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Team Doctors Top 10 Articles for 2012 Shared by 19567 Visitors!

  ________________________________________________________________________________________ 1.  Stress Fracture Of the Second Metatarsal – Self Help Tips to Treatment and Prevention from The Barefoot Running Doctor   Date Posted May 25, 2012 - Total Shares 6,916 - Total Visits 8,085 ________________________________________________________________________________________ 2. Video Tutorial #157a What Is Foot Pronation And Foot Supination? Is It Good Or Bad?  Date Posted March 9, 2012 - Total Shares 4779 - Total Visits 5282 ________________________________________________________________________________________ 3. Cracking […]

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1.  Stress Fracture Of the Second Metatarsal – Self Help Tips to Treatment and Prevention from The Barefoot Running Doctor   Date Posted May 25, 2012 - Total Shares 6,916 - Total Visits 8,085

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2. Video Tutorial #157a What Is Foot Pronation And Foot Supination? Is It Good Or Bad?  Date Posted March 9, 2012 - Total Shares 4779 - Total Visits 5282

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3. Cracking Achy Knee Pain or Chondromalacia Patella – Treatment and Prevention Tips from The Barefoot Running Doctor  Date Posted May 25, 2012 – Total Shares – 2194 – Total Visits 3114

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4Video Tutorial #12 Is Running Bad For Your Knees? How Does The Body Spring Back Safely From Impacts Of Running and Walking?  Date Posted June 13, 2012 – Total Shares – 1187 – Total Visits 2368

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5. I Have Heel Pain. Should I Give Up On Barefoot Running Date Posted January 27, 2012 – Total Shares 1321 – Total Visits 2136

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6. Video Tutorial #28 Self-Tests  To Reduce Over Pronation From Impacts During Walking and Running  Date Posted June 18 2012 – Total Shares 622 – Total Visits 1693

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 7.  Why Do I Run Barefoot… Date Posted February 21, 2012 – Total Shares 427 – Total Visits 1618

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8. Neck Pain, Upper Back Pain, Shoulder Pain With Numbness. Could it be Thoracic Outlet Syndrome?  Date Posted August 7, 2012 – Total Shares 1319 – Total Visits 1577

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9. The Ed Coan Story – What I Learned from the Strongest Man in the World Date Posted February 28, 2012- Total Shares 1015 – Total Visits 1493

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10. Video Tutorial #80 Dr James Stoxen DC Demonstrates How To Self-Help Deep Tissue Treatment Of The Ankle (Subtalar Joint Inside)  Date Posted August 1, 2012 – Total Shares 423 – Total Visits 1137

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Morton’s Neuroma – Self Help Tips, Treatment and Prevention From The Barefoot Running Doctor at Team Doctors

Morton’s Metatarsalgia ICD-9 355.6 Morton’s Neuroma – Self Help Tips, Treatment and Prevention From The Barefoot Running Doctor at Team Doctors  Tips For Better Health Ask the doctor, Dr. James Stoxen DC In this article is everything you ever wanted to know about Morton’s neuroma and more! Is your foot hurting? Do you have tingling […]

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Morton’s Metatarsalgia ICD-9 355.6

Morton’s Neuroma – Self Help Tips, Treatment and Prevention From The Barefoot Running Doctor at Team Doctors 

Tips For Better Health

Ask the doctor, Dr. James Stoxen DC

In this article is everything you ever wanted to know about Morton’s neuroma and more!

Is your foot hurting?

Do you have tingling in the feet or burning feet?

Do you have foot aches and do you have toe numbness?

The “Morton’s Metatarsalgia ICD-9 355.6” (pain between the toes) was first observed in 1835 by Filippo Civinini (1805-1844) (1)

Morton’s neuroma is a common cause of metatarsal swelling and pain – on the bottom of the foot that radiates from between the third and fourth metatarsals, which may cause extreme pain and disability.

Morton’s neuroma, also known as Mortons toe, is one of the most common disorders encountered in the foot (2) and a common cause of metatarsalgia or pain between the third and fourth toes. (3)

Although Morton neuroma is a common diagnosis, debate exists as to the best surgical and nonsurgical treatments. This article discusses the cause, how to diagnose it, nonsurgical and surgical management, and surgical complications of Morton’s neuroma (4) as well as how to avoid it.

What is a Morton’s Neuroma?

Most neuromas, 53%, are located in between the third and fourth toes (metatarsal heads) where the branches of the medial and lateral plantar nerves join. (2) However, neuromas have been found in between the second metatarsal bone and third metatarsal bones in 25% and 22% between the fourth and fifth toes. (2)

The fibrous neuroma develops when the area around the nerve is inflamed and heals itself with scar tissue, which leads to an enlargement of the nerve. This enlargement gets compressed with every step causing it to get bigger and bigger.

When it flares up, Morton’s neuroma creates a sensation of burning or sharp pain and numbness on the front part of the foot (forefoot). These symptoms radiate foot pain in the front of the foot.

“Why do my feet hurt?”

I did not have any injury so how did I get this?

Morton’s neuroma is different from a traumatic neuroma as it happens over time. It starts like a random common pain in the foot. People say, “The bottom of my foot hurts when I walk” They should say, “The bottom of my foot hurts when I walk in these pointy toe high heel shoes.

Why don’t men get it as often?

Morton’s Neuroma occurs more often in women than men, and particularly in those who wear narrow, high-heeled shoes. (5) Men do wear shoes that are too narrow but not on the same scale as the narrow pointed shoes that women wear, plus lifting the heel slides the foot down into this narrow point further squeezing the toes pinching the nerves.

Morton’s neuroma is not a true neuroma. A true neuroma is a tumor of nerves.

Morton’s Neuroma Diagnosis is instead a condition which, “consists of scar tissue and blood vessels that infiltrate the nerve fibers and cause further damage to the nerve and its covering” (6)

Aren’t Morton’s Neuroma Only For Middle Aged Women who wear high heel pointy-toed shoes? No!

The female-to-male ratio for Morton’s neuroma is 5:1 and up to 10:1 (7) however some as young as 15 have got them and men get them too.

How do you get Morton’s neuroma? What causes Morton’s neuroma?

Don’t all Morton’s neuroma’s hurt? Will I know when I have them?

No! You can be checked for the risk factors in a few minutes by a few easy tests and by watching yourself walk.

Then you can make the adjustments I recommend in this article to reduce the risk before your feet start swelling and you have pain.

If you know the cause of a condition you can treat and prevent it.

There could be several causes of a Morton’s neuroma. So, if you are looking for a magic cure, there is not one single remedy.

What are the causes of the Morton’s neuroma?

The neuroma pain is caused by over use stress and strain in the area that leads to the release of inflammation. When an area has chronic inflammation, it doesn’t necessarily cause a swollen foot, but over time, it leads to a constant layering of scar tissue in the area.

That is what doctors and scientists feel cause the neuroma.

Some doctors and scientists believe this abnormal over use stress comes from an abnormal or poor walking form such as overpronation (foot over rolls when it plants), the combination of hypo mobility and hyper mobility where the bones of the foot are both stiff or locked and others move excessively to make up for the locked ones, and of course the obvious, narrow or high heel shoes.

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You don’t have to have chronic pain in the area to have a constant layering of scar tissue. Only when the inflammation gets high enough do you have a swollen foot and feel pain. Inflammation can stay under the brains radar as “silent inflammation” or “low grade inflammation” but still over years do its damage. Inflammation in the foot can get pretty high without you feeling pain.

Some people have pain in their feet every day and think its normal. They don’t realize that part of the inflammatory process is the layering down of scar tissue. Chronic low grade inflammation increases the risk for many diseases of aging so don’t let this chronic foot pain go on.

For more information on the damaging effects of inflammation read these articles:

The Inflammation-Depression Connection Approach and The Science Based Natural Approach to Depression, click here

Video Tutorial #37 Aches, Pains, Allergies, Fatigue, Brain Fog, Diseases of Aging Have One Common Thread… INFLAMMATION, click here

Don’t wait until you have a painful swollen foot and a thick fibrous neuroma between your toes because then it is more difficult to treat.

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What is the standard examination in a doctor’s office to confirm a Morton’s neuroma?

Morton’s Neuroma Tests

Web Space Compression Tenderness Test – Doctors push their thumb between the 3rd and 4th toes (metatarsals). If there is pain there they suspect a Morton’s neuroma.

Foot Squeeze Test – Doctors squeeze the foot from the sides and if it hurts between the bones, they suspect a Morton’s neuroma. (8)

Gauthers Test - involves squeezing the metatarsals together and moving them up and down for 30 seconds, which leads to pain.

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Morton’s Neuroma Diagnosis

How do I know it’s not a foot stress fracture?

The Morton’s pain and foot symptoms are different from a foot stress fracture symptoms in that it feels like there is a ball or stone in the bones of the foot. Patients feel as if they have a bruise causing pain and swelling under the third or fourth toe or line a stone impact bruise where the bottom of the foot hurts between the second metatarsal bone and third metatarsal bone but primarily between the third toe and fourth toe and knuckle joints of the toes.

What else could this pain be?

With such a limited physical examination, doctors are unable to rule out other conditions that may be causing the pain. This might be a stress fracture of the neck of the metatarsal, a neoplasm or cancer, Freiburg osteochondrosis, ganglion cysts, a true neuroma, a neurofibroma, a schwannoma or a locked and misaligned, metatarsal.

The foot has 33 joints to absorb the impact forces of over 3,500,000 impacts or steps from walking or running per year. If one or two toes are locked other toes may have to move excessively to take up the impact forces. It is important for doctors to check for these abnormal movement patterns of the toes to see if this is the cause of a Morton’s neuroma.

In my office I find most patients have a locked and misaligned metatarsal, which is part of a more complex locking of many bones of the foot. Read on…

Because most doctors do not check for joint play or abnormal movement patterns in the 33 joints of the foot a lot of them miss this. Also because doctors are not taught how to manipulate the foot they wouldn’t think to look for it.

You check for locked or excessively moving bones in the foot with the foot wiggle test. It wasn’t invented by one of the Wiggles but I have checked the Wiggles with this test.

Morton’s Neuroma Vs Metatarsalgia – Diagnostic Tests Diagnostics

Diagnostic Imaging

The first step is to make sure you have a Morton’s neuroma and not some mystery condition or misdiagnosed!

I think you will be amazed at what the research reveals about how often Morton’s neuroma is misdiagnosed and how often it is actually seen on MRI and sonography.  You still have to question if the bulged bundle of nerve and fibrous tissue is the cause of your pain.

What I want you to get out of this section is this:

Even though you have evidence of a neuroma it does not mean the pain is coming from the neuroma and it doesn’t mean you still cant avoid surgery by opening some additional space for what ever is being pinched causing the pain. I do it all the time!

X-rays Are No Benefit!

The usual route for a foot injury is to take radio-graphs of the entire foot however this is not an injury and x-rays are no help determine a positive Morton’s neuroma diagnosis vs metatarsalgia (simple pain in the toes).

This is because the neuroma is a soft tissue and you usually cannot see these soft tissue neuromas on x-rays. They are best for bones and joints. A doctor may take x-rays because every case is different and it’s hard to determine if they are medically necessary without knowing all the variables in your case. It’s safe to say you cannot see a neuroma on an x-ray.

How do I know it’s not a foot stress fracture?

The Morton’s pain, foot symptoms can different from symptoms of a stress fracture in that they feel there is a ball or stone in the bones in the foot. Patients feel as if they have a bruise causing pain and swelling under the third or fourth toe or line a stone impact bruise where the bottom of the foot hurts between the second metatarsal bone and third metatarsal bone but primarily between the third toe and fourth toe and knuckle joints of the toes.

If the pain is in the second metatarsal it could be a locking of that bone. Also you would treat a neuroma almost the same way as a stress fracture so its not critical if its hard to distinguish between the two.

For more information on stress fractures of the foot, read this article I wrote:

Stress Fracture Of the Second Metatarsal – Self Help Tips to Treatment and Prevention from The Barefoot Running Doctor, click here to view

MRI or Ultrasonography?

For many soft tissue conditions, the Morton’s neuroma MRI is the diagnostic test of choice. However, for Morton’s neuroma MRI can is good for large neuromas but the ultrasonograph is best if the neuroma is less than 5 mm.

In a study of 25 patients with confirmed Morton’s Neuroma Diagnosis, 88% were picked up by the MRI scan and 96% were picked up by the ultrasonograph. Of those 4 that were missed by the MRI and caught by the ultrasonograph, 4 of 5 were smaller than 5 mm. So for smaller neuromas, the ultrasonograph may be more sensitive. (9)

Sonography is good to differentiate between a Morton’s Neuroma Diagnosis 15.2%, an inflammation of the bursa between the toes 20.5%, and just simple swelling of the toe joints 11.7%. (10)

However, just because there is evidence of a neuroma on ultrasonography, it does not mean that the pain is coming from the neuroma. So if your doctor finds a neuroma on an MRI and ultrasonography, do not assume this is where the pain is coming from and rush off for surgery. Read on!

Not All Mortons Neuromas Are Painful Conditions

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In a study, researchers did ultrasonography on 96 feet with no pain. In this observational prospective study, patients with asymptomatic forefeet (they had no foot pain!) who were seen by two foot and ankle surgeons for unrelated mid- or hind foot pathology were examined clinically and sonographically for the presence of interdigital nerve thickening (a fibrous neuroma). (11)

Fifty-four percent of the volunteers (26 of 48) had sonographic nerve thickening and in 17 cases (35.4%) enlarged nerves were found bilaterally. (11)

Ultrasound, even in highly skilled hands, has a high rate of incidental finding of an asymptomatic inter-digital nerve enlargement (painless Morton’s neuroma), which can lead to a false diagnosis of a Morton’s neuroma. Sonographic evidence of Morton’s neuroma per se is unreliable unless it is correlated with an equivocal clinical examination. Clinical examination is still the gold standard for the diagnosis of a Morton’s neuroma. (11)

The physical exam done by someone who has reversed the symptoms of metatarsalgia where there was evidence of a Morton’s neuroma is your best physician for this.

If you go to a surgeon, what are you more likely to get? Surgery So if you go to a surgeon and he recommends surgery you should not be surprised.

While more research has been conducted since these reviews, Morton’s neuroma continues to be a complex condition with a wide variety of conservative and surgical interventions.

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The Typical Conservative Standard Treatment Protocol For Those Who Evaluate And Treat You As A Lever Mechanism

The pain caused by Morton’s neuroma is typically associated with standing activity and may be linked to wearing heels or tight shoes that compress the toe box. (12)

This is normally what doctors quote as the cause of Morton’s neuroma. If this is what they think the cause is then they are limited to changing your footwear, standard physical therapy, drugs and surgery.

There are three stages to this lever method treatment approach, which involve progressively more invasive and expensive treatment approaches.

1. The first stage consisted of

  • Patient Education
  • Footwear Modifications and
  • Metatarsal Inflammation Relief with Physical Therapy (13)

2. The second stage consists of a steroid/local anesthetic injection into the affected interspace.

note; Stage one and two conservative treatments include footwear changes, steroid injections, physical therapy, and topical or NSAID pain reliever.(13)

3. The third stage is surgical excision of the inflamed interdigital nerve. (13)

What is interesting is 79% got better even with this very weak treatment approach. With this course of care, (21%) of the patient’s eventually required surgical excision of the nerve (13).

Just think how many may more of the 21% would have avoided surgery with a more aggressive treatment approach outlined later in this article.

Stage 1. Typical Footwear Modifications for Morton’s Neuroma

Conservative measures such as footwear modification and targeted injection of the hot spot are attempted before considering surgical intervention. (14)

The usual patient education varies depending on the depth of knowledge of the physician, how much time he or she has to educate you and the variables in your case. You may be asked to lose weight, don’t stand a lot and maybe some instructions on how to walk with less stress on your toes.

The typical footwear recommendations they make are:

  1. Do not to wear pointy toed or narrow toed shoes.
  2. Do not wear high heel shoes.
  3. Wear footwear that is of a soft material. I disagree with this!
  4. Get custom fit orthotics. I disagree with this!

I never recommend orthotics!
I never recommend a softer material for footwear!
(I explain this later)

Stage 2. Steroid/Local Anesthetic Injection for Morton’s Neuroma

Some doctors have such little faith in physical therapy, footwear modifications etc that they just recommend an injection into your foot right away the first day.

A single ultrasound-guided corticosteroid injection resulted in generally short-term pain relief for symptomatic Morton’s neuromas. The effectiveness of the injection appears to be more significant and long-lasting for lesions smaller than 5 mm. (3)

Ultrasound guided alcohol ablation of Morton’s neuroma may offer an alternative to surgery. In this study, 32% had complete resolution of pain, 66% improved but 20% went on to have surgery because of continuing pain (1)

After doctors see that conservative measures fail, surgical treatment can be indicated.

If all you had was injections before surgery you haven’t done all you can to treat this condition to prevent surgery.

Stage 3. Surgical Excision Of The Morton’s Neuroma This is what the surgery looks like

Morton’s Neuroma Surgery

There are two approaches to surgery to neuroma removal. There is the plantar approach and the dorsal approach.

The Plantar Approach – The plantar approach neuroma removal, can leave a painful scar on the weight bearing area; hence, some prefer the dorsal approach. (16)

The Dorsal Approachneuroma removal is associated with better rehabilitation and less scar problems. There can be residual numbness after surgery. (16)

Most studies reveal the outcome of Morton’s neuroma excision in the treatment of metatarsalgia with a postoperative success rate of 80 – 90%.

After neuroma excision, numbness in the web space postoperative is very common but most patients are unaware of the sensory loss.

After neuroma excision surgery you could be left with a stump neuroma. A stump neuroma is a stump from a severed nerve. In some patients it causes no symptoms but with others it is extremely painful.

Keh et al. who reported a 93% long-term subjective relief from neurectomy (surgically remove the nerve)

However, the authors report that many patients complain of some residual discomfort in the region of the surgery and 70% still have some degree of footwear restriction. (17)

After surgery can I wear my heels again? Most likely, NO!

So many ladies think that once they operate to remove the neuroma they can eventually go back to the high heels again. Not so!

Footwear problems in patients may affect the outcome of neuroma removal surgery in spite of providing good pain relief. In our series, the majority (71%) had problems wearing fashionable shoes even though they were happy with the surgery. Only 29% of patients had no footwear restriction (2)

Some women resist footwear modifications or the footwear modifications of any kind. In my opinion of those I have seen where the footwear modifications were a softer shoe with an orthotic make the overall mechanics of their condition were worse.

I feel the footwear I am recommending is more effective because of the common sense reasoning behind it and because more there are more attractive style options to choose from with these recommendations.

A big applause from the shoe fan-addicts

Surgeons don’t want to admit that the surgery for Morton’s Neuroma does not always work 100% of the time!

The excision of plantar neuromas is not always successful. Publications show failures as high as 14–21%. (18)

These are the studies the surgeons do not want published. Not all studies get to the public for obvious reasons.

Do you think a clinic would publish a study with poor outcomes? Who would recommend their center if they published a study saying they had poor outcomes?

If after surgery you still have pain, what is the course of care for now?

Wasn’t surgery the LAST resort?

Spinal Cord Stimulator? I call this a radical option!

Spinal cord stimulators are used when all avenues of controlling chronic debilitating pain are exhausted. It is like a tens unit that is implanted in the abdomen which has wires that run up inside your spinal cord and deliver a current to the cord area. The patient can increase or decrease the impulse from a remote they carry around with them.

Usually these stimulators are implanted when patients have a failed back surgery syndrome. Doctors rationalize this surgery because the alternative is prescription drugs, most commonly narcotic painkillers. Because patients tend to increase the dosage as years go by the risk for overdose is greater.

I had 2 patients that had spinal cord stimulators surgically implanted in their bodies. Interesting enough, the patients had to have a psychological exam before the surgery to see if they could handle the stimulator permanently implanted in their spinal cord area.

After care at Team Doctors, because of the relief they had from the treatment approach, both patients decided to have these stimulators surgically removed.

However, in one study, SCS immediately abolished pain of the Morton’s neuroma and the patient was able to perform her normal daily activities within 1 month. (19)

The Team Doctors Human Spring Model and Approach to Mortons Neuromas

The cause and development of Morton’s Neuroma remain controversial. (20)

Although the pathology of Morton’s neuromas is understood the development or causes of Morton’s neuroma are less agreed upon.

Why?

Because doctors cannot agree on the cause of Morton’s Neuroma it makes it difficult for physicians to treat this common injury until it is too late, requiring surgery.

I explain why in this post…

What causes the abnormal nerve to become inflamed  between the 3rd and 4th metatarsal heads that leads to Morton’s neuroma?

The first thing we have to understand is that chronic trauma has been proposed as possible factor in the cause of thickening of the nerve and pain described as Morton’s neuroma. (20) The nerve can thicken from a chronic inflammatory process that happens without pain.

So if we can isolate the sources of the chronic trauma and address it, we may be able to tone down the inflammation enough to reduce the pain thus save you from unnecessary pain and suffering and importantly unnecessary surgery.

This is the most sensible plan!

What can cause chronic trauma to the toes of the foot?

First we need to address the footwear cause of chronic trauma.

I agree with abstaining from pointy-toed shoes, narrow shoes and high heel shoes. If the toes are jammed together by the shoe then the toes will damage the nerve between them.

You MUST have a shoe with an open toe box. Don’t worry ladies, there are some really sharp shoes with open toe box styles.

I do not agree with wearing shoes with soft material. Here is why.

First, soft materials allow the foot to collapse into the material destabilizing the foot position. The pressure of the body weight can cause the foot to sink in at the ball of the foot so that there is the unequal weight distribution leading to a collapse of the toes together, increasing pressure between the toes.

Orthotics, Inserts and Arch Supports

Apart from the etiology, increased load, which is transferred to the central metatarsals, some doctors feel Morton’s neuroma can be treated successfully with orthotic devices. (21)

I remove orthotics and take a different approach for many reasons:

We already know that the nerve is pinched from pressure on the toes. So, then further jamming the toes in the bound shoe with a space occupying shim that doesn’t allow the bones to move? How do you approach the orthotic concept when you are barefoot?

There are easier and more long-term ways to transfer the load off the sore toes without a shim (orthotic) you have to put in every shoe.

Orthotics vs. Spring Down Motion

So many scientists now believe that footwear is the leading cause of deforming foot conditions. What I recommend is that children and adults walk, run and work out the barefeet as much as possible.

Zipfel, B. & Berger, L.R. Shod versus unshod: the emergence of forefoot pathology in modern humans. Conclusions: The pathological lesions found in the metatarsals of the three recent human groups generally appeared to be more severe than those found in the pre-pastoral group. This result may support the hypothesis that pathological variation in the metatarsus was affected by habitual behavior including the wearing of footwear and exposure to modern substrates. (22)

When does this scar tissue formation start?

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There is plenty of evidence that the irritation that could be the initial stages of development of Morton’s neuroma starts in childhood.

According to the results of a study presented at the 2009 American Association Orthopedic Surgeons Annual Meeting, many young children are wearing shoes that are too small. As a result, these children may be at high risk for having serious foot deformities.

Improper footwear is well recognized to be an extrinsic factor regarding the development of forefoot deformities. Small forefoot boxes in children’s footwear could impair toe function and proper development and promote early establishment of forefoot deformity,” said lead author Norman Espinosa, MD, of the University of Zürich.

The study, which took place in Switzerland, included 128 boys and 120 girls from age 5 to age 10. Researchers measured the children’s feet as well as their indoor and outdoor footwear to determine whether the children were wearing properly sized shoes. They also compared their footwear measurements to the sizes given on the manufacturers’ labels to see if the shoes were marked properly. Finally, they measured the angles of the children’s toes to learn whether any of the subjects were developing hallux valgus.

The study found that most of the children tested were wearing the wrong size shoes. “We defined fitting as perfect when the inner shoe length surmounted the foot length by at least 10 mm (optimal 12 mm),” explained Dr. Espinosa.

More than half (52.8 percent) of the children had outdoor shoes that were too small; 13.3 percent of children were wearing outdoor shoes that were too large for them. A similar pattern was seen with children’s indoor shoes or slippers. Six in 10 children (61.6 percent) were wearing indoor shoes that were too small; 1 in 10 (10.2 per­cent) were wearing shoes that were too large.

In part, the problem may arise because parents buy shoes based on the size marked by the manufacturer, perhaps without even having the child present to try on the shoe. When researchers compared the size marked on the shoe to the actual size of the shoe, they found that more than 90 percent of both indoor and outdoor shoes were smaller than the manufacturer’s marked size. Indoor shoes were almost always (97.6 percent) smaller than the manufacturer’s marked size.

“It was a truly striking finding,” says Dr. Espinosa. “The shoe sizes given by the manufacturers almost never matched with the true sizes measured by our group.”

To prevent these problems, Dr. Espinosa makes the following recommendations for parents:

  • Measure the child’s feet every time new footwear is purchased.
  • Consider the actual size of the shoe rather than just the number marked on the inside of the shoe or the box.
  • Check for shoe fit every month or so, especially during times of a growth spurt. Many children will outgrow shoes long before the shoes wear out.

“We truly did not expect such a large percentage of incorrectly declared shoe sizes,” he says. “We now know that we should focus on parental education to help prevent early onset of juvenile foot deformity.” (23)

American Academy of Orthopedic Surgeons
American Association of Orthopedic Surgeons

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What are other causes of stress on the metatarsals and surrounding tissues? What causes the irritation that leads to inflammation and scar tissue formation?

Morton’s neuroma is known to develop as a result of chronic nerve stress and irritation, particularly with excessive toe dorsiflexion.

One researcher describes it like this, Most likely a mechanically induced degenerative neuropathy that has a strong predilection for the third common digital nerve in middle aged women. (24)

Excessive motion between the third and fourth metatarsals

This explanation is made simpler by a review of the anatomy of the foot, muscles of the foot, ligaments of the foot, the foot tendons their strategic attachment and function to suspend in the foot as an integrated spring.

The answer I am providing gives us additional options for more innovative and common sense examination approaches, preventive maintenance and treatment options you and your doctor can explore.

Landing With Excessive Pronation dorsiflexion

Excessive Foot Pronation Theory

A biomechanical theory of causation involves the mechanics of the foot and ankle that excessively pronates the foot may compensate by dorsiflexion of the metatarsals subsequently irritating of the nerve between the bones.

Pronation, Neutral and Supination Landing

Excessive Dorsiflexion Theory

So mechanically it is most common with women who lift their toes up and those who’s foot rolls from the outside to the inside outside the safe range.

Dorsiflexion of toes

A foot that is mechanically unstable – weakness in the spring suspension system The tibialis posterior lifts and locks digit 1-3 leaving an abnormal movement between 3 and 4.

Excessive motion between the third and fourth metatarsals and metatarsal heads, the tethered third common digital nerve in the third web space, the third and fourth metatarsal heads flanking the third common digital nerve, the excessive weight bearing over use stress on the forefoot, particularly by wearing pointed and high-heeled shoes. (24)

Micro damage to the third common digital nerve causes inflammation, then scar tissue then repeats to layer scar tissue over and over again. Nerve fiber degeneration and excessive intraneual fibrous tissue formation resulting in an excessively large nerve. The enlargement can cause further trauma making it hurt more. (24)

First, you have to ask yourself this. If the cause is narrow footwear that squeezes the toes together, why is it mostly between the 3rd and 4th toes?

You would think that there would be an equal distribution of neuromas between all the toes in the foot.

The answer I am providing gives us additional options for more innovative and common sense examination approaches, preventive maintenance and treatment options you and your doctor can explore.

The answers lie in something you do every day without thinking. The answers lie in the way you walk.

Simply by closely observing your walking patterns we can see where the chronic damage is coming from. Which is causing the accumulation of fibrous scar tissue, the Morton’s neuroma and high levels of inflammation and pain in the toes, called metatarsalgia.

The Gait Evaluation – A more Thorough Examination

Videotape your walk—-

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Allow me to introduce you to your human spring.

What is the difference between an intact or locked spring?

  • When your spring mechanism is intact, you spring off the ground.
  • When your spring mechanism is locked, you bang into the ground!

This should make sense

The natural spring mechanism is integrated into all 7 floors of the human body.

Essentially, the human body is a giant human spring. The body is a giant spring with 7 floors of springs: 

  1. The arch
  2. The subtalar joint
  3. The ankle mortise
  4. The knee
  5. The hip
  6. The spine
  7. The head-neck
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There are two mechanisms that allow the body to function as a spring:

  • The configuration of the arch with the 26 bones and the ligament attachments.
    • All 33 joints must have complete inner-joint mobility for the foot to roll from the outside to the inside without stress on any of the metatarsals.
  • The spring suspension system which is composed of the muscles and tendons that attach on the under surface of the arch.
    • The balance of strength in your suspension system muscles determine if your foot rolls within the safe range between rolling from the outside (supination) to the inside (pronation)
    • The muscles that prevent over pronation and over supination of the foot consist of the tibialis posterior, tibialis anterior, peroneus longus, and peroneus brevis.

The strength of these supination and pronation spring suspension muscles and tendons are not covered much in bodybuilding or fitness magazines, training routines etc. but of all the muscles, in fact these are THE most important muscles in the body to work.

Why?

  • These muscles suspend your foot as a leaf spring so it can bounce your body off the ground instead of bang your body into the ground.
  • They store FREE elastic energy when your mass impacts the ground when they stretch. This storage of energy is what allows your body to move more efficiently as a spring mechanism rather than an inefficient lever mechanism.

These muscles, which I also refer to the pronator supinator cuff muscles, maintain the foot and lower limb in the safe range between supination and pronation.

When your foot lands it absorbs the force of the impacts two ways:

  1. It loads the impact force in the arch mechanism
  2. It rolls the impact force gradually from the outside to the inside.

The Tibialis Posterior Muscle (below) (blue tendon) This is the tibialis posterior (blue tendon) that supports the first metatarsal-cuneiform, second and third. You can also see the tibialis posterior (blue tendon), which attaches at the mid-arch at the first second and third metatarsal cuneiform joints where the spring action happens on impact.

What I have found consistently in patient after patient is a weakness in the tibialis posterior muscle. When it is weak it cannot stop the foot from over rolling into an unsafe position. When this happens the arch drops and locks in the first, second and third metatarsal cuneiform joints.

If this joint area is stiff or locked then the tibialis posterior cannot contract maximally against this joint. It’s impossible if the joint is locked. I find this muscle to be the weakest of the cuff.

When the persons walk compensates for this arch collapse drop and lock the patient has to roll the foot outward (toe out) to roll the foot around the locked arch area the foot rolls over the tibialis posterior tendon.

This abnormal stress on the tendon leads to a painful spasm of the tibialis posterior muscle-tendon that further compresses the first, second and third metatarsals together. (see blue tendon attachment)

Spasms in the muscles that cross a joint or two joints cause the joints to become compressed and when we apply this understanding to the human spring model, spasms cause a preload internal compressive force on the human spring. This preload internal compressive force reduces the overall force of impact capacity you can load into the spring mechanism.

  • When your spring mechanism gets weak your spring mechanism collapses into a lever mechanism.
  • When it collapses, the brain senses the abnormal movement patterns of walking as a lever and tries to protect you from the over use stress and strain by tripping spasms.
  • Spasms compress the spring further.

Why is there hypermobility between the 3rd and 4th metatarsals?

If you look at the attachment of the tibialis posterior (blue), the tendons attach strategically on the first metatarsal bone, second metatarsal bone and third metatarsal bone and not the fourth metatarsal bone or fifth metatarsal bone.

The fourth and fifth metatarsals are not controlled by this tendon. They typically remain freely moving. In fact they must move more to make up for a lack of movement in the first second and third metatarsals.

When you have locking of the second and third toes at the arch joint spring (metatarsal-cuneiform) joints the foot can no longer push off straight with the second toe pointing towards the target.

The way the foot compensates for this locking is when you point the foot out like a duck walk or slew foot so you can roll around the locked joint.

So you have a complex of three metatarsals that are locked or stiffer than normal and between the 3rd and 4th metatarsals an excessive motion.

One study stated the cause of the neuroma fibrous formation was from an increased load transferred to the middle metatarsals on weight bearing. (26)

Any motion of a joint or complex of joints outside its normal range lead to abnormal movement patterns that can cause stress and strain, wear and tear, widespread silent inflammation, which starts as an invisibly swollen foot, which can lead to scar tissue development and later painful inflammation and a visibly swollen foot.

This excessive motion is what I feel causes the excessive irritation to the nerve that leads to the accumulation of fibrous scar tissue formation.

Foot Lock

When your body impacts the ground, the force of the impact is spread across 33 joints of the foot and ankle.

I do what is called motion palpation of all 33 joints of the foot to screen for any locked joints that could be preventing the safe and full loading of the stress of impacts into the body.

If any of these 33 joints are locked the stress of this impact will not be absorbed by the protective mechanism, the arch spring and the human spring suspension system, it will be transferred to the tissues leading to any number of impact stress related conditions:

Some call this an over use injury but in reality it is an injury where stress is not distributed evenly due to some joints in the foot locking and others moving too much.

The spring suspension system of the arch and its suspension system muscles and tendons protects your body from abnormal stress that leads to conditions When this drops and locks it creates over use stress through the entire body in a pattern that is predictable. Its just like a machine.

The over use stress on the other structures could manifest as over use injuries such as:

  • Plantar Fasciitis
  • Heel Spurs
  • Heel Pain
  • Foot Pain
  • Morton’s neuromas
  • Tibialis Posterior Tendon Dysfunction (see below)
  • Ankle Sprain
  • Shin Splints
  • TFL & Illiotibial Band Syndrome
  • Gluteus Medius Pain
  • Lower Back Pain
  • Mid Back Pain
  • Neck Pain Syndromes 
  • Headaches

In his book, How I Got My Wiggle Back, Anthony Field talks about how his wife had chronic debilitating pain from Morton’s neuroma’s in both feet for 9 years. She had the MRI and the doctor said she needed surgery to remove the neuromas in both her feet. I treated her with this approach or 4-5 hours for 4 days and she was pain free which made the surgery medically unnecessary. (30)

So if you feel you have metatarsalgia or Morton’s neuroma from a weak dropped and locked spring mechanism then you should evaluate yourself for other conditions that may be developing up the pattern.

 

To think you wont get these actually does not abide by the laws of physics and nature. So more often than not you will see these conditions in your future if these abnormal mechanics are left untreated.

________________________________________________________________________________________

High Heels

Also, another study determined that high heels increased pressure on the 3rd and 4th metatarsals. The aggravation and possibly the etiology of these forms of forefoot pain may be related to acute or chronic extrinsic pressure to the forefoot.

The role of non-weight bearing, compression of the metatarsal heads, weight bearing, and toe-stance (on the metatarsal heads) on the intermetatarsal pressure of the third interspace was measured in eleven asymptomatic volunteers.

Intermetatarsal pressures for

  • Non weight bearing 21mm Hg
  • Non weight bearing with medial-lateral compression of the metatarsal heads 21mm Hg
  • Weight bearing 29mm Hg
  • Toe Stance 36 mm Hg

These findings support the proposition that increases in forefoot plantar pressures convey greater pressures to the inter metatarsal space and metatarsal heads (27)

_____________________________________________________________________________________

The Combined Effect

If you look at the combination of the high heels elevating pressures between the toes in the forefoot, the rolling of the compressive force of the landings from the inside to the outside with over pronation combined with the locking of the first 3 toes and a excessively moving 4th toe you have a bigger picture of the full cause of this scar tissue formation between the toes.

Now we have a more thorough approach with more options to reverse this mechanical abnormality to reverse this condition with conservative care.

The Gait Evaluation – A more Thorough Examination

Simply by evaluating the gait (shown by example above in this post) you can watch it back advancing the movie slowly frame by frame to look for the conditions that might lead to Morton’s Neuroma below;

  • Are your feet, shins and legs relaxed prior and during impact?
  • At impact and while transferring the weight across the planted foot are any of the toes off the ground?
  • Does your calf shake when it hits the ground (from the back)?
  • Do you push or pull your body across the ground or spring your body off the ground?
  • Does your foot point straight with the second toe being the pointer toe towards the direction you are going or do you point your toe outward like a duck walk?
  • Is your shin, ankle and foot in alignment or do you have a weak or weak ankles? (over pronation)
  • Do you walk heel-toe or land heel first? There is no spring there. The impact goes bone (heel) to bone (talus) to bone (shin) The spring suspension system is in the middle/front of the foot!

How do we correct the form and technique of your walk?

  1. Relax your foot on impact. Do not pull your toes up (dorsiflexion) prior to landing and as you transfer the weight onto your foot. This causes increased pressure when has been shown to increase the risk of Morton’s neuroma.
  2. Plant the foot with the second metatarsal toe pointing to the direction you are going. If half of the weight is on the big toe and the other half on toes 3-5 then the weight is equally distributed across the foot. This will reduce the over use stress on the third metatarsal bones and fourth metatarsal bones.
If you have a visible weakness in your tibialis posterior it is impossible for us to strengthen it within a few weeks to keep the foot from over rolling into an unsafe position to cause damage to the body. Therefore we need to check this over rolling movement with some form of shoe. However we have to accomplish this without locking up the arch, as we know this leads to stress in the metatarsals.

The answer is to control the over rolling at the heel which still allows the body to be protected from the impacts by the spring mechanism because there is nothing inhibiting the healthy rolling and loading of the arch mechanism.

Safe and Unsafe Zone

Shoes – What are the best shoes for walking or running with Morton’s Neuroma?

If your muscles aren’t strong enough to hold the foot from rolling too far to the inside you wont be able to strengthen them fast enough to maintain them in the safe range between supination to pronation (outside foot to inside foot).

So you will have to get a shoe that prevents the over rolling. Here is where other doctors and I differ.

Many doctors insist on putting an orthotic or arch support to keep the arch from over rolling.

What already explained was that there was too much pressure on these joints causing the neuroma.

Why add another space occupying shim in the already confining shoe to potentially squeeze it down further.

If you inhibit spring movement with the orthotic the muscles cannot get stronger because you inhibit the spring loading down.

I never recommend orthotics for this purpose.

For more information I recommend viewing Tutorial #97 On Your Feet All Day? Fatigued? Achy? Over Pronation? I Recommend Footwear with Extended Medial Counters, click here 

Human Spring Approach to Morton’s neuroma

I have developed a 3-step approach to restoring safer, spring loading capacity:

  1. Phase I – Release the spring from forces that create compressive forces on the human spring from muscle spasms.
  2. Phase II – Strengthen the spring suspension system muscles
  3. Phase III – Impact train the spring suspension system

Phase Ia Morton’s Neuroma Stretches treatment:

    •  Morton’s Neuroma Stretches – Remove restrictions from the spring mechanism in the 33 joints of the foot with stretching and mobilization of all 33 joints of the foot specifically those of the hypo-mobile (stiff or locked) digit 1, 2 and 3.
    • You will be physically separating all the bones of the forefoot with the same muscle and tendon stretching and joint manipulation I do in my office to allow more room for the nerve to pass between the joints. This spreads out the stress to all the 33 joints lessening the stress on specifically (the third metatarsal and fourth metatarsal).

Dr Stoxen’s best stretches for Morton’s Neuroma, video tutorials:

Video Tutorial #84 Scissor Stretching Of The Feet
Video Tutorial #85 Stretching Great For Morton’s Neuromas And Heels
Video Tutorial #88 Stretching Of The Foot While Sitting At Your Chair
Video Tutorial #89 A Stretch To Increase The Flexibility Of Your Foot

Phase Ib – Morton’s Neuroma Deep Tissue Treatments:

      • These treatments are focused on relaxing the painful spasms in the tense muscles of the spring suspension system primarily the tibialis posterior that are compressing the arch spring. Essentially you are releasing the over use stress from the metatarsals with a stiff or locked spring.
      • One massage therapist noted positive results with massage to reverse a Morton’s neuroma (28) I suggest you read this article.
      • When you do the deep tissue treatments below, the purpose is to release the compressive forces from your entire lower body to allow the bones to move more freely the way they were designed to move and not compressed with abnormal restrictive and excessive movements that cause inflammation and scar tissue formation between the toes.

View the Links below to Dr Stoxen’s self help video tutorials for Morton’s Neuroma:

Video Tutorial #78 Deep Tissue Treatment Of The Knee Popliteus Muscle
Video Tutorial #79 Deep Tissue Treatment Of The Gluteus Medius Muscle of the Hip
Video Tutorial #80 Deep Tissue Treatment Of The Subtalar Joint Of The Ankle On The Inside
Video Tutorial #81 Deep Tissue Treatment Of The Ankle (Subtalar Joint Outside) 
Video Tutorial #82 Deep Tissue Treatment Under 
Video Tutorial #83 Deep Tissue Treatment Above 
Video Tutorial #87 Deep Tissue Of The Ankle Mortise

Watch above as Dr. Stoxen demonstrates the deep tissue treatment he uses to release the muscles under the toes. Specifically pay attention to the pain under the 3rd and 4th metatarsal. pictured is the deep tissue point.

Deep Tissue Release Point for Morton’s Neuroma

 

Watch above as Dr. Stoxen demonstrates a great stretch for Morton’s Neuroma!

Probe your body with deep pressure for pain and sore ropy spasms outlined in these video tutorials.

      • If you feel them treat them at the same time with the technique I recommend in the video tutorial.
      • Release all preload tension on the spring for maximum safe deep loading of the spring mechanism.
      • Now lets release the abnormal over use stress from the foot muscles that is causing the over use stress on the body by releasing the entire integrated spring mechanism from toe to head.

Manipulative Therapy

In one review of research on the efficiency of manual therapies on many different musculoskeletal disorders, the evidence was inconclusive, but favorable toward the use of manipulation and mobilization of the foot to decrease pain associated with Morton’s neuroma. (29)

We need to spread out the forces on the landings across all the toes. We also need to keep the pressure off the toes from landing the foot on the side or rolling the weight over the foot so it compresses the bones together.

I adjust the metatarsal cuneiform joints of all toes and spend approximately 10 – 30 hours stretching, doing deep tissue on compressive painful muscle spasms and manipulating patients feet to normalize the movement and mechanics.

Patients will tell you I really aggressively work on these muscles and joints the entire time and that this is a grueling process for not only the patient but for the doctor as well. In fact, patients have described this as a ‘pain exorcism’ or an overhaul, which addresses the accumulation of 40- 60 years of stiffness, inflammation and deformation of the body.

Dr. James Stoxen DC Shares About ‘THE PAIN EXORCISM in detail in his interview on BFM 89.9 The Business Station, From Kuala Lumpur, May 25, 2012, click here to listen now

You may think this is a long time to spend on treating the feet however remember that these patients have had their feet locked in a leather or rubber-binding device squeezing the toes for decades.

If you wear sandals all summer, that is 4 months or about 1,000,000 impacts with the foot in a dorsiflexed locked position as this is required to keep sandals on the feet.

Some female patients have to wear high heels every day for work and therefore are working in heels for 3 decades by their 55th birthday.

If the doctor is right that the deformities start in childhood with shoes that are ill fitting  that means that by age 55 each patient has the damaging forces from between 100,000,000 – 130,000,000 abnormal impacts on this 33 joint complex to accumulate deformities and scar tissue which therefore stiffens the mechanism and scar tissue surrounding the nerves between the bones.

When they come to me the analogy is like trying to thaw out a piece of frozen steak with my bare hands. That is how stiff these feet are.

Morton’s Neuroma Exercises

Phase II and III – Strengthen the spring suspension system, primarily the tibialis posterior muscle with lever system training or strength training and later spring mechanism training with running, jumping and plyometric drills.

Treating the client’s muscular imbalances was an important step in combating compensation patterns the client had adopted to avoid painful motions of the foot.

You must develop of the spring suspension system muscles! This requires;

movement training

SPRING RESISTANCE TRAINING– Strengthen the spring suspension system muscles like a lever. Train with resistance exercises adding cuffs strapped to the foot moving it in a variety of directions such as eversion, inversion, abduction, adduction, pronation and supination.

SPRING IMPACT TRAINING – Strengthen the spring like a spring. I restore the spring suspension system muscles ability to resist impacts with barefoot drills like zigzag patterns, circular patterns, shuffle patterns as well as doing multi direction plyometric drills with graduated increased speeds starting with walking, jogging, running plyometrics.

Because we are going to release our natural spring mechanism, artificial spring protection like heavy cushioned soles wont be necessary. In fact, we should set a goal to get back to walking and running barefoot like we did as a youth.

Why?

The inability to walk or run barefoot safely is one of the first signs of aging ” Dr. James Stoxen DC

Are we running to slow the aging process or speed it up? Then when you’re in the competition you can cheat by putting shoes on that allow for additional recoil of the elastic of the shoe!

Please read these articles which discuss the training of the body to improve impact resistance.

      • Video Tutorial #12 Is Running Bad For Your Knees? How Does The Body Spring Back Safely From Impacts Of Running and Walking?, click here to view
      • Tutorial #28 Self-Tests & Exercises To Reduce Over Pronation and Over Supination From Impacts During Walking and Running , click here to view

Can I wear high heels with Morton’s neuromas? NO!

Can I still run with Morton’s neuromas?

Hey, I have seen women run at high speeds down the street in high heels. Would I recommend it? No way!

If you cannot walk without banging into the ground you have no business running!

How do you know when it is safe to run again?

You just don’t go out and run and see what happens!

You have to videotape yourself walking, jogging and running at increased speeds, which test the impact resistance of the spring suspension system to maintain the foot and limb in the safe range.

Watch this video below of national champion taekwondo, Christian Medina and Dr Stoxen running barefoot down the street. One of our staff was in the back of an SUV videotaping through the window while another staff member was driving.

These are the snapshots taken from the video analysis.

Dr. James Stoxen Dc barefoot running training with Christian Medina

As you can see we ran the entire run in zig-zag patterns. This forces the foot to land in positions that naturally release the 33 joints from different angles and strengthens the suspension system muscles equally from the inside and the outside.

That is how I have been able to run barefoot on solid concrete and asphalt streets without Morton’s Neuromas, shin splints or other impact related conditions.

In conclusion…

There is no one perfect approach. However, we should approach Morton’s neuromas and other conditions with logic that follow the laws of physics and nature.

I have tried my best to present to you my best recommendations based on these laws, the prevailing scientific literature and my many years of clinical experience.

You may not rush off to your family chiropractor or alternative medical center for this but I have found that conservative treatment at our chiropractic center with an integrative medical approach.

Please feel free to share your Morton’s Neuroma story in complete anonymity in the comments below. I will advise the best I can.

Thank you for sharing this article with those you feel it can help!

References – Morton’s Neuroma

1.  Pasero G, Marson P.  [Filippo Civinini (1805-1844) and the discovery of plantar neuroma].  Reumatismo. 2006 Oct-Dec;58(4):319-22. [PubMed]

2.  Pace A, Scammell B, Dhar S. The outcome of Morton’s neurectomy in the treatment of metatarsalgia.  Int Orthop. 2010 Apr;34(4):511-5. doi: 10.1007/s00264-009-0812-3. Epub 2009 May 30.  [PubMed]

3.  Fazal MA, Khan I, Thomas C. Ultrasonography and magnetic resonance imaging in the diagnosis of Morton’s neuroma. J Am Podiatr Med Assoc. 2012 May-Jun;102(3):184-6. [PubMed]

4.  Adams WR 2nd.  Morton’s neuroma. Clin Podiatr Med Surg. 2010 Oct;27(4):535-45. doi: 10.1016/j.cpm.2010.06.004.  [PubMed]

5.  Summers A. Diagnosis and treatment of Morton’s neuroma. Emerg Nurse. 2010 Sep;18(5):16-7. PubMed]

6.  Quinn TJ, Jacobson JA, Craig JG, et al. Sonography of Morton’s neuromas. AJR. 2000;174(6):1723–1728.  [PubMed]

7.  Summers A. Diagnosis and treatment of Morton’s neuroma. Emerg Nurse. 2010;18(5):16–17. [PubMed]

8.  Owens R, Gougoulias N, Guthrie H, Sakellariou A. Frimley Morton’s neuroma: clinical testing and imaging in 76 feet, compared to a control group. Foot Ankle Surg. 2011 Sep;17(3):197-200. doi: 10.1016/j.fas.2010.07.002. Epub 2010 Sep 17. [PubMed]

9.  Fazal MA, Khan I, Thomas C. Ultrasonography and magnetic resonance imaging in the diagnosis of Morton’s neuroma. J Am Podiatr Med Assoc. 2012 May-Jun;102(3):184-6. [PubMed]

10.  Iagnocco A., Coari G., Palombi G., Valesini G.  Sonography in the study of Metatarsalgia, J Rheumatol 2001 Jun;28(6);1338-40  [PubMed]

11.  Symeonidis PD, Iselin LD, Simmons N, Fowler S, Dracopoulos G, Stavrou P.  Prevalence of interdigital nerve enlargements in an asymptomatic population.   Foot Ankle Int. 2012 Jul;33(7):543-7. doi: 10.3113/FAI.2012.0543.  [PubMed]

12.  Peng H, Swierzewski SJ., III Morton’s Neuroma [PubMed]

13. Bennett GL, Graham CE, Mauldin DM.  Morton’s interdigital neuroma: a comprehensive treatment protocol.  Foot Ankle Int. 1995 Dec;16(12):760-3.  [PubMed]

14. Hassouna H, Singh D.  Morton’s metatarsalgia: pathogenesis, aetiology and current management.  Acta Orthop Belg. 2005 Dec;71(6):646-55.  [PubMed]

15.  Fazal MA, Khan I, Thomas C. Ultrasonography and magnetic resonance imaging in the diagnosis of Morton’s neuroma. J Am Podiatr Med Assoc. 2012 May-Jun;102(3):184-6. [PubMed]

16.  Faraj AA, Hosur A. The outcome after using two different approaches for excision of Morton’s neuroma.   Chin Med J (Engl). 2010 Aug;123(16):2195-8.  [PubMed]

17.  Keh R, Ballew K. Long term follow-up of Morton’s neuroma. J Foot Surg. 1992;31(1):93–95. [PubMed]

18.  Johnson JE, Johnson KA, Unni KK. Persistent pain after excision of an interdigital neuroma. Results of reoperation. J Bone Joint Surg Am. 1988;70(5):651–657.  [PubMed]

19.  Spinal cord stimulation for recurrent painful neuromas of the foot. Neurol Sci. 2011 Aug;32(4):723-5. doi: 10.1007/s10072-011-0649-6. Epub 2011 Jun 16.  Messina G, Nazzi V, Sinisi M, Dones I, Pollo B, Franzini A[PubMed]

20.  Hassouna H, Singh D.  Morton’s metatarsalgia: pathogenesis, aetiology and current management.  Acta Orthop Belg. 2005 Dec;71(6):646-55.   [PubMed]

21.  Fuhrmann RA, Roth A, Venbrocks RA. [Metatarsalgia. Differential diagnosis and therapeutic algorithm].  Orthopade. 2005 Aug;34(8):767-8, 769-72, 774-5.  [PubMed]

22.  Zipfel, B. & Berger, L.R. Shod versus unshod: the emergence of forefoot pathology in modern humans. (The Foot:  The International Journal Of Foot Science – Volume 17, issue 4 – December  (2007)  [PubMed]

23.  Norman Espinosa, MD, American Academy of Orthopedic Surgeons AAOS Now
March 2009 Issue  [PubMed]

24. Wu KK, Mortons Interdigital Neuroma: a clinical review of its etiology, treatment and results. J Foot Ankle Surg 1996 Mar-Apr;35(2):112-9; discussion 187-8.  [PubMed]

25.  Rattray F, Ludwig L. Clinical Massage Therapy: Understanding, Assessing And Treating over 70 Conditions. Elmira, ON: Talus Incorporated; 2000.  [PubMed]

26.  Symeonidis PD, Iselin LD, Simmons N, Fowler S, Dracopoulos G, Stavrou P.  Prevalence of interdigital nerve enlargements in an asymptomatic population.   Foot Ankle Int. 2012 Jul;33(7):543-7. doi: 10.3113/FAI.2012.0543.  [PubMed]

27.  Holmes GB Jr. Quantitative determination of intermetatarsal pressure.  Foot Ankle. 1992 Nov-Dec;13(9):532-5.  [PubMed]

28.  Berry K, Gonzalez P, Bowman RG. Physical Medicine and Treatment for Morton Neuroma. Medscape  [PubMed]

29.  Bronfort G, Haas M, Evans R, et al. Effectiveness of manual therapies: the UK evidence report. [Accessed January 24, 2012];Chiropractic & Osteopathy. 2010 18(3):1–33.  [PubMed]

30.  Field A., Truman G. How I Got My Wiggle Back, Wiley Publishing (2012)  [Amazon.com]

 


 
Disclaimer

 

Newspaper Article, Fitness Community Conversation, by By James Janega, Chicago Tribune

  Dr. James Stoxen DC of Team Doctors Treatment Center in Chicago joined 26 other community health and fitness enthusiasts for a Trib Nation fitness community conversation lunch. Tribune host and health writer Julie Deardorff shared with selected guests and journalists about what fitness meant to them. Their passions and personal stories were inspirational. Fitness Community Conversation By […]

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Dr. James Stoxen DC of Team Doctors Treatment Center in Chicago joined 26 other community health and fitness enthusiasts for a Trib Nation fitness community conversation lunch. Tribune host and health writer Julie Deardorff shared with selected guests and journalists about what fitness meant to them. Their passions and personal stories were inspirational.

Tribune health reporter Julie Deardorff (standing), Dr. James Stoxen DC (Center) and 26 other guests and journalists at the Trib Nation fitness lunch. (November 13, 2012)

Fitness Community Conversation
By James Janega
Chicago Tribune
November 13, 2012

To view the original article, click here

What do a chiropractor, a meditation teacher, a truck driver and an “adventurpreneur” have in common with an outdoors enthusiast, a workplace wellness provider, a Lake Michigan circumnavigator and a paratriathlete?

They all share an interest in fitness, as did the rest of the 27 guests and journalists invited by Tribune host and health writer  Julie Deardorff to join Tuesday’s Trib Nation fitness community conversation lunch.

Their passions and personal stories were inspiring, and the conversation cast fitness in terms that included the pride of overcoming personal inertia, the discount it gets folks on health insurance premiums — and as a life-affirming element in a comeback from cancer.

That was how Jenn Gibbons couched Recovery on Water, a rowing team for breast cancer survivors. Jenn became the first person to row around Lake Michigan.

Jonathon Dugas of the Vitality Group hopes his company can improve the health choices of entire workforces. Trucker and runner Jeff Clark seeks to inspire longhaul truckers to adopt healthier habits on the road.

Impossible as it seemed, writer and personal trainer Nicki Anderson once had been an obese teen, a key factor in her passion to help others attain their own healthier lifestyles through fitness.

The collective posture of the room improved as personal trainer Victoria Gray described how to improve office posture — chin up and back, not jutting forward, and ears aligned with shoulders while sitting; middle fingers lightly touching outside trouser seams while standing. (Try it. Right?)

Womens’ Running and Runners World writer and “adventurpreneur” (I love that) Jenny Hadfield talked about the importance of community on “breaking the sitting disease.” Beside her, exercise physiologist Joel Woldt of Revolution Training Centers discussed the importance of aligning long-term diet, fitness and motivation to reduce health risk factors.

Meditation teacher Elesa Commerse drew a focus on mental fitness, while chiropractor and author Dr. James Stoxen DC described his passion for understanding the mechanics of movement.

For Susan Chamberlin, a board member of the National Outdoor Leadership School, fitness in the backcountry was about risk management.

Keri Schindler and Melissa Stockwell of the paratriathletic group “Dare 2 Tri” concluded by talking about the healing power of striving against odds. Stockwell’s observation after running races as an amputee was that people told her they could keep running because she did.

It made a motto real for her: “One person inspires many.”

And isn’t that what we all do for one another when we get fit?

Is there a topic you think would make a good Trib Nation lunchtime conversation? Tell us at Email TribNation

– James Janega

Dr. James Stoxen DC Has Been Appointed to the Advisory Board for the American Board of Anti-Aging Health Practitioners and The American Board of Anti-Aging /Regenerative Medicine

  Dr. James Stoxen DC Has Been appointed to the Advisory Board for the American Board of Anti-Aging Health Practitioners (ABAAHP) and The American Board of Anti-Aging /Regenerative Medicine (ABAARM)   The American Board of Anti-Aging Health Practitioners was founded in 1999 to provide advanced education, representation, and specialty recognition of scientific and healthcare professionals. The long-term […]

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Dr. James Stoxen DC Has Been appointed to the Advisory Board for the American Board of Anti-Aging Health Practitioners (ABAAHP) and The American Board of Anti-Aging /Regenerative Medicine (ABAARM)

Dr. James Stoxen DC

 

The American Board of Anti-Aging Health Practitioners was founded in 1999 to provide advanced education, representation, and specialty recognition of scientific and healthcare professionals. The long-term objective of ABAAHP is to achieve formal sub-specialty recognition and a new status for Anti-Aging medicine and for those practicing it as qualified clinicians. Together, the A4M and ABAAHP represent over 24,000 physicians, scientific and healthcare practitioners from 110 nations. The process involves the single step of a written examination, which demonstrates proficiency in several key areas of Anti-Aging medicine. After passing the written exam and completion of certification criteria, a certificate is issued to the healthcare practitioner confirming their status as a Diplomate of Anti-Aging Medicine.

The American Board of Anti-Aging Health Practitioners (ABAAHP) is a certification program of the American Academy of Anti-Aging Medicine. ABAAHP issues Diplomate Certification to Doctors of Chiropractic (DC), Doctors of Dentistry (DDS), Naturopathic Doctors (ND), Registered Pharmacists (R.Ph.), Scientists (PhD and similar), Registered Nurses (RN), Nurse Practitioners (NP), Physician Assistants (PA), Doctors of Pharmacy (PharmD) and Acupuncturists.

The ABAAHP program is the first certification program of its kind. It raises the standard of professional care and recognition offered by practitioners delivering integrative, complementary, and alternative healthcare as well as allied health professionals. By completing the ABAAHP process, you receive specialty certification as a Diplomate practicing Anti-Aging medicine.

The American Board of Anti-Aging / Regenerative Medicine was founded in 1997 as a professional physician certification and review board for individuals with M.D. (Doctor of Medicine), D.O. (Doctor of Osteopathic Medicine), M.B.B.S. (Bachelor of Medicine/Bachelor of Science), or D.P.M. (Doctor of Podiatric Medicine) degrees. ABAARM offers these medical professionals with recognition of their specialty knowledge and clinical practice of Anti-Aging medical care. The long-term objective of ABAARM is to achieve formal sub-specialty recognition and a new status for Anti-Aging medicine and for those practicing it as qualified clinicians.

The American Board of Anti-Aging /Regenerative Medicine (ABAARM) is a certification program of the American Academy of Anti-Aging Medicine. ABAARM issues Board Certification to individuals with M.D., D.O., D.P.M. and M.B.B.S. degrees. Together, the A4M and ABAARM represent over 24,000 physicians from 110 nations in the new clinical specialty of Anti-Aging medicine.

Dr James Stoxen DC is proud to be on the advisory board for the International Sports Hall of Fame. Thank you Dr Robert Goldman for your trust in our judgment on who shall be inducted in the ISHOF.

Dr. James Stoxen DC Appointed to The Expert Discussion Panel at The 2012 Shanghai World Congress on Anti-Aging Medicine

  Dr. James Stoxen DC  was honored to be a part of The Expert Discussion Panel at the The 2012 Shanghai World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo (A4MC) on October 19,2012. Located at The Shanghai World Expo Exhibition & Convention Center. The Expert Discussion Panel were chosen from a pool of Medical experts which […]

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Dr. James Stoxen DC  was honored to be a part of The Expert Discussion Panel at the The 2012 Shanghai World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo (A4MC) on October 19,2012. Located at The Shanghai World Expo Exhibition & Convention Center.

Prof. Xuetao Pei M.DPhD, Dr. Dapeng Jin MD,  Dr. Stephen Barrie, ND, Dr. Robert M. Goldman, MD, PhD, DO, FAASP, Dr. James Stoxen DC, Dr. Stanislaw Burzynski, MD, Dr. James Ho, M.D.

The Expert Discussion Panel were chosen from a pool of Medical experts which included: Presidents of Medical Associations, Directors of International Anti-aging Departments as well as Doctors from top international hospitals and top World renowned doctors. The forum answered questions from the audience about anti-aging and progressive regenerative medicine.

The Expert Discussion Panel Included:

Prof. Xuetao Pei, M.D. Ph.D, (China)

Director, Professor of Beijing Institute of Transfusion Medicine, AMMS Stem Cell & Regenerative Medicine Center
Chief Scientist of National Stem Cell Research (PRC)
Board of Scientific Advisors, Asian-Pacific Academy of Anti-Aging Medicine
Board of Scientific Advisors/Asia-Oceania – The American Academy of Anti-Aging Medicine (A4M)

Dr. Jin Dapeng, M.D., (China)

President of the General Assembly
Dean of Beijing Chaoyang Hospital (AAA hospital)
Board of Scientific Advisors of WAAAM/A4M/APAAAM
Formal Secretary of Beijing Health Bureau
Chairman of Beijing medical association
Professor of Beijing University School of Public Health
Member of the National Committee of the Chinese People’s Political Consultative Conference
Vice president of the Chinese Hospital Management Association

Dr. Stephen Barrie, ND (USA)

Chief Science Officer of Lawke Center for Functional Medicine
Founder and former CEO/ Chairman of Great Smokies Diagnostic Laboratory (now Genova Diagnostics)
Founded one of the first health Internet sites – HealthyLiving.com
NY Times best-selling author of several health books including “7 Day Detox Miracle” and “Energize Your Life”
Pioneered the concept of “home” and “direct to consumer” laboratory testing
Co-founder of iNutritionals, the country’s leading developer and provider of supplements and tools for brain health

Prof. Robert Goldman, M.D, Ph.D, DO, FAASP (USA)

Co-Founder & Chairman of the Board- The American Academy of Anti-Aging Medicine (A4M)
Chairman – International Medical Commission
Co-founder of the anti-aging medical disciplines
World Anti-Aging Medicine President American Academy of Anti-Aging Medicine International Medical Chair
World Bodybuilding Federation International Medical Chairman.

Dr. James Stoxen DC (USA)

President, Team Doctors, Treatment and Training Center
Advisory Board for the The American Board of Anti-Aging /Regenerative Medicine (ABAARM)
Advisory Board for the American Board of Anti-Aging Health Practitioners (ABAAHP)
Global Advisory Board of  The International Sports Hall of Fame
Inducted in the Personal Trainers Hall of Fame
Inducted in the National Fitness Hall of Fame

Dr. Stanislaw Burzynski, MD Ph.D, (USA)

President, Burzynski Research Institute
Pioneer in cancer research, known worldwide for discovering Antineoplastons, which act as molecular switches to turn off cancer cells without destroying normal cells.
Owner, Burzynski Clinic, Houston, TX

Dr. James Ho, M.D Ph.D (China)

Special advisor of The Beijing Municipal Government.
Pioneer in introducing functional medicine to China
Lab Director and license holder of Genova Diagnostics

The Conference as well as the Discussion were broadcast live on China’s largest official web portal, People’s Daily Online , which is the top official website in china.

People’s Daily Online, founded on Jan. 1, 1997, is a large-scale information platform constructed by People’s Daily – one of the world’s top tennewspapers. It is also one of the largest comprehensive Internet media on the Internet. As a leading key news website in China, it upholds “authority and strength generated from people”. With “authority, popularity and credibility” as tenet, it takes the objectives “multi-language, all media forms, globalization and full coverage”, and “disseminating China’s news and covering world news” as its mission. On June 20, 2008, during his inspection tour of People’s Daily Online, President Hu Jintao noted “People’s Daily Online has played a unique role in advocating the Party’s belief, guiding public opinion and warmly serving citizens in the years since inception.”People’s Daily Online is also a teaching base for the Party School of the Communist Party of China’

Dr. James Stoxen DC and Dr. Robert Goldman M.D, Ph.D, DO, FAASP

A special thank you to Dr. Robert Goldman, Co-Founder & Chairman of the Board of The American Academy of Anti-Aging Medicine (A4M) for all of his support.

A special thanks to Stephanie Kuo, the Chairman of the World Anti-Aging Academy of Medicine/  WAAAM/A4MCHINA as well as the Deputy Chairman and General-Secretary of APAAAM/CAAAM and Director of the International Division of China Health Promotional Foundation

 

 

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Dr. James Stoxen DC Has Been Appointed To Serve On The Global Advisory Board Of The International Sports Hall of Fame

  Dr. James Stoxen DC has been appointed to serve on the Global Advisory Board for the International Sports Hall of Fame. It is an honor to be appointed to serve on the Global advisory board of the International Sports Hall of Fame! “The International Sports Hall of Fame is a 501(c) Non Profit foundation […]

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Dr. James Stoxen DC has been appointed to serve on the Global Advisory Board for the International Sports Hall of Fame.

Dr. James Stoxen DC and Dr. Dr Robert M. Goldman MD, PhD, DO

It is an honor to be appointed to serve on the Global advisory board of the International Sports Hall of Fame!

“The International Sports Hall of Fame is a 501(c) Non Profit foundation established to honor the world’s greatest athlete legends in all sports. This is a global organization that believes recognition of these remarkable sports people should endure and be recognized long after their careers have ended. Just as important is what Hall of Fame candidates do later in life, in giving back to others and society, with charity work, and mentoring young people. The induction ceremonies are held annually every March at the Arnold Schwarzenegger Sports Festival, which is the world’s largest annual sports weekend, hosting 150,000 attendees and over 18,000 competing athletes. “

Dr. James Stoxen DC and Dr. Dr Robert M. Goldman MD, PhD, DO

Dr. Stoxen’s responsibilities as a Global Advisory Board member include assisting in making recommendations for potential candidates for induction into the the International Sports Hall of Fame.

Founder of the International Sports Hall of Fame, Dr. Robert M Goldman Md, PhD, DO;

Dr. Robert M Goldman MD, PhD, DO founded the International Sports Hall of Fame to honor and recognize the world’s greatest sports legends, not only for their sports achievements while competitive, but also what they have done to give back and help others.

Dr. Goldman, a former world champion strength athlete with over 20 world records. click here and listed numerous times in the Guinness Book of World Records, has for 25 years, been Chairman of the International Medical Commission, overseeing sport medicine committees in over 184 nations, thus is no stranger to interfacing with sports legends past and present globally. He is also Chairman and co-founder of the American Academy of Anti-Aging Medicine (A4M), the largest Preventative Medicine medical society in the world, as well founder and international President Emeritis of the National Academy of Sports Medicine (NASM). Dr Goldman was inducted into the World Hall of Fame of Physical Fitness, was awarded the Healthy American Fitness Leader Award from the President’s Council on Physical Fitness & Sports and U.S. Chamber of Commerce, and was the recipient of the ‘Gold Medal for Science, the Grand Prize for Medicine, the Humanitarian Award, the Business Development Award, and awarded the 2012 LifeTime Achievement Award in Medicine & Science.

Other distinguished members on the Global Advisory Board of the International Sports Hall of Fame include:

Dr Thomas Allen DO, MPH

Dr Allen is a Clinical Professor in the Center for Exercise and Sports Medicine at the University of Oklahoma School of Community Medicine.  Dr Allen is board certified in both Internal Medicine and Pulmonary Medicine and holds a CAQ in Sports Medicine.

Randy Couture

Randy Duane Couture, is an American mixed martial artist, Greco-Roman wrestler, and actor. During his tenures in the Ultimate Fighting Championship (UFC), Couture became a three-time UFC Heavyweight Champion, two-time UFC Light Heavyweight Champion, an Interim UFC Light Heavyweight Champion, and was the UFC 13 Heavyweight Tournament Winner. Couture is the first fighter to hold two UFC championship titles in two different divisions (heavyweight and light heavyweight).

Dr Nick DiNubulie MD

Former Team Orthopedic Consultant-NBA Phillidelphia 76ers
Special Advisor-Presidents Council Physical Fitness & Sports
Nicholas A. DiNubile, MD serves as A4M’s Vice President. Dr. DiNubile is an Orthopaedic Surgeon specializing in Sports Medicine in private practice in Havertown, Pennsylvania. He is the author of the bestselling book, FrameWork- Your 7 Step Program for Healthy Muscles, Bones & Joints, and also is Executive Producer and host of the award winning national PBS television special, “Your Body’s FrameWork..” Dr. DiNubile serves as Orthopaedic Consultant to the Philadelphia 76ers Basketball Team and Pennsylvania Ballet.

Dr.Eduardo H. De Rose, MD, PhD

Member-International Olympic Committee Medical Commission
Past-president of the Brazilian Society of Sports Medicine (SBME)(two times), Honorary President of the Pan-American Confederation of Sports Medicine (COPAMEDE) and Honorary President, elected in Beijing 2006, of the International Federation of Sports Medicine (FIMS).

Dr.Rafael Santonja Gomez, Pharm.D

President-International Federation of Body Building & Fitness
President of the Spanish Association of Bodybuilding 1982/1990 Honour Medal of the Syrian Olympic Committee 1994 Honour Medal of the Pan-American Sports Organization Congress 1996 Honour Guest of the City of San Pedro Sula (Honduras 1997)

Master Alan Goldberg

Master Alan Goldberg is an American Martial Artist; he is one of the most respected individuals in the world of martial arts today. Born and raised in Brooklyn, New York.

 

Stedman Graham

Graham is an entrepreneur and CEO of S. Graham & Associates, a Chicago-based corporate and educational marketing and consulting firm. He is also founder of AAD (formerly, Athletes Against Drugs), a non-profit organization that provides services to youth and has awarded over $1.5 million in scholarships since its founding in 1985.

Fairfax Hackley

Member-International Boxing Hall of Fame
Organizing Committee-Arnold Sports Festival

 

Mark Henry

Mark Jerrold Henry is a two-time Olympian, winner of national and world titles in powerlifting and weightlifting, world record holder in powerlifting, is a strength prodigy, and many experts in the field consider him to be the most naturally gifted strongman in history. His best lifts in weightlifting and powerlifting, added together, comprise a total which is the best in history.

Dr Ronald Klatz, MD, DO

Co-Founder-National Academy of Sports Medicine (NASM)
Dr. Ronald Klatz , who coined the term “anti-aging medicine,” is recognized as a leading authority in the new clinical science of anti-aging medicine. Physician founder and President of the American Academy of Anti-Aging Medicine Inc. (“A4M”).

Dr. Klatz is the inventor, developer, or administrator of 100-plus scientific patents. In recognition of his pioneering medical breakthroughs, he was awarded the Gold Medal in Science for Brain Resuscitation Technology (1993) and the Grand Prize in Medicine for Brain Cooling Technology (1994). In addition, Dr. Klatz has been named as a Top 10 Medical Innovator in Biomedical Technology (1997) by the National Institute of Electromedical Information, and received the Ground Breaker Award in Health Care (1999) with Presidential Acknowledgment by William Jefferson Clinton from Transitional Services of New York.

Dr. Klatz has served as a contributor, editor, reviewer and advisor to Archives of Gerontology and Geriatrics, Journal of Gerontology, Osteopathic Annals Medical Journal, Patient Care Medical Journal, Total Health for Longevity, and 50 Plus magazine. His columns on wellness and longevity have appeared in Pioneer Press (a division of Time-Life Inc), Townsend Letter for Doctors and Patients, Spa Management Journal, The Wellness Channel, Fitness & Longevity Digest, Alternative Medicine Digest, Nutritional Science News, Healing Retreats & Spas, Skin Inc., and Longevity SA (for which he is served as Senior Medical Editor)

Dr. Klatz has co-hosted the national Fox Network television series Anti-Aging Update and served as national advisor for Physician’s Radio Network. He has appeared in interviews on CNN, USA Today TV, ABC News, NBC News, CBS News, Good Morning America, The Today Show, the Oprah Winfrey Show, Extra Daily TV News (partial list). Dr. Klatz has participated in articles appearing in the New York Times, USA Today, Chicago Tribune, Newsweek, Harper’s Bazaar, MacLean’s [Canada], Forbes Magazine, and Investor’s Business Daily (partial list).

Dr. Klatz is highly regarded by scientific and academic colleagues for his continuing medical education lectures on the demographics of aging and the impact of biomedical technologies on longevity. His scientific articles have been published in Resident and Staff Physician, British Journal of Sports Medicine. Medical Times/The Journal of Family Medicine, Osteopathic Annals, and American Medical Association News (partial list).

James Lorimer

Co-Founder-Arnold Sports Festival. Jim Lorimer was born on October 7, 1926 in Bristol, Pennsylvania, USA. In 1949, Jim married Martha Jean Whittaker. They have 3 children and 4 grandchildren.“When I was 13 years old, I wrote to FBI director J. Edgar Hoover and asked for advice on becoming an agent. Mr. Hoover’s response was that I should first become an attorney or an accountant.

Jim is a Certified Personal Trainer by the National Academy of Sports Medicine. During the administration of President George H. W. Bush, Jim served on the President’s Council on Physical Fitness and Sports.

In 2002, Jim received the “Arnold Schwarzenegger Classic Lifetime Achievement Award” for his contributions to sports, his community and his nation. Iron Man Magazine presented its “Lifetime Achievement Award” to Jim in 2005.

Dr. Joseph Maroon MD

Team Neursurgeon-NFL Pittsburg Steelers
Vice Chairman Neurosurgeon Univ of Pittsburgh
Joseph C. Maroon, M.D., serves as A4M’s Senior Vice President. Dr. Maroon is a board certified Professor and Vice Chairman of Neurological Surgery at the University of Pittsburgh School of Medicine and the Heindl Scholar in Neuroscience. A renowned neurosurgeon at the University of Pittsburgh Medical Center, Dr. Maroon obtained his medical and neurosurgical training at Indiana University, Georgetown University, Oxford University in England and the University of Vermont.

James Manion 

Chairman-IFBB Professional League
President-National Physique Committee
James Manion is President of the National Physique Committee (NPC) of the USA, the American national affiliate of the 175-country-strong International Federation of Bodybuilding & Fitness (IFBB).

Dan O’Malley

Dan O’Malley is a coach, mentor, motivational speaker and businessman. He was a two sport professional athlete who competed in boxing and wrestling. During his athletic career, Dan faced many top contenders, Hall of Famers, and world champions, including former undisputed World Heavyweight Champion James “Buster” Douglas, the first man to knock out Mike Tyson. He was trained in the art of wrestling by Hall of Fame champion Buddy Rogers.

Dr.Thomas P. Rosandich, Ph.D.

President & Chief Executive Officer
United States Sports Academy
Dr. Thomas P. Rosandich, founder, president, and CEO of the United States Sports Academy, has been a prominent leader in sport for more than 50 years. As a coach and as an educator, Dr. Rosandich traveled extensively, creating sports programs around the world literally from scratch and building the United States Sports Academy into the largest sports educational institution in the world.

Prof. Rano Izhar Rahmat

Prof. Rano Izhar Rahmat a world-renowned expert on anti-aging and fitness performance, is the CEO-Asia of International Fitness Professional Association, Special Advisor to the World Anti-Aging Academy of Medicine and President of the Singapore Bodybuilding Federation – 1st athlete to be elected as President in 49 years since the establishment of the federation. He is a leading health and science speaker across United States and Asia.

Governor Arnold Schwarzenegger

Austrian and American former professional bodybuilder, actor, businessman, investor, and politician. Schwarzenegger served as the 38th Governor of California from 2003 until 2011 and the most successful Chairman of the Presidents Council on Physical Fitness & Sports in history He also founded the Governor’s Council on Physical Fitness & Sports.

Dr. James Stoxen DC

President, Team Doctors
Dr. James Stoxen, D.C., owns and operates Team Doctors Chiropractic Treatment and Training Center. Team Doctors combines chiropractic care, therapy, active rehabilitation and strength training to prepare athletes for competitions.

 Dr Jan Todd PhD

World Champion Weightlifter
Founder-Stark Physical Culture Museum
Dr. Jan Todd, the Roy J. McLean Fellow in Sport History, is a professor in the Department of Kinesiology and Health Education at The University of Texas at Austin. Dr. Todd is a member of the Sport Management faculty, and teaches classes in sport history, sport philosophy, and sport and ethics. An active lecturer, Dr. Todd was named the Seward Staley Honor Lecturer for the North American Society for Sport History in 2008.

Dr Terry Todd PhD

World Champion Weightlifter
Founder-Stark Physical Culture Museum
Dr. Terry Todd (born December 31, 1937), is a former Powerlifter, and Olympic weightlifter. Dr. Todd is co-founder of the H.J. Lutcher Stark Center for Physical Culture and Sports, co-editor of Iron Game History: The Journal of Physical Culture, and creator and event director of the Arnold Strongman Classic.

David P. Webster OBE

Scotland’s David Webster has one of the most remarkable bodies of work of anyone in the world of Physical Culture, which includes many competitive sports.

 

Mr Min Zhu

Deputy Chairman-China Collection Sports Committee
Deputy President-China General Chamber of Commerce Foreign Affairs Committee
Mr Zhu is well known to the China Olympic Committee and has one of the largest collections of International Olympic
and China Olympic Committee artifacts and memorabilia. He was very involved in the development and execution of the Beijing Olympic Games as Deputy of China’s government ‘Think Tank’/China’s International Studies Foundation.

The 2012 International Sports Hall of Fame inductees were:

Governor Arnold Schwarzenegger, 7 Time Mr. Olympia, bodybuilding champion, movie star and former Governor of the State of California.

Cory Everson, 6 Time undefeated Ms. Olympia, bodybuilding champion, & movie star.

Mark Henry, 2 time Olympian, winner of national and world titles in powerlifting and weightlifting, world record holder in powerlifting, His best lifts in weightlifting and powerlifting, added together, comprise a total which is the best in history.

Jack LaLanneAmerican fitness, exercise, and nutritional expert and motivational speaker who is sometimes called “the godfather of fitness” and the “first fitness superhero.

Randy Duane Couture, an American mixed martial artist, Greco-Roman wrestler, and actor. three-time UFC Heavyweight Champion, two-time UFC Light Heavyweight Champion, an Interim UFC Light Heavyweight Champion, and was the UFC 13 Heavyweight Tournament Winner.
James Lorimer A man of great vision, principle and loyalty. Jim is an extremely hardworking and dedicated professional whose passion for sport; in particular, bodybuilding and fitness, is clearly evidenced by the fact that the Arnold Sports Festival has become, under his stewardship, the largest multi-sport festival in the U.S.A. 

 

 

“用生命走和跑!”的演讲视频和笔记。通过杠杆机制还是弹簧机制?(中文)在2012年上海抗衰老药物国际会议上呈现。

  人体弹簧系统可保护人体免受冲击伤害。如果该弹簧系统发生僵化,身体组织所要承受的冲击力会大大增加,从而发生炎症与严重损伤。此类情况若发生在膝盖部位,我们即称之为髌骨软化 膝盖疼痛或软骨撕裂,若发生在足骨或胫骨,则称之为应力性骨折。我在临床实验中发现,多数因跑步受伤,罹患足底筋膜炎、胫纤维炎、足跟痛、“跑步膝”、髋痛、髂胫束综合症与椎间盘脱出等病症的人,其弹簧系统都无法有效吸收外界冲击力。   CLICK HERE TO SEE THE LECTURE ON THE ORIGINAL SITE. _________________________________________________________________________________________ [介绍] 下一位演讲者,他会给我们介绍一个新的医疗的方式,接下来的演讲对咱们中医学和抗衰老医学,和其他我们今天讲了很多,这个医学叫做运动医学,我20年前到美国之后发现美国这门学科跟中医很多是相象的,今天要把抗衰老医学来统一整合很多不同的医学,抗衰老医学就像是一个大熔炉一样,我们要一起做很多事情,这门学科是我在美国看到不同的学派里面,学科里面,在美国经常创造性的提出很多非常特殊的治疗方法,接下来的演讲者就是创造了一个非常有意思的方法,给我们带来的讲座是:科学地走与跑:杠杆原理还是弹簧原理?运动医学:体内炎症的治疗。 人体弹簧模型及治疗方法总结…. 在医学院里,教科书和科研论文都将人体分解开来详细分析,然而通过现代医疗体系我们并不能将这些数据汇总而做出合理的总体分析。 医生和科学家都将人体杠杆机制为基础,来检查、治疗和维护人体。 我感到在当今医学界及保健业中采用的杠杆系统并不完全。我感到人们忽略了某种十分重要的机制。确实存在太多医学无法有效解释的疑团困扰着医生们和科学家们,与此同时病人对于慢性疼痛更是无能为力。 比如… 为什么即有人采用抗阻训练来加强杠杆系统的强度,又有人用肌肉增强训练加强弹簧机制,然而医生们只把人体当作杠杆系统来治疗?人体不是当作弹簧系统来分析更好吗? 为什么医生们认为撞击损害身体,而运动员又会练习高强度撞击跳跃来提升敏捷性、速度及抗伤害能力呢? 30多年前,我开始着力寻找这些让医生苦恼而让病人痛苦的难题的答案。我感到这些答案能够告诉我们怎样发挥人体的潜能。我避开作为一名医生的普通思路,从不同的逻辑角度来看待人体:从机械工程师的角度,从解剖学家的视角,以及从医生的专业角度来多方面分析人体机构。在此基础上我又总结了多年来采访、治疗及训练世界各地上百名参与各个项目的精英运动员所获得的经验。我发现的答案令我和世界各地的许多医生都感到非常兴奋,而我很高兴来与您分享我的研究成果! 我发现的是.. 人体活动时不仅仅是一个杠杆系统,而且还是一个弹簧系统。 人体弹簧模型及治疗手段 您的每一个动作动力都来源于一个奇妙的弹簧系统。如果您能明白其运作原理,了解该机制的重要功能,认识到弹簧可能会如何退化并锁定,如何影响您的健康,那么您就会恍然大悟,为什么那么多病人被误诊而痛苦不堪。 在我为您讲解完怎样去释放、强化、再加载您的人体弹簧之后,您会明白为什么其他的治疗都毫无作用的同时,我的病人全都能康复。理解了人体弹簧,您就能理解为什么有些运动员能够跳高跨越跳杆7尺之多,或是连续跑步50英里,而很多人走路、跑步、举重物时,甚至坐在椅子上站起来时都会感到疼痛。您身体的活动效率与您人体弹簧机制的强度息息相关。 如果这个理论是正确的,那么医学界就必须要纠正现有的检查和治疗手段,加入有效地应对人体弹簧系统的治疗元素。我在本演讲中总结了人体弹簧理论及治疗方法。 对人体工程机构的彻底误解 不幸的时,医学界并没有将人体当作一个活弹簧来对待,而因此对人体如何在由物理定律和物理常识掌控的世界中运动、保护自己及循环能量是一无所知。当今的医疗手段背离自然、并且无视物理定律和工程学分析。 在人体弹簧模型中,人体是一个弹簧系统(而非杠杆系统),并作为弹簧机制而保护身体经受撞击,并高效回收利用能量。 如果人体弹簧一旦锁住,撞击将被身体各组织吸收,导致慢性炎症以及严重伤害。如果在膝盖处发生炎症则会导致软骨磨损或老化,之后导致病人接受人工膝关节置换手术。如果是胫骨则为外胫夹。 在足部发生则可能引起足底筋膜炎、足跟骨刺、跖受压性骨折或是简单乘坐脚疼。 我的临床经验告诉我,很多人跑步受伤,如足底筋膜炎、外胫夹、跟痛症、膝盖痛、髋痛、骼胫带综合症以及椎间盘突出,这些都是走路、跑步或运动中人体弹簧机制无法有效吸收碰撞而造成的。 为什么人体弹簧机制及治疗手段是抗衰老医生的首选 脊骨神经专家 詹姆斯·斯塔克森医生 ________________________________________________________________________________________ 从卧床到赤足运动 重焕您的青春 赤足——无支撑物 穿鞋——4个支撑物 运动控制——4个支撑物 器械矫正术——6个支撑物 矫正鞋与矫正术——足部束缚 手杖——7个支撑物 四脚步行器——10个支撑物 轮椅——四轮——反相适应 卧床——床——反相适应 _______________________________________________________________________________ Injuries Can Happen […]

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人体弹簧系统可保护人体免受冲击伤害。如果该弹簧系统发生僵化,身体组织所要承受的冲击力会大大增加,从而发生炎症与严重损伤。此类情况若发生在膝盖部位,我们即称之为髌骨软化 膝盖疼痛或软骨撕裂,若发生在足骨或胫骨,则称之为应力性骨折。我在临床实验中发现,多数因跑步受伤,罹患足底筋膜炎、胫纤维炎、足跟痛、“跑步膝”、髋痛、髂胫束综合症与椎间盘脱出等病症的人,其弹簧系统都无法有效吸收外界冲击力。

 

CLICK HERE TO SEE THE LECTURE ON THE ORIGINAL SITE.

_________________________________________________________________________________________

[介绍] 下一位演讲者,他会给我们介绍一个新的医疗的方式,接下来的演讲对咱们中医学和抗衰老医学,和其他我们今天讲了很多,这个医学叫做运动医学,我20年前到美国之后发现美国这门学科跟中医很多是相象的,今天要把抗衰老医学来统一整合很多不同的医学,抗衰老医学就像是一个大熔炉一样,我们要一起做很多事情,这门学科是我在美国看到不同的学派里面,学科里面,在美国经常创造性的提出很多非常特殊的治疗方法,接下来的演讲者就是创造了一个非常有意思的方法,给我们带来的讲座是:科学地走与跑:杠杆原理还是弹簧原理?运动医学:体内炎症的治疗。

人体弹簧模型及治疗方法总结….

在医学院里,教科书和科研论文都将人体分解开来详细分析,然而通过现代医疗体系我们并不能将这些数据汇总而做出合理的总体分析。

医生和科学家都将人体杠杆机制为基础,来检查、治疗和维护人体。

我感到在当今医学界及保健业中采用的杠杆系统并不完全。我感到人们忽略了某种十分重要的机制。确实存在太多医学无法有效解释的疑团困扰着医生们和科学家们,与此同时病人对于慢性疼痛更是无能为力。

比如…

为什么即有人采用抗阻训练来加强杠杆系统的强度,又有人用肌肉增强训练加强弹簧机制,然而医生们只把人体当作杠杆系统来治疗?人体不是当作弹簧系统来分析更好吗?

为什么医生们认为撞击损害身体,而运动员又会练习高强度撞击跳跃来提升敏捷性、速度及抗伤害能力呢?

30多年前,我开始着力寻找这些让医生苦恼而让病人痛苦的难题的答案。我感到这些答案能够告诉我们怎样发挥人体的潜能。我避开作为一名医生的普通思路,从不同的逻辑角度来看待人体:从机械工程师的角度,从解剖学家的视角,以及从医生的专业角度来多方面分析人体机构。在此基础上我又总结了多年来采访、治疗及训练世界各地上百名参与各个项目的精英运动员所获得的经验。我发现的答案令我和世界各地的许多医生都感到非常兴奋,而我很高兴来与您分享我的研究成果!

我发现的是..

人体活动时不仅仅是一个杠杆系统,而且还是一个弹簧系统。

人体弹簧模型及治疗手段

您的每一个动作动力都来源于一个奇妙的弹簧系统。如果您能明白其运作原理,了解该机制的重要功能,认识到弹簧可能会如何退化并锁定,如何影响您的健康,那么您就会恍然大悟,为什么那么多病人被误诊而痛苦不堪。

在我为您讲解完怎样去释放、强化、再加载您的人体弹簧之后,您会明白为什么其他的治疗都毫无作用的同时,我的病人全都能康复。理解了人体弹簧,您就能理解为什么有些运动员能够跳高跨越跳杆7尺之多,或是连续跑步50英里,而很多人走路、跑步、举重物时,甚至坐在椅子上站起来时都会感到疼痛。您身体的活动效率与您人体弹簧机制的强度息息相关。

如果这个理论是正确的,那么医学界就必须要纠正现有的检查和治疗手段,加入有效地应对人体弹簧系统的治疗元素。我在本演讲中总结了人体弹簧理论及治疗方法。

对人体工程机构的彻底误解

不幸的时,医学界并没有将人体当作一个活弹簧来对待,而因此对人体如何在由物理定律和物理常识掌控的世界中运动、保护自己及循环能量是一无所知。当今的医疗手段背离自然、并且无视物理定律和工程学分析。

在人体弹簧模型中,人体是一个弹簧系统(而非杠杆系统),并作为弹簧机制而保护身体经受撞击,并高效回收利用能量。

如果人体弹簧一旦锁住,撞击将被身体各组织吸收,导致慢性炎症以及严重伤害。如果在膝盖处发生炎症则会导致软骨磨损或老化,之后导致病人接受人工膝关节置换手术。如果是胫骨则为外胫夹。

在足部发生则可能引起足底筋膜炎、足跟骨刺、跖受压性骨折或是简单乘坐脚疼。

我的临床经验告诉我,很多人跑步受伤,如足底筋膜炎、外胫夹、跟痛症、膝盖痛、髋痛、骼胫带综合症以及椎间盘突出,这些都是走路、跑步或运动中人体弹簧机制无法有效吸收碰撞而造成的。

为什么人体弹簧机制及治疗手段是抗衰老医生的首选

脊骨神经专家 詹姆斯·斯塔克森医生

________________________________________________________________________________________

从卧床到赤足运动

重焕您的青春

赤足——无支撑物
穿鞋——4个支撑物
运动控制——4个支撑物
器械矫正术——6个支撑物
矫正鞋与矫正术——足部束缚
手杖——7个支撑物
四脚步行器——10个支撑物
轮椅——四轮——反相适应
卧床——床——反相适应

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Injuries Can Happen When Running
跑步时可能会受伤

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左拉·巴德(Zola Budd) 赤足跑步者

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Kinesthetic learning via Kinesthetic Senses
通过运动感觉进行体验学习(Kinesthetic learning)

  • 切运动的强度、效率与安全性都是由神经肌肉因素决定的;运动感觉与基本本体感受机制尤为重要:通过它们,我们可以了解自己肌肉骨骼系统各个组成部分在运动中所处的位置及其时空关系。
  • 通过整合信息,我们即可完成既定动作,并使其姿势、速度、加速度与时间控制的准确性达到最高。
  • 提高本体感受效率的方法之一,即减少或完全阻断其他感觉系统的信息输入
Roman R. (1986) Trenirovka Tyazheloatleta (Training of the Weightlifter) Fizkura I Sport Moscow 

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Creep (a word used in physics)
蠕变(物理学术语)

  • 随着加荷速率的增加,胶原组织的强度与刚度都会显著提高。
  • 我们强调应当合理利用高加速度训练方法。
  • 项研究表明,膝盖韧带负荷极限可提高约50%,此时投票率增加4倍(Kennedy等,1976)。

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赤足跑与穿鞋跑的生物力学及生理学比较(以熟练赤足跑步者为实验对象)

  • 研究者利用跑台测力仪对8名受试者进行了分析。
  • 与正常穿鞋跑步相比,运动员在赤足跑时,踝关节跖屈度更大。
  • 赤足跑可减少冲击力与步伐方面的改变。

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Can Barefoot Activity Alleviate Knee Pain and Arthritis?
赤足运动是否能够缓解膝盖疼痛与关节炎?

  • 研究员就我们穿鞋与赤脚运动时的膝关节内收力矩(EKAM)分别做了测量。EKAM反映了膝盖关节负荷从内侧到外侧的分布情况。
  • EKAM值越高,膝关节退化(罹患膝关节炎)就越快、越严重。
  • 研究员发现,与赤足走路和跑步相比,穿运动鞋和跑鞋活动时,EKAM值会有所上升。

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Foot Strike Patterns And Collision Forces In Habitually Barefoot Versus Shod Runners
赤足活动与穿鞋运动在步态与碰撞力方面的比较

  • 习惯赤足跑步的人通常以前脚掌触地。
  • 习惯穿鞋跑步的人因为有现代跑鞋的气垫鞋跟做支持,大多数情况下都是以脚跟触地。
  • 运动学与动力学分析表明,即使在坚硬地面上运动,赤足跑者迈步所产生的碰撞力也比穿鞋跑步的人小——前者以前脚掌触地,而后者是以脚跟触地。
  • 之所以会有上述差距,主要是因为赤脚触地时,足弓可更为充分地发挥作用,而且踝关节的协调性也比较好,能够减少人体与地面碰撞时的有效质量。

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Effects Of Footwear And Strike Type On Running Economy
跑鞋与步态对“跑步经济性”(Running Economy)的影响

  • 在穿着最为简单的跑鞋运动时,若人以前脚掌触地,此时跑步者的跑步经济性可提高2.41%。
  • 在穿着最为简单的跑鞋运动时,若人以脚跟触地,此时跑步者的跑步经济性可提高3.32%.
  • 研究员没有测量穿鞋跑时的足弓张力,但在赤足情况下,前脚掌触地所产生的足弓张力比脚跟触地要大得多。
  • 赤足跑、以前脚掌触地时的跖屈肌输出力要比穿鞋跑、以脚跟触地时的大得多。
  • 与穿鞋跑相比,赤足跑时的跟腱——小腿三头肌张力与膝盖弯曲度也要小得多。
  • 如果不考虑步态,且能控制跑鞋质量与步频,穿简单跑鞋跑步的经济性要比穿传统跑鞋运动高。究其原因,可能是因为在前一情况下,下肢可储存与释放更多弹性能量。

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The Effect of Running Shoes on Lower Extremity Joint Torques
跑鞋对下肢关节力矩的影响

  • 研究者让68名受试者先是赤脚、然后穿上同类稳定跑鞋跑步。
  • 在跑台测力仪上,研究者分别收集了两种情况下的三维运动资料以及与之同步的地面反作用力数据。
  • 我们发现,与赤脚跑步相比,受试者在穿鞋跑步时,其臀、膝与踝关节的力矩有所提高。
  • 臀内旋力矩提高了54%。
  • 膝弯曲力矩提高了36%。
  • 膝内翻力矩提高了38%。

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The Normal Orientation Of The Human Hallux And The Effect Of Footwear
人类大脚拇指正常形态以及跑鞋对其的影响

  •  研究者通过测量38张射线照片中的脚趾角度来确定每名受试者大脚拇指的形态。
  • 符合解剖学设计的跑鞋对大脚拇指有矫正作用,前提是外展拇指肌能够充分活动。

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Shod Versus Unshod: The Emergence Of Forefoot Pathology In Modern Humans?
穿鞋与赤脚:现代人急需前脚病理学?

  • 研究者就现代穿鞋运动者与赤脚运动者发生跖骨病状的频率分别做了调查。
  • 为研究其病理变化,调查者观察了四类人的跖骨情况,其中三类是乡村与城市中的穿鞋人群(梭托人、祖鲁人与欧洲人),一类是农耕时代之前出现的全新世人(Holocene people),后者赤脚生活。
  • 研究结果表明,三类穿鞋人群的跖骨病理损伤要比赤脚人群严重。
  • 有假说认为,穿鞋以及与现代基质材料接触会对跖骨的病理变化产生影响,上述研究结果也许可以证明该假说。

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Shock Attenuation During Barefoot Running
赤脚跑时的减震情况

  • 研究者在8名受试者右胫骨末端内侧与头前面安置了压电单轴加速度计,以测量其运动时的减震情况。
  • 研究者发现,赤脚跑的动力学及运动学要素与穿鞋跑有所不同。
  • 尽管赤脚跑时腿部受到的冲击力较大,但身体完全能够在冲击力传到头部之前将其减弱。
  • 尚需进一步研究。

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Mechanical Comparison of Barefoot and Shod Running
赤足跑与穿鞋跑的力学比较

  • 让35名受试者在跑台测力仪上以3.33 m x s(-1)的速度跑动4分钟,共跑两次。
  • 与穿鞋跑相比,赤足跑步时的触地与腾空时间较短、负峰值较低、制动与推进冲量较高、小腿三头肌的预先激活程度较高。
  • 总之,赤足跑到一定步数时,为减轻重复迈步时产生的高机械应力,冲击力峰值会有所降低。

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Plantar Pressure Measurements During Barefoot And Shod Running – Relationships To Lower Limb Kinematics
赤足跑与穿鞋跑时的足底压力测量结果——及其与下肢运动的关系

  • 7名受试者
  • 触地后内旋提高的平均速度与相应的“足跟平衡”速度相关。
  • 用高速压力垫测量法对赤脚跑与穿鞋跑(鞋——地互动情况)加以测量,可以预测胫骨内旋速度。
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Walking Barefoot Decreases Loading on the Lower Extremity Joints in Knee Osteoarthritis
赤脚走路可降低下肢关节负荷,对舒缓关节炎有益

  • 研究者让75名患有膝关节炎的受试者穿着平日穿的鞋子走步,并对其进行了步态分析。
  • 在其步行时,研究者在多部件测力板上对外部标记进行了光电子探测,并且使其与步行速度相符。
  • 赤脚走步时,臀与膝关节最高负荷会大大降低;膝内翻力矩降低了11.9%。
  • 鞋子可能会增加下肢关节负担,对健康不利。
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Fatigue Of The Plantar Intrinsic Foot Muscles Increases Navicular Drop
足底肌肉疲劳会加重舟状骨下降

  • 21名健康成年人
  • 对其外展拇指肌做表面肌电图
  • 人静止不动时,足部肌肉对支撑足内侧纵弓起重要作用。如果此处肌肉因疲劳而无法正常发挥作用,足内转情况则会加重(表现为舟状骨下降)。

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A Case for Bare Feet
赤足案例

  • 罹患扁平足的6岁儿童平日多穿鞋运动,由此表明,足弓发育的关键时期在6岁之前。
  • 此外,只有在光脚时,足部才能得到最佳的发育条件。因此应当鼓励儿童多进行赤脚运动。

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Barefoot To Bedridden
从赤脚运动到卧床

赤足——无支撑物
穿鞋——4个支撑物
运动控制——4个支撑物
器械矫正术——6个支撑物
矫正鞋与矫正术——足部束缚
手杖——7个支撑物
四脚步行器——10个支撑物
轮椅——四轮——反相适应
卧床——床——反相适应

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What is Human Spring

什么是“人体弹簧”(Human Spring)?

______________________________________________________________________________

Bob Beamon

鲍勃·比蒙(Bob Beamon

跳远世界纪录创造者

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Human Spring Model

Human Spring Model

人体弹簧模式

  1. 人体弹簧可储存机械势能,因此是一种效率机制。
  2. 人体弹簧可吸收触地冲力,因此是一种保护机制。
  3. 人体弹簧可根据地形调整身体机制,使人在凹凸地面上运动时也能“脚踏实地”
  4. 人体弹簧与生物力学相统一,因此对无压力/张力运动十分重要。
  5. “弹簧”弹力不足将导致身体疲劳、无法自愈、增加发生急性伤害的危险并加速身体系统的老化。

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Elastic or Spring Energy

弹性/弹簧能量

  • 跑步时,身体的每一次弹跳都是通过肌腱单位在触地时伸展、在跃起前收缩来实现的。
  • 肌腱单位的长度变化大多是由筋腱来维持的,已有证据表明,肌肉会根据此种变化进行等长收缩。
  • 研究者已发现,跑步时的肌肉运动与筋腱的拉伸紧密相关——筋腱通过伸缩来为下一轮运动储存能量。
  • 等长收缩要比动态收缩经济得多。

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Eccentric vs Concentric Training

 离心训练与向心训练

  • 离心收缩是指肌肉因服从外加符合而产生的活动,肌复合体会因此而拉长。与向心收缩相比,离心收缩不仅在新陈代谢方面效率更高,而且可以产生更高的动能。(Kaneko,1984)(Komi,1973)(Rodgers Berger ,1974)
  • 除此之外,有研究发现,向心收缩与离心收缩由肌肉的收缩速度决定(Komi,1973)。
  • 肌肉收缩速度增加时,最大离心力也会增加,而即使特定肌肉群的肌电图样相当稳定,最大向心力也会减少。

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What Surfaces are Best For Barefoot Running?

哪种地面最适合赤足跑?

  • 在最为坚硬的地面上跑步,正常的跃动模式一般是这样的:腿部先收缩,后拉伸。
  •  而在最为柔软的地面上跑步,该模式却正好相反:腿部先是伸展(最长为8 cm),随后以同样长度缩回。
  • 因此在此过程中,人体质量中心的下移距离会比地面下陷深度少5到7厘米;而在硬地上跑步,该下移距离与地面下陷深度基本相同。
  • 这种独特的腿部活动中,关节先伸展,后弯曲,因此可能会减少伸展肌的预拉伸程度。该假设也得到了证实:人在最为柔软的地面上跳跃时,尽管关节力矩与腿部运动量与在硬地上跳跃相似,但肌肉动员能力会增加50%。
  • 因此,我们可以改变腿部运动的外部环境,即选择在软地上训练。这样既可以维持质量中心的正常动态,又能减少伸展肌的伸缩循环,从而提升肌肉动员能力。

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Human Spring

人体弹簧

 ________________________________________________________________________

Force Of Impact/Energy Stored And Released

Spring Mechanics – Hookes Law

弹簧的机制——虎克定律(Hookes Law      

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Running Injuries

跑步损伤

最重要的是,弹簧悬置系统可以应对触地时产生的冲击力。

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What To Consider When Evaluating Injuries

进行损伤评估时,应当考虑哪些因素?

  • 提升力量与耐力是耐力训练的固有特性与基本原则。力量耐力训练的成果主要由以下因素决定:
  • 负荷大小
  • 两次训练之间的休息时间
  • 每次训练时长
  • 运动员自身的力量与耐力素质
  • 运动的人体运动学结构
  • 静态及动态力量耐力训练的相对比例

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Elastic Deformity

弹性变形

  •  此种变形为可逆性变形。一旦不再受到外力影响,物体即会恢复原状。
  •  弹簧具有以下能力:变形、储存能量、恢复原状、释放能量。
  • 弹簧具有以下能力:变形、储存能量、恢复原状、释放能量。
  • 这是老化背后的关键法则。

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Plastic Deformity

塑性变形

  • 在物理学与材料科学中,“可塑性”是指材料在受力后发生不可逆形状变化的特性。
  • 人体弹簧会变形并储存能量;若变形后不能完全恢复原状,释放的能量会变少。
  • 如果弹簧变形后不能完全恢复原状,那么它释放的能量会变少。

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Yield

Elastic Deformity vs Plastic Deformity

弹性变形 vs.塑性变形

________________________________________________________________________________

Yield Strength

屈服强度

  • 超出弹性极限之后即会发生永久变形。
  • 导致永久变形发生的最低压力值是可以测量的。

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Compressive Forces

 

压缩力

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Preventive or Anti-aging Medicine Is not working in Orthopedic Medicine with the current Model and Approach

骨科医学中,该模式与锻炼法并不使用预防衰老或抗衰老药物

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Train the Landings Vs Take Offs

触地训练 vs. 跃起训练

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Spring Suspension System

弹簧悬置系统

  • 有研究发现,中心极限训练可大大提高离心力量与耐力,但对向心力量与耐力产生的影响微乎其微(Frided ,1983)。
  • 进行中心收缩(centric contraction)时肌复合体会被拉长,因此处于伸展状态的SEC弹性结构承受的负担要比进行向心收缩时大,发生损伤的风险也有所增加。所以肌肉劳损多发生在运动的离心阶段,这也是不足为奇的。

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Gait Analysis

步态分析

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Compensating Motion

补偿运动

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Understanding the Dynamics of Human Spring

了解人体弹簧的动力学原理

______________________________________________________________________________

Cascade following Breakdown of the Impact Protection and Energy Recycling Mechanisms

冲击保护与能量循环系统崩溃所引起的一系列不良后果

  • 疼痛与加速老化
  • 隐性炎 症
  • 劳损
  • 紧张与疲劳
  • 补偿异常运动
  • 弹簧系统僵化
  • 弹簧悬置系统弱化

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Reduction in Spring Elastic Capacity of Collagenous Tissues with Age

 胶原组织弹性承载力会随年龄增长而降低

  • 人体组织会随着年龄的增长而老化:胶原组织会发生变化(与僵化类似),韧带强度与刚度都会降低。
  • 发生这种变化时,人体即进入衰退过程,身体活动会减少,疾病与其他不明症状则会增加(Frankel V 与Nordin M, 1980)。
  • 适应过程十分缓慢;若肌肉质量增加,可能会加重肌肉负担,从而导致筋腱与韧带等肌肉中的结缔组织损伤。(ZalesskyBurkhanov ,1981,美国)
  • 因此肌肉过度肥大常常会减缓肌肉在锻炼、退化、以及速度/速度力量训练后的恢复速度,使发生损伤的几率大为增加。

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Landing Muscles

触地肌肉

Spring Suspension System Muscles

弹簧悬置系统肌肉

  • 临时肌腱能量存储机制能大大减少肌肉束延长速度与能量吸收速度。可以说,肌腱的作用与功率衰减器类似,可在能量耗散过程中避免肌肉因快速强劲拉伸而发生损伤。
  • 要使肌腱弹簧发挥最大功效,其力学性能与功能必须一致。
  • 从弹性机制的角度来看,这种性能即肌腱刚度。已有越来越多的证据表明,肌腱刚度可通过“重塑”来调整,以使肌肉——肌腱——负荷系统能够有效运行。还有几项研究发现,长期锻炼对肌腱刚度的增加有显著效果。

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Connective Tissue Strength vs Muscle Strength

结缔组织强度 vs 肌肉强度

  •  此外,肌肉组织可在几天之内适应新增负荷。
  • 肌腱、韧带等结缔组织以及关节、骨骼、软骨等包含大量结缔组织的系统只在经历数周或数月后的逐步加载训练后,才有明显适应或者增厚的迹象。
  • 因此在开运动处方时,必须考虑不同系统的适应速度,避免适应速度低的系统因过度训练而发生损伤。
  •  要使结缔组织发生酸痛与损伤的几率降到最低,应当逐渐增加训练负荷,避免激增或爆发式训练。

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Free Stored Elastic Energy

释放已储存的弹性能量

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Anatomical silent, painful inflammation

Levels of Silent vs Painful Inflammation

 隐性与痛性炎症的级别

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Causes of Weakness in the Human Spring Suspension System

 人体弹簧悬置系统的弱化原因

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Nature January 2010  Lieberman et al., Nature, 463: 531-565

《自然》(Nature),20101月,Lieberman等;《自然》,463: 531-565

科学家发现,赤足跑或者穿着简单鞋类跑步的人群多以跖骨球或脚掌中心触地,从而可避免以足跟触地。因此这类人可充分利用腿、足结构与某些牛顿力学原理来避免冲击引起的疼痛与损伤。而穿鞋跑步的人多以脚跟触地,他们反复承受的冲击力是体重的两到三倍。

  •  赤脚跑步的人,其步态与穿鞋跑步者有明显差异。
  • 赤脚跑步者常以脚掌中心或前部触地,这样几乎不会产生冲击碰撞;而多数穿鞋跑步、以脚跟触地的人所产生的冲击要多得多。
  • 多数现代人都认为赤足跑步十分危险,会带来伤害。其实人们在世界上最为坚硬的地面上赤脚跑步时,也不会有些微的不适与痛感。只要长出了茧子,脚底皮肤就不会被磨伤了。再者说,某些人穿鞋跑的方式并不科学,比起他们的跑步方法来,赤脚跑也许要安全得多。

丹尼尔·E·利伯曼(Daniel E Lieberman),哈佛大学新设系别——人类进化生物学教授

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Modern society has changed forcing us to wear shoes causing weakness

现代社会已经发生了变化,我们被迫穿上了导致身体虚弱的鞋子

现代化生活设备是使人身体日渐虚弱的罪魁祸首

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Static Evaluation

 静态评估

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Dynamic Lever Evaluation

动态杠杆评估

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Dynamic Spring Evaluation

动态弹簧评估

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Patients Don’t Think They Have an Abnormal Gait

父母并不认为他们的步态不正常

Gait Analysis

步态分析

_____________________________________________________________________ 

Can Inserts Interfere with Spring Loading

衬垫是否会干扰弹簧加载?

____________________________________________________________________________

Steps to Increasing Impact Protection and Energy Recycling

提高冲击保护与能量循环效果的步骤

  • 释放人体弹簧上的异常内部压力(Abnormal Internal Compressive Force)
  • 增加弹簧的力道加载深度
  • 通过强化杠杆系统来加强弹簧悬置系统
  • 通过强化弹簧系统来加强弹簧悬置系统
  • 保持
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STEP ONE
第一步

释放人体弹簧上的异常内部压力(Abnormal Internal Compressive Force)

________________________________________________________________________________

Treatment of Muscle Spasms that Preload the Spring Protection and Energy Recycling Mechanisms

治疗肌痉挛(预先加载弹簧保护与能量循环系统)

  • 肌索会检查肌肉纤维的长度变化以及变化速度。
  • 高尔基腱器官会在肌肉收缩拉伸时对其张力与肌腱进行监控。
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Employ Hookes Law – Increase Depth Of Loading Of Forces Into The Human Spring

应用虎克定律(Hookes Law)——增加弹簧的力道加载深度
  • 动态增强式——冲击拉伸
  • 进行增强式冲击拉伸时,首先迅速结束离心加载,随后进行短时等长收缩,最后突然释放已储存的弹性能量,使收缩的肌肉强力反弹。
  • 进行这种伸缩运动的目的,并不在于扩大运动范围,而是为满足某种运动需要来利用特定拉伸现象、增加动作的速度性力量。

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Current Standard of Care

现代医疗标准

杠杆模式与冲击保护方面的知识和提升抗冲击及能量循环能力的方法没有物理学上的关联。

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Relax Preload Muscle Tension to Maximize Depth of Safe Loading Elastic Spring Elements to do the Work

缓和预加载肌肉张力,使安全加载弹簧单元发挥最大效用

  • 肌肉的放松能力在快速运动,尤其是周期性运动中起着尤为重要的作用。进行快速周期性运动时,三磷酸腺苷(ATP)会在肌肉收缩的间歇期间起协助作用。
  • 充分动用与恢复储存在肌复合体中的弹性能量和拉伸势能,是进行有效高速周期性与非周期性运动的先决条件。
  • 有研究报告称,效率较高的跑步运动可使在运动周期中消耗的机械能恢复60%,剩余40%(Verhkoshanski,1996)。
  • 上述科学家认为,肌肉对弹性势能的储存能力与长跑运动员的表现有关,非代谢能源贡献越大,跑步速度就越快。

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STEP TWO

第二步

Strengthening the Human Spring Lever Mechanisms

强化人体弹簧与杠杆系统

Resistance Lever Exercises

抗阻力杠杆训练

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STEP THREE

第三步

通过冲击式训练强化弹簧系统及其组成肌肉

  • 赤脚跑
  • 跳跃训练
  • 伸展——收缩循环训练(Plyometrics

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Running-Related Injury Prevention through Barefoot Adaptations

通过适应赤足跑来避免跑步损伤

  • 有研究者提出假设,适应赤足跑之后,身体会产生减震效果,这也是赤足跑步者较少受伤的内在原因之一。该效果与内侧纵弓在加载时会发生变形有关。
  • 还有假设称,穿上鞋子之后,足弓无法在不发生僵化的情况下变形,因此穿鞋跑步者受伤的频率较高。
  • 为评估以上假说,研究者对17名休闲跑步者进行了分析,以研究在赤足运动量增大时,受试者内侧足纵弓对负荷的适应情况
  • 受试者纵弓在负载情况下发生了变形,为上述假说提供了证明。
  • 也有其他证据表明,之所以会发生这种变形,是因为赤足运动中,脚部光滑上皮细胞的传感反馈发挥了重要作用。现代跑鞋会隔绝人的感觉,这也许是穿鞋跑步会频频受伤的主要原因。此类伤害被认为是“伪神经性”伤害。
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There is a gap in the way doctors think and do and what athletes and patients require for top performance

医生的想法和治疗方法与运动员及病人对最佳状态的需要并不相符。

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Retraining Abnormal Movement Patterns Running-Walking Form & Technique

异常走-跑运动再训练方法与技术

训练者要进行反复训练,以固定其运动模式。

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Bang and Twist Walking VS Spring Roll Walking

重踏扭动行走法(Bang And Twist Walkingvs 弹跳滚动行走法(Spring And Roll Walking

_______________________________________________________________________ 

Deceleration Landing

减速触地

_______________________________________________________________________ 

Neutral Landing

中性触地

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Acceleration Landing

加速触地

______________________________________________________________________________

Old men running: mechanical work and elastic bounce

老年人跑步训练:机械功与弹力

有假说称,年老受试者的受损肌肉运动时,其质量中心的垂直振动振幅较小,向上加速度较低,腾空时间也较短。该假说已经得到了证实。

也就是说:

  1. 其储存的弹性能量较少
  2. 其步频较 高
  3. 其为根据环境调整身体质量中心而作的外功较少
  4. 其为适应质量中心、提高肢体运动速度而作的内功较多

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Second Toe Towards The Target

第二趾朝向目标

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Human Lever Model and Approach Vs Human Lever and Human Spring Model and Approach

人体杠杆模式及训练法 Vs 人体杠杆及弹簧模式与训练法

现在是转变思维模式、采取这种新训练模式的时候吗

________________________________________________________________________________

Human Lever and Human Spring Model and Approach

人体杠杆及弹簧模式与训练法

先进再生医学与抗衰老医学被定义为用于早期检查、治疗及预防年龄相关疾病的科学。当前的护理标准只要求医生在病人出现相关症状时,对其肌肉骨骼系统进行评估。

抗衰老医学与人体弹簧模式及训练法已经超出了上述标准。这种方法采用了特殊的医疗方式,以提高病人的身体素质为目标,使医疗对象在疼痛发生之前就有达到奥林匹克级别、符合自己年龄的身体素质。

Thank you!

谢谢!

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Lecture Video and Notes for Walk and Run For Life! Through Lever Mechanisms or Spring Mechanisms? (English) Presented at The 2012 Shanghai World Congress on Anti-Aging Medicine

  Walk and Run For Life! Through Lever Mechanisms or Spring Mechanisms? This lecture was presented by Dr. James Stoxen DC at the The World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo, Shanghai, China October 18, 2012 CLICK HERE TO SEE THE LECTURE ON THE ORIGINAL SITE. Summary of the human spring model and approach…. The lessons taught […]

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Walk and Run For Life! Through Lever Mechanisms or Spring Mechanisms?

This lecture was presented by Dr. James Stoxen DC at the The World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo, Shanghai, China October 18, 2012

CLICK HERE TO SEE THE LECTURE ON THE ORIGINAL SITE.

Summary of the human spring model and approach….

The lessons taught in medical schools, medical books and scientific papers about how the body works and how it breaks down, though based on modern medical constructs, just didn’t add up.

Doctors and scientists use the HUMAN LEVER MODEL as the model for the basis of how they examine, treat and maintain the human body.

I felt that the lever model and approach taught in the medical and fitness industries was incomplete.  I felt it was obvious that the world was missing something big. There were just too many unexplained mysteries that perplexed doctors and scientists and left patients feeling hopeless, frustrated and in a chronic state of pain and suffering.

For example…

Why is there resistance exercise which work levers and plyometrics which work spring mechanisms but doctors only examine and treat the body like a lever mechanism?  Shouldn’t the body be examined and treated as a spring mechanism?

Why are impacts considered damaging to the human body however athletes use drills of high impact jumps as the primary way to improve quickness, speed and injury resistance?

Over 30 years ago I set out to find the answers to the many questions that frustrate doctors and their patients who suffer.  I felt these answers would provide us with the secrets to the best approach to allow us to reach the true potential of our human body. I took off my white coat and considered the human form from different logical points of view: a mechanical engineer, an anatomist and a physicist. I then combined this new perspective with my years of experience interviewing, treating and training hundreds elite athletes in many sports from around the world. What I found was fascinating to me, doctors around the world and I’m excited to share it with you!

This is what I determined..

The human body moves as a lever mechanism AND a spring mechanism.

The Human Spring Model and Approach

Every movement you make is powered by a miraculous spring mechanism. Once you learn how it works, the important functions it serves, how it breaks down and locks, and how it effects so many aspects of your health, you will see why so many suffer and are misdiagnosed.

Then when I teach you my new approach to releasing, strengthening and supercharging your human spring, you will understand why my patients recover when other approaches have failed.  Understanding the human spring will help you understand how certain athletes can high jump seven feet over a bar or run fifty miles without stopping, while other people can’t jog, walk, lift weights of even get up out of a chair without pain. The efficiency of your body’s motion has everything to do with the integrity of your human spring.

If this theory is true, it means that medicine must change all the examination and treatment protocols to include an effective treatment approach for the human spring element in human movement.   I have outlined the human spring theory and approach in this lecture.

A Painful Misunderstanding of Human Engineering

Unfortunately, the world doesn’t regard the body as a living spring. Consequently, they are missing out on the most important aspects of how the human body moves, protects itself, recycles energy and functions in a world governed by the laws of nature, physics, engineering and common sense. Today’s current medical practices and exercise approaches defy the laws of nature, physics and engineering.

The Human Spring Model says the body has a spring mechanism (not a lever mechanism) that functions to protect the body from impacts as well as recycles energy for optimum efficiency.

If it locks then the force of impact is taken up by the tissues and as a result we have chronic inflammation and severe injuries. In the knee it could be mistaken knee pain, torn cartilage or degeneration of the cartilage possibly leading to artificial knee replacement. In the shin bone or tibia bone we call it shin splints.

In the foot it could be plantar fasciitis, heel spurs, metatarsal stress fractures or just foot pain.

From my clinical experience, the majority of the people who have injuries from running such as plantar fasciitis, shin splints, heel pain, runners knee, hip pain, illiotibial band syndrome and herniated discs.  The theory says that the pain comes after impacts of walking, running or participation in sports happen because the spring mechanism can’t effectively absorb the impact into the spring.

Why the Human Spring Model and Approach is best for an Anti-aging Doctor

by Dr. James Stoxen DC

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Bedridden to Barefoot

Reclaim Your Youth

  • Barefoot – No Supports
  • Footwear – 4 Supports
  • Motion Control – 4 Supports
  • Orthotics – 6 Supports
  • Orthopedic Shoes and Orthotics – Foot Lock
  • Cane – 7 Supports
  • 4-Prong Walker – 10 Supports
  • Wheel Chair – 4 Wheels – reverse adaptation
  • Bedridden – Bed – reverse adaptation

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Injuries Can Happen When Running

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Zola Budd Barefoot Runner

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Kinesthetic learning via Kinesthetic Senses

  • Strength, efficiency and safety of all movement is determined by neuromuscular factors, in particular the sense of kinesthesis and the underlying proprioceptive mechanisms which inform us about where all the components of our musculoskeletal system are and what they are doing relative to one another in space and time.
  •  The integration of information enables us to execute a given movement in the most appropriate way in terms of pattern, velocity, acceleration and timing.
  •  One way of improving proprioceptive efficiency is to diminish or block input from other sensory systems.
Roman R. (1986) Trenirovka Tyazheloatleta (Training of the Weightlifter) Fizkura I Sport Moscow 
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 Creep (a word used in physics)

  •  Collagenous tissue increases significantly in strength and stiffness with increased rate of loading.
  •  There by emphasizing the intelligent use of training with high acceleration methods.
  • One study found an increase of almost 50% in load of knee ligaments to failure when the voting rate was increased for four fold  (Kennedy et al 1976)

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Biomechanical And Physiological Comparison Of Barefoot And Two Shod Conditions In Experienced Barefoot Runners.

  •  8 subjects analyzed using instrumented treadmill analysis
  •  Compared to the standard shod condition when running barefoot the athletes landed in more plantar flexion at the ankle.
  •  Barefoot running caused reduced impact forces and changes in stride kinematics.

Squadrone R, Gallozzi C., J Sports Med Phys Fitness. 2009 Mar;49(1):6-13.

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Can Barefoot Activity Alleviate Knee Pain and Arthritis

  •  They looked at the external knee adduction moment (EKAM) when we are wearing shoes and when we are barefoot. EKAM represents knee load distribution from the inside to the outside of the knee joint.
  •  The higher the EKAM is, the greater and faster the progressions of deterioration (osteoarthritis) of the knee joint.
  •  These researchers found that sneakers and running shoes increased EKAM when compared to barefoot walking and barefoot running.

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Foot Strike Patterns And Collision Forces In Habitually Barefoot Versus Shod Runners

  •  habitually barefoot endurance runners often land on the fore-foot
  •  habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe.
  •  Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers.
  •  This difference results primarily from a more plantar flexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground.

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  •  Runners were 2.41% more economical in the minimal-shoe condition when forefoot striking.
  •  3.32% more economical in the minimal-shoe condition when rear foot striking.
  •  Arch strain was not measured in the shod condition but was significantly greater during forefoot than rearfoot striking when barefoot.
  •  Plantar flexor force output was significantly higher in forefoot than in rear foot striking and in barefoot than in shod running.
  •  Achilles tendon-triceps surae strain and knee flexion were also lower in barefoot than in a standard-shoe running shoe.
  •  Minimally shod runners are modestly but significantly more economical than traditionally shod runners regardless of strike type, after controlling for shoe mass and stride frequency.  The likely cause of this difference is more elastic energy storage and release in the lower extremity during minimal-shoe running.

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The Effect of Running Shoes on Lower Extremity Joint Torques

  •  68 subjects ran barefoot and in the same type of stability running footwear.
  •  Three-dimensional motion capture data were collected in synchrony with ground reaction force data from an instrumented treadmill for each of the 2 conditions.
  •  Increased joint torques at the hip, knee, and ankle were observed with running shoes compared with running barefoot.
  •  54% increase in the hip internal rotation torque.
  • 36% increase in knee flexion torque.
  • 38% increase in knee varus torque were measured when running with shoes compared to barefoot.

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The Normal Orientation Of The Human Hallux And The Effect Of Footwear

  • The orientation of each hallux was determined in thirty-eight radiographs by measuring the angle.
  • The wearing of anatomically designed shoes would often allow the hallux to straighten, provided the abductor hallucis muscle functioned adequately.

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Shod Versus Unshod: The Emergence Of Forefoot Pathology In Modern Humans?

  • They investigated the frequency of metatarsal bone pathologies in contemporary and habitually unshod vs shod
  • The metatarsal elements from four human groups were examined for pathological variation. Three were from recent rural and urban shod populations (Sotho, Zulu and European) and one from habitually unshod pre-pastoral Holocene people.
  • The pathological lesions found in the metatarsals of the three shod human groups generally appeared to be more severe than those found in the unshod group.
  • This result may support the hypothesis that pathological variation in the metatarsus was affected by wearing of footwear and exposure to modern substrates.

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Shock Attenuation in Barefoot Running

  • 8 subjects were instrumented with piezoelectric uniaxial accelerometers to measure shock attenuation which were attached to the distal aspect of the right tibia on the medial side and to the front of the head.
  • Differences in the kinetics and kinematics of running was observed when comparing barefoot and shod running
  • Although the impact at the leg is greater at contact BF, the body is capable of attenuating the impact before it reaches the head.
  • Future research is required

Julia A. Freedman, Janet S. Dufek, John A. Mercer

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Mechanical Comparison of Barefoot and Shod Running

  • 35 subjects ran two bouts of 4 minutes at 3.33 m x s(-1) on a treadmill dynamometer
  • Barefoot showed mainly lower contact and flight time, lower passive peak, higher braking and pushing impulses, higher pre-activation of triceps surae muscles than shod.
  • It was concluded that when performed on a sufficient number of steps, barefoot running leads to a reduction of impact peak in order to reduce the high mechanical stress occurring during repetitive steps.

Plantar Pressure Measurements During Barefoot And Shod Running – Relationships To Lower Limb Kinematics

  • 7 subjects
  • The average velocity of the increase in internal rotation after contact was related to corresponding ‘heel balance’ velocities.
  • The high-speed pressure mat measures of barefoot and shod running (shoe-ground interface) were shown to be predictive of tibial internal rotation velocity.

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Walking Barefoot Decreases Loading on the Lower Extremity Joints in Knee Osteoarthritis

  • Gait analyses were performed on 75 subjects with knee OA while they were wearing their everyday walking shoes and while they were walking
  • Optoelectronic detection of external markers during ambulation over a multicomponent force plate, and were matched for speed.
  • Peak joint loads at the hips and knees significantly decreased during barefoot walking, with an 11.9% reduction noted in the knee adduction moment.
  • Shoes may detrimentally increase loads on the lower extremity joints.

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  • Surface electromyography of the abductor hallucis muscle was recorded.
  • The intrinsic foot muscles play a role in support of the medial longitudinal arch in static stance. Disrupting the function of these muscles through fatigue resulted in an increase in pronation as assessed by navicular drop.

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A high concentration of flat foot among six-year-old children who wore shoes as compared with those who did not, implies that the critical age for development of the arch is before six years.

Furthermore, optimum foot development occurs in the barefoot environment, and, therefore, children should be encouraged to partake in barefoot activity.

Paul J. Lucas* , Michael M. Berrow, Richard K. Frazine, and Robert A. Neinast

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Barefoot To Bedridden

Barefoot – No Supports
Footwear – 4 Supports
Motion Control – 4 Supports
Orthotics – 6 Supports
Orthopedic Shoes and Orthotics – 6 Supports
Cane – 7 Supports
4-Prong Walker – 10 Supports
Wheel Chair – 4 Wheels
Bedridden

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What is Human Spring

_______________________________________________________________________________

Bob Beamon

Bob Beamon

World Record Long Jump

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Human Spring Model

  1. The human spring stores mechanical potential energy therefore it is an efficiency mechanism.
  2. The human spring absorbs forces of landings therefore it is a protective mechanism.
  3. The human spring allows the foot to land on uneven surfaces adjusting the body mechanics to the terrain.
  4. The human spring is integrated into the biomechanics therefore it is essential for stress/strain free motion

Weakness or locking of the spring can lead to fatigue, increased risk for acute injury, inability to heal and accelerated aging of the body’s systems.

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Elastic or Spring Energy

  • In the elastic-like bounce of the body at each running step the muscle-tendon units are stretched after landing and recoil before take-off.
  • Evidence has been provided suggesting that muscle is kept quasi-isometric with the consequence that the length change of the muscle–tendon unit is mostly sustained by tendons.
  • It has been found that much of the muscle activity in running is associated with tensioning of the tendons, which thereby store energy for successful cycles of movement.
  • Isometric conntractions are considerably less expensive than dynamic contractions.

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Eccentric vs Concentric Training

  • An eccentric contraction refers to muscle action winch the muscle force succumbs to the imposed load and the muscle complex lengthens. Not only is it metabolically much more efficient than concentric contraction, but it’s also capable of generating higher forces (Kaneko 1984)  (Komi 1973)  (Rodgers And Berger 1974)
  • In addition this difference between concentric and eccentric contractions has been found to depend on the velocity of contraction (Komi 1973)
  • As the velocity of contraction increases, so do those maximums eccentric force increase whereas the maximum concentric force decreases even though the corresponding EMG for the given muscle group remains reasonably constant.

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What Surfaces are Best For Barefoot Running?

  • On the stiffest surfaces, the legs compressed in early stance and then extended in late stance in the pattern that is typical for normal bouncing gaits.
  • On the softest surfaces, however, subjects reversed this pattern so that the legs extended up to 8 cm in early stance and then compressed by a similar distance in late stance.
  • Consequently, the center of mass moved downward during stance by 5-7 cm less than the surface compressed and by a similar distance as on the stiffest surfaces.
  • This unique leg action probably reduced extensor muscle pre-stretch because the joints first extended and then flexed during stance. This interpretation is supported by the observation that hoppers increased muscle activation by 50% on the softest surface despite similar joint moments and mechanical leg work as on the stiffest surface.
  • Thus, the extreme adjustment to leg mechanics for very soft surfaces helps maintain normal center of mass dynamics but requires high muscle activation levels due to the loss of the normal extensor muscle stretch-shorten cycle.

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Human Spring

________________________________________________________________________________

Spring Mechanics – Hookes Law  

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Running Injuries

Most important is the ability of the spring suspension system to handle the force of the landings.

________________________________________________________________________________

What To Consider When Evaluating Injuries

The development of strength–endurance is a an inherent characteristic and the fundamental principle of training for developing general endurance. Training for strength–endurance is determined predominantly by:

  • The magnitude of the load
  • The rest interval between training sessions
  • The length of the training period
  • Additional levels of strength–endurance of the athlete
  • The kinesiological structure of the movement
  • Relative involvement of static and dynamic strength–endurance

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Elastic Deformity

  • This type of deformation is reversible. Once the forces are no longer applied, the object returns to its original shape.
  • The ability of the spring to deform, store energy, reform to its exact original shape, releasing energy.
  • THE ABILITY OF THE SPRING TO DEFORM, STORE ENERGY, REFORM TO ITS EXACT ORIGINAL SHAPE, RELEASING ENERGY
  • This is the key principle behind aging

Journal of Applied Physics, M. Mooney, September 1940, Volume: 11 Issue 9 Page (s) 582 – 592

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Plastic Deformity  

In physics and materials science, plasticity describes the deformation of a material undergoing non-reversable changes of the shape in response to applied forces.

The human spring deforms, stores energy, does not return to its exact original shape, releases less energy.

ENERGY, DOES NOT RETURN TO ITS EXACT ORIGINAL SHAPE, RELEASES LESS ENERGY

J. Lubliner, 2008, Plasticity theory, Dover, ISBN 0-486-46290-0, ISBN 978-0-486-46290-5.

________________________________________________________________________________

Elastic Deformity vs Plastic Deformity

________________________________________________________________________________

Yield

Yield Strength

  • Beyond the elastic limit, permanent deformation will occur.
  • The lowest stress at which permanent deformation can be measured.

________________________________________________________________________________

 

 

Compressive Forces

_______________________________________________________________________________

Preventive or Anti-aging Medicine Is not working in Orthopedic Medicine with the current Model and Approach

_______________________________________________________________________________

Train the Landings Vs Take Offs

Spring Suspension System

  • (Frided 1983) found that eccentric training to failure produces market increases in eccentric strength–endurance, but minimal changes in concentric strength–endurance.
  • Since lengthening of muscle complex occurs with the centric contraction the stretching SEC series elastic component is exposed to greater strain than under concentric conditions and the potential for increase of injury. Thus it is not surprising to learn that most muscle strains and ruptures occur during the Eccentric phase of movement  (Garrett 1986)

Friden J,,,, Seger J, Sjostrom M & Ekblom B 1983a Adaptive Response in Human Skeletal Muscle Subjected to Prolonged Eccentric Training Int J Sports Med 4(3): 177-176

Garrett W (1986) Basic science of musculotendonous injuries In Nicholas J & Hershman E (eds) The Lower Extremity and Spine in Sports & Exercise CV Mosby Co, St Louis : 42-58

 _______________________________________________________________________

Gait Analysis

_______________________________________________________________________________

Compensating Motion

 _______________________________________________________________________________

Understanding the Dynamics of Human Spring

_____________________________________________________________________________________

Cascade following Breakdown of the Impact Protection and Energy Recycling Mechanisms

  • Pain and accelerated ageing
  • Silent inflammation
  • Wear and tear
  • Stress and strain
  • Compensating abnormal movement
  • Drop and lock of the spring mechanism
  • Weakness in spring suspension system

________________________________________________________________________________

Reduction in Spring Elastic Capacity of Collagenous Tissues with Age 

  • Aging reveals changes in collagenous tissues similar to those caused by immobilization with reduction in strength and stiffness of ligaments occurring with advanced age.
  • These changes may need you not only to the degenerative process, but also to reduce physical activity, superimpose disease states and other undefined processes  (Frankel V & Nordin M 1980)
  • Adaptation occurs more slowly and connective tissue such as tendons and ligaments that in muscle and any increase tension may possible in the muscle tenderness complexes by the increased muscle mass can cause damage to these structures (Zalessky & Burkhanov 1981) the US.
  • Thus extensive hypertrophy usually leads to slower muscle recovery after exercise, deterioration and speed, speed–strength and speed as well as an increased incidence of injury.

Frankel V & Nordin M 1980 Basic Biomechanics of the Skeletal System Lee & Febiger
Zalesky M & Burkhanov A (19810 Muscle Condition and work capacity in track and field athletes Legkaya Athletika 1: 1-7

______________________________________________________________________________

Landing Muscles

Spring Suspension System Muscles

  • Temporary tendon energy storage led to a significant reduction in muscle fascicle lengthening velocity and the rate of energy absorption. We conclude that tendons function as power attenuators that probably protect muscles against damage from rapid and forceful lengthening during energy dissipation.
  • For tendon springs to operate effectively, their mechanical properties must be matched to their function.
  • For elastic mechanisms is tendon stiffness, and there is increasing evidence that the stiffness of a tendon is ‘tuned’ by remodeling to allow for the effective operation of the muscle–tendon-load system. Several studies have now documented significant increases in tendon stiffness in response to long-term exercise.

__________________________________________________________________________________

Connective Tissue Strength vs Muscle Strength

  • More over, muscle tissue adapts to increase loading within several days.
  • Connective tissue such as tendons ligaments and joints and bones or systems which contain a high proportion of connective tissue such as bone and cartilage only display significant adaptation and hypertrophy after several weeks or months of progressive loading.
  • It is vital that the prescription of training takes into account the different rates of adaptation of all systems involved and avoids overtraining systems with the lowest rates of adaptation.
  • Gradual increase in training load and avoidance of impulse or explosive methods is essential for minimizing the occurrence of connective tissue soreness and injury

McDonagh and Davis 1984

______________________________________________________________________________

Free Stored Elastic Energy 

______________________________________________________________________

Levels of Silent vs Painful Inflammation

______________________________________________________________________ 

Causes of Weakness in the Human Spring Suspension System

______________________________________________________________________________

Nature January 2010  Lieberman et al., Nature, 463: 531-565

  • Scientists have found that people who run barefoot, or in minimal footwear, tend to avoid Heel-striking, and instead land on the ball of the foot or the middle of the foot. In so doing, these runners use the architecture of the foot and leg and some clever Newtonian physics to avoid hurtful and potentially damaging impacts, equivalent to two to three times body weight, that shod heel-strikers repeatedly experience.
  • People who don’t wear shoes when they run have an astonishingly different strike.
  • By landing on the middle or front of the foot, barefoot runners have almost no impact collision, much less than most shod runners generate when they heel-strike.
  • Most people today think barefoot running is dangerous and hurts, but actually you can run barefoot on the world’s hardest surfaces without the slightest discomfort and pain. All you need is a few calluses to avoid roughing up the skin of the foot. Further, it might be less injurious than the way some people run in shoes.

Daniel E Lieberman, a professor in Harvard’s new department of human evolutionary biology

_____________________________________________________________________________

Modern society has changed forcing us to wear shoes causing weakness

_____________________________________________________________________________________

Static Evaluation

__________________________________________________________________________________________

Dynamic Lever Evaluation

_____________________________________________________________________________________

Dynamic Spring Evaluation

_____________________________________________________________________________

Patients Don’t Think They Have an Abnormal Gait

_____________________________________________________________________________

Gait Analysis

_____________________________________________________________________________

Can Inserts Interfere with Spring Loading _____________________________________________________________________________

Steps to Increasing Impact Protection and Energy Recycling

  • Release The Abnormal Internal Compressive Force On The Human Spring
  • Increase Depth Of Loading Of Forces Into The Human Spring
  • Strengthen The Spring Suspension System via Lever Strengthening
  • Strengthen The Spring Suspension System via Spring Strengthening
  • Maintain

_____________________________________________________________________________

STEP ONE

Release The Abnormal Internal Compressive Force On The Human Spring

______________________________________________________________________________

Treatment of Muscle Spasms that Preload the Spring Protection and Energy Recycling Mechanisms

  • Muscle spindles which detect changes in muscle fiber length and rate of change of  length.
  • Golgi tendon organs which monitor the tension and muscle tendon during muscle contraction or stretching.

_______________________________________________________________________________

Employ Hookes Law – Increase Depth Of Loading Of Forces Into The Human Spring

  • Dynamic Plyometric-Impact Stretching
  • Plyometric impulsive stretching, which involves rapid termination of eccentric loading followed by a brief isometric phase and an explosive rebound belying and stored elastic energy and powerful reflex muscle contraction.
  • This stretch shortening action is not intended to increase range of motion, but to use specific stretching phenomena and to increase speed strength of movement for a specific sporting purpose.

________________________________________________________________________________

 

Current Standard of Care

Lever Model has no physics for understanding Impact Protection or How To Increase Impact Resistance or Improve Energy Recycling.

__________________________________________________________________________________

Relax Preload Muscle Tension to Maximize Depth of Safe Loading Elastic Spring Elements to do the Work

  • The ability to relax muscle is very important for rapid movements especially in cyclical actions, which involve recent assists of ATP during the phases between muscle contractions.
  • The adequate retrieval of elastic energy stored in the muscle complex, together with the stretch–shortening potential of force output, or valuable prerequisites for efficient high velocity cyclic and acyclic movement.
  • Verhkoshanski 1996  reports that economical sprinting activity can result in the recovery of about 60% of total mechanical energy expended in the movement cycle, with the remaining 40% being
  • He had set a high correlation between the muscular capacity to store potential elastic energy and the performance of distance runners, with an increase in the contribution from non-metabolic energy sources taking place with increased in running velocity.
__________________________________________________________________________________________
STEP TWO

Strengthening the Human Spring Lever Mechanisms

Resistance Lever Exercises

 

________________________________________________________________________________

STEP THREE

Strengthen the Spring Mechanism Muscles and Systems Through Impacts

Barefoot Running
Jumping Drills
Plometrics
________________________________________________________________________ 

Running-Related Injury Prevention through Barefoot Adaptations

  • It is hypothesized that the adaptations which produce shock absorption, an inherent consequence of barefoot activity and a mechanism responsible for the low injury frequency in unshod populations, are related to deflection of the medial longitudinal arch of the foot on loading.
  • It is also hypothesized that the known inability of this arch of the shod foot to deflect without failure (foot rigidity) is responsible for the high injury frequency in shod populations.
  • To evaluate these hypotheses, 17 recreational runners were analyzed to study the adaptive pattern of the medial longitudinal arch of the foot due to increased barefoot weight-bearing activity.
  • Changes occurred in the medial longitudinal arch which allowed deflection of this arch on loading which substantiated the hypotheses.
  • Other evidence suggests that sensory feedback largely from the glabrous epithelium of the foot is the element of barefoot activity which induced these adaptations.
  • The sensory insulation inherent in the modern running shoe appears responsible for the high injury frequency associated with running. The injuries are considered “pseudo-neuropathic” in nature.

_____________________________________________________________________________

There is a gap in the way doctors think and do and what athletes and patients require for top performance

_____________________________________________________________________________

Retraining Abnormal Movement Patterns Running-Walking Form & Technique

Training Involves Repeated Movements To Store Patterns

_____________________________________________________________________________

Bang and Twist Walking VS Spring Roll Walking

Bang And Twist Walking vs Spring And Roll Walking

_____________________________________________________________________________

Deceleration Landing

_____________________________________________________________________________

Neutral Landing

_____________________________________________________________________________

Acceleration Landing

_____________________________________________________________________________

Old men running: mechanical work and elastic bounce

The results support the working hypothesis that the impaired muscle function in the old subjects results in a smaller amplitude of the vertical oscillation of the centre of mass, with a lower upward acceleration and a reduced duration of the aerial phase.

These in turn imply:

  • (i) less elastic energy stored
  • (ii) a higher step frequency
  • (iii) a lower external work to maintain the motion of the centre of mass of the body relative to the surroundings, and
  • (iv) a greater internal work to accelerate the limbs relative to the centre of mass.

Second Toe Towards The Target

__________________________________________________________________________________

Human Lever Model and Approach Vs

Human Lever and Human Spring Model and Approach

Is it Time for a Paradigm Shift to this New Model and Approach

__________________________________________________________________________________

Human Lever and Human Spring Model and Approach

Progressive regenerative medicine and anti-aging medicine is defined as the earliest detection, intervention and prevention of age-related diseases. The current standard of care only requires doctors to do evaluations of the musculoskeletal systems when patients present with signs and symptoms of anti-aging related diseases.

Anti-aging medicine and the Human Spring Model and Approach exceeds this standard by practicing a form of medicine aimed at improving patients’ performance to the Olympic level for their age group before the pain even starts.

__________________________________________________________________________________

Thank you!

 

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Presentation Abstract: New Aggressive Approaches To Disconnecting The Inflammation-Depression Connection. World Congress On Anti-Aging Medicine And Regenerative Biomedical Technologies Expo (A4MC) Shanghai, China October 18-20, 2012

Depression ICD-9 296.3 Title: New Aggressive Approaches To Disconnecting The Inflammation-Depression Connection. To be presented at: The World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo Date: Oct 18-20th, 2012 Address: Shanghai World Expo Exhibition & Convention Center 1099 Guo Zhan Road, Shanghai, China, 200126  By Dr James Stoxen DC Depression is a mood disorder that […]

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Depression ICD-9 296.3

Title: New Aggressive Approaches To Disconnecting The Inflammation-Depression Connection.
To be presented at: The World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo
Date: Oct 18-20th, 2012
Address: Shanghai World Expo Exhibition & Convention Center
1099 Guo Zhan Road, Shanghai, China, 200126 
By Dr James Stoxen DC

Depression is a mood disorder that affects serotonin levels in the brain. Because of its physiological cause, many people believe that clinical depression must be cured through chemical intervention. Drug Free Therapy for signs of depression might include A healthy diet which plays an important part in healthy brain depression symptoms. Eating vitamin-rich foods balance out chemicals in the brain and provides a natural intervention for depression for some who experience severe depression syndromes. Avoiding complex sugars and too many carbohydrates, which lead to mood swings, helps stabilize emotions. Adding exercise cannot go overlooked as an important aspect of a drug-free depression treatmentTalk therapyCognitive behavioral therapy and interpersonal therapy are also very effective in overcoming chronic depressionDrugless depression treatments vary from person to person. However, herbal supplements and intervention have helped some patients. Consulting with a knowledgeable pharmacist or herbal treatment specialist can help you make the right choice for your specific treatment plan.

DR. STOXEN’S LECTURE STARTS AT 15:58 AND GOES THROUGH 16:12 ON THE VIDEO PLAYER ABOVE

YOU CAN WATCH THE LIVE LINK TO THE ENTIRE CONFERENCE IN THE VIDEO ABOVE. !!!  CLICK HERE TO SEE THE LECTURE ON THE ORIGINAL SITE.

people’s daily online is the top official website in china.

People’s Daily Online, founded on Jan. 1, 1997, is a large-scale information platform constructed by People’s Daily – one of the world’s top ten newspapers. It is also one of the largest comprehensive Internet media on the Internet. As a leading key news website in China, it upholds “authority and strength generated from people”. With “authority, popularity and credibility” as tenet, it takes the objectives “multi-language, all media forms, globalization and full coverage”, and “disseminating China’s news and covering world news” as its mission. On June 20, 2008, during his inspection tour of People’s Daily Online, President Hu Jintao noted “People’s Daily Online has played a unique role in advocating the Party’s belief, guiding public opinion and warmly serving netizens in the years since inception.”People’s Daily Online is also a teaching base for the Party School of the Communist Party of China’

Presentation Abstract:

New Aggressive Approaches to Disconnecting the Inflammation-Depression Connection

Depression represents a major public health problem it is estimated that up to 16 – 20% of the population has had depression at any one time and that 5 to 7% of the population is assumed to suffer from major depression. Studies have also shown that there is a correlation between chronic depression and the development of Alzheimer’s, Parkinson’ and dementia in later life.

There is substantial literature linking inflammation with the risk for depression. The purpose of my presentation is to list the inflammatory mediators and their link to depression. Patients with inflammatory disorders such as MS, cardiovascular disorders, rheumatoid arthritis, osteoarthritis

Increase inflammatory cytokine expression and the development of concurrent psychiatric symptoms were initially observed after administration of cytokine therapy to patients afflicted with cancer hepatitis and MS. It has been found that patients with depression have high levels of inflammatory biomarkers. This suggests that inflammation can be a mediator for depression.

The purpose of this presentation is to review these studies and determine their potential to lead to interventions which may reduce the risks for inflammatory diseases of aging such as osteoarthritis cardiovascular disease and his symptoms related to varying degrees of depression.

Depression it is obviously a stress sensitive disorder however the actual causal mechanism for their relationship is unknown. Research team led by Carnegie melon University’s Sheldon: has found that chronic psychological stresses associated with the bodies losing its ability to regulate the inflammatory response which can promote the development and progression of the disease called depression. So while inflammation can cause or be linked to depression, and the stress and depression can also be linked back to inflammation.

Aging is also associated with increased likelihood of chronic pain and inflammatory conditions. A part despite improving knowledge is of underlying mechanisms of chronic pain many patients who have chronic pain receive inadequate care both short-term and long-term. We are going to discuss some novel ways to reduce chronic pain, chronic inflammation and disability dust reducing overall inflammation and possibly reducing the risk of the development and exacerbation of chronic depression.

We will also discuss the treatments, which can and may reduce depression. Currently antidepressants only produced remission and 30% of patients. The part of the problem is that the pathophysiology of depression has not been well understood and treatments are based on empirical data and not on the mechanisms or causes of action. Many research studies suggest that addressing pro-inflammatory cytokine production represents a possible strategy to treat depression besides the use of psychotropic drugs.

This will include the relationship between dietary influences and the risk of depression, and fatty acid supplementation for the fresh and add the adiposity risk factors for childhood and adult onset depression. I will also discuss the role of inactivity in inflammation and end depression as well as the effects of exercise and the increase and decrease of inflammation associated with exercise.

I will discuss natural ways to decrease levels of systemic inflammation both from a treatment and preventive approach to use with or without psychotropic drugs.

Presentation Abstract: Walk and Run For Life via Lever Mechanisms or Spring Mechanisms? World Congress On Anti-Aging Medicine And Regenerative Biomedical Technologies Expo (A4MC) Shanghai, China, October 18-20, 2012

  Title: Walk and Run For Life! Through Lever Mechanisms or Spring Mechanisms? To be presented at: The World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo Date:Oct.18-20th, 2012 Address: Shanghai World Expo Exhibition & Convention Center 1099 Guo Zhan Road, Shanghai, China, 200126  By Dr James Stoxen DC   The Human Spring Model is […]

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Title: Walk and Run For Life! Through Lever Mechanisms or Spring Mechanisms?
To be presented at: The World Congress on Anti-Aging Medicine and Regenerative Biomedical Technologies Expo
Date:Oct.18-20th, 2012
Address: Shanghai World Expo Exhibition & Convention Center
1099 Guo Zhan Road, Shanghai, China, 200126 
By Dr James Stoxen DC

 

The Human Spring Model is Plyometric Training and Barefoot Running vs The Human Lever Model, Resistance Training and Shod Running Why the Human Spring Model and Approach is best for an Anti-aging Doctor

If the Human Spring Mechanism which functions to protect the body from impacts should lock then the force of impact is taken up by the tissues and as a result we have chronic inflammation and severe injuries. In the knee we call it Chondromalacia Patella or torn cartillage. In the foot bone or shin bone or tibia bone we call it stress fractures. From my clinical experience, the majority of the people who have injuries from running such as plantar fasciitis, shin splints, heel pain, runners knee, hip pain, Iliotibial Band Syndrome and herniated discs are because the spring mechanism can’t effectively absorb the impact into the spring.

CLICK HERE TO SEE THE LECTURE ON THE ORIGINAL SITE.

people’s daily online is the top official website in china.

People’s Daily Online, founded on Jan. 1, 1997, is a large-scale information platform constructed by People’s Daily – one of the world’s top ten newspapers. It is also one of the largest comprehensive Internet media on the Internet. As a leading key news website in China, it upholds “authority and strength generated from people”. With “authority, popularity and credibility” as tenet, it takes the objectives “multi-language, all media forms, globalization and full coverage”, and “disseminating China’s news and covering world news” as its mission. On June 20, 2008, during his inspection tour of People’s Daily Online, President Hu Jintao noted “People’s Daily Online has played a unique role in advocating the Party’s belief, guiding public opinion and warmly serving netizens in the years since inception.”People’s Daily Online is also a teaching base for the Party School of the Communist Party of China’

Presentation Abstract:

Running, as decades of studies have shown, is one of the best ways for your patients to put distance between themselves and the aging process. The medical quandary, though, has been determining for mature patients when the physical demands of running – the current lever model suggests that impacts are bad for us causing wear and tear on bone and joints leading to degeneration, inflammation and accelerated aging.   Many physicians err on the side of caution, supportive footwear, orthotics and even prematurely advising patients to stop running.

Why is it that elite coaches around the world use impact training or plyometrics to bolster performance in sports?

Who is right?

I will answer that mystery by suggesting that the current model physicians are using to understand human movement, evaluate, treat, rehabilitate and maintain the human body is not the ideal model according to the latest research and the laws of nature and physics.  I will provide evidence that the human body moves as both a lever but more importantly as a spring mechanism.  Therefore the entire standard of care approach to understanding, examining, treating, rehabilitating and maintaining the human body must be changed.

In this presentation I will discuss the differences between the current human lever model vs the human spring model citing the laws of physics, nature and through interpretations of the results and conclusions from the most current research.  I will cite the arguments that healthy humans may not ambulate with levers rather lever mechanisms and spring mechanisms.

Then I will review the current examination approaches, treatment, training and anti-aging approaches based on the human lever model vs the human spring model.

Progressive regenerative medicine and anti-aging medicine is defined as the earliest detection, intervention and prevention of age-related diseases. The current standard of care only requires doctors to do evaluations of the musculoskeletal systems when patients present with signs and symptoms of anti-aging related diseases.  Anti-aging medicine exceeds this standard by practicing a form of medicine aimed at improving patients’ performance to the Olympic level for their age group before the pain even starts.

Top coaches and athletes focus on form and technique of human movement patterns for optimum performance.  This should be the level anti-aging minded doctors function.  These same athletes and coaches use high impact training methods, plyometrics which are contrary to the current standard of care.  Current doctors recommend lever training or resistance training while anti-aging doctors should focus on what top athletes and coaches use to build stronger spring mechanisms.

These human spring mechanisms serve to protect the body from around to 250 million impacts felt in a lifetime.  These human spring mechanisms also help to recycle energy thus reducing overall fatigue.  Lever systems cannot protect an object from impacts nor can they recycle energy.

Example:

Now, let’s breakdown what is addressed when assessing running as a medical tool, from an anti-aging perspective.  Running has been proven to burn calories – strengthen the heart and to lower blood pressure – increases mental sharpness and makes you more alert. It makes you feel happier and the release of endorphins provides a feeling of euphoria. It can also decrease memory loss in elderly people.

Unfortunately, these astonishing benefits are enjoyed by only a relatively handful of patients with so many more that could be receiving them.  Why?  Because many adult patients cannot run because of arthritic conditions that are contraindicated for running.

Why can’t as many adults run as they did in their youth?  Why can children run barefoot and many adults can’t?  Is the inability to run barefoot the first sign of aging?  Are running shoes healthy for us?  Are any binding or motion-altering device healthy for us while exercising and specifically running?  Does the running shoe bind the natural spring we are born with replacing it with an artificial spring in the shoe?  What are the consequences to the reduction of the adaptation process of the body’s natural spring to resist impacts and recycle energy?

I will discuss the current approach in medicine I call the barefoot to bedridden approach which involves doctor’s prescribing more supports causing reverse adaptation.  The approach I am presenting, bedridden to barefoot or the Human Spring approach promotes healthy adaptation with the goal of restoring the body’s ability to support itself, which is the best approach to help your patients have an anti-aging lifestyle

We educate and coach our patients in the practice of resistance exercises to increase lever strength of the weight bearing joints, thus improving general running ability. However this is not the ideal model of training the body for sport.  The development of spring strength through impacts via plyometrics is of paramount concern for athletes to improve performance in running as it impacts speed, quickness, balance, agility and coordination, and is essential for safe directional changes, stopping and starting.

However few physicians understand the concepts of spring strength and plyometric training. In fact physicians commonly advise against this form of exercise as they feel it creates too much shock to the skeleton. Some fear it may even contribute to premature aging through the wear and tear theory. But running and spring training performed with a properly prepared spring mechanism and sound bio-mechanics do not damage joints. (Note: research shows that people who run regularly and those who don’t run at all have the same risks of developing osteoarthritis).

Spring strength improves the efficiency of walking and running. Having a finely-tuned spring mechanism acts as a shock absorber to better protect the skeleton from stress and strain and potential wear and tear, inflammation and pain. A healthy spring mechanism can recycle more natural energy back into the walking and running effort.

In assessing patients, it is essential for physicians to employ specific testing to determine the exact level of absolute AND spring strength.

In this presentation I will clearly define absolute and spring strength, outline the differences between them and review what causes decreases in strength. From that base, I’ll present new and innovative examination, treatment, rehabilitation and anti-aging approach.

Crucially, I’ll demonstrate new and innovative orthopedic testing methods I have developed for physicians to more accurately determine not only if the human spring mechanisms are functional but patients’ levels of spring strength through the incremental increased forces of standing (50% body weight), walking (1.25 x body weight), running (3x body weight), sprinting (4x body weight), and plyometric jumping (estimated up to 10x body weight).

This is pivotal in evaluating when it is safe for a patient to go from walking to jogging, running to sprinting and even jump training. After all, as speeds increase from walking to running, forces increase from one times body weight to five times body weight. Stepping up to advanced plyometric jump training increases the force to ten times body weight.  This is a more accurate assessment of the integrity of the patients ability to resist impacts than the current model.

Then via video demonstrations, you’ll learn how to release the spring mechanism back into the gait courtesy of a new approach.

You will witness new exercise methods, which are performed barefoot to increase absolute strength and spring strength safely.

We all should be developing a healthy anti-aging lifestyle through walking and running with maximum human spring in our steps.

The Inflammation-Depression Connection Approach and The Science Based Natural Approach to Depression

Depression ICD-9 296.3 The Inflammation-Depression Connection Approach and The Science Based Natural Approach to Depression News You may have seen all the media on ABC, CBS, NBC, CNN, FOX, The Today Show, and many others about how Wiggle front man, Anthony Field, one of many celebrities with depression and feelings of depression, that was handicapped […]

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Depression ICD-9 296.3

The Inflammation-Depression Connection Approach and The Science Based Natural Approach to Depression

News

You may have seen all the media on ABC, CBS, NBC, CNN, FOX, The Today Show, and many others about how Wiggle front man, Anthony Field, one of many celebrities with depression and feelings of depression, that was handicapped by chronic pain, chronic fatigue, misdiagnosed fibromyalgia and clinical depressive disorder during his 20 years on the road..

Watch Anthony Field’s interviews on CNN and The Today Show where he discusses the inflammation-depression connection approach;

CNN Shanon Cook Interviews Anthony Field, a celebrity with depression who had what he called a mental breakdown but not a nervous breakdown.  He healed himself by disconnecting the Inflammation-Depression Connection, one of the theories of depression Dr Stoxen mentions in this article and presentation. Watch Below

THE TODAY SHOW! For the first time Anthony Field, founder and co-star of the world’s most popular children’s musical group, The Wiggles, tells his inspiring, behind-the-scenes story of how he overcame depression, a life-threatening illness and chronic pain to get his life back. Watch Below:

 


 

The prevalence of depression has increased 10% every decade since 1910

How do you describe depression?

There are many theories of depression and its causes.

There are many types of depression such as endogenous depression, existential depression, perinatal depression, neurotic depression, atypical depression, geriatric depression, anxious depression, unipolar depression, maternal depression and even college depression.  There are songs about depression, quotes about depression and depression blogs and forums.

I treat the causes of inflammation which are linked strongly to depression.  

No matter what the link is like depression and relationships, depression and work or how you describe depression, science says that higher than normal levels of chronic inflammation could be a link to an increased risk of depression.

First, I don’t treat depression.  

Second, I never recommend a patient reduce or get off antidepressants.  

That is a choice the patient makes with their doctor.  

Many scientists have stated the connection between inflammation and depression and are recommending treatment to reduce inflammation.  The studies are here for you to review.  Has your doctor reviewed this science with you? Are you doing everything, “naturally” to ease your depression?

Here is an important question for you…

Does your doctor practice empathy when treating your depression?  or does your doctor treat your depression like the common cold and just give you pills? If you feel your doctor has no empathy for your depression and only prescribes you pills, I hope this presentation from Bangkok helps you learn more about the Inflammation-Depression Connection and what you can do to reduce depression symptoms naturally.

Depression is a mood disorder that affects serotonin levels in the brain. Because of its physiological cause, many people believe that clinical depression must be cured through chemical intervention.  High levels of chronic inflammation have been linked to lower levels of serotonin.  In fact if you go to Pub Med and search the database of scientific papers there are over 2000 articles or studies that connect inflammation to depression.

In fact, many scientists state that depression is an inflammatory disorder.

Read this paper “Is depression an inflammatory disorder?” by Charles L. Raison from the Mind-Body Program; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine who summarizes all the studies for you.   The paper is offered free here from this link. 

Instead of recommending that you reduce inflammation by attacking the sources of inflammation in your body like muscle and joint inflammation, dietary inflammation, inflammation from airborne particles and inflammation caused by stress, many doctors just give you antidepressants to keep the serotonin from being recycled and away you go.

Do you know there is a drug approved in Europe that does the opposite of the selective serotonin inhibitors (antidepressants) that claims to be just as effective?

Confusing?   Of course it is!

Maybe you need to do more research!

Watch Below as Dr. Stoxen gives his lecture presentation, The Empathy Deficit in the Treatment of Depressed Patients and The Inflammation-Depression Connection Approach at The 4th Anti-Aging And Regenerative Medicine Conference, Bangkok, Thailand, September 7-9, 2012)

Dr Stoxen reviewed over 2000 of the latest scientific papers extensively before he did this presentation.  

That saves you a time but you should still do more research.

This is especially true if the only remedy your doctor gives you are anti-depressants.

If your depression is connected to inflammation, aggressively reducing inflammation may not provide total relief  but it could help patients to reduce their dosage of antidepressants.

The best natural treatment for depression that is connected to inflammation involves attacking all sources of inflammation.

This includes:

  • This includes treating dietary inflammation with a healthy diet.
  • Treatment includes reducing lung inflammation with a reduction in airborne particles.
  • Treatment may require reduction in other inflammation producing activities like sunburn, gingivitis etc
  • It also includes treating muscle and joint inflammation with treatment.

For more in depth information about the effects of chronic high levels of inflammation read this article:  Video Tutorial #37 Aches, Pains, Allergies, Fatigue, Brain Fog, Diseases of Aging Have One Common Thread… INFLAMMATION

How do I ease depression, connected to dietary inflammation with a healthy diet?

 

Below is the Lecture and Power point notes used for Dr. Stoxen’s lecture to assist you in connecting the Inflammation-Depression Connection Approach;


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“Scientific studies have found there is a connection between inflammation and depression.

People with depression are always talking about the aches and pains that they have with. “Depression Hurts” What we have found is that a lot of these patients that have these aches and pains are actually being treated with anti inflammatories, the patient might have a chronic condition that is left untreated or they have an inflammatory disorder that is treated less than optimal.” 

“In this presentation i’m going to outline for you the different incidences found in connections between inflammation and depression in research.”

“I first discovered the connection between inflammation and the diseases of aging in 2005 at The Asia Pacific Anti-Aging conference in Bali Indonesia. It was during a presentation given by Bill Anton from Melbourne, Australia.

-Dr. James Stoxen DC

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Incidence of Depression

  • The prevalence of depression is increasing 10% every decade since 1910
  • The leading cause of disability in the United States
  • The number of Americans taking antidepressant drugs doubled in the decade from 1996 to 2005, from 13.3 million to 27 million.
  • Today 10% of every man, woman and child in America takes an antidepressant or some drug.

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“This would answer the question why so many people in the United States and around the world are depressed. If 10% of every man woman and child in the United States takes a pill for some sort of depressive disorder. In the last decade over 150 million prescriptions have been given for anti depressant medication.” 

“Is depression being treated like a common cold?

Have a cold?  Take these…

Have depression? Take these…

-Dr. James Stoxen DC

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______________________________________________________________________________________________

Is this Your Office Visit with the Doctor for Depression?

The doctor reviewed tests conducted by the nurse and then spent less than 10 minutes with the patient.

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Here’s something to help your cholesterol, something for your blood pressure, and for your depression, here is an antidepressant. Shouldn’t have too many side effects ,though you might experience a loss of sex drive, but we have a drug for that. Would you like me to add that to your prescriptions? Good luck and I’ll see you in three months when your prescription runs out.” 

-Dr. James Stoxen DC

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“It’s unfortunate that with the demands on doctors that our office visit are only 8-10 minutes. Many doctors are are dealing with patients with very complex problems with very little empathy” 

“Empathy is being able to connect with that patient to be able to feel what that patient feels. When your able to feel what the patient is feeling your able to respond with true care and love. These 8-10 office visits where people come in with depression should not be treated as if they have a common cold. and prescribed anti-depressants.” 

“Empathy is not something your born with it’s a learned skill. The Dali Lama said, ‘This is a learned skill and if you learn it and practice it then it can improve your life as well’. I know it’s improved my life. 

“In fact, Richard Davidson studied Tibetan Monks who used meditation and practiced empathy and said there was significant activity in the insula of the brain, the region of the brain that mediates bodily representation of emotional states of others who empathize.” 

-Dr. James Stoxen DC

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What is depression?  

How to describe depression:  The DSM-iv Criterion for Major Depression or to Define Depression is… 

  • A period of at least two weeks during which there is either a depressed mood or the loss of interest or pleasure in nearly all activities.
  • In children and adolescents, the mood may be irritable rather than sad.
  • The individual must also experience at least four additional symptoms drawn from a list that includes changes in appetite or weight, sleep, psycho motor activity, decreased energy, feelings of worthlessness or guilt, difficulty thinking, concentrating or making decisions, or recurring thoughts of death or suicide, plans or attempts.
  • The episode must be accompanied by clinically significant distress or impairment in social, occupational, or important areas of functioning.
  • It’s normal for people to feel a range of moods.
  • It’s not realistic for people to be in a great mood all the time.

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“I don’t know if you heard about this incident we had in Aurora, Colorado, United States. There was a young man and he was suffering from depression. He took out a gun and shot people in a theatre. This is a serious problem.” 

“According to the prescription labeling it states that 3% of those that take anti depressants will have feelings of suicide or perhaps killing others. With 30 million people taking these medications that adds up to be 900,000 people at any given time feeling like killing themselves or maybe even killing others.”

-Dr. James Stoxen DC

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Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, 1994 (DSM-IV).

______________________________________________________________________________________________

Cytokine-Induced or Sickness Syndrome

The administration of high concentration of pro-inflammatory cytokines often leads to a condition known as systemic inflammatory response syndrome (SIRS) which are the same feelings of depression as those who have not had cytokines induced.  People define the effects of depression as those we define depression as the same DSM depression symptoms.

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 “If you ever talk to someone that is depressed, many of them share that they feel like they have a cold all the time. They don’t feel like getting out of bed, they want to keep on sleeping and they are re numerating in their minds all day and night their troubles.” 

“As doctors it would benefit our patients if we just asked ‘what is bothering you’, ‘what is troubling you’. Perhaps show an interest and ask how they like their career. Ask them about their family. Try to show some empathy. 

-Dr. James Stoxen DC

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Myers JS. Pro inflammatory cytokines and sickness behavior: implications for depression and cancer-related symptoms. Oncology nursing forum. 2008;35(5):802-807


Inflammation and Depression Painful and Silent Arthritic Inflammation

  • After reviewing over 1,000 citations linking inflammation to depression we can make the assumption that inflammation is linked to and perhaps a leading cause of depression.
  • When our bodies release inflammation that leads to chronic pain, worry or have stress our bodies release low-grade inflammation.
  • When we have chronically high levels of inflammation, feel chronic pain, worry or have stress our bodies release comforting levels of serotonin to help us cope.
  • The body feels as if it is being attacked. We also have depression when we are unable to meet the demands or challenges of these attacks, leading to more stress.
  • Patients consciously and subconsciously feel hopelessly locked up by three conditions, inflammation, chronic pain and depression.

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Science has proven that if we are put in a room with negative thoughts then inflammation will increase. They can prove this with blood tests.“ 

-Dr. James Stoxen DC

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Copeland W et al. Cumulative Depression Episodes Predict Later C-Reactive Protein Levels: A Prospective Analysis. Biological Psychiatry. 2012;71(1).


Unemployment

Finnish scientists found that stress-induced low-grade inflammation might be a link between unemployment and ill health.

Hintikka J et al. Unemployment and ill health: a connection through inflammation? BMC Public Health. 2009; 9:410.

______________________________________________________________________________________________

 Coronary Artery Disease

In a study of over 677 participants, 433 had no depressive symptoms, 86 had depressive symptoms at one assessment, and 138 had depressive symptoms at two or more annual assessments. Across all three groups, greater depressive symptoms were associated with higher subsequent levels of IL-6.

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 This is a study where they found people with high levels of Interleukin 6 (IL-6), which is a cytokine is found in coronary artery disease and depression.

-Dr. James Stoxen DC

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Dulvis HE et al. Depressive symptoms, health behaviors, and subsequent inflammation in patients with coronary heart disease: prospective findings from the heart and soul study. Am J Psychiatry. 2011;168(9):913-20.

_____________________________________________________________________________________________

 Pollution

In experiments, mice subjected to the same particulate matter as that of a major city displayed more depressive-like responses and impairments in spatial learning and memory as compared with mice exposed to fresh air.

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 As I discussed earlier, encourage your patients to get out into the fresh air. This may seem like a simple recommendation because it is! The answer is not to just whip out the prescription pad and prescribe these antidepressant medications. They may become psychologically addicted to these.

-Dr. James Stoxen DC

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Fonken LK et al. Air pollution impairs cognition, provokes depressive-like behaviors and alters hippocampal cytokine expression and morphology. Mol Psychiatry. 2011;16(10):987-995

_____________________________________________________________________________________________

Cigarette Smoking

Lifelong cigarette smokers have a higher prevalence of common diseases such as atherosclerosis and COPD with significant systemic impact.

A low-grade systemic inflammatory response is evident in smokers as confirmed by numerous population-based studies. Some inflammatory mediators are still significantly raised in ex-smokers up to 10 to 20 years after quitting, suggesting ongoing low-grade inflammatory response persisting in former smokers.

Yanbaeva DG, Dentener MA et al. Systemic effects of smoking. Chest. 2007;131(5):1557-1566.

_____________________________________________________________________________________________

Gut Inflammation Vagus Nerve – Blood-Brain Barrier

  • Peripheral pro-inflammatory cytokines such as IL-1 and IL-6 can affect central nervous system functioning by penetrating the blood-brain barrier directly through active transport mechanisms.
  • Inflammation can move from the periphery to the brain directly through activation of the afferent through the Vagus nerve.
  • A group of studies have shown that the primary cause of inflammation may be a dysfunction of the gut-brains axis. This is a bidirectional mechanism.

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 ”It’s kind of strange that while I was lecturing at many medical conferences around the world and I asked the doctors who were at the top of their field, how is it that these cytokines pass the blood brain barrier? Do you know that I could not get a straight answer? There are some hypothesis, however, one doesn’t know how this happens.

-Dr. James Stoxen DC

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Wilson CJ, Finch CE, Cohen HJ. Cytokines and cognition–the case for a head-to-toe inflammatory paradigm. J Am Geriatr Soc. 2002;12:2041-2056.



Memory

Low performances in immediate verbal recall and delayed verbal recall are associated with higher IL-6 levels in women with recurring major depressive disorder.

The results of this study it suggests the existence of an association between inflammatory imbalance and cognitive impairment in major depressive disorder.

Grassi-Oliveira R, Bauer ME et al. Interleukin-6 and verbal memory in recurrent major depressive disorder. Neuro Endocrinol Lett. 2011;32(4):540-544.

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 Suicide

The results of studies demonstrate for the first time that suicidal patients display a distinct peripheral blood cytokine profile compared to non-suicidal depressed patients. This study provides further support for a role of inflammation in the pathophysiology of suicide.

Janelidze S, Mattei D et al. Cytokine levels in the blood may distinguish suicide attempters from depressed patients. Brain Behav Immun. 2011b;25(2):335-339.

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Post-Stroke Depression 

The cause of post-stroke depression is still not clear. However, studies have indicated that immune dysregulation plays a role in the pathophysiology of depression. What was found was a significant increase in the cytokines:

  • IL-6, IL 10
  • TNFa
  • Interferon Y
  • The ratios of IL-6/IL10 TNFa/IL10 were also elevated.

Su JA, Chou SY et al. Cytokine changes in the pathophysiology of poststroke depression. General hospital psychiatry. 2012;34(1):35-39.

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Overweight and Obesity

  • Depression (and the inactivity plus diet changes associated with it) cause obesity.
  • The obesity leads to inflammation, which cycles back around to lead to depression.
  • Depression may lead to inactivity and dietary changes, which leads to obesity, which leads to inflammation.
  • Obesity associated inflammation that affects the brain may promote addictive behaviors, leading to a self-perpetuating cycle that may affect not only foods but addictions to drugs, alcohol and gambling.
  • Targeted diet and exercise programs are beneficial

Shelton RC, Miller AH. Inflammation in depression: is adiposity a cause? Dialogues Clin Neurosci. 2011;13(1): 41-53.

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Anxiety vs Depression:    The Mind-Body Inflammation Connection

There are effects of depression which lead to more depression

There are depression effects that lead to other diseases

  • Inflammation Leads To Stress
  • That Can Lead To Depression
  • Depression Can Increase In Inflammation

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As I mentioned before it’s beneficial to recommend to your patients to try to get their mind off of whats depressing them and go outside or exercise.

Every time they start bringing up those negative thoughts up more inflammation occurs which makes it increasingly difficult to take care of the patient.” 

-Dr. James Stoxen DC

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Weil, A. The Depression-Inflammation Connection. The Huffington Post. 4 Nov 2011.

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The IDO Pathway

QUIN (quinolinic acid), kynurine and glutamate are linked to Alzheimer’s, Parkinson’s, ALS and dementia.

In 2011 a study stated that the kynurine/tryptophan ratios or the kynurine production may be influenced by the inflammatory process and may be implicated in the pathophysiology of suicidal behavior.

Shelton, RC, Miller, AH. Eating Ourselves to Death and Despair: the Contribution of Adiposity and Inflammation to Depression. Prog Neurobiol. 2010;91(4):275-299.

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Inflammation and the IDO Pathway

  • Idoleamine 2.3-dioxygenase IDO + tryptophan 2.3-dioxygenase (enzyme) competes with tryptophan metabolism which reduces serotonin.
  • Tryptophan is metabolized to kynurine by kynurine hydrxygenase to kynurine acid (KYNA) which antagonizes A7 nicotinic acetylcholine receptors, which leads to striatal dopamine release, which is in the brain of depressed patients.
  • Kynurine is converted with enzyme kynurine 3-monoxygenase (KMO) to quinolinic acid (QUIN).
  • QUIN activates N-methyl-D-aspartic acid (NMDA) receptors and releases glutamate.
  • This leads to the formation of neurotoxins such as the glutamate agonist quinolinic acid and contributes to the increase in apoptosis of astrocytes, oligodendroglia and neurons.
  • QUIN, kynurine and glutamate are all implicated in pathophysiology of Alzheimer’s, Parkinson’s, ALS and dementia.

Shelton, RC, Miller, AH. Eating Ourselves to Death and Despair: the Contribution of Adiposity and Inflammation to Depression. Prog Neurobiol. 2010;91(4):275-299.

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 Selective Serotonin Reuptake Inhibitors

  • In mild to moderate depression, the benefit may be mild to zero.
  • In severe depression the improvements may be more substantial.
  • Sometimes the drug takes 6-8 weeks to work.
  • In studies, there are sexual side effects in approximately 17% to 41% (likely to be overestimated when there are no placebos).
  • There is a decrease in dopamine and norepinephrine which could lead to erectile dysfunction.
  • However, the sexual side effects may be the same with another drug.
  • There is dependence withdrawal, which may be severe.

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“What is interesting is that according to some of these studies slight to zero improvement in mild to moderate depression and sometimes I think that if we would just work with the patient and show that we are doing something for them then sometimes patients actually get better.” 

We all have our bad days where we might not want to go to work or talk to patients and there are other days that we are more positive and want that interaction with people. How about start by asking the patient how they are feeling and really meaning it?”  

-Dr. James Stoxen DC

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  1. Hu XH et al. Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate. Journ Clin Psy. 2004;65(7):959-65.
  2. Landén M et al. Incidence of sexual side effects in refractory depression during treatment with citalopram or paroxetine. Journ Clin Psy. 2005;66(1):100-6.

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Selective Serotonin Reuptake Inhibitors

  • At first people feel wonderful.
  • They feel as if the cloud lifted.
  • They feel they can handle minor issues more easily.
  • They are hopeful, confident and feel improved self-worth.
  • These drugs are not addictive but patients do feel dependent.
  • When they want to wean themselves off the drug without healing the body of inflammation and other causes, they experience withdrawals which are severe.
  • Patients expect you to put them on antidepressant drugs.
  • When you suggest options to these drugs patients are relieved they have these options.
  • If you do have to put patients on antidepressants, it is not a sign of failure, but never give up trying to help the patient be self-sufficient.
  • This is best for everyone.

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 Patients expect you to put them on these medications but is that what is best vs what is convenient?

-Dr. James Stoxen DC

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Selective Serotonin Reuptake Inhibitors

  • A study of 22 studies data showed that while pharmacological antidepressant treatment reduced overall depressive symptoms, it did not reduce levels of TNFa.
  • However, antidepressant treatment did reduce levels of Il-1b and possibly IL-6.
  • While efficacious for depressive symptoms, it did not appear to reduce cytokine levels.

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 “While drugs conserve the serotonin, what is being done to reduce the high levels of inflammation that actually create problems with these other chemicals that lead to diseases such as Alzheimer’s, Dementia and Parkinson’s Disease.” 

-Dr. James Stoxen DC

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There is a drug that lowers serotonin and it has the same effectiveness as the drugs that increase available serotonin. It has been shown to be as effective as some selective serotonin reuptake inhibitors.

So how can it be that one drug lowers it and one drug raises it and they both have the same effect on depression?

Most serotonin reuptake inhibitors are not as effective as you think.

  • JAMA 2002 article about a study in the NIH stated a particular popular SSRI had about the same or a little better results than placebo.
  • JAMA 2010 January 6, 2010 stated the real biochemical effect of SSRIs as nonexistent to negligible for severe depression.
  1. Walsh BT, Seidman SN, Sysko R, Gould M. Placebo response in studies of major depression: variable, substantial, and growing. JAMA. 2002;287:1840-1847.
  2. Fournier JC, DeRubeis RJ, Hollon SD et al. Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis. JAMA. 2010;303(1):47-53.

 Antidepressants

  • Research has shown that these antidepressants are effective in the short term and can lose effectiveness in the long term.
  • Patients want relief now: that’s what you prescribe them.
  • I don’t feel the standard of care provides an adequate treatment protocol to adequately reduce levels of inflammation.

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 Patients want relief right away but there are other alternatives.

-Dr. James Stoxen DC

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Inflammation Approach to Treating Depression

  • Treat Inflammatory Diseases- Like Hepatitis, Heart Disease
  • Reduce Pulmonary Inflammation
  • Inflammation of the Skin-Psoriasis – 60% have depression in their life
  • Dietary Inflammation
  • Arthritic Inflammation

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We reduce pulmonary inflammation by helping the patient to quite smoking as well as getting the patient outside into nature.

Treat all of the above, aggressively!!

 

-Dr. James Stoxen DC

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Miller AH, Maletic V, Raison CL. Inflammation and Its Discontents: The Role of Cytokines in the Pathophysiology of Major Depression. Biological Psychiatry. 2009;65(9):732-741

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Where I Attack Depression – Inflammation

Prescribe a cholesterol-reducing drug – you talk about diet.

If you prescribe in antidepressant, do you talk about inflammation?

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Diet, Supplements, Exercise, and an Aggressive Attack on Inflammation

Diet can have a profound affect on inflammation and therefore depression.

Discuss how food is the patient’s new drug.

What they eat could be a drug that increases or decreases depression.

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Comfort Food Can Cause the Brain to be Uncomfortable

Comfort Food – Simple Carbohydrates

  • Candy
  • Ice cream
  • Chips
  • White flour
  • Potatoes
  • Crackers

Increase blood sugar —–> Increase beta endorphins
Beta endorphins help us ease physical and emotional pain

The Crash – Decrease Beta Endorphins

  • Crave sugar
  • Feel overwhelmed
  • Can’t tolerate pain
  • Feel isolated

Remedy: switch the patient to complex carbohydrates

Westover AN, Marangell LB. A cross-national relationship between sugar consumption and major depression? Depress Anxiety. 2002;16(3):118-120.

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Fat

Decreased cholesterol below 160 can lead to depression

Omega 6 fatty acids – increase inflammation

  • Vegetable Oils
  • Corn Oils
  • Egg Yolks
  • Omega-3 fatty acids – decrease inflammation

Fish

Omega 3:Omega 6 used to be 1:1
Now 1:25 last 100 years

Omega 3 is for reduction of inflammation and nerve cell function

  1. Tanskanen A, Hibbeln JR, Tuomilehto J et al. Fish consumption and depressive symptoms in the general population in Finland. Psychiatr Serv. 2001;52(4):529-531.
  2. Kiecolt-Glaser JK, Belury MA, Andridge R et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725-1734.

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Omega 3 

  • Brain behavior Immunology 2010 – This study showed that 2.5 g of EPA–DHA mirrored the proportions of fatty acids in the typical American diet and that by supplementing patients with this amount there was a 14% decrease in IL-6 production and a 20% reduction in anxiety symptoms.
  • Studies suggest that maternal DHA deficiency may lead to the development of major depressive disorder in pregnancy and postpartum. These studies are suggesting clinical benefit for supplementation with EPA in major depressive disorders.
  1. Kiecolt-Glaser JK, Belury MA, Andridge R et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725-1734.
  2. Mozurkewich E, Chilimigras J, Klemens C et al. The mothers, Omega-3 and mental health study. BMC Pregnancy Childbirth. 2011;11:46.

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Food Sensitivities and Food Allergies

Common examples are:

  • Wheat (Gluten)
  • Corn
  • Coffee
  • Sugar
  • Dairy
  • Eggs
  • Lettuce
  • Beef
  • Pork
  • Chicken

Elimination diet and blood tests

Genuis SJ. Sensitivity-related illness: the escalating pandemic of allergy, food intolerance and chemical sensitivity. Sci Total Environ.2010;408(24):6047-6061.

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D/L Phenylalanine for Norepinephrine Deficiency

  • D/L-Phenylalanine is converted to Tyrosine.
  • Tyrosine is converted to Dopamine.
  • D or L-Phenylalanine creates Dopamine and Norepinephrine.
  • Tyrosine is the parent compound for Adrenaline.
  • Norepinephrine- and Phenylalanin- like compounds exist in chocolate – That is why we crave chocolate when depressed.
  • Some studies say D/L-Phenylalanine is as good as antidepressants.
  • D/L-Phenylalanine – 500mg/day and up to 2-3000 mg/day.

Ruhé HG, Mason NS, Schene AH. Mood is indirectly related to serotonin, norepinephrine and dopamine levels in humans: a meta-analysis of monoamine depletion studies. Mol Psychiatry. 2007 Apr;12(4):331-359.

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Supplements That Support Mood

  • B6 helps in production of serotonin from 5HTP

100 mg/day

  • B12

100 mg/ day
500 mg/day with poor absorption

  • 5HTP
  • Antioxidants
  • Mineral Supplements

CA+ 500 mg/day
Chromium 200-300 mg/day

  • Fish Oil

Normal 1000 mg-5000 mg
Asthma, diabetes, heart disease, arthritis, cancer, injury, chronic pain – 5000 mg
Bipolar – 10,000 mg

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Curcumin

Is a plant derived dietary spice with various biological activities including anti-carcinogenic and anti-inflammatory effects. Its therapeutic applications have been studied in a variety of conditions including rheumatoid arthritis, colon cancer and depression.

Guimarães MR, Coimbra LS, de Aquino SG et al. Potent anti-inflammatory effects of systemically administered curcumin modulate periodontal disease in vivo. J Periodontal Res. 2011;46(2):269-279.

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Pain Exorcism

Sometimes we work for 30 – 40 hours on a patient with hands on treatments and vibration therapy to reduce silent inflammation. In these cases a few anti-inflammatories are not good enough to reduce this much inflammation.

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I have patients that take 10-20 anti-inflammatories a day and still they are loaded with inflammation.“ 

-Dr. James Stoxen DC

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Levels of Inflammation

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“This is a chart I developed about 20 years ago showing levels of Inflammation. In the red you see painful areas of the body, yellow is silent inflammation and green is normal.”

“There is a way to feel the patients body and determine where the silent inflammation is. You may have felt this when you have gotten a massage.”

-Dr. James Stoxen DC

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Levels of Silent Inflammation vs Painful Inflammation

Inflammation Patterns

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Painful and Silent Arthritic Inflammation

  • It is low-grade inflammation.
  • Low-grade inflammation is what research is telling us contributes to depression.
  • Painful Arthritic Inflammation
  • Silent Arthritic Inflammation

We know how to find painful arthritic inflammation.

  • How do we examine for silent arthritic inflammation?
  • How do we treat silent arthritic inflammation?

Kojima M, Kojima T, Suzuki S, Oguchi T et al. Depression, inflammation, and pain in patients with rheumatoid arthritis. Arthritis Rheum. 2009;61(8):1018-1024.

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Breakdown of Biomechanics

  • Accelerated aging
  • Pain
  • Silent inflammation
  • Wear and tear
  • Stress and strain
  • Compensating abnormal movement
  • Drop and lock of the spring mechanism
  • Weakness in spring suspension system

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 On average each person takes 10,000 steps per day. That adds up to 3.5 million steps in a year. In the first 30 years a person will have had 100 million impacts or collisions with the ground. Any subtle abnormal walking mechanics can lead to a tremendous amount of inflammation that is released in their life.

-Dr. James Stoxen DC

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Gait Analysis

 

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Compensating Motion

Remembering to keep your second toe pointing towards the target will allow you to accomplish many important positive changes in your gait.

1. It will allow you to have an alignment that will keep your knee hinging at the angle it was designed to hinge at reducing stress on the knee.
2. It will align your leg to allow the calf muscles to be aligned for the maximal contraction up the middle. This will maximize the venous return via the contraction of the calf to squeeze the blood back to fill the heart.
3. It will allow you to get maximum spring from your muscles.
4. It keeps your bodyweight from rolling over the inside edge of your big toe. This forces the big toe laterally and squeezes the rest of the toes together causing bunions and mortons neuromas

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External Forces and Internal Compressive Forces on the Human -Body Mapped Out

Internal and External Forces and Conditions

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“This is how levels of silent inflammation maps itself out on the human body and the conditions that it can lead to. Compressive injuries such as hip and knee joint degeneration and ultimately in the end, hip and knee surgery.” 

“If you think about it. If someone needs hip replacement surgery there had to be at least 30-40 years of abnormal movement patterns causing inflammation leaking into the body which could cause cardiovascular disease and other diseases of aging.”

-Dr. James Stoxen DC

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Take a look at the footwear

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“Modern society has changed forcing us to wear shoes causing weakness”

“One of the simplest things you can do for your patients is to take a look at their footwear.  As you can see this one is not very well designed. It’s got a gap in the middle that allows the arch to collapse. The front and back end comes up as well. That’s not very beneficial to the patient. 

“Prescribing a shoe with an extended medial counter can actually help them stay in the safe range. Especially those patients who are on their feet all day. That may be you, doctors. I know I use a shoe that has an extended medial counter support.”

-Dr. James Stoxen DC

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 Keep the foot in the safe range

Unsafe Range vs Safe Range

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 “It’s very important for the foot to stay in the safe range. If it rolls outside of the safe range as you can see above on the left then it creates the stress and strain, wear and tear and the release of inflammation.” 

-Dr. James Stoxen DC

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 “When you go to a doctors office normal standard of care is approximately 20 minutes of re education per visit. That is what is covered by the health insurance.

Then I go back to Empathy. Empathy means that even though the health insurance only covers 20 minutes of care the patient needs about an hours worth of deep tissue work to actually get out of the pain and reduce inflammation.”

-Dr. James Stoxen DC

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Vibration Therapy 

Vibrational Massage from the feet to the head 

  • 45 minutes before treatment
  • Stimulates circulation to flush the inflammatory chemicals out of the body
  • Increases the levels of Oxygen, nutrients and hormones

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“Our VIP patients fly in on Saturday and at 9:00 am we start the deep tissue treatment and vibratory therapy. Vibratory therapy is a vibrational massage from the feet all the way to the head for approximately 45 minutes before the treatment.”  These treatments can last all day for several days straight.”  

-Dr. James Stoxen DC

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Biomedical Stimulation – Vibration Therapy

Vibration therapy reduces plasma IL-6 and muscle soreness after downhill running inflammatory markers were assessed pre-run, post-run, 24 hours and 120 hours post run.

IL-6

  • 24 hours decreased 31%.
  • 120 hours decreased another 31%.

Histamine 

  • 24 hours decreased 50%.
  • 120 hours decreased another 48%.

The treatments were once a day on the upper and lower legs ONLY.

 British Journal of Sports Medicine 2008

Broadbent S, Rousseau JJ, Thorp RM. Vibration therapy reduces plasma IL6 and muscle soreness after downhill running. Br J Sports Med. 2010;44(12):888-894.

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Deep Tissue/Self-help

Removes painful and silent inflammation muscle spasms

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 “I apply deep tissue treatment on the patient with a goal to remove every single painful and silently inflamed muscle spasm I find according within the pattern of abnormal movement which causes these compressive forces on the joints that lead to inflammation.”  theory

-Dr. James Stoxen DC

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Exercise 

  • Alleviates stress and anxiety
  • Increases confidence
  • It’s a distraction from negative thoughts and feelings
  • Elevates mood
  • Boosts serotonin over the long term
  • Increases stress tolerance
  • Decreases fear of tragedy
  • Improves social interaction
  • Aerobic exercise – 30 minutes per day
  • Resistance exercise – 30 minutes per day

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The goals should be to improve mood so patients can get free from dependency on drugs.

“Don’t give up!”

-Dr. James Stoxen DC

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Daley A. Exercise and depression: a review of reviews. J Clin Psychol Med Settings. 2008;15(2):140-147.


Exercise and Depression:  Exercise is a Powerful Anti-depressant

Depression and exercise:  A 1999 study by researchers at Duke University, published in the Archives of Internal Medicine, compared exercise, medication, and a combination of the two among a group of 156 middle-aged and elderly patients with non-suicidal depression. Medication was a selective serotonin reuptake inhibitor.

  • The exercises were performed three times a week for 45 minutes and included 30 minutes of brisk walking or jogging.
  • After 16 weeks all three groups showed similar improvements.

A follow a to this study published in psychosomatic medicine in 2000 check back on how the patients were doing six months after the study.

  • The exercise-only group was actually doing better than the other two.
  • Fewer than one third of the medication-free exercisers had relapsed back into depression, compared to over half of the patients in the med and the med/exercise groups.

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 When your talking with patients about depression take the time to do a careful history and show some empathy. Find out what is going on in their life, consult with them and do whatever you can with natural therapies before you are so quick to prescribe anti depressant medication.

-Dr. James Stoxen DC

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What is empathy? 

The definition of Empathy is the ability to understand another’s experience, to communicate and confirm that understanding with the other person and to then act in a helpful manner.

There is increasing evidence in medical practice that emotional interactions/clinical empathy with patients are fundamental to patient healing. Medical effectiveness does not merely rely on technical expertise but also on interpersonal communication between the patient and physician.

Doctors who practice detachment seem to miss important cues about what patients were thinking and feeling with regard to their diagnoses and treatment and this wastes time, leads to missed diagnoses, and an inadequate adherence to treatment. Thus, physicians should strive to be empathic and engage in communication with their patients as soon as possible and communicate with them until solutions are achieved.

Showing “clinical empathy” to patients can improve their satisfaction of care and motivate them to stick to their treatment plan. One example of showing empathy might be as simple as truly listening to your patients, not just hearing them.  By really paying attention to your patients, talking one on one and honing in on what your patients are sharing, you will be able to make a better diagnosis.

Studies have also been shown that Doctors who take the time to listen and understand what their patients are going through could actually have a positive effect on their patients’ pain tolerance and stress levels. To read more about this study look at this article from the Huffington Post; Doctor Empathy Could Decrease Stress, Pain Sensitivity In Patients: Study, click here

Clinical empathy is an essential medical skill.  Showing empathy and sympathy can produce changes in physician behavior and patient outcomes.  Physicians must also model an empathetic approach to patient care. Practicing empathy can also help with the treatment of Chronic Depression or mood disorder by showing that you care.

“Our profession now needs to incorporate the teaching of clinical empathy more widely into clinical practice at all levels beginning with the selection of candidates for medical school,”

“The behavioral aspects of empathy and sympathy – the empathic response – can be assessed and integrated into medical schools’ core communication skills training.”, Dr. Robert Buckman, Princess Margaret Hospital and the Faculty of Medicine, University of Toronto Canada Medical Association Journal

Empathy is the ability to identify with and/or feel another’s feelings. It is the act of imaginatively standing in another’s shoes and seeing the world through their eyes. It creates feelings of deep connectedness with others. Love can’t happen without it. Neither can justice or peace or any other kind of beneficial relationship. Empathy is the glue that holds us together. And in a world that encourages self interest and mindless consumption above all else, it’s a commodity in short supply.

Read how Anthony Field reduced his clinical depression in his book, How I Got My Wiggle Back.

Not only can clinical empathy help your patients it can help you as a Doctor too. An example of this is Wiggles frontman Anthony Field who  shares about his inspiring, behind-the-scenes story of how he overcame depression, chronic pain and more with the help of Dr. James Stoxen DC in a healing memoir book written by Anthony Field and Greg Truman entitled, How I Got My Wiggle Back. To order How I Got My Wiggle Back on Amazon.com, click here

Dr. James Stoxen DC and The Team Doctors Staff in Chicago, IL have always ascribed to a similar principle, placing high value on every single patient interaction from the initial examination or phone call to each and every treatment visit.  We practice empathy and  treat our patients the same way we would want to be treated and daily. Empathy has always been among our most valuable treatment tools.

Do we have an “empathy deficit”? We see the costs of our “me-first” mindset: record breakdowns in relationships, endemic corruption, environmental degradation, inequitable social structures, and a whole generation increasingly unable to deeply connect–to anything or anyone. Now, scientists have confirmed we’re experiencing a steep decline in our capacity for empathy.

Empathy is at the heart of human connection. It’s the glue that keeps us together. With it in short supply, what will become of us as a species?

To find out the answers, we’re hunting down the best and brightest “social revolutionaries”–empathic leaders who are transforming the lives, structures and organizations around them.

Physicians are treating depression like the common cold giving out anti-depressants in a rushed office visit not showing empathy for their patients.”  

Dr. Stoxen also speaks about Richard Davidson, one of the world’s top brain scientist, who began an ongoing study of the brains of Tibetan monks, the so-called “Olympians” of meditation, each of whom had accomplished at least 10,000 hours of meditation.

The scans revealed significant activity in the insula, which is extremely important in detecting emotions. Increased in the temporal parietal juncture, particularly the right hemisphere. Studies have implicated this area as important in processing empathy, especially in perceiving the mental and emotional state of others.

Buddhist monks believe mental attributes and positive emotions such as compassion, loving kindness and empathy are skills that can be cultivated.

Science is beginning to back that up.

Dr. James Stoxen DC is one of the “social revolutionaries” who is tackling some of our most pressing world problems from an empathic perspective.

Stand In My Shoes is a crowd-fuelled social change film about exposing what President Barack Obama coined the “Empathy Deficit” in our world, and the global hunt for social revolutionaries dedicated to creating a countermovement of kindness.

Other ‘social revolutionaries’ include the Dalai Lama and Marianne Williamson (One of TIME’s 50 Most Influential Women), both of whom advocate for a more compassionate culture; Bill Drayton (Ashoka), who teaches entrepreneurs to be empathic leaders; David Jones (CEO, Euro RSCG, One Young World) and Craig Davis (Publicis Mojo, Brand Karma), business moguls who argue that doing good is good business; Blake Mycoskie (TOMS), pioneer of the one-for-one movement; Mary Gordon (Roots of Empathy), founder of programs to teaching children empathy; organisational change architect Margot Cairnes, author The Moral Molecule and neuro-economist Dr Paul Zak, Roman Krznaric, cultural thinker and Julianne Moore, Mark Ruffalo, or Meryl Streep, celebrities who speak out for a more empathic media culture. We’re also on the hunt for fresh-faced social revolutionaries to feature

More research that suggests inflammation may contribute to depression

Dowlati Y, Herrmann N, Swardfager W, et al. A meta-analysis of cytokines in major depression. Biol Psychiatry. 2010;67:446–57. [PubMed]

Howren MB, Lamkin DM, Suls J. Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosom Med. 2009;71:171–86. [PubMed]

Pasco JA, Nicholson GC, Williams LJ, et al. Association of high-sensitivity C-reactive protein with de novo major depression. Br J Psychiatry. 2010;197:372–7. [PubMed]

Liukkonen T, Silvennoinen-Kassinen S, Jokelainen J, et al. The association between C-reactive protein levels and depression: results from the northern Finland 1966 birth cohort study. Biol Psychiatry. 2006;60:825–30. [PubMed]

Danner M, Kasl SV, Abramson JL, Vaccarino V. Association between depression and elevated C-reactive protein. Psychosom Med. 2003;65:347–56. [PubMed]

Eisenberger NI, Inagaki TK, Mashal NM, Irwin MR. Inflammation and social experience: an inflammatory challenge induces feelings of social disconnection in addition to depressed mood. Brain Behav Immun. 2010;24:558–63. [PMC free article] [PubMed]

Wright CE, Strike PC, Brydon L, Steptoe A. Acute inflammation and negative mood: mediation by cytokine activation. Brain Behav Immun. 2005;19:345–50. [PubMed]

Harrison NA, Brydon L, Walker C, et al. Neural origins of human sickness in interoceptive responses to inflammation. Biol Psychiatry. 2009;66:415–22. [PMC free article] [PubMed]

Dantzer R, O’Connor JC, Freund GG, et al. From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci. 2008;9:46–56. [PMC free article] [PubMed]

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VIP Invitation: Stand In My Shoes Film Kickstarter Launch September 20, 2012 Hollywood, California

  Where: Hemingway’s  Lounge 1st  Floor 6356 Hollywood Boulevard Hollywood, CA 90028 When: Thursday September 20th, 7PM RSVP! BY 18TH SEPTEMBER 2012 I’m happy to share with you a project I’m proud to be involved with: a new social change film project called Stand In My Shoes Directed by Kurt Engfehr (Bowling for Colombine, The Yes Men, […]

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Where: Hemingway’s  Lounge 1st  Floor 6356 Hollywood Boulevard Hollywood, CA 90028
When: Thursday September 20th, 7PM
RSVP!
BY 18TH SEPTEMBER 2012

I’m happy to share with you a project I’m proud to be involved with: a new social change film project called Stand In My Shoes Directed by Kurt Engfehr (Bowling for Colombine, The Yes Men, Farenheit 9/11) about the “empathy deficit” in our culture, and how the world’s most influential social entrepeneurs are out there using the power of empathy to transform businesses and lives.

“Having worked with thousands of patients who spend long hours on their feet, I can say with confidence I have seen incredible improvements in the overall wellbeing by recommending different footwear to improve alignment.  By recommending Apple/Fox Conn or other workers in Chinese manufacturing factories specially designed shoes, I believe this a positive practical solution could help reduce overall fatigue and chronic inflammation and pain that could alleviate some of their suffering to a degree. It would also show that companies like Apple are prepared to practice empathy for everyone in their supply chain who are contributing to their global success.” Dr. James Stoxen DC

On September 20 there will be an event to support the US Kickstarter launch of this project. Hosted by gifted comedian Kyle Cease – who has been touted as the next Jim Carrey – the night promises to be fun event with great speakers, food, wine and good company.

I hope you and your guest can attend this VIP fundraising event to support this positive social change film as I am. I’m sure we all agree empathy is a much needed message in these current times!

Check out The kickstarter site, click here 

Watch the Trailer below:

You might also like the post Stand in My Shoes: The Empathy Deficit in the Treatment of Depressed Patients and The Inflammation-Depression Connection Approach, click here

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