I'm taking bigger steps, my wife says

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The genetics of back pain - is back pain genetic or does a genetic trait cause back problems in families?

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Lower Back Pain Study Shows Chiropractic is Most Effective Treatment Long Term

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The US healthcare monopolies, and how cost shifting costs us

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Better options for tendon problems - Hint; the tendon is a symptom, not the problem

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New article in NY Times talks about new theories about side stiches

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The Equation Of Running And Winning Free Of Pain

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Should children run marathons - something every runner should consider reading

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Jack La Lane was a chiropractor. I didn't know that and more...

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USA Track and Field NJ y Open & Masters Indoor Track & Field Championships

Today, 2-20-11 I was on the medical staff for the USATF open and masters indoor track and field championships at the John Bennett Indoor Athletic Complex in Toms River.  As many of my patients already know, I have been their medical director since 1992 and also do my best to make sure that their events have medical staffing which is typically all volunteer.  


This particular event features athletes who are at lease 18 years of age and some are in the 80's.  Pictured above was the start of the 50 yard dash.  Below to the left is one of our patients, Jane Vaneewan who got into track and field when her doctor told her she had some health issues.  Rather than take pills, she found track and field and on a given weekend, is a national competitor, often doing at least one if not more events,  To the right was an older high jumper. I was watching his jumps which were quite good for his age group.  Lastly, the bottom photo was of a high jumper.  


I was quite busy today, since we had one runner who I suspect fractured his ankle and another who severely pulled his hamstring.  Stuff happens but I was also able to help quite a few runners.  When I was packing up and leaving, one of the runners I worked on came over to thank me.  I turned out that he had some problems that continually were occurring and he had been through all sorts of therapies which did not work.  He ran after I taped his feet and worked on him free of pain for the first time in years. He is planning to visit and bring members of his team he trains with to the office from Pennsylvania because he believes he finally found someone who understands running problems. 

 It is nice to receive that type of endorsement.  I also met a number of coaches who brought over their team members because the liked the way I helped their athletes.I love working with runners and seeing them improve with my treatment.  It is quite rewarding which is why I will work for pizza and soda and the occasional T Shirt I receive at an event.

How to stay running injury free this spring

The weather is finally warming from this deplorable winter and many runners are testing out the roads during some of our warmer February days.  As many of our patients who run know, injuries tend to happen when you load up poorly functioning bodies with exercise.

Simple tests to screen yourself and see if your body may require some help before hitting the road.
1. Balance on one leg - This simple test where you balance on each leg, for 30 seconds will tell you if you are likely to have running problems.  Lift the leg until your thigh is perpendicular to your body (90 degrees).  If you lose your balance on one or both sides, you should visit your chiropractor or muscle therapist to have them find the muscular imbalance and correct it.  Often, problems in the back of the calf by the posterior knee are part of the problem as well as the gluteal muscles and the oblique muscles in the abdomen.  An imbalance of tension in these muscles will cause you to over and under stride with the net result being pain.  Get it checked out by a professional and then hit the road.
2. Crouch down slowly.  If you lose your balance or have a hard time getting up from this position unassisted, you are having problems and should have them checked out.  Imbalances such as the ones I spoke about in the first test will make it difficult to do this correctly.  What will likely happen if you run like this - pain in the hips, shins and the legs will tighten.  See a professional before running.

Great warm up exercises before your run
1. Hip Extensions - get on all fours and lift the right leg bent at 90 degrees 10 -20 times.  This will help warm up the gluts.
2. Lateral leg raises - While on your side, with the bottom leg bent, lift the top leg straight up for 10 - 20 repetitions.
3. Calf raises - Stand on the stoop on one foot with the ball of the foot on the edge.  Let the calf stretch out all the way and then slowly push off and lift your body.  Do these 10 -20 times.  These are great for warming up the front and the back of the lower leg.
4.  Balancing for 30 seconds on each leg - Essentially, this is the same as the test mentioned above.  This will help warm up the muscles and prepare them for exercises.

Avoid stretching - little evidence to support this unless we have a young growing child. Exercises is what you should do even if you grew up with the notion that you should stretch before the run.  Trust me, you will run stronger with exercises instead.

Other things that may help
1. Foam rollers - especially if the gluts and lateral legs are tight, this will perform a crude form of myofascial release and improve the way you feel during your run. Never do this after exercise, only before
2. Mild stretching after the run to ensure the muscles heal with more flexibility.  Gentle, not vigorous.

I hope you find this useful.  If you have any questions, or opinions, please forward them to backfixer@aol.com

Fewer scans recommended for lower back pain says a recent NY Times article

The other day I read about the American College of Physicians recent updated recommendations concerning ordering routine scans such as x rays and MRI for back pain (http://www.nytimes.com/2011/02/15/health/research/15screening.html). 


The study states "Routinely ordering X-rays and CT orM.R.I. scans drives up health care costs, and does not help resolve the problem, the college’s “best practice advice” guidelines say. On the contrary, the guidelines suggest, the scans may pick up unrelated abnormalities, leading to additional tests or procedures that are of no benefit, and some scans expose patients to high levels of radiation. The recommendations are the first in a series of papers aimed at helping doctors and patients identify misused medical treatments."


On one hand, I totally agree because many physicians who do not have good evaluation skills for lower back problems will rely on scans that can be expensive in the case of an MRI or CT scan, and the tests either come back negative or show a lesion that may have nothing to do at all with why the person is in pain.  A proper evaluation is essential, and requires more than just feeling the muscles, checking reflexes and doing a straight leg raise test, which we are taught in school to do.  Many of the newer doctors who specialize in physical medicine such as chiropractors are now using active evaluation methods which tell us much more about what is going on functionally. We can then use a standing lumbar xray to deduce the overall condition of the structures.  Unlike many doctors who order lower back films taken on a table, standing films yield more useful information because it shows posture (a component of lower back pain in many cases), alignment as well as other useful information such as the quality of the hip sockets (which can be problematic in older patients).


The big question of course is when is it appropriate.  In our office, we typically do not taken plain films in children under 18, unless trauma was involved.  Over 18, if I deduce there was trauma or recurrent injuries, films are indicated to determine where the injuries occured and to what extent.  Most people over the mid 30's on will likely be candidates for x rays films with trauma or if the problem is recurrent.  While we do not perform blanket screenings, the use of plain films is quite helpful, especially in the chiropractic office since we are performing manual work and the films also alert us to anomalies.  Recently, an older patient we took films on looked to have a slight curvature in his back.  The films showed the curve to be over 30 degrees which is quite significant and alters the way we would treat him.  Obviously, this gives us medical necessity.


The article continues by saying "Most lower back pain is caused by strain on bones, muscles and ligaments. It can be treated with over-the-counter painkillers and usually abates within a few days, said an author of the practice guidelines, Dr. Amir Qaseem, director of clinical policy in medical education at the American College of Physicians." Personally, I think this shows the typical lack of true knowledge of what back pain is and why most people are not helped.  Pain killers may hide the pain, however, they never fix the body mechanics that create the problem. When you teach legions of primary care doctors that this is what back pain is, which is what typically happens, you get poor patient satisfaction, mediocre outcomes and people developing chronic back problems.


Lower back pain, especially chronic problems, most commonly start at the feet.  The more asymmetrical or inefficient your body is designed, the more you tend to suffer from back problems. Our patients know this because they see the results we get, and the way we are able to demonstrate to them where the problems are coming from and how quickly we often can turn these problems around.  To dismiss this as strain on bones, muscles and ligaments ignores that all structures against gravity experience this.  Not all structures have pain.  It is when these structures are overloaded by asymmetrical forces that the back breaks down and joints are damaged.  This is why we rarely perform tests such as MRI because 
1. most people improve from our care and not only feel better but function better too.
2. Those who do not improve after a reasonable course of care (2-3 weeks) are then referred for MRI or other advanced scans.  Since most people improve, few scans are ordered.


This is my opinion based on many years of experience.  Of course, I value your opinion too.  You can email any questions to backfixer@aol.com

Defying Medical Convention - Dr. Charschan's New Book arriving soon

Many of our patients know that a few years ago, I decided to write a book on chronic pain for consumers.  Like Syms, the clothing chain, they always say " An Educated Consumer is our Best Customer."

In the current american health care system, an educated consumer is their worst customer.  This is because the system for many years thrived on people who just took orders from their doctors, took their cholesterol meds because their numbers were not favorable and went for unproven and often ineffective therapies and treatments at great cost that were unreliable, and often dangerous.  In many other countries during the healthcare debate that had universal healthcare, where the systems were about the patients and their needs, rather than the systems themselves, they looked at us like we were nuts to not consider universal healthcare.  We heard about the horror stories of waits to see specialists, with little mention of the fact that in the end, people who live in these countries will still defend their often imperfect but affordable and cost effective healthcare delivery systems.

One of my biggest frustrations is the way the insurance companies have perverted health care delivery in our country.  The American Medical Association has maintained their monopoly on medical practice, owning the coding systems doctors use, making sure care stayed expensive.  Doctors were specialized and taught to believe that organs just went bad and that we must find the disease and treat it with the appropriate drug.  Tests took the place over the years of good manual (by hand) diagnostic skills and many of these tests come back negative, at a great cost to the system.

In my world or rehabilitation, insurance companies raised the co payments everyone pays, so they essentially pay less and we pay more.  In rehab, where people need multiple visits, this makes sense, setting up a financial barrier for the truly needy.  With a periodic office visit, a $50 co pay makes sense.  With rehabilitation 2-3 times weekly, this quickly creates an economic burden, something insurance was designed to take care of and has now been perverted by the insurance industry so they can make more money for their shareholders.  Just recently, Aetna had a great quarter, while they reduced our reimbursements for the umpteenth time and raised your insurance rates.

The healthcare paradigm in the United States is very broken indeed, and more than ever, cost effective solutions are essential. This is why I wrote this book.  I often see inappropriate rehab on a wing and a prayer without consistent results.  This is largely because the public does not understand chronic pain or why they experience it.  This groundbreaking book explains body mechanics in simple terms, why most people suffer from chronic pain and what you as the public can do to get better and more consistent results.  It makes you a smarter patient which the health care abhors and helps you find the practitioners who are about the patient, rather than the system. It also offers some self help advice, and some exercises and helps people understand the health care system better.

I plan to get the book in Amazon.com as an e book within the following month,

The cost of managing chronic pain, are there better options?

I recently came across an article on the NY times regarding Treating chronic pain and its associated costs (http://www.nytimes.com/2011/02/05/health/05patient.html?_r=1&ref=health).

There are many causes of chronic pain as discussed in this article.  Most of them are afford-ably treated in our office but many of them never quite get to us. Whether from a bad lower back disc, or from a bad auto accident, or from functional mechanical pain, many of the patients who have visited us have already seen the neurologist, the orthopedist, the rehab therapist, the rhumatologist, all at great cost from the care, the injections, the medications and other types of interventions, many of which have little worth because quite simply, they are expensive and have little effectiveness.

The big problem for most people is that most doctors know little about body mechanics, believe the pain is a disease process and treat problems that they quite frankly, do not understand.  This leads to treatments for the pain, rather than the cause of the pain which more often than not can be explained and proved to be mechanical in nature.  Mechanical problems require a mechanical based evaluation to understand the problem and finally, require a mechanically based solution.  This is why many medically based treatments simply can't work.  They do not find the source of the problem and many doctors recommend muscle relaxants believing inflammation just happens which is just ridiculous.

The benefit of seeing a chiropractor is all their solutions are mechanically based and chiropractic has a long history of helping people with chronic pain.  In our office, you have the added advantage of myofascial release treatment and Graston techniques, two methods that address the myofascial system, commonly part of the cause of chronic pain syndromes.  Secondly, we check out posture and your feet, often at the root of chronic pain.  The best part is that care is based on functional improvements that will become more pronounced from visit to visit, resulting in a marked reduction of pain. The other major benefit that as compared to many of the medical rehab and drug based regimens, chiropractic uses no drugs and the rehab is closely tied to manipulative therapy, improved joint function your body will age better because it functions better. Chiropractic should be on the top of the list of treatments people should explore before doing less conservative methods of medical care because quite simply, its more appropriate in most cases.

Big breakfasts don't help you lose weight, study says.

A recent study published by the NY times suggests having a large breakfast does not decrease the need for or the desire for food for the rest of the day (http://www.nytimes.com/2011/02/01/health/research/01diet.html?_r=1). The recent German study found that a large breakfast only adds to the amount of foot consumed by someone during the day adding to calories consumed .

The bottom line of the study suggests that to decrease overall calories during the day, either eliminate or markedly reduce the size of the breakfast. This should reduce overall caloric intake.

Personally, I love a big breakfast.  Often, when I have a large breakfast, I have no problem skipping lunch and because I view food as fuel (being a chiropractor is a physical job and I need the right type of fuel), I avoid the urge to eat lunch and may or may not have a snack.  During the normal work week, when I go to the office, my breakfast consists of coffee with milk and 1/2 regular bagel with creamed cheese.  This is sufficient because the creamed cheese has the protein I need and the bagel gives me some carbs to get the day started.

After the holidays, many of us want to shed that unneeded weight and myself included, have decided it was time to shrink myself.  Successful diets work or don't work depending on what you eat and how you apply the diet to your lifestyle.

Many diets suggest you should limit portions.  My current diet has a reduction of carbohydrates such as breads (cut the usual portion of bread in half, eat half a bagel, use pita bread or have a wrap instead of a hero), making it a practice to leave some food on the plate because we are typically full before our body tells us we are.  In other words, leave 1/3 of the food over that you would usually eat. Many of our portions are super sized compared to the rest of the world anyway.

You can also fool yourself into doing this by using a smaller plate and then avoiding second portions.  If this sounds like calorie limitation, it is.  This is much easier than attempting to measure out four oz of meat.

My result, I have lost 10 pounds since New Years and plan to lose another 8-10.  Why starve yourself?  Just eat more appropriately, less carbs, more protein.

One last thing... Exercise.  Cardio classes are great to burn off weight along with swimming and running.  Too much of this will increase your appetite so be careful to mix it up with some other type of exercise such as weight lifting.

Big breakfast - not a problem if you are in control IMHO.

What to you think?  As always, I value your opinion.

More problems with muscles and cholesterol meds such as Lipitor. Are they really necessary

  Recently, I have had a number of patients who, because of their cholesterol medication (Lipitor, etc.) have had the side effect of muscular spasms and mechanical problems in their bodies that have been exacerbated.  This disturbing trend continues to get worse because people are being scared into taking these medications when their cholesterol numbers are not very high (under 300 for triglycerides).  The drug companies have become great at selling doctors on the preventative nature of these drugs which are quite dangerous (this is why, you must have your blood taken every three months - to discover if it is causing damage to the liver or muscles).
    What's worse, is current epidimiological studies show that at best, these medications may give you an additional year, while treating a questionable disease calling it prevention. 
    Years ago, we did not have these drugs and some people had heart attacks. The question is Do these drugs prevent them and at what cost?
    The other question is - when do the benefits outweigh the risks?
    In my opinion, this is not preventative but interventional and the general public needs to understand the difference.  The other question is, with all the potential health problems out there, with this being one small piece of the puzzle, does health care by the triglyceride numbers really make people healthy?  Based on my findings, dealing with real people, and seeing the creation of problems they never needed to have because of the medication, primary care and cardiologists as well need to re look at this question and reevaluate who really needs these meds to stay healthy.
    In my humble opinion, if your triglycerides are under 300, stay away. What is your opinion?  As always, I value your thoughts.

Fighting colds naturally - Dr. Charschan's cold survival kit

There are many people who have colds, and I am one of them. You can however, get more control over how you feel and how long these symptoms persist with my simple plan that I have outlined below. Most people who have colds can benefit from this regimen.

1. Echinacea (helps fight cold viruses as the body is being attacked)

2. Amino Lysine 400 IU

3. 5000 mg vitamin c powder - one level tsp taken with orange juice


Take this as follows

At the onset of symptoms, take a tablet of Echinacea per ever two hours for 3-4 doses total. Echinacea is only effective at the onset. If you are well into the symptoms, don't barther.

Vitamin C powder - take ever two hours. If you begin to get diahrea or feel gassy, stop taking it. This means you have saturated your body. Vitamin C powder acidifies your system and gives it a fighting chance. Typically, colds make your body basic. If you are on medications that are altering your body chemistry, check with your pharmacist first. You can then take doses of this periodically as the symptoms begin to abate.

Amino Lysine is anti viral and can be taken with the vitamin C powder.

This regimen will shorten colds, get you feeling better faster. If you have a really nasty virus, you may find that it takes many doses of vitamin C to get to the point of diahrea or gassiness. If it is mild, you may reach this with one or two doses.

Doubts about foot orthotics - Do they really help?

The NY Times published an article on 1/18/11 regarding this subjective and was rather inconclusive, weighing the pro's and cons (http://www.nytimes.com/2011/01/18/health/nutrition/18best.html?_r=1&adxnnl=1&adxnnlx=1295442225-gWl5Mb3DkEtHteTDkRIX8A).  Please read the article for yourself as I am a large proponent of these devices.

Foot orthotics have become a huge industry, with both custom (hand made or scan made) and non custom orthotics (store purchased). The results as the article suggests can seem quite variable, with people using them at the suggestion of perhaps their podiatrist to use them to treat plantar fasciitis, shin pain, knee pain or in the case of our office, symmetry and alignment issues creating back, neck and human frame issues.

From a purely mechanical standpoint, they improve symmetry and body alignment.  In our office, I find that most people who visit us have body style issues which are inherited and passed down through the generations.
The more asymmetrical someone is built, the more problems you will likely have with your back and neck and it is predictable.

I believe, based on years of practice, that the hit or miss approach to treat a symptom with orthotics, whether using off the shelf orthotics or custom is bound to frustrate many, since it shows a clear lack of understanding from the practitioner, who should know more than the patient.

Do they work and what should you expect?  I believe that correct expectations is part of the problem.
1. Orthotics are merely a brace, therefore, they will only correct while you wear them.  The question is then : what do they do when you don't wear them?  The answer is; they are only effective when they are in ones shoes.
2. What do they really do?  They correct (if applied with the proper understanding of their function and the way they were made if custom) gait (the way you walk) and improve body symmetry at the ground level.  This means that they will level you out, similar to taking a 2x4 and using it to level the foundation of a house.  The difference is, they only correct while you wear them.  In other words, if they are not in your shoes, they are not doing anything.  You also should be advised to wear sandals in the summer with arches and avoid the flat ones (for more year round correction).  Also note, if you are wearing heels over 2 inches, you will not need an orthotic since the feet cannot overpronate (turn out) or supinate (turn in) with high shoes which alters your gait.
3. The device did not help my condition. Orthotics do not fix conditions.  They merely, create symmetry at the ground level.  The myofascia which controls muscle movement (newest information  - check out Thomas Meyers book on Anatomy Trains) will mold according to the forces placed upon it.  In other words, if your body is a mess because of your body style, and you have plantar fascia because your body's fascial system is a mess (very common), you will not get relief.  Podiatrists will commonly treat the foot and ignore the body above it (lunacy) which is why you have the condition.  Using orthotics may level the hips but you are still a mess.  A good chiropractor who understands a style of myofascial therapy is a must.
4. They need to be worn all the time.  If you can correct the problem 70 percent of the time, in combination with body work (chiropractor, massage therapist, both), you are much more likely to get a successful outcome you will be happy with.  If your doctor understands the gait process (few do), your results and the orthotics you get whether custom or non will be much more effective (I see many poorly thought out and casted orthotics from other orthotics).

In closing, orthotics are not a one size fits all solution.  Your best bet is to see a practitioner who really understands the gait process.  Changes we make with either custom or non custom orthotics are provable and reproducible and I do this all the time showing people how running gait predictably improves with the right shoes and device.

What do you think?  As always, I value your opinion.  Please write me with your questions at backfixer@aol.com and visit our web sites at http://www.backfixer1.com/ or.http://njrunningdoc.com/.  Also, stay tuned for my new book on the subject.

The $99 health plan brought to you by Sams Club - What does this really offer?

News flash: Sams Club offers a preventative health care plan for under $100 (http://money.cnn.com/2011/01/11/news/companies/sams_club_selling_healthcare_service/index.htm).

Sams club today presented a preventative health care plan for $99 which makes use of the internet, applying the concept of what a financial planner does but to healthcare.  I applaud them for doing this because many people do not regularly go to doctors for various reasons. Here is a way that puts the consumer in control.

"What you get: For $99, buyers of the program get an annual subscription to a web-based program that includes an at-home blood screening test that tracks an individual's cholesterol, blood sugar and Hemoglobin levels.

That information is then used to create a personalized Prevention Plan that identifies, prioritizes and explains users' health risks and recommends steps to improve their health.

Buyers of the program also get access to a 24/7 nurse line, two health coaching sessions, recommended prevention screenings, schedule and alerts based on age, gender and risks and a physician summary that can be shown to a doctor."

As a chiropractor, I look primarily at musculoskeletal health, which affects organ systems in ways we are just beginning to understand (Thomas Meyers book on Anatomy Trains shows deep muscular and organ connections).  While this gives you a light basis for managing your health, it does not substitute for doctors visits and will not cover doctors visits.  If you have a problem, you can prescreen and even discuss it with someone on their 24/7 nurse line.  The problem I see is that from the medical point of view, which this clearly comes from, these basic screenings tell you nothing about the musculoskeletal system, and most nurses and medical providers have little musculoskeletal training to properly advise you.

The good news is that as always, chiropractic care has always been affordable and the cost of an office visit is relatively inexpensive, when compared to many medical visits and the patient satisfaction continues to stay high.

If you do not go to doctors regularly, this may be money well spent, putting you in the doctors chair able to find out when to go to the regular doctor.  If you are using this for advice on back or neck pain or some other complaint, a visit to our office is priceless.

Safe Methods For Snow Removal

Follow some simple tips to protect yourself while shoveling snow. 
1. Use a fencers stance when pushing or lifting snow. It will help you protect your lower back.
2. If the temperature is in the low 20's the snow will be powder like and light. If the temperature is closer to 30, the snow flakes will be larger, wetter and heavier. Push and lift accordingly.
3. Snow that has been pushed against your driveway by the plow is always heavier. Dig , push and lift with caution.
4. If you are getting out of breath and are older, take frequent breaks. People suffer heart attacks moving snow and you do not want to be a statistic.
5. If you are sore and it is getting worse after shoveling, call us.www.backfixer1.com

Another study shows chiropractic is much less expensive and more effective for lower back problems

I came across a study that was in the December 2010 issue of JMPT (journal of manipulative therapeutics) that shows after adjusting for risk adjustment ( a fancy way of saying severity), the cost of chiropractic intervention was markedly less than going the traditional medical route (http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55052)

One of the major cost drivers we experience in our office is when our patient decides to go to the emergency room for care.  Typically, they are given pain killers or a shot of toradol for the pain which does nothing for the problem.

In many managed care plans, the medical doctor must give the referral.  To their credit, many tell their patients that they can only offer medication and then refer them to someone like me for further intervention.  Others, find themselves being sent from specialist (often orthopedics) to rehab, without having the problem that created the back issue ever resolved.  I treat many patients who tell me they are fine as long as they do the exercises and then get ready in bed to be able to move.  This tells me their problem is now subacute and have never been resolved. This causes periodic exacerbations, spinal, hip and knee degeneration and of course, they become less active and avoid painful activities.

In our office, we look for the cause and use tests that show the mechanical faults leading to back pain. Through active evaluation (a process of treat, test and treat), we get to the root of the back problem and other problems such as the hip, foot and knee improve as well, since these are merely symptoms of the gait issue that created them.  Perhaps, the greater level of understanding chiropractors have avoids costly MRI and other tests that come with increasing severity.

Many studies really need to compare not just the episode, but with chiropractic care, do people have far fewer episodes of back pain.  Also, foot orthotics are quite helpful as well as myofascial treatment to the region, which is becoming a larger part of many more progressive chiropractic practices as they move away from the less effective and more expensive model of heat, ultrasound and passive care and move toward the model of exercise, myofascial and active modes of care.

What do you think?  As always, I value your opinion.

Dead Butt Syndromes and other fairy tales affecting those who run

A few weeks ago, I read an article that was posted on the NY Times web site regarding something called Dead Butt Syndrome (http://well.blogs.nytimes.com/2010/12/21/when-the-diagnosis-is-dead-butt-syndrome/).  Apparently, this is a problem with the gluteus medius (one of the larger muscles in the butt) which as this person. The person who wrote this article is a veteran runner and as she said “For people who have persistent pain, it’s healing gone wrong,” Dr. Bright said. “That gluteus medius isn’t firing the way it’s supposed to. You’re getting an inhibition of the muscle fibers. It’s kind of dead.” 


The problem with this all encompassing diagnosis of Dead Butt Syndrome is the same with many of the attempts to globally diagnose and then come up with a cure without fully understanding the mechanisms involved.  


Over the past year, I have been reading and reviewing Thomas Meyers book on Anatomy Trains (available through Amazon.com) which shows the myofascia actually controls motion, not the muscles making this diagnosis a part of the problem rather than the solution. 

 As many of our patients know, I diagnose through active evaluation, treat the fascial restrictions and then retest the firing patterns involved.  Sometimes my first impressions are right on but I do a number of maneuvers until I figure out how to restore a more normal firing pattern.  Often, tight hip capsules (fibrous tissue surrounding the hip) can cause this problem, as well as foot overpronation and gait asymmetry.  It does not just happen to nice people like this author.  The Fascia surrounding the muscles tighten, cause the gluteus medius to recruit in other muscles such as the obliques , hamstrings, other gluteal muscles, erector spinae and even affect the upper back as the problem worsens.  

My concern is the piecemeal type of diagnosis this is, only addresses the symptom, which is really a gait issue.  This person was over and under striding (one leg is tight in back, the other tight in front causing a short stride one one side and a longer stride on the other) way before the symptoms appeared and likely ran and stretched through it.  Like most things mechanical, you can run it until it dies or fix it so it wont. The net effect is it torques the pelvis, causing a loss of leverage and your legs tighten.  Your stride shortens, you pull muscles, have problems in the calves and you mechanically have some real issues.  To fix this, you need to understand that this diagnosis of dead butt is just a symptom, rather than the problem.  You cannot, as many our runners know after visiting many practitioners who were not effective enough, fix this with a quick itis or osis diagnosis which sounds medically intelligent but hardly will lead to a solution, because of the lack of understanding of the gait mechanism that created it.  Enough said.


There is no such thing as a dead butt.  There is a thing called foot overpronation or supination or asymmetric gait which will cause this type of a problem. For those looking for a solution, you can email me directly at backfixer@aol.com.  I would be most happy to give you cost effective guidance on problems like this.


What do you think?  As always, I value your opinion