, chiropractors, physical therapists and so on and so forth. They stand you up and they look at you and they look at your pelvis and look to see if it’s leveled. They say, “Oh, well you're off by 1 millimeter on this side.” The typical thing. Then they don’t ever ask you to move – walk. Like walk through the space. Because when you're walking, that’s when we discover the walking pattern.
This is a typical example of a herniated disc that needed surgery. Now, I can see there’s still some disc left. See that? There’s a millimeter left. That’s good enough for me. I think I could heal that disc. That happened at surgery. Now have you ever seen back surgery performed? Have you ever done an x-ray postoperative of a back surgery? That’s what it looks like. There are a couple of screws put in at the top and at the bottom. They’re interconnected with hardware to stabilize the spine.
Now if you had a car accident, or broken bones, so on and so forth, by all means, seek out that doctor who is going to put in that hardware who is going to stabilize those bones before you become paralyzed. But for herniated discs or the discs that have had abnormal wear over the years, it’s certainly not necessary to put all that hardware in the spine and there are some ramifications. First of all, you're putting metal in the body and the second thing is that maybe we can cure it without having to go through the surgery.
Now, in this situation, what we're talking about is that if you could imagine that the spinal column sits on top of the pelvis. So the pelvis is kind of a stationary, kind of a one bone that does have sacroiliac joints, a little bit of movement there. But that’s not as significant as people think. It’s one bone that if we look at that body as an upside down puppet, if we have a puppet like this, and we move it this way, and the puppet releases its finger, or it lifts its toe and we flip it upside down. What were going to do is - if I have a wire on this right side and I pull down here, then I can tilt the pelvis down to the left. If I have a wire here, I can pull here and I can tilt the pelvis down to the right. I can manipulate these wires here, I can adjust the pelvis bone sort of like a puppet can be adjusted to be able to move and shake anyway I want it to.
So in that case, let’s look at the biomechanics of walking. In this particular situation, here’s a person walking with a normal strong sturdy kinematic chain that’s coming from the foot, the outer calf right here and the outer thigh and outer hip. Because this left side is stable, this would be called the Trendelenburg Test. That’s a test normally reserved for people who we think have been paralyzed. However, we do a modified Trendelenburg Test where we tell the patient, ”Okay stand up and lift your leg up, and move your body in the center of this mirror.” If we see them kind of leaning this way or that way, that means that they have a weakness in the planted side. This means that this leg right here, this hip muscle and all these muscles that go all the way down to my foot are what keeps my foot stable as I walk through the space. When I step on this foot, I'm using these muscles to stabilize my pelvis as I plant that foot.
So as we are checking the walking style, if we see a dip in the pelvis on the right, that means this entire left side is weak. So what came first, the chicken or the egg? So did the back go out of whack, or did the foot go out of alignment? And I’m here to tell you that it’s always the foot.
Here's a perfect example. Here’s a patient who is lifting something out of the back of the truck. He feels a searing pain on the left side of his lower back and he has the hip muscle spasm and burning pain in the hip on the left side. When I lay him on his back, the first place I go is to his foot. Both feet and where I’m going to check are the areas of the pattern that become disrupted with what we call “weak ankles, fallen arch, or abnormal movement mechanics in the foot.” What we’re finding is that right here in the arch area, this area is supposed to have a nice springiness to it. The muscles that come on the outside of the leg and the inside of the leg have a certain very important function. When the foot first plants – let’s say we’re dealing with a 75 kilogram person – let’s say 100 to make it easy on me – I’m not very good with Math. So when we have a 100 kilogram person and they step down, that’s 100 kilograms of pressure on the foot with just normal walking or standing. If we were to increase our speed from walking to running, as the speed increases, the amount of pressure that is applied to the foot increases up to 5 and 6 fold. Therefore, in a situation where a person that weights 100 kilograms, it would be close to 400, 500 or 600 kilograms at full speed sprinting. Do you understand? Because the full body weight comes down with acceleration of the speed of running. So how is it that our arch maintains the same integrity, the springiness and the shock absorption with walking as it does with these higher speeds with running? Because the tension levels are different. What happens is that when you were a child, your body goes through a mapping – or a programming of your brain. As you’re just moving your legs in the crib, or as you're crawling, you begin to stand and you start to walk, you develop these endograms, or these motor mapping in the brain that start to register all the movement patterns that you're developing as you're walking, as Mom holds you up and you walk about. You start to develop these endograms or walking patterns or stimuli that comes from the sensory from the mechanical receptors that are on the bottom of the foot. They register the amount of weight and pressure that your body is placing on your foot. What they do is make an alteration through the descending track to change the tension level of the muscles that support the arch of the foot. Do you see what I mean? That’s very important to know because we are going to find out how selection of footwear will vex that very important relationship between how much pressure – maybe this is 400 kg when we’re running at maybe ¾ speed. However, the body only registers at 300 kilograms. So in the process, our arch will collapse because the sensory component is not registering properly. Do you understand what I’m saying? It’s not registering the right sensory component.
Certain footwear that you wear every day could be destroying the mechanics of your body. Some of you ladies who like to wear high-heeled shoes, trying to tell you to not wear high-heeled shoes is like whistling in the wind. I gave up on that a long time ago. You try to talk to a lady, who is in a soap opera and does a cosmetic commercial for about a million dollars, and she’s on “Dancing with the Stars” and her legs have to look sexy, and they call me into the theatre to work with her – you might as well forget it. You know. “Do you wear sensible shoes?” You're barking up the wrong tree. “Do you want me to wear orthopedic shoes, Doc, are you kidding me.” I’m like “No.”
So what we have to do as doctors is to understand that you ladies don’t want to wear sensible shoes and not only that. So what I found is that sensible shoes are not always the answer. We have to find out what is. What we’re finding now is that if an engineer looked at the body and said, “Something is wrong with the fifth floor – which is the back - he’s not going to say, maybe there’s something wrong with the 6th floor that’s causing the 5th floor to go bad. That’s not his first choice. That’s ridiculous. If there’s something wrong with the 5th floor, then we need to look at the 4th, the 3rd, the 2nd and the 1st. That’s only logical. Right?
So when we’re looking at this area of the problem, what we’re finding is that the spine swivels with each walk. That’s what gives you that kind of wiggle in your buttocks when you move. Then you have this pressure from gravity pulling you downward and that’s some of the forces of gravity that were working with. Here we’re talking about just a simple video that I made. As you can see, on the right, do you see how the foot turns out and on the left, here it does not. Now I’m going to go back over that one more time. They say that bunions are hereditary. That’s ridiculous. That bunion, which is a lateral deviation of the big toe, is because you're walking right over the top of the big toe and it’s getting forced over to the side. That’s a mechanical dysfunction. And if you want to get rid of it, you start to get your feet straight. Bring your feet back on straight so that they're pointing in the right direction. You know it does not take a rocket scientist to see that if our feet are pointed straight, that it’s difficult for that toe to be laterally deviated. You know, if one part is going this way and one part is going that way, something in the middle is going to go wrong. That would be your hip socket degenerating to the point where you need replacement surgery. So if you throw an extra 30 pounds on your body, plus if you're over weight or if you're carrying extra weight and you have all this inflammation of your subtalar joint, your knee, your hip, your back, in between your shoulder blades and you have an ache and in the back of your skull called a headache, because the entire framework has been vexed from this abnormal movement pattern in the back. Substantial amounts of inflammation will be disseminated through your body. Do you know where it goes? It collects in your foot and ankle. And Guys, when you take off your shoes and then remove the sock and see that imprint of the sock on your skin that is digging into the skin, that’s the inflammation.
If people say well that’s swollen ankles and I’m going to give you a water pill for that. Well, why? Is it because I’m drinking too much water? That inflammation is collected from multiple joint areas that seep down to the area where gravity is. Patients who initially come into my office with all these aches and pains, fibromyalgia and they have chronic fatigue syndrome- I immediately take off their shoes and socks. Their feet are always swollen. The ladies call them “cankles”. Ankles and calves mixed together because they're so swollen, you can’t even see your ankles. That’s the inflammation. Your tissues are bathing in a toxic soup. Dr. Veren talked about it today. She said inflammation has a lot to do with aging and disease processes. She’s absolutely correct. Every other doctor will tell you the same thing.
When we’re breaking down this treatment process, we’re breaking it down in stages. We have goals for the patient to meet down the line. I see a lot of chiropractors and therapists and doctors that when they see the patient, they really have no direction. They don’t know where they're going with anything. Neither does the patient. They're completely lost. You have no action plan. In a business you have an action plan. You have a business plan that you stick to. If you're a teacher you have a lesson plan. Why is it that doctors don’t have an Action Plan? That’s insane. You have to have a plan, because if you don’t plan - what is the saying? “If you fail to plan – plan to fail.”
We get fired by our patients if we don’t have a plan. They will fire us and find somebody else. You’ve been fired. Just like Donald Trump will tell you. You’ve been fired. And you don’t get to hear “Doctor, you're fired.” They just go somewhere else. But you’ve been fired because you haven’t put together an action plan. This action plan consists of 3 steps. You are really feeling pain throughout your entire body. Your aches keep you up at night. You're having difficult sleeping and you have high levels of inflammation and you have chronic fatigue and you just don’t feel well.
First of all, we can’t start exercise, because if you exercise a joint or a set of joints that are not aligned in moving properly, then you're going to accelerate the damage. Its almost like this: the front end alignment of my car is out, so let’s drive to Johannesburg real fast and see what happens. That just does not make any sense. The first thing that we're going to do is take in our vehicle to have it realigned and then we’ll drive to Johannesburg with the good alignment. It’s just logical thinking. Some of this is just basic stuff.
So what we’re going to do is spend the first 2 or 3 weeks on your joints, we’re going to bring your musculoskeletal system and your movement pattern in your body as close to perfect as humanly possible. So what I’m going to do is rebuild your entire framework by hand with some therapy. Essentially I’m going to rebuild your entire framework by hand and when I get done with you, you're not going to have a spasm in your entire frame from your spine down to your foot.
When I take my thumbs and I find the patient that has the fallen arches. What you're going to find is that from the base of the heel all the way to the tip of the big toe, and the second toe and between those 2 toes, because the first and second toe hold all the weight, that is where the stress and stress is going to come on fallen arches or arches that have collapsed and locked.
The other 3 toes are there for guidance. In 20 years, I have found maybe 15 patients out of thousands who had some muscle spasms and soreness and tenderness in these little toes here. And that is statistically important.
So all the muscle problems – the tenderness is going to be on the medial side of the big toe right at this metatarsal phalangeal joint. Right at the surface there. Between these 2 toes and a little bit on the 2nd toe – inside of the second metatarsal. On the dorsal side of the foot and between the two toes. I’m mapping this thing very nicely for you because if you follow this instruction on how to reverse fallen arches, everything from heel spurs to bunions to chondromalacia patella or indiscriminate pain around the periarticular surface of the patella, TFL spasms, hip joint spasms, back problems, pain between the shoulder blades, headaches will go away and there will be more permanent this way. Because not only are you going to fix them with this treatment that’s going to reverse the effects of the aging, but you're also going to give them exercises that are more correct 99.9% of the population is doing training that will completely ruin their bodies. People will work out and within 2 to 3 months, they are going to have something break on them and I’ll tell you another thing. 23 million people in America run 3 days a week. 16 million of them pull up with an injury once a year. Is that insane? You're trying to get healthy and within a year you have like an 80% chance you're going to hurt yourself doing something that you're trying to do to get yourself healthy.
Running is the best cardiovascular form of exercise that I found because what it does is it not only gives you good heart pumping and circulation and improvement of your musculoskeletal system, but it also improves your bone density. Now people say running is bad for you because it will wear out your knees. That is completely false. If you drive your vehicle with good alignment, you will not wear out the moving parts. If your body is aligned and has good mechanics, you could run until you're 120 years old and not experience joint damage. Joint damage comes from misaligned joints period. That’s how it works.
I know because I have patients that have never had a pain here, but down to the lower neck, they're in a lot of pain for 20 years. I've taken x-rays and see 1, 2, 3 are perfect – not one bit of calcium deposit, nothing on that area, but 6 and7 are loaded with calcium deposit. Those joints are all 80 years old. Only the joints that have had abnormal movement patterns have the calcium deposits and the scar tissue. So after we have all the restriction removed, then we can begin exercise. But not the kind of exercise that you see in the Hollywood body building. You can throw all that out the window. That’s all got to go and if we don’t turn our patients back into healthy people by taking charge of their exercise programs, because we know more than the personal trainer. Because we are doctors, we’re going to see a lot more sick people coming in needing hip joint and knee joint replacements or wondering why they can’t run for 6 months without having injuries all the time.
The personal trainer with the knowledge of basics from classes that they take does not mean that they understand the mechanics of the joints of the foot. There are only 160 articles in the literature about pronation syndrome and not one of them deals with the real cause of the breakdown of the foot. The last zone right here is where we bring them back into sport competition. Or this is where they are exercising without us they’ve been released from our care. That means - Go do your thing- have fun. And those are areas where they say, Doctor, when can I run again? That’s the green zone. Now you can run again. So those are the areas. So shifting patients from a disease-based medicine to an anti-aging medication is a paradigm shift that you’re going to have to go over with the patient. It’s easy for them to understand to come in for pain, but what you're going to talk about is to maintain a good healthy structure so that they don’t have these levels of inflammation.
So in the first stage we're going to do is work on the mechanics. Does anyone have unilateral pain that is not traumatic? Anyone have knee pain that they can’t seem to get rid of – or back pain that they can’t get rid of. Which one? Don’t tell me – don’t tell me, come on up. Everybody give her a round of applause.
What’s your name? Tina again? That’s right, Tina. She runs a center in this small town. Yes, that’s right. Okay now the first thing that we always do is we say “Ma’am, you're going to have to take off your shoes. And they say “I hate my feet, I hate my feet.”. It's because their feet are deformed from wearing shoes that are not good. I’m going to teach you how I instantly learned that it was the right side where she has the chronic hip pain.
Look at her feet and tell me what you see. Do you see anything that looks interesting? She has beautiful feet. Nice polish. What do you find about her feet? Do you see anything that I talked about that might point you to the right side as opposed to the left? She has bunions that are equal on both sides. Do you want me to show you? Okay. This is the metatarsal cuneiform joint. This is the mid arch. This is where the breakdown occurs. So if you look at this side and that side, this one is bigger. That’s what tells you. There’s more degeneration on the right. That foot is more fixated. Do you see how much bigger it is on the right? The breakdown comes in the mid arch. The arch has to spring down and has to spring up for proper movement to occur. If it does not spring up and spring down, what happens is you have to work harder. The accessory muscles have to come into play to allow you to have the same walking style. Okay and also if this does not spring down and spring up, its locked, and then what happens is that you can’t put your foot forward. The second toe is what aligns with the target. The big foot is inside the target. So you're a little bit pigeon-toed when you walk. So if your kids are a walking pigeon-toed, that’s great, but if they walk like a duck, not great. Because once you walk and if you're pointing this way and you walk like a duck, you start to immediately deviate the big toe because you roll over the top of it.
Okay what we've established is that this is the metatarsal cuneiform joint right here. She has more calcification here so what you have to do is she can’t bend forward and take the shock spring down and spring up. So she has to roll around it like this because the foot does not move any more, it’s frozen, it’s stuck.
So what we have to do is see how you walk. Let’s have you walk this way a little bit. Just walk to the corner of the room there. See the right side how it’s pointed out? It’s very obvious. See how her foot is frozen from here to here. And it bends too much right in the ankle area. Go ahead and do that one more time. Watch the ankle. She kind of rolls over her foot. Instead of bending the foot like this, nicely. She kind of rolls over it like that. Does not move a lot. The other thing is there is not a good flexion of the toes. Did you notice how she had her toe kind of like this? Then let’s lift this up and do a little check on her feet. Oh, before we do this, let’s do the Trendelenburg test which is kind of fun because we find out a lot about who does a lot drinking and who doesn’t. Come over here and stand up. Just teasing you. You can joke with them because they don’t like their feet looked at. Okay, what we’re going to do is there would be a mirror in front of them. And she would use the crack in the mirror as the center point where she would need to keep her body. So what I tell her is that hopefully you have good balance because you have to demonstrate and you don’t want to balance yourself, and you better be in good shape. So they're both not too good. That’s okay. Now, let’s take a look at these shoes. First of all, oh, very sexy. They wobble a little bit. That’s not good. We put your shoe down. You want to look at the bottom of the shoe. Does it have a rounded surface, is it nice and sturdy. Is she going to fall on this shoe? Not good. I would tell you to take these back. Her sitting shoes – she wears them when she’s sitting. The other thing is that the toe actually plants down which is nice. The majority of the pressure is going to be on the ball of her foot.
Shoes were designed 300 years ago with this little and unfortunately what it does is it takes the straight shoe and it rolls it this way and you're already deviating. So these design flaws which are built in the shoe to make your foot look sexier.
I always tell the story about the fellow who picks up the girl on the date and then in about an hour she starts to get a little tired, her feet start to hurt a little. Then he says after dinner, do you want to go dancing? And she says, well I’m a little tired, my feet hurt and my back is a little stiff. And then he says okay, no problem, he’s polite and everything. Well I’m going to go home early because I’m tired and go to sleep and get up early as opposed to being real excited and wanting to dance all night. The next day his friend asks, “How was your date?” And he says “Well it was okay.” What do you mean okay? Well you know, she was tired and she had foot pain and she didn’t want to go dancing, but she had on some sexy shoes, so I think I’ll call her back.
It does not work like that. Men want to date a woman who has energy who has vitality who is not tired and not in pain and does not complain. They would rather have you wear something that you're comfortable in so you can enjoy yourself and go out dancing. So that might be a little bit of a way of me swaying you into something that's a little more sensible.
If you're going to buy a shoe – when you put on high-heeled shoes, first of all, your foot is already bent down, so you don’t articulate here anymore. You ladies kind of walk like this. The whole leg kind of swings forward like this instead of a push off. You don’t get the push off anymore. Certainly your legs are in a contracted state which makes your legs look sexier. However your muscles don’t contract. Unfortunately what does happen is if the calf muscles do not contract, you don’t get any venous return. If you understand. Venous return comes from the veins and the deep veins in the calves have valves. When the calf muscles contract, it squeezes the blood through the chamber up thorough the next chamber through a valve system then it clams down shut when gravity brings the blood back down. When the valve actually collapses, that’s when you have the varicosities in the deep veins and so on.
That’s not a good thing because it makes you a higher risk for stroke and also varicose veins don’t look pretty.
Me on my left side I have varicosities right here that I can see on my right side. It’s fleeing. That’s because I've always had some trouble with my left side. If there was anything going on, it was always on my left. I’m just a little more curious about my body. What I've discovered is that I think it’s related. I think that you can almost bank on the fact that if you don’t have good calf contraction, you're going to have difficulty with overall circulation.
There was a very famous writer who flew me to California to look at his girlfriend’s mother and I can’t tell you who it is because it’s not a good thing. What happened is she was having difficulty breathing after 15 steps and she had open heart surgery and clots from her pulmonary artery. She had some strokes in her lungs and she had clots releasing from her calves. She was taking nitroglycerine about 5 times since she had a heart attack or some symptoms of heart attack. I looked at her, and her legs were discolored. She was only 51 and her legs were full of edema. Very bad bunions. Much worse than Tina's walking; it was more of a hobbling. I told him I’ll go ahead and work on the right leg for a couple of hours. (And he went and took a shower). I worked on her right leg and hit it with a very strong vibrational machine. I only did it on the outside, because I know that if I’m not careful with that type of patient, we could have a clot release. We have to be cautious with this type of treatment. Because if there is any chance of clotting and we disrupt that, we are going to cause problems. It’s never happened to me – thank God. But this releases circulation; it improves circulation in the deep veins which is great for overall heart function. If the ventricle fills up easier without a lot of effort, then the heart does not have to pump so hard. Do you see what I mean? They’ll have better stamina and they’ll feel better. This is what happened. I spent about 30 hours with her relieving the muscles spasms between her toes. (Go ahead and take a rest here. Lie down and relax.)
It took me about 14 days in total, 3 hours a day and because she was so bad. But what I did was (I’m glad you have this long dress on) we’ll start right here, and what we’re going to do is apply a little pressure right here and it’s going to be a little tender right there. Right? It’s tender right there. A lot worse. But look here; when I press down here did you see how that big toe straightened out? Take a look at that. Isn’t that amazing? Why did that happen? It’s because I engaged the muscle; it's called the abductor hallucis brevis. When I engage the muscle, watch what happens. Oh, look there it goes – right back to normal again. You see you're supposed to have this space between these 2 bones and if you look like what they call the Rick Shaw riders in China, I was just in China in November you see their feet and they have perfect separation between their toes. They don’t have this lateral deviation of the big toe because they walk barefoot.
So when I press here, you see how it starts to move back into position because this muscle is not functioning anymore. It’s weak. What I’m going to do first of all - if you look at a grid, this is stronger and this is weaker. As the muscle goes into atomic protective spasm, when it’s going into a spastic state on account of my stiff muscles, everything aches, those are spasms. Those spasms are set up by the brain. You see, you have a walking style which is mapped in your brain that the body is used to. And if you have a walking style that is outside of that pattern that is established in the brain as a mapping pattern and it’s causing damage to the structure, then the brain does not know what to do. All it knows to do is to bring spasms to the region to protect it. So unfortunately, those spasms don’t turn off unless you relieve the actual irritating factor from the body. So by taking medications like Selma and all these different muscle relaxants, they just make the patient really tired and they don’t act upon these specific groups that are patterned after.
If you give me 30 patients with hip pain and knee pain and foot pain like what we’re dealing with right here, I will tell you that the pattern is the same with all 30 patients. So once you understand how I go about reversing these abnormal movement patterns through reversing of the spasm and rebuilding the arch, springiness then you're going to be able to heal thousands of patients, one after another almost like a doughnut shop. Put the bread in, and the donut comes out the back end like a factory.
I swear to you, it just repeats itself, over and over again. It’s a function of accelerated aging. This patient did not have to have this happen. She is aging too quickly. We need to reverse this before it starts to affect the entire frame. So what we're going to do is look underneath this big toe. Then right underneath this, where this big bump is that we found that didn’t look right. This bump is the calcium deposit right underneath the metatarsal cuneiform joint. It’s more painful here, right? But if we move here, it’s not as painful, right?
Right underneath there is where we have some inflammation and you can feel it, if you want – do you mind? You don’t’ have to feel it, you can see it. There it is now, kind of sticking out. What we’re going to do now is to test the movement and see how it moves. Okay. And these toes seem to be projecting downward. This one is projecting upward. Sometimes doctors think that were barbaric. Let me tell you something, I will show you a video where I’m manipulating a foot and it looks like I’m starving to death and that meat is in the freezer and I need to get it thawed out really fast so that I can eat it. That’s how aggressive I am with the foot. Like I said, if this lady weighs 50 kilos, you know, or 40 kilos, which I suspect is probably true, 40 or 41 or less, that’s 40 times 5. That’s 200 kilos of pressure when she’s running. That’s 5 times the body weight. This foot is certainly a durable structure.
When I was a kid I was racing my friend barefoot and I had a swim suit on, and my foot slipped off the pedal and it went right into the spokes, and I flipped off over the handle bars because it came about the crossbar and the spokes just jammed the foot like that, I flipped and it was scraped up, but I walked around no problem the next day. The foot is very durable.
What we’re going to do first of all is manipulate this toe because it’s not right, and it actually released very nicely. Did you hear it? It didn’t hurt me a bit. Good. So now this hurts, right? This is painful, right? A little bit? Now, what we’re going to do is this: it is very simple. It’s so simple it’s ridiculous. We’re going to take our thumb (I call it Chinese Human Itch.) it’s one thumb print right here. If you're an acupuncturist you know that’s how you meander your way through the body. We’re going to put our pressure right here at the beginning of the muscle that actually supports the foot. These are intrinsic muscles. The other muscles are going to be along the outside and the inside of the foot. Those are the long muscles that support the arch and maintain the springiness to the arch. Since I've been holding this, it’s gone now. Now describe what you felt when it was first painful and then what happened. It kind of melted away. Right? The pain. So we’re going to apply the pressure right here which is a lot worse right there. On a scale of 1 to 10, what was it. A little tender. Tender is pain. Let’s call it that. What’s it at on a scale of 1 to 10? Four. Okay, tell me when you can still feel it. All that it means is that you’ve had it for a little longer. Now it’s at 3. Tell me when it’s at 2. It's going down, right? Tell me when it’s at zero. Not quite. Then it’s going down. So maybe it was an 8 and now its going down to a 4. We’ll get a guy to see what’s going on. So what she’s saying is “Doctor, you must be releasing the pressure.” You know what I tell her? “I’m really not that nice.” I’m not that nice.
Once we relieve the pressure, I get my hand on this side of the joint, proximal to the metatarsal cuneiform joint. And the other treatments are starting from the metatarsal cuneiform joint here and you're going to work your way right down in between these two toes and you're going to put your thumb kind of at an angle and get right in on that muscle and you're going to hit it. You're going to hold it there until the pain goes away. That’s a little more painful, right?
Because these bones are coming too close together and because this bone is coming into the first metatarsal phalangeal joint that’s lurking laterally. Right? And it’s coming into contact with the second and what happens is it goes all the way down the line and then the nerve gets pinched right around here. That’s called the neuroma. They operate on that. I don’t ever operate. I just treat it and it goes away very quickly so you don’t have to have an operation for that. You can if you want, but it makes your beautiful feet look kind of scarred up.
I’m going right down to the bone, and sometimes they will swear at you. That’s why you stand way back here where they can’t reach you.
I have one of the meanest patients, some of the toughest guys in the world, like Andre Arlovski, Heavy Weight Champion, without the gloves they choke each other. They hit an elbow in the face. It’s a brutal sport. And he screams worse than anybody. James, no, please, no, James, I kill you. I kill you. The ladies can take the pain because they have the shoes on with constant pain.
A little painful right there? Right. This type of pain becomes almost redundant, it becomes boring almost. After I teach you where the painful areas are, you are almost going to be bored by this whole thing. And you're going to say “Oh, another pronation syndrome, a herniated disc, or whatever.” Okay, Alma, you know what to do. She knows where to put the pads and the muscle stimulation goes here on the outer calf. And the outer thigh, the outer hips and then that warms it up for me so I don’t have to work so hard. We put it on tetanizing current to kill off the muscle spasms. Then we put like a giant vibrator – called the G5 and that just is almost like a jack hammer. It’s so strong and it just brings that circulation back to the leg. When you get up, your leg feels 10, 15 pounds lighter. Your leg is nice and red, blood flowing through it. Just wakes it right up. People who have had cold feet all their life: They go into bed with their husband or their wife, and they want to get close and they say “Ah your feet are cold. AHH! It’s a horrifying feeling when your wife or husband doesn’t want to get close to you. Why are your legs cold? It’s because the circulation first affects the distal area of your body. You know that, right? Well you know what’s so crazy is that Diabetes affects the toes, right? Right? And you have to have your toes amputated if you get gangrene. Well this has not as much to do with the fact that of course it’s distal, but also the wrist does not have muscle spasms from abnormal movement mechanics. But this area does. When I start to look at her calf area, it’s going to be very painful right along here. If you look right there? Right along the outside of the calf. Right there. And what I've done is I've moved the gastroc and soleus out of the way. The big muscles that you’re exercising which do you absolutely no good. They do very little good for you. If you develop the calf muscles to pull on the Achilles tendon, what it does is it pulls the heel up and your foot is already locked down, so it actually stretches the foot down and it makes it plantar.
If you don’t do the concomitant exercises to the muscles that come around this pulley system and attach on either the medial or lateral sides to stabilize pronation and supination, then you're going to cause more damage by doing calf raises and not to giving the ability, changing directions, balance, agility and coordination. Plus these muscles that come around here that attach on strategic points of the arch are a second jet propulsion type of mechanism for pushing the body through the space. On top of the Achilles tendon, they have the second layer of musculature that will make them faster or jump higher. Jumping ability comes from the foot. It does not come from the thigh and the hip as much. It comes from the foot. Try to jump and dunk a basketball flatfooted; it’s just not going to happen. So along the lateral aspect of the calf right here, you're going to feel some tendons.
Alright. So what I’m going to do is kind of go underneath. And what do they say, it’s so warm and it feels so good. Do you know what that is? That’s normal. Underneath on the lateral, just medial to the fibula. Still sore? Know that they will lie to you, because they want to get it over with. They just want it to go away. Will this ever go away? Now it’s gone. Right? So I would just - I’m not going to go through the whole – the cuboid has a natural position that’s like a flagstone. So if you lock the back of the heel nicely, the arch cannot fall. It’s not possible. So if you want to stabilize your foot, you find a shoe that will stabilize your heel. A good fitting shoe that has some very solid leather that will stabilize the heel. That’s the first step. Really. A very solid leather shoe that ties up. And that way the arch will not fall. Okay then if you don’t then it will fall. That’s what happens. So we stabilize it from the back. We work here, here, like I showed you. Now along the outside, the tibialis posterior, because it has 3 strategic attachments, 2 right here and 1 right in this area that holds up the arch and gives it the spring. Then it goes along the lateral thigh. And I’ll quickly demonstrate this for you. If I press here, you don’t feel pain, right? Now you can see my thumbs are right with the amount of pressure I’m putting. And I’m not a nice guy so I’m applying a lot of pressure. But if I press here – whoah- see what I mean? That’s because this area is the area of strain. When she walks that way, (when I showed you) that’s the muscle that’s affected. This muscle does not want to see the leg turn inward like that. It wants to hold it back to keep it from turning. That’s why it contracts all the way down. With this muscle it comes to a point like this. It becomes a fascia.
This is called a Tensor fasciae latae and then you have the illiotibial band that connects that down to the knee. It crosses the knee joint so it affects the articular surface of the knee because it misaligns the knee from front to back and the kneecap is in a trochlear groove here. It’s a pulley system. So if you go to the health club and the wire is outside the center of the pulley, it will wear the insulation off of the wire and the same thing happens with the kneecap. It wears out the outer surface of the kneecap. Now typically, what they’ll do is after the season is over, they’ll scrape the kneecap. It does not have to cause pain, though. If this is your wife, then you’ll know when she’s approaching. You can hear her from a few paces back. When you put pressure here, it just gets worse. You don’t have any. She has very clean knees. Now I've seen some patients with some nasty problems where with perfectly normal kneecap, but no cracking, then you hear other people with minor problems here and have tremendous cracking of the knee. That’s more genetic. This genetic structure here varies with patients. Then of course what we're going to do is a little muscle testing. I've given up on the muscle testing of the foot. What I want you to do is bring your foot this way. Hold it really tight and I’m going to pull this way. Don’t let me do that. Forget about it. This foot is really strong. Even if it’s weak, it’s still stronger than you could muster up to muscle test it. I've never seen muscle testing of inversion/aversion and adduction/abduction becomes a 4 out of 5 or weaker ever. It’s always 5 out of 5. Don’t even waste your time, you're better off palpating, watching the walking style observing the structure of the foot. I want you to put your foot right there. Hard, push. It’s giving way very quickly and she feels the cramping.
The reason why she feels the cramping is that typically the brain has been able to compensate for the lateral movement when she tried the lateral movement the brain engaged other accessory muscles to do the job. Then that would demand that her foot be turned out this way to bring in the quadriceps. But unfortunately I am smarter than her brain. And I go out to come in and that’s why it tried but it couldn’t pull or do anything. Then what’s going to happen is right along – (can you just turn a little bit to the side. That’s fine right there just lean back just like this.)
Right here, the gluteus medius right here (do you feel a little tender right here) and the mediums are going to be involved. Like I said, when the foot drops, it drops and turns, and the thigh internally rotates. So the muscles of the hip want to turn the leg out. They want to resist that. That’s why these muscles around the hip socket here are going to spasm, which are going to confuse you and you’re going to think lower back pain when it’s really not.
Now, if you look at all the muscles we’ve been talking about, we’ve been talking about some big muscles. The calves are big. Did you ever work calves where you go underneath and you go banging, you could knock off about 10 reps with about 300 pounds. Because you know that calves are pretty strong. When you do one set, you may break out into a sweat. You can work out for an hour and half doing training, pounding weights, but if you work out and you never break a sweat, you work your calves, you will break a sweat. The calves are what get set it’s like a pumping mechanism that blasts that blood right through the body. It’s an incredible advantage to have your calves to work the blood back from gravity back up to the heart. How else is it going to get back up there? Is just that the veins don’t have a muscular layer. They’re just like flexible vessels. So it can bring the blood up, it has to have the contraction. As you can see, her contractility of her calves was depleted because of the mechanical dysfunction in her feet.
What we would do is work the outer hip and then she would be centered up in the shoe that will stabilize the foot and I will tell you that each visit that the amount of pain that she felt during the deep tissue work would reduce if everything goes as planned, by the 6th treatment. The whole hip socket area would be completely void of any tenderness or spasm as well as the area of the Tensor fasciae latae.
All that would be left for me to do now, which is great, because I’m getting tired. At 6:30 at night, she comes in, and it’s like oh my goodness, I hope she wore her shoes today. I’m sweating. It’s a lot of work everyday. So now all that’s left is a little bit of work right here nd maybe a little bit of work here in the foot. And by visits 7, 8 and 9. And what’s really great, is this is not predicated on visit counts. When I start here, I work around the outer hip with the gluteus medius down here, this area here, the big toe, second toe, I can take a little coffee break for about 5 minutes and chat about your center and then I say “Okay let’s get back in.” And then I go right back at it again. That’s called 2 passes – that’s 2 visits.
You know, maybe it’ll take me 30minutes to get down this way all the way. But now it takes me 22 because it’s going away faster. I’m breaking down the reflex in the brain. It’s happening faster because it’s giving up. I’m winning. I’m breaking the reflex through the stretch reflex. Pretty soon we’re only working for 5 minutes here and here. And that’s visits 9 and 10. We’re done.
I've worked on an athlete for 6 hours in one day and one more time after that and from the searing screaming back problem, and knee pain and he was fatigued, and he had numbness in his feet because his blood wasn’t getting down, he was an athlete – an ultimate fighter. When he would get out of bed he would fall on his face because he couldn’t feel his feet. He had almost like a neuropathy. After 6 hours and then 2 hours the next day it was completely gone. Then he said there’s nothing. Yeah, I could come back, but I don’t know why. And you know, I also said you know what, I don’t either because there’s nothing left because that’s all it took. It wasn’t my 10 visits. It was how much time I spent in the abnormal pattern that reversed the problem. So you can do this yourself at home. You can bring your let up and put your pressure on these areas yourself. You can do it yourself. I do it. I have nothing better to do when I’m sitting on the couch while I’m watching TV. I may as well be doing something to help myself. I go ahead and stick my thumb into my leg. Get in the bullets and feel better. I stand on my feet 16 hours a day and I certainly don’t want to have chronic arthritis or fatigue or anything like that. So you can do this at home. Thank you very much.
For your trying to meet a man. You know, look beautiful. If you didn’t have pain it must not be a sexy shoe, is what he is saying. So Andy Warhol stated definitively that his designers at Ace Company asked him to design a little painful component to the shoe so that you would understand that it was part of the plan. So I think that’s really masochistic, but Andy Warhol of course went through a rough time. He had some problems. His girlfriend shot him. And then Miss Valerie Solanas later wrote the book S.C.U.M. Manifesto. The initials stand for Society for Cutting Up Men. She must have worn the shoes, but she wasn’t really happy with Andy Warhol. He was not really a nice guy and she later went to jail and passed on.
Here we had some shoes that were considered healthy. You could be thrown off by these footwear manufacturers. I’m meeting with a couple of them this year in Japan. Here’s the funny part – is that the foot is straight, so if we put a mark in the center of the heel here, and we put a line right through the center of the heel, where does that line end up? Does it end up over here? Or does it end up over here? In other words, does the structure of the shoe twist our feet when we walk? Does it twist our feet? Not only that, but it has the upturn right here. Well that’s because they said “we’ll make it like a rocker so you roll over the op and you don’t have to work so hard.” There are consequences to that. You know, 18 the 19 attendants that are used to squeeze and push the body forward, he flexor tendons – those muscles attach on the toes. So by flipping your foot backwards you're actually reversing the arch and you're taking those muscles completely out of the gate, which is the reason why this poor lady’s toe does not move any more when she walks. She noticed that. That normal mechanism of pushing off with your toes is what stimulates blood flow back to your heart. This is a foolish design. I think it’s ridiculous that doctors are not involved.
Did you know that the largest manufacturer of shoes in China had 40,000 workers working for him? He’s a patient of mine. He flies in from Boca Raton. He owns a shoe company out there. A nice one, I like it. He said to me “in the 20 years that I was making shoes, for the biggest shoe companies in the world. There was never a doctor who visited us to determine whether the shoes were healthy for the people. Like I said before, some of these shoes if they have too much of the padding or shock absorption – we’re all supposed to think that shock absorption is where it’s at. When in reality, when we put some sort of soft spongy material between the sensory component or the mechanical receptors of our foot, that determine how much load is being placed on it whether we’re walking or running, that those sensory receptors that are built and designed specifically to give the brain an idea how fast we’re running so it can make the adjustments on the tensile strength of the arch to absorb the additional shock of faster movements, those are all vexed by these soft shoes. So what happens is we have these young kids that co
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