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| Transcript Cape Town, South Africa January 27-28, 2007 |
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Abnormal Biomechanics and the Aging Process
First African International Anti-Aging and Aesthetic Congress and Exhibition
January 27-28, 2007
Cape Town, South Africa
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
I’d like to thank you for inviting me to South Africa. So far I’ve been having a great time. We went out to the beach and restaurants yesterday and I had dinner with Dr. Goldman. We ordered 3 salads and we mixed them all together. You know, after you hang around with these anti-aging doctors, you start to act like them, you start to eat like them and pretty soon you get slimmer and better looking. So the more you can participate with these anti-aging doctors, by attending their workshops, or by working with them or just go out and have dinner with them, if you like, and find out what they eat; that helps out a lot.
I’m going to speak a little bit today about the abnormal biomechanics and the aging and that’s basically very simple because it applies to everybody because we all have to walk. As you know, to get to a place from point A or to point B, you have to walk to get there, and that means that your joints have to move.
I was always fascinated by the movement of the joints. Back in my early days I wanted to use sports medicine. I don’t know whether God looked upon me in a way that answered my prayers, but it seemed like everything fell into place very quickly. What actually happened was that my first day in practice, the strongest man in the world, and pound per pound, walked in and wanted treatment for his knee.
Here is a guy who had already broke about 8 or 10 world records for lifting huge amounts of weight. In other words, let’s say to give you an example; I believe you deal with kilos. Is that right? So maybe 965 pounds squat, that w0uld be something 385 kilos - 400 kilos. So if you could imagine a fellow that is 5 foot 6, 220 pounds, breaking world records in the 110 kilos, the 220 pound class, the 240, the 280 and the 300 pound open class. In other words, he had broken all the records in all the weight classes above him. Guys that weighed 300 pounds were lifting less weight than him. So it was fascinating to go to the World Championships. I was sort of his physical doctor. I am his doctor that takes care of his bones and joints with the nutrition. And they would say, “There’s Ed Cohen, and there’s his chiropractor and he must have all the answers.”
Well people would come up to me and say “What’s the answer to this man’s super human strength. How is it that he can lift 400 kilos on his back and not have the weight crush him under his bones? And year after year, we would attend the WC and you know my education had to keep up with those questions. So I became a student of movement and mechanics. What I found was I said to him, “Well listen, you know what we could do. I like going to these World Championships because they’re asking me to write articles in magazines such as Muscle and Fitness and the like, I said, “Why don’t you just come in 3 days a week. After all the patients are gone, I’ll go through your body like a fine tooth comb and I will work around all of your joints between your toes, around your ankle bones, all the way through the leg and through the hip and the back, and I will make your body function as close to perfect as humanly possible with my hands. So that’s what I did.
I can remember there was a patient that came in who had a herniated disc. It was 6 millimeters, had spinal stenosis, and was crying. His son was in the office asking, “Can you save him from surgery? We have no health insurance. It can break us. It’s a real problem and what can you do.” Well, I decided, what is it that I can do? I can do as much as I can for this man and it will make his body as close to perfect as humanly possible. And let’s just hopefully see that the herniated disc will shake out. Because of the fact that we did go as far as we possibly could to make it as close to perfect as humanly possible. And you know - he recovered.
I said, well what’s good for this patient is also good for my other patients. So I started to integrate those programs or those treatment processes into my other clients. What I found was that as I sifted through the body, there were certain patterns that kept repeating themselves over and over again. It was interesting that it all boiled down to: it all comes down to the foot.
You know, when you go to the doctor’s office and you have a problem with your back, it’s amazing to me how we look at the back. We touch the back and bend the back this way and bend that way; when in reality that’s certainly not the way an engineer would look at it. We take an x-ray of the back and then we say, “Well, you have a problem with your back. We’re going to strengthen your back and your front to help your back. Then we’re going to manipulate your back, we’re going to inject your back and we’re going to do surgery on your back.”
You know the body is for more far reaching than such regional care. I know you also look at the philosophy behind treatment. Like the doctor said, the philosophy behind treatment of one doctor is completely different and separate than the philosophy and treatment of another doctor. For instance, as soon as you walk into my office, I watch the way you walk. As soon as somebody walks into another doctor’s office, they’ll be sitting down. I want to know how you walk when you come in because I know that there are floors beneath the back underneath the spine. If I don’t take a real careful look at them, knowing what I know from my sifting around with these World Champions, that I’m never going to heal that back, because these floors if they’re vexed, they’re never going to be able to allow the back to have complete healing, whether it’s on the fence, whether it’s going to make it or it’s going to surgery. And obviously surgery is not the favorite option of the patient. Then what we have to do is look at these areas to make sure that we’re not missing anything. So that’s where I developed this amazing treatment that I’m going to demonstrate all this in a workshop today at 4:00. I welcome all of you to attend and most certainly you can be a patient. I will examine you.
What we’ve just heard is that pain, arthritis, back problems, wear and tear of the joints are very uncomfortable. After a while we take our medication, it goes away and we can function. And so on and so forth. But that’s all changed. Anti-aging medicine, which I love because it’s more along the lines of what I think about because I want that athlete to continue to break world records year after year because by the time he hurts himself on a 16 week training cycle, he’s done and so are you. By the time that you’ve herniated your disc, well then you have some permanent damage there. Well, we can’t have that. In our office, we deal with very famous people. We deal with World Champions who are fighting for millions of dollars.
My last athlete had 800,000 Pay Per View buys at $49.50. You do the math. This is not like you can’t have room for error. If the Performing Arts, they call me and they say, “Dr. could you come down, we have the Aerosmith Group, or the Mariah Carey Tour. We have something that’s down. We need them right now.” Well it’s not a crack, crack out the door. It’s a 4 to 5 hour treatment. What you’re going to find is that at anti-aging medicine, it’s not waiting for the problem to come, then we’re going to go do a fix them up job. It’s more integrated. Here’s another thing that you have to understand about. Do you know that there are other things that are lingering that we’re finding now because of the studies that I call the billion dollar pathway or the pathway where arachadonic acid and some injury or chronic disease process creates inflammation? You're going to hear about it from the various lectures today from Dr. Anton and other doctors that inflammation or the levels of cytokines or CRPs C-reactive proteins which come from the liver. They’re directly related to the level of risk of cardiac disease. So you know those aches and pains are a lot more important now than they were before.
Over 175 million people suffer from pain in the United States. I don’t know what the levels are here in South Africa, but that’s not the big picture. 175 million people with pain. What’s happened to our health care system that that many people are in pain? The only innovation in medicine has been with surgery and the advent of drugs.
You know, I’m not opposed to drugs. I had a toothache that was shooting pain up into my skull this way, that way and it was so bad I could not concentrate. The pain was searing through my skull into my shoulders, it was horrible pain. I was begging for the doctor to inject some sort of pain killer to my tooth before he pulled it. It was very painful.
However, when we’re talking about pain that is a frank inflammatory process that we know we have some swelling, some visible swelling or in the back. In the case where few backs are swollen when they have pain, we know there is an inflammatory process underlying that pain that is actually bringing a toxic soup that is infesting our body and our tissues are bathing in this toxic soup which is creating aging or a higher risk for disease processes.
Now the other problem that we’re seeing is that having pain can also limit exercise and that leads to obesity. Over 65% of the American population are over weight or obese. The excess weight that is subcutaneous fat that exists under our skin as a result of our not exercising also produces inflammation. Inflammation creates a decrease of the ability or increase sensitivity to insulin. The rise in insulin will causes a decrease in growth hormone. So it’s a feedback loop that’s negative.
The decrease in growth hormone causes an increase in fat deposition. Increase in fat deposition causes an increase in inflammation. Increase in inflammation - you get the picture. So somewhere down the line we have to stop that process from happening. That’s why we see a lot of people who gain weight. When they get injured they actually gain weight. Being overweight actually contributes to a very different circulatory and respiratory and mobility related disease such as hypertension, arthritis gall bladder disease, stroke, heart attack and cancer.
Anti-aging medicine like the doctor mentioned, the word “Anti” I understand what he’s saying. But anti-aging medicine is different from disease-based medicine. We're still trying to qualify that, but at least we have something to go on to begin to investigate some of these disease processes that are not necessarily creating symptoms or actually diseases that we have: like a tumor that we have to cut it out. By the time that happens, obviously we are scared to death.
So what if there was a safe and effective treatment that could stop most joint and muscle pain now. What I’m saying is it okay that 175 million people live with chronic joint muscle pain? That if this treatment could prevent the cause of our osteoarthritis, even if it was subtle. Do you know that I had 7 patients that came to me last year that had hip pain that was a level 8 and 10, which means on the pain scale moderate to severe to severe? When I took the x-rays, of course I like to joke around with everybody, I like to laugh it up, but when we got to the point when we put the x-ray in the view box, and there was no more joint left in the hip, it was gone. Unfortunately, I had to tell the patient, I have bad news; I really can’t help you because your bones are touching now and you should have been in here about 10 years ago. Well that does not do anything for the patient now. Unfortunately now that patient is looking at something that is very scary not only for him, but his entire immediate family and everyone that works with him and everyone that communicates with him. His life is going to change dramatically from here on in the situation in the manner in which he lives, so on and so forth.
So we don’t want to get to that stage. Anti-aging medicine does not allow us to get to that stage. What I’d like to know is why is it that it’s thought of that the concept of having a hip joint replacement surgery is so innovative and so magnificent.
I just want to know one thing: That magnificent procedure that the amazing doctor performed called the hip joint replacement. What about the doctor who’s managing the care of the patient that allowed the degeneration of the hip joint to the point where there’s nothing left of it? That’s the tragedy. Why are we rewarding something that’s supposedly magnificent and saves us some time, when we should have been looking after that? We have not been doing the things that we should do when the patients are in their 30’s and in their 40’s and even younger to prevent these problems from occurring in the first place.
So what biomechanics allows you to do is allow you to evaluate the patient. I will tell you that in Bangkok at the Brumengrad International Hospital, I pulled someone out of the audience that had unilateral knee pain. And I said please walk across the hallway. I said your pain is on the right side. And he said yes. Then I laid him on the table and said “You lied to me because your pain is on both sides.” He said you’re right.
Because I can just watch the way the patient moves and I can tell you that after looking at a lot of patients I have been able to determine exactly what’s wrong based on the way they move. We all have always been in our offices and I will tell you that it’s not easy to do a cartwheel, but certainly if we practice we can do a cartwheel. This is not really doing a cartwheel; all you’re asked to do is watch the patient walk. After you’ve watched them walk, you're going to find out that you're going to notice from one patient to another and pretty soon you're going to get really good at it.
Patients will have a little bit improved confidence in your ability if you can say, “Well you marked down that you have knee pain on the right side, but why didn’t you tell me about this chronic fatigue? Also, your foot hurts you too because I know that you have those problems.” They look at me like I’m from outer space. It’s because I know that the knee pain can occur because it’s a hinge joint. It does not occur by itself. It’s in the middle of the complex of bones and it has to occur as a result of some sort of malfunction in the foot. So why is this situation with the foot so important? Well it’s important because walking is a poor exercise for daily life.
No. 1. We take 6,000 to 10,000 steps per day – you can’t stop walking. Try it. Patients with subtle abnormal biomechanics like they spoke to you about those patients who had hip pain for 3 months: those degenerative processes were going on for 20 years unnoticed. If they went to a doctor with expert knowledge or experience and abnormal movement patterns of biomechanics, then they would have been able to pick it up a lot sooner and they wouldn’t have had this problem and we wouldn’t have been the bearer of bad news to the patient. Who likes to do that?
I like to laugh it up and joke around with my patients and I'm certainly not interested in having the patient a grown man cry.
It also creates chronic inflammation and disease. This toe right here is damaged permanently. There’s not much I can do. I can do a lot with his foot. A lot more than anyone else because of his fabulous new track knee. However, that foot has been degenerating for years. You can see it because the big toes are laterally deviated. That does not happen overnight. That patient has had a poor walking style for a while. Knowing what happens we can pick it up. What about the diet. In china, which is where you're’ going to be bringing in your policies. They just signed a deal to bring in one of the fast food giants 2 stores per week. They’re going to bring in 10,000 stores that we tell people not to eat because of the high levels of fat, inflammatory foods that they're going to swoop down and gobble up. However, that type of fast food is going to cause disease processes that Chinese government might want to look into. I had spoken to them in China. I was in Gwan Cho giving a presentation on diet, its effects on disease processes.
So the combination – let’s just say that if we had a patient who was eating a lot of fast food or was on the run – a salesperson or someone and they’re 30 pounds overweight. Now what happens is that the arch of the foot is a truss system and that truss system has been designed to accommodate 100 kilos, let’s say. So then we add 20 kilos to the frame and then we’re wondering why our feet hurt. The other factor is that when we’re young, when we’re children, we don’t have foot problems, because we’re running around in the backyard in all different directions, chasing after each other, also, we’re up in the forest, we’re up in the hills, we’re having a fun time at the beach, and as we age, we become more methodical and we’re on sidewalks and then we get in our car, we drive to work and then we walk to the office. You know, the corporate rut, we walk to the office for a rut, we walk in building that we’re in and we sit down and we get back up and we go have lunch and it’s a vicious cycle.
What you have to understand that all we do as we age, we move forward, so our body starts to program our system like a rut, it programs our system to be strong within that plane of motion and weaken other planes.
You hear the story about the 70 year old woman who merely reached for a can of peas and fell and broke her hip. Why doesn’t this happen to us? It’s because over the years, her body was programmed to move only in straight directions. So these movement patterns of side to side are no longer practiced. We're going to get into that word practice in a minute.
What happens is that she no longer has the balance, coordination, and agility because she’s not practicing those movements. So therefore when she gets into the position that she does not practice, she’s uncomfortable, and has no coordination and agility and she falls and has permanent injury.
This is the movement pattern that we’re describing here where the foot is turned out. You can see it on the right if you watch the movement pattern. Well basically you saw that the foot was turned out. So if the body is going straight and the foot is turned out this way, one part is going this way, and the other part is going that way, something in the middle is going to give. That might be your ankle joint or your subtalar joint that could be your knee, chondromalacia, just vague pain around your knee cap, or hip socket pain where it hurts around here. You know what’s so funny is that patients describe lower back pain as pain right in here when it's not even lower back pain. When you stick your thumb into the gluteus medius, it makes you scream and makes their eyes bug out like they saw a ghost and their hair stands up like Don King. That pain is searing pain and you know that that muscle is creating tremendous volumes of inflammatory chemicals that are causing us to age very quickly. So combined with that, diet, plus this inflammation, that happens with every step we take, we see that we’re going to end up with wide spread inflammation that’s out of control. This inflammation is what doctors are saying that causes the damage to the cells.
You're going to hear about it all week. What’s fascinating also is that because this syndrome also causes a cascading domino effect all the way up the body, it creates bunions and heel spurs, and ankle arthritis, back pain, hip pain, spondylosis and degenerative changes all the way up the frame.
Like I said before, the natural response to overpronation syndrome or poor movement pattern and diet is inflammation. The American Heart Association and Center for Disease and Control recently published a joint scientific statement that using inflammatory markers in clinical and public health practice determined that the levels of C-reactive proteins or the inflammation that comes from the joints and poor food choices, is directly related to the level of heart attack and stroke. By the way, it’s more directly related to heart and attack and stroke than any other biomarker.
Therefore, measuring inflammation is certainly a very important component to your practice. It certainly should be measured prior the patient getting treatment to determine what the level of your outcome may be at the end. Really what we’re talking about here is joint inflammation or the levels of what they say “Tumor Necrosis Factor, IL-6, Interleukin 6, 8 10” (and IL 1 alpha). So these inflammatory biomarkers can be assessed in blood test. I think you're going to find out more about that in the other lectures.
Basically what it does is that level of inflammation makes us feel older than we really are. In a situation that we’re describing here is that we ache all over and some of the fibromyalgias and the chronic fatigue syndromes that I'm finding - that other doctors have given up on. I’ll tell you that when a patient comes in with fibromyalgia that is described as aching all over and they have chronic fatigue and they can’t seem to get any better. Then those patients have an over pronation syndrome that’s gotten out of control. It’s been infested in every part of their body. Then this release of inflammatory chemicals actually causes a problem with not only weakness and feeling malaise, but their bodies are weakening by the week, by the day. Like I spoke to you that the levels of inflammation decrease the levels of growth hormone which causes an inability for the body to rebuild itself.
Inflammation is also found when you have sinusitis or when you have a cold or the flu which makes you tired. High levels of inflammation make you tired. Having allergies makes you tired from the levels of inflammation. Sometimes missing the boat on your diagnosis is because the patient aches all over. They have multiple joint levels of inflammatory processes going on that have to be stopped. What happens in the kinematic chain - what we call the connection of the bones and joints is that initially it starts with the foot and then it is damaged up the chain - I call it the ‘Chain of Self-destruction’. With every step you take, you destroy your joints and tissues and weaken them causing more scar tissue formation, calcium deposits in the processes that are ongoing without your knowing. Women can have a bunion formation that’s been going on for 15 years that does not cause pain. I call bunions ‘chronic arthritis’. It’s degenerative arthritis of the foot. In fact, the first and second toe is where all the weight of the body is held. So, you’re damaging the very foundation of your frame that holds your entire weight and the mechanics of the first and second toe are vital to your longevity. In fact, if you damage them, you will have abnormal biomechanics for the rest of your life because this damage is permanent. You know, oh, bunionectomies, straighten the toe - that’s real nice, you fit in your sandals a little better, but it’s not the same thing. It does not completely correct the problem and bring the biomechanics back to near perfect.
Biomechanics began to be studied with sports medicine primarily. I used to read the Soviet’s Sports Review back in 1986. I had volumes of the Soviet’s Sports Review because I enjoyed reading the articles on cinematography of sport and the movement patterns of the Hamlin Throw and the movement patterns of the Hammer throw and the techniques. Because I thought that not only as a doctor, if I studied these movement techniques of the joints and the way the body moves, then maybe not only could I determine the reason for the man’s pain when he threw the hammer at the Olympic Games, but I could also improve his technique to let him throw the hammer further and let him win a gold medal. It does not do me any good to be second place with my athletes at the Olympics. In ultimate fighting in Boxing, second place is called losing. When you are in the middle of the ring, like I have been on many, many occasions with fighters, to be on the other side of the ring when the cameras are panning, is not the place to be. That is not the place to be.
So specific movement patterns and general movement patterns are the way we determine the movement patterns of the body. Basically, generalized movement patterns are developed in childhood. They are how you walk; it’s how you run; the way you stand from a seated position are developed in childhood.
These movement patterns are consistent with what we call brain mapping or engrams. Engrams are where the sensory component of the brain and the motor component of the brain are stored in the brain, not in any particular area of the brain. But these are movement patterns that are stored in the brain, a series of impulses that come from the body and they are managed there in the computer system of the brain.
Basically what we can do is either develop engrams of movement or brain patterning that has the body moving in a good way which does not cause a very efficient movement pattern which allows us to still have energy at Midnight after a long hard day without pain or we could have engrams or movement patterns that self destruct all the joints of the body and by 7:30 at night we’re putting our feet up on the coffee table saying, ‘Wow, was that a rough day. My back is killing me. Bring me some of that Ibuprofen.’
Therefore, depending upon how your movement patterns are designed and stored in your brain will determine how your joints move and basically whether you’re going to have self-destructing movement patterns which are inefficient and cause weakness and development of inflammation, weight gain and these factors that increase the aging process; or you're going to have engrams that are developed as a result of good patterns.
Now, this is fascinating because we know that in Sports Medicine, we can take an athlete and put them on a 4 inch bar and have them walk across the bar. They’ll take 2 or 3 steps and they’ll fall. That’s okay because we’ll say, ‘Look, don’t give up. Get back up there and let’s do it again.’ And they’ll walk across maybe 6 steps. Then very soon after about a week of walking back and forth on that little bar, about 4 feet above the ground, they’ll walk across with no problem.
Then after maybe 10 or 12 years of training, that silliness – that’s a pattern that has been engrained and burned into our heads. It’s so solid that’s burned into our system, that we’re now doing back flips off that bar. We look at these athletes in the Olympic Games and we watch them as they do these amazing tricks and performances, and we say, ‘My God, how can they do this?’ Certainly it’s practice, practice, practice.
So when I talk about generalized movement patterns, what I’m talking about is that movement pattern that creates abnormal wear and tear, stress and strain on your joints, release of inflammation and damage can be retrained in your body to create a movement pattern that is more efficient with more agility and coordination.
How do we do that? Well, it’s about training. But it’s not about going to the gym. I’m going to tell you that almost 100% of you are not exercising the way you should. I know it. I know this because I work with some of the top athletes in the world. They’re not even exercising properly.
Therefore, obviously when we look at medicine, disease based medicine will take an x-ray of an ankle when a person has had pain for 5 or 6 years, whereas anti-aging medicine looks at the mechanics. The earliest detection and prevention of age-related diseases has a lot to do with movement patterns. Certainly those patients that have arthritis by their midlife and 85% of them by the 7th decade have arthritis in their joints with permanent damage to their moving structures. If we embrace the art of evaluating the patient with biomechanics that’s the way we do it in anti-aging medicine. We don’t wait for a patient to have physical signs on an x-ray before we integrate treatment. Not only that, but when we have pain and inflammation, we know that the movement patterns are array. Our first choice in anti-aging medicine is not to prescribe anti-inflammatories and pain killers.
I've been in practice 20 years and I know I’m a chiropractor, so what? The bottom line is that patients can get through pain. If a patient is walking across the floor, according to Rush Presbyterian-St. Luke’s in Chicago, a very well known institution, they said that patients that were given acetaminophen were actually putting more weight on the painful affected side which we know is not what we’re looking for. We’re not looking for if we have pain in the joint and it’s damaging wear and tear and stress and strain on the joint; well let’s put more weight on it. That’s insanity. Like I said, if my tooth is killing me, I want you to inject that tooth with a very strong pain killer because it hurts.
But if a patient is walking and we put a pain killer in the joint: the pain is something that’s important that has been given to you as a warning signal to let you know that you're not supposed to put weight on that joint. Let it heal. Rest it for a little while and let it heal.
We’re looking at joint mechanics of the foot; we’re looking at two different problems. It’s not that difficult. You're going to learn a lot from today and certainly if you attend my workshop. I’m going to evaluate patients right on the spot and talk about ladies footwear and what to look for and what not to look for. We’re going to talk about some of the evildoers. Like Andy Warhol who is a shoe designer for a fashionable shoe company. He stated that women find it to be interesting to have pain in their feet while wearing fashionable sexy shoes as part of the courtship component of life. Andy Warhol stated they designed a painful part into the shoe. You ladies have pain at the end of the day so you see the shoe must be sexy because it has pain.
We’re talking about two different types of movement patterns. One is abnormal supination, or oversupination, or overpronation. I use the “over” because supination and pronation is a vital part of the shock absorption effect of the foot. When the foot plants in supination or the foot turns slightly out, it rolls the weight across the foot and then pushes off; that’s called pronation. That’s part of the shock absorption effect of the foot. That’s why we don’t feel this banging when we hit the ground.
There’s so much emphasis in scientific literature: there are 160 articles about pronation and overpronation. This literature has been centering itself on the subtalar joints. That would be right about between the heel -or the calcaneous and the talus or right here in this area. Isn’t it fascinating that it does not hurt that much, but in fact that’s the area- the joint that is torn up? When you think about he joint that is right underneath the framework of the entire body is becoming weakened and it’s no longer a stabilizing factor in your frame. Then everything goes from there.
The way we evaluate the subtalar joint is we grasp the heel with our hands and we tug on the back end while the patient is supine. What you're going to find is there’s going to be a separation, or a clunking like “clucking sounds”. It opens up a millimeter or two. Sometimes it’s good, it’s solid. But in most cases with this overpronation syndrome and damage to the foot, you're going to find the concomitant subtalar joint weakness or laxity.
In the body there are parts that are either moving correctly, or what they call hypermobile – too much movement, or lack of mobility, which is called hypomobility.
If I find the subtalar joint is hyper or mobile, then I must have some kind of hypomobile segment in that foot area; that’s related, they go hand in hand. (Like I said, after sifting through 20,000 patients or more through the last 20 years.) At one time, our practice was seeing approximately 4,000 to 5,000 patients per year, certainly not all by me. We were looking at feet. That’s a lot of people. My experience tells me that where the subtalar joint is excessively moving, the mid arch is where the mobility is lacking. That’s exactly hat the discovery was. What causes overpronation? Nobody really knows. It’s not discussed in the literature. I’m the only one sticking my neck on the line. In China, they say if you stick your head out of the cage, you’re going to get shot at.
Dr. Goldman talked about those who step out and stick their neck on the line, and they got the most arrows in their back. Well, I’m not feeling any arrows yet. Things are good. People are embracing this theory that I have because I will tell you, it’s solid and it works. I’m demonstrating that at 4:00 this afternoon. I will pull any one of you out of the audience and will evaluate your gait and your joints. I will show you the exactly pattern that I’m finding that’s repeating itself again over and over again, patient after patient. You can use this technique to be able to help your patients get better. It’s going to happen very quickly for you.
So why does this foot go into a varus deformity on the right? Why does the entire complex of bones become damaged? It’s because there’s a lack of movement in the foot. There’s an actual spring mechanism that occurs that allows the foot to plant and bend and push off. Once the foot becomes frozen in the mid arch, it can no longer do that. What happens in this situation, there’s a bump on the top of the foot in the area called the metatarsal cuneiform joint. We’ll just call it the mid arch. If you take your finger and roll it across the foot at the top, you’re going to find at the metatarsal cuneiform joint a calcium deposit. That means that the joints are locked. Why is it locked?
I was an anatomy instructor back in college. I used to get a kick out of it, because I entered Chiropractic College when I was about 19 years old. The students were all older than me and they thought ‘Do you know what you’re doing?’ I always thought it was interesting to really know and kind of stump them, therefore I was overboard and a little excessive and compulsive about learning about the joints and the muscles, and where they attach.
Everybody talks about the Achilles tendon, the Achilles tendon tears and the like. Did you know there is a whole group of muscles that are underneath the Achilles in the gastroc and soleus area that we forgot the names. Well, what are they doing there? They have to have a function. Why are they there? They’re there because they serve a purpose. The tibialis posterior – this angle is from looking at the back of the heel.
See the muscles- what you're seeing is that there are muscles and tendons that loop around the back of the heel that have strategic attachments at the arch. What they do is they maintain the arch and its good integrity with springy movements. It maintains that spring. What happens is when we plant our foot, we not only have a supination to pronation absorption of shock of walking and running, but we also have the spring mechanism to spring our bodies or absorb the shock into the spring then unload that energy and thrust the body forward and to be able to throw the ball into the hoop at 10 feet up or to jump 7 feet in the air over a bar. That’s the spring mechanism that the athletes are trying to develop and it comes from the muscles that we’re not working on.
Even if you go to the health club and you do calf raises. That does nothing – nothing for those muscles that maintain the arch integrity. People are always trying to put something underneath the arch as if that’s going to help: an arch support, orthotics or something else. Well, if my belly sticks out, I’m certainly not going to wear a corset every day of my life. That’s insane. What I’m going to do is develop the structural integrity of my core muscles and I’m going to reduce the fat and build my body back up. The same thing applies to the foot. Putting something under the foot to change the structural integrity only vexes the entire brain mapping and it does not do anything for long-term benefit of the patient.
So as you can see, the arrows would be coming my way from the orthotics companies. Certainly, they're not going to like what I’m going to say in my book. But I can’t help that. Things have to evolve.
Why do we have weakness in this pronator supinator cuff: that’s what I call it. Because of injury, or we didn’t do the rehabilitation right.
The tibialis posterior tendon which holds the arch up – there’s a syndrome called the TPTD, the Tibialis Posterior Tendon Dysfunction Syndrome. The tendon will snap if it’s too weak, then they have to reattach it surgically. Why is it weak? It’s because the arch locks because we don’t do certain movements for incorporating those muscles. What are those movements? That’s abduction, adduction, inversion/aversion of the foot, because all we do is walk straight ahead down the hallway into the office, and that’s all we do. We don’t do this – or any dodge ball, or any type of activities that demand our feet going side to side.
Also, we are overweight, and we wear shoes all the time. Also, the world is covered with concrete – it’s hard. Before, we would walk up to the market place; walk down hills and various different terrains to develop those muscles. Once we get our foot on an unleveled plain, those muscles have to engage to stabilize the frame from below to maintain that health and integrity to maintain the proper position. That also stimulates those muscles to develop the integrity of those to keep them actually strong so that we have good mechanics.
What we’re talking about is moving away from the Hollywood type of exercises. Certainly, I know that very well. My clients are the Who's Who of the Games and the Tony's. I sat down with a young man who won the Dancing With the Stars competition and I told him “Look, movement is more than front to back and side to side, etc.” This was very compelling to him to hear that, and he changed his technique of training.
How early can this aging process happen? It happens at childhood. Arches developed in childhood. If you put your child in a constricting shoe - you know it’s silly, if you're going to do like a curl, then you're not going to have a sport coat on, and a shirt and a windbreaker and a parka. You're going to take that off and actually what you're going to do is exercise with your arm exposed. The same thing with the foot. Why would you put on a shoe and think you’re going to run around and do calisthetics, etc. with a shoe when the shoe actually restricts movement in the 3 levels. There are 3 floors underneath the foot or underneath where the shoe is that are restricted by the footwear that are keeping our foundation from being developed and being springy and strong and maintain good integrity of movement thru our walking style. So take your shoes off and train barefoot.
It’s always amazing to me, and I didn’t even realize it in our office. We’ve been training in our office with weights barefoot since 1991. 16 years. I just didn’t think about it. One day a patient came in and said, well I can’t find any place to exercise, can I come back here? And I asked why? They said, it’s because they won’t let me exercise with my shoes off. I said, my God that’s crazy. So what does it cause when we have problems with our feet? We end up with Achilles tendons tears. I’m going to go back to this one. This is a real great story and I’m very proud of myself for that. What happened is we had a young man who came into my office about 5 years ago and he actually had an Achilles tendon tear and he went to Northwestern University and they are certainly one of the best in the world and they were advising him to do this with his foot. This is the scar from surgery where he had the Achilles tendon reattached. And here’s the result of his 3 years with me. This is the knockout punch that happened this year. This is him winning the WBC World title; he’s the number one title in the Heavy Weight Class. Not only can you reconstruct the joints, but you can also improve the athletic ability. So what we have with this goes right up into the joints of the lower back. Degenerative joint disease of the hip, back aches. Some of these problems are eluding you because you're really not doing the evaluation of the mechanics on the movement patterns.
This herniated disc that you're looking at in the x-ray has a lot more to do with movement patterns of the body and what’s happening underneath in the various 5 floors hat are underneath the herniated disc that are extremely important to rebuilding that disc. You have to level off the pelvis and the movement pattern has to be changed. That means practicing walking style. You mean I have to practice walking. Yes, you have to practice walking, because you're walking like a penguin. One leg is going this way, your body is gong that way and your back is never going to heal. You have to do some work that I’m going to recommend for you in our training center. I’m going to go over all that this afternoon more.
We’re going to go to break, but we’re talking about a weakness in the cuff - the muscles that actually maintain the spring mechanisms of the foot. Then we have the arch drops and it locks at the metatarsal cuneiform joint as you remember, you’ll see the calcium deposits there. All you have to do is grab a hold of it, and check it and you’ll see it’s frozen. What happens is that the foot can no longer plant with a nice spring mechanism and push off, so you have to turn your foot out to accommodate the lack of movement in the mid arch area so there is no real toe off. It’s a shortened gait and also creates a lot of fatigue. It’s abnormal movement, its not efficient gait, so they’re tired all the time. The toe out and the combination of no toe off creates a reduced calf contraction and that reduced calf contraction with the stiffness in the calf causes the decrease in venus return as a result of the muscles in the calf not able to squeeze the blood through venus system and return blood back to the hart. Not only that, but people with Diabetes who have poor circulation in their legs if they have an infection and you're trying to give them antibiotics and they have this abnormal movement pattern restricts the blood flow.
Did you ever get a massage and you get that muscle that is real stiff and when you press on it and blood just surges into your muscle and you feel warm. It’s because the blood is coming back. Oh that feels good. No, that’s normal. Surging blood, no, that’s the way it’s supposed to feel all the time. You’ve been living with some problems. Why? This could be corrected. So when you feed them the antibiotics, a treatment of choice, who cares? It can’t get down there. You can’t get white blood cells down into the infected area. So how do you think you're going to get the antibiotics to the affected area? Why, you wonder did 60,000 people in the United State of America supposedly “the best health service in the world” have their leg amputated. 60,000 people in America. It’s pathetic that many people get so bad that they have to have a part of their body come off. It’s amazing to me: so reduced circulation and torsion of the tibial torsion which is inward rotation of the tibula and fibula to accommodate for this abnormal movement pattern.
In fact, circulation of the thighs, hips, and weakness reduce venus return as we mentioned, poor circulation, increased risk of infection to the foot, reduced filling of the heart, systemic inflammation accelerate aging and disease processes.
Why is it that you're talking about people you can’t figure out? Some people jack themselves up in the morning to get through the day because they have to make a living. Then there are patients who resort to other stimulants which are going to get them in trouble. The diagnosis becomes confusing and is also misunderstood
Here we have a shoe we’re going to talk a lot about shoes this afternoon. Obesity, footwear, poorly designed footwear, lack of exercise, inappropriate exercise, the movement patterns, side to side, twisting and turning motions and aging fragility. Here’s a perfect example about deformation, feet and fashion. In Monte Carlo I’m giving a talk specifically on deformation.
Here we have an example of China for 1,000 years it was okay to deform the feet for fashion. Look on the right how disgusting those feet look. Did you know that 10% of the women that went through this foot binding technique died? Because they wanted to look good. They had a willow gait. They hobbled around because their feet hurt. Look at this little baby’s feet. See how the big toe turns out to the side? That’s normal. Look at these children’s feet. Look at the first one on the left. See how the big toe and second toe are in separation and as we age, the big toe turns out because the pronation gait will twist that toe to the side.
We break this down. This is the red area where we have frank inflammation and pain. Yellow is where we have no pain, after 10 or 12 treatments, the patient is pain free. However inflammation continues because the movement patterns are not perfect yet. The green areas are where the movement patterns are more perfect. We have more stabilization of the foot and movement patterns and agility, coordination and these movements now are better and we can begin to exercise or running. Things are more complex, like sports.
This is a little sound bite on the techniques that I’m going to teach you. Here is a treatment of the abductor hallucis brevis which is on the medial aspect of the big toe. And here we are between the 2 toes, the metatarsal phalangeal joints which is one of the joints on men which is extremely painful. Women have bunions. That’s the difference between men and women.
Now, here we have a contact on the proximal and the distal portion of the metatarsal cuneiform joint and we’re doing an adjustment of that area to bring the moving mechanics back to the joint. I always love this one. Here’s a guy who is trying to get in shape, he’s overweight, he jumps on the treadmill in his basement, because that’s the answer - get a treadmill, then …he runs and oh, my God, oops.
I recommend that you come to the biomechanics workshop. We will teach you to restore muscles and joints to near perfect functions and that’s going to happen at 4:00 this afternoon.
Thank you very much for inviting me. I appreciate it. You’ve been a great audience. Any questions?
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