Did you know...?
• All high school athletes in this country must undergo a physical exam prior to participating in their sport. That exam, however, is a medical exam (eyes, ears, nose and throat). (See Fig. 1)
||Skin (Non- communicable)_________________
|Ears (Otoscope) ___________________
|Lymph Nodes _____________________
||Nervous System ___________________________
||Height ______________ Weight ______________
|Blood Pressure ____________________
|| Feet ___________________________
|| Posture ________________________
|| Structural ______________________
Figure 1. Medical exam high school athletes must undergo prior to participating in their sport of choice.
• In virtually every high school in the country, young athletes are allowed to participate in a strength program merely by being on the team, not by passing any required evaluation to determine if they are structurally ready.
• When I worked with the New York Giants and consulted with the Chicago Bulls, they made every new player pass the six tests (at the base of the pyramid) to begin their conditioning program (Fig. 2), before they could enter the weight room.
Furthermore, we live in a world where the cost of arthritic conditions runs this country $86 billion per year, and the anticipated growth of this industry is 40 percent over the next twenty-three years. And chiropractors are begging for new patients? The simple answer is this: as a profession, if we can unify our message, provide good biomechanical exams to high school athletes whether they have symptoms or not, tell the parents and athletes what you found and how they can fix it, several great things would happen.
1) Our high school athletes would have fewer injuries during their high school years.
2) Our high school athletes would learn structural management at a younger age, which would include the need for chiropractic adjustments over the course of their lifetime.
3) This group of people would grow up knowing the value of chiropractic, and would both use it and encourage others, including their children.
4) This would greatly impact the predicted 40 percent increase in arthritic costs, as chiropractic adjustments mobilize joints, and that’s the number one solution to preventing premature breakdown or degeneration of joints.
5) The world would begin to understand that "paying later" is never a better option.
In upstate New York, our practice is made up of many high school athletes, and you’d be amazed at the biomechanical imbalances with which this age group suffers. In many cases, symptoms have not yet begun. But, as a profession, we have to teach the public that symptoms should never be the initiator of action. This age group should take action long before symptoms occur and, once you start doing the appropriate exam on them (The Structural Fingerprint® Exam), you, too, will see there is much work to be done with this age group.
In addition, this age group is replenished each and every year. There is a built-in support mechanism. All parents want the best for their kids and, if you can show evidence to the parent of "biomechanical issues" that will impact that child’s future, most parents will pay for and take action to help resolve that potential issue.
Case History #1
This young man came into our office in acute pain. He had severe left posterior knee pain with an associated left Achilles tendonitis. Upon our physical exam, it was obvious where much of the problem originated. In Fig. 3, you can see the gross imbalances in both the arches of the feet (severe pronation of the left foot) and an increased Q-angle of the left knee.
This is a classic case of biomechanical need, as this young man would have been the victim of anti-inflammatories, physical therapy and staying out of running for some prolonged period of time, just to let the injury heal. However, as soon as his demanding training resumed, clearly, the injuries would come right back.
Our treatment for his acute injuries consisted of cold laser therapy and extremity adjusting and, within two weeks, we had him symptom free. However, at that point in time, we did a thorough structural exam on him to determine the other biomechanical contributing factors. The first correction we made was to put him in custom orthotics, so as to balance the foundation. The outcome was incredible (Fig. 4). Note the difference in his undershorts in Fig. 3 and Fig. 4. This imbalance can certainly reflect his pelvis, showing significant imbalance. This imbalance was greatly corrected with only the insertion of custom orthotics.
Case History #2
This young runner, 18 years old, presented with severe shin splints. Shin splints are quite common in high school athletes. However, if the biomechanics above the knees are not addressed, oftentimes you’ll miss the underlying cause of this injury. Treating only the sight of injury makes us equivalent to the medical model providers out there, and chiropractors know too much biomechanically not to use all information available for the benefit of each athlete’s future.
With this athlete, we again treated him for an acute injury of the shins, with cold laser therapy, custom orthotics, ice treatments at home and proteolytic enzymes for nutritional support; but our Structural Fingerprint™ Exam uncovered the real cause for this condition. As seen in Fig. 5, there is a 49-degree sacral base angle and a severely anterior Ferguson’s Gravity Line. Try leaning forward and feel the increased demand on your forefoot as well as your shin muscles. Until this young man makes pelvic and lumbo-sacral changes, he will never get away from this injury. And, here’s where it all comes together. There is no other profession equipped to deal with these biomechanical issues. Chiropractic is head and shoulders above everyone, yet, as a profession, we’ve not unified our talents to let the world know what we do.
Figure 5. There is a 49° sacral base angle and a severely anterior Ferguson's Gravity Line. Until this young man makes pelvic and lumbosacral changes, he will never get away from this injury.
Another test we perform on all athletes is a center of gravity scan. We look at the athlete’s center of gravity from front to back and left to right. This proprioceptive scan gives a wealth of information, and provides visual evidence to the patient as to the need for a corrective program.
In this particular case, the center of gravity was virtually off the chart as compared to a more normal scan and clearly shows the neurological effect of his foot imbalances, as well as his abnormal low back biomedichamics that are seen in Fig. 5. (The arrow notes the only part of the graph that can be seen.)
Gaining Access to High School Athletes
This is the most difficult task for any chiropractor to achieve. We all want to deliver our services to this group, but can’t figure out how to make contact with them. Here are several ways to make this happen;
1) Contact your local Athletic Director and ask to speak at the "Meet the Coaches Night." In many cases, this is mandatory for parents of high school athletes to attend, so you’ll have a captured audience to address. If a good power point presentation is given, the chances are great that you’ll gain many new patients from this one talk.
2) Ask your local high school about any opportunities to speak with parent groups, as parents are more interested than anyone else about their high school children.
3) Advertise to high school athletes and refer to common injuries they suffer with, like shin splints, knee pains, hip and ITB problems, etc. This will begin the process of letting them know you work with high school athletes.
4) Contact individual coaches to ask if you can meet with either the teams, or with parents of team members, to explain why your "product" is so much more valuable than what is currently available.
Stand Out from the Competition
You have to show why you are better than everyone else. As a chiropractor, you have so many more effective tools to make this claim. Here are reasons why you should be "the best:"
1) You don’t want the athletes to wait until they’re broken. You can perform a biomechanical exam on them today and give them corrective information.
2) You read your X-rays from a biomechanical perspective, not just a pathology perspective. These findings become the starting point for each patient, and re-X-rays should be considered at anytime after the first six months of care.
3) We, as a profession, have the best tool available, the chiropractic adjustment. When this tool is used to restore mobility to joints, and used enough over time to help get postural changes, that’s how a young athlete will have an improved life. If we only use the adjustment to eliminate symptoms, we’re shortchanging many patients from potential benefits that can occur.
4) As a chiropractor, we understand the role of rehabilitation, in combination with chiropractic adjustments, and this package is much more than any other professional has to offer the athletic community.
5) Custom orthotics make this package a "Gold Level Package," and these must be recommended to stabilize from the ground up. Without custom orthotics, the structure will have a reduced potential of benefit.
The orthodontists painstakingly educated the public years ago and, today, they are enjoying the fruits of their labor. When we remind patients of what orthodontists do, and then tell them we do that with the structure, it makes perfect sense. Then, when we remind them a child wears braces for three to four years (and it’s not based on symptoms), suggesting a one year program for their child also makes perfect sense. Can you imagine how great your results would be if you had one year of unlimited care to provide to a growing athlete? Well, that could be the future of chiropractic—if we can band together with this message of structural management.
For more information on The Structural Management® Program, contact Dr. Maggs at 1-518-393-6566 or email him at