By: Tim Maggs, DC
Many Chiropractors would love to become more involved with both industry and sports teams in their area. These same Chiropractors know they could provide tremendous benefits if given the opportunity. The problem arises when they attempt to become involved, as politics and mis-education usually barricades the entry.
The Medical Model
Chiropractors who offer to treat pain ‘better’ or ‘quicker’ may think they have an advantage, but it’s a weak sales pitch in both arenas. Athletes and employees are becoming prematurely injured because no one is addressing structural balance and wellness, or the improvement of the individual’s ‘architecture,’ especially through prevention. To introduce such a thought to the team trainer or the personnel director of a company will take time and good communication skills, and that’s not something most of us have an excess of.
Both industries are familiar with the medical model. This model of care in both industrial and athletic injuries is flawed for two reasons: 1) Care is only provided after the individual is injured. This suggests there is no testing or corrective recommendations that could help an individual to both reduce the vulnerability of injury while also improving their overall conditioning and wellness. 2) All testing is pathological testing; therefore, always having a (-) conclusions on the tests. Pathology is responsible in very few cases for low back pain. Most neuromusculoskeletal pains are due to biomechanical distortions, yet no one in the healthcare industry is looking for them, finding them and correcting them. Thus, it becomes impossible to correct what you can’t find.
The Structural Fingerprint™ Exam
There are many contributing factors that determine the status of one’s structure, such as heredity, prior injuries, weight, height, activities, job description, conditioning status, shoes, mattress, diet, age, etc. It’s impossible to ever know which contributor is the most influential, so an understanding of the status of a person’s structure is critical, as the improvement of that structure is far more likely if we know where we’re starting from.
The Structural Fingerprint™ Exam begins with an examination of the feet, then moves up to check the Q angles of the knees, then range of motion, muscle integrity, joint capacity, etc. About 75% of the information comes from four standing X-rays, with a wealth of specific biomechanical information coming from them. All of this testing is done to determine two things; structural balances and imbalances (Fig. 1) and joint and muscle restrictions. Once these unique findings can be determined, then a proactive program can be designed to begin to address the improvements of all distortions and defects.
Need for Re-Education
While the whole premise of industrial and sports medicine is based on an inefficient and ineffective methodology, the more cost-effective approach requires re-education in an effort to make people understand the logic in early detection and correction vs. post-injury care. ‘Pay now’ instead of ‘pay later’ will always cost less when preservation is the key.
The same applies with the human workforce. All individuals would become injured less and spend less if they learned their specific biomechanical distortions and defects before they broke down. Therefore, a structural exam would be appropriate for all.
Now, the real challenges begin. Even though we know the formula to help industry and sports keep injuries to a minimum, we’re dealing with a society that has been mis-educated and has been taught to wait until they break down before they do anything.
The first step is to motivate and educate the gate-keeper to these people, and that can be a team trainer, coach, athletic director or strength coach. The list goes on to include business owner, personnel director, human resources director, director of training, etc. There is no magical formula to know who the best party is, so there must be a commitment to knock on as many doors until someone who cares about people wellness and bottom line costs hears what you have to say.
The next step is to get in front of the workforce, whether it is a team or employees in a company, and begin the re-education process. For the most part, people do not want to hurt. They also do not want to become injured, as the secondary stresses are voluminous for all involved. Most importantly, no one wants to degenerate prematurely.
If the message is delivered correctly, then everyone will become motivated to undergo a Structural Fingerprint™ Exam, and then act on the recommendations that come from the exam. An ongoing education program is mandatory, as some people require more time before they ‘get it.’ We need to keep the information going to them, so that they ultimately stay highly motivated and educated to maintain their structural wellness until the day they die.
Digital Scanning of the Feet with the 3D BodyView®
We often need to provide a quick and inexpensive means of teaching and showing structural imbalances. The four X-rays that are used in the Structural Fingerprint™ Exam show a wealth of information; however, some people need something less involved to show them the need for the complete exam. Digital scanning of the feet (Fig. 2) is the perfect source for that individualized information.
A picture is worth a thousand words, and the colorized presentation of the foot scan on the 3D BodyView clearly shows an individual if there are structural imbalances and whether a further review is needed. Many pro teams have digitalized scanning done on all players before the season begins, and then custom orthotics are provided. This is the first step in providing a full structural exam.
As you can see in Fig. 3, the color comparisons are vastly different, suggesting an imbalance in the structure. It’s important for the doctor not to overstate what is seen. For example, you would never want to say that the patient is definitely going to have back or knee problems from the information seen. The difference in colorization only shows there is an imbalance in the two sides of the body, and sometimes it’s even seen in the front and back of the foot. From that, the doctor has to encourage the patient to pursue it further with a structural exam to determine what imbalances exist and what should be done to improve them.
As you see in Fig. 4, the two sides are incredibly similar. This happens to be of a patient who has been through extensive treatment for the past three years for a degenerative disc in the low back, and is doing very well at the time of this writing.
You can see the abnormal wear and tear of the outer heels on an individual who is 54 years old and runs marathons. After undergoing one year of proper recommendations, you can see the difference in his latest worn-out shoes, and the significant similarities in the wear patterns. These are the results we should all look for.
The 3D BodyView should make it much easier for us to enter locker rooms and work sites and efficiently examine the weight balances and imbalances of many people in a reasonably short period of time. The information gotten is then used to motivate the individual to pursue the more in-depth evaluation, which includes X-rays and takes place in the office.
Once this initial relationship is established, this now becomes a once- or twice-a-year event, and the presentation of the message never stops. Most importantly, no one wants to break down prematurely, and if you can get this message out there, you’ll be busier than you ever dreamed possible.