Episode Transcript
[00:00:00] Speaker A: I had the wonderful opportunity of working four years with the New York Giants, but I was shocked. They almost waited for them to become injured and then they'd send them down the hall to the physical therapist or the chiropractor. Youth sports has grown bigger than the NFL now and they still are governed by health insurance guidelines. So you can see the major gap there.
[00:00:26] Speaker B: All right, everyone, welcome back to Chirocast, brought to you by Chirotouch.
It's been a little while since our last episode and we are excited to be back with a conversation that feels especially timely. We're going to talk about youth sports today. They're growing very fast and unfortunately, so are some of the injuries that come with them.
Today, our guest, we are joined by Dr. Tim Mangs. He's a chiropractor, author and educator who spent more than 25 years focused on one question. How do we protect young athletes before they get injured? Dr. Maggs is the founder of Sepoya, aka Concerned Parents of Young Athletes. It's a national preventative program that helps identify structural imbalances early and and positions chiropractors as leaders in youth Sports Injury Prevention. Dr. Maggs, welcome. We're so happy to have you here.
[00:01:26] Speaker A: Thank you, Dr. Steff. It's a joy to be here. It's probably my favorite topic to talk about, so I look forward to the next hour.
[00:01:34] Speaker B: Yeah.
So before we talk about program and framework, I wanna start with you. And your lead in here was perfect.
When did youth sports for course become such a meaningful focus for you in your career?
[00:01:48] Speaker A: It started probably close to 25 years ago.
Approximately 30 years ago. I had the wonderful opportunity of working four years with the New York Giants and that was a tremendous eye opener to me because here you're dealing with these multi million dollar athletes.
But I was shocked when the care of them, they almost waited for them to become injured and then they'd send them down the hall to the physical therapist or the chiropractor. And chiropractors are in every locker room. Every pro football team, for example, has a chiropractor, but they're kind of off in the corner and they adjust players that like to be adjusted. They, you know, if they're not getting better, traditionally they send them to the chiropractor, but that's not what I'm talking about at all. So once I saw that, it started what I have now developed as the structural management program.
And that started then. And I say I didn't know enough then, but I knew there's information that we can find on athletes before they become injured. So that started the whole thing. And then approximately five years, six years after that, I had a case in my office where a high school kid came in and he. He had a Division 1 scholarship waiting for him, but he was in the final semester of high school and he couldn't run because of a back injury.
So the clock was ticking and it became critically important that we evaluate and understand what it was and get him better. And we did. But I said, this whole market or this whole population is really not looked at at all. They are kind of an afterthought.
[00:03:38] Speaker B: Okay, side question. Are you still a Giants fan?
[00:03:41] Speaker A: I am.
[00:03:42] Speaker B: I am okay. Okay.
[00:03:44] Speaker A: As painful as that is, I am okay.
[00:03:47] Speaker B: So, audience, so they know. Dr. Maggs, where do you live?
[00:03:50] Speaker A: Right now I live. Well, for those who aren't in the area, I live near Albany or Saratoga, New York.
[00:03:57] Speaker B: Yep. And so I'm down the road or down the thruway in Rochester, New York. And so at some point when you're down the thruway, there's like an invisible line that happens. And we're all Bills fans. So very close to Buffalo. Go Bills. Sorry, Giants.
[00:04:11] Speaker A: Well, I'm rooting for you now, believe me.
[00:04:14] Speaker B: Good times. Good times. All right, cool.
So tell me about your program. I know that's kind of open ended, but I want to hear about it.
[00:04:22] Speaker A: No, it's a. It's a good question. It's such a broad topic.
And when we started, my goal was when I started the structural management program, it was also the beginning of what we call the structural fingerprint exam. And that exam is a biomechanical exam. So if you look at every human being as an architectural structure, and let's say they don't talk to you, let's say they don't give you any information, there are tests that can be done on that structure, much like a building that can tell you where the asymmetries are, the imbalances are as a person ages, where the wear and tear is, where the restrictions are, and all of that is vital information on the longevity of that structure.
So we then started realizing at the age of 12, we can do this structural fingerprint exam. And we really hope that they've never been injured, although most of them have. But even with a never before injured and not currently injured young athlete, we can do our biomechanical exam and give very unique critical information that is going to affect their lifetime. And now we've really incorporated. How do you, how do you correct what you found to put them into safer position for sports.
So we've evolved it tremendously over the last 25 years.
And now, you know, youth sports has grown bigger than the NFL now, and they still are governed by health insurance guidelines.
So you can see the major gap there.
[00:06:06] Speaker B: Yeah.
So in terms of youth sports, like you just said, how much it's grown and how much more popular maybe they've been in more recent years, what do you think has changed the most, besides the volume? Right.
What do you think has changed or been happening that is contributing to what these kids are experiencing now?
[00:06:26] Speaker A: It's a great question.
If you see where it's at now, it's larger than the NFL.
Private equity firms are now investing billions. And if you go on AI chatgpt, it'll confirm that they're investing billions into youth sports because there's just such a fever now. I say church is no longer what you do on Sunday. It's sports.
So it's taking the place religion. So with that being said, the demand on these younger athletes is to start younger.
The parents are really the, the contributors to the fever because all of us as parents want our child to do better, to play more, to get a scholarship, to, you know, go. So I have a very large middle school, high school practice, and I can tell you, at the age of 12 and 13, these kids have two or three coaches.
They're in the weight room at that age.
And all of it starts with the routine medical exam. Eyes, ears, nose and throat.
So you can see the catastrophe that's occurring. The loading has increased, the volume has increased, the full calendar has increased, and they're starting younger and no one is looking at any part of their mechanical structure.
[00:07:58] Speaker B: Yeah, I was just going to say it seems like, yes, you want to. They all have to get physicals. Right. And be cleared to be able to practice.
But I feel like a lot of that, the focus of that physical is let's make sure it's safe for this kid to participate so they don't die. Right. So they're checking out their heart, hopefully, and some other things too. But yeah, I mean, and this is not to knock traditional medicine because they have their place and their focus, but that's what their focus is. It's not biomechanical. And it seems that they're kind of missing the boat. So seems like a good opportunity for chiropractors to step in.
[00:08:34] Speaker A: Well, I, I, you know, I've gone out on the edge and I, I, even on my website, the wrong doctors are in charge. The wrong testing is being done. And what happens is they don't know that they're the wrong doctors. They're doing what they know. But, but the medical model is the cause of musculoskeletal problems because it's a reactive model and then they treat the symptoms.
So the chiropractic profession, unfortunately, Dr. Steff, I'm critical of us because I say we have morphed into that model where we're treating pain, we market pain, and yet we're the only ones who really understand biomechanics. And we're the only ones that has the scope of practice that will allow us to take biomechanical X rays, allow us to take get MRIs to identify the degrees of the injuries, allow us to do chiropractic and physical therapy. We're one stop shopping. But we as a profession, we need to rally together and understand it. And I think I've developed the turnkey system that would be optimal and ideal for the profession to embrace.
[00:09:49] Speaker B: Would you propose that chiropractors be the ones that, you know, if they're trained in this type of specialization. But do you think that we should be the ones clearing kids to participate or should it be like a team effort? Like, what do you, how do you envision that if it was like a pie in the sky situation?
[00:10:05] Speaker A: Yeah. And again, I love your questions. You, I think you're really hitting the nail on the head. We should be the lead authority on musculoskeletal. When it goes into the concussion world, that's neurology. And although we might have an opinion, I think the neurologist has to be in charge or if it's outside our scope, it's a fracture or a Liz Frank injury, that type of thing. But for musculoskeletal, I can tell you because I've examined now well over 3,000 kids in the last 20 years. And that's X rays of every one of those kids.
Every one of them has imbalances in asymmetries.
And then the truth is the medical community does not understand musculoskeletal.
[00:10:53] Speaker B: Sure.
[00:10:53] Speaker A: You know what I mean? They'll go to the docs, and the docs will recommend a medication or go to physical therapy for a brief stint of physical therapy. But no one is looking at the biomechanical faults or we call a structural fingerprint. And then I'll tell you another piece that really adds to this whole thing.
As these kids are growing, their legs do not grow evenly.
So every year or two years, it's important to look at femoral head height and to adapt accordingly to try to get them level with the appropriate orthotic and lift, because they're not level, and very often they keep growing more unlevel.
And I call femoral head height the most important measurement in the body because it tells you what the lower extremity weight distribution is, the imbalance, and it's a foundation of the spine. The spine is on an imbalanced foundation.
So it's a critical measurement. And I've now got eight research papers published on this topic, and it's staggering the data that is available in the information that's out there. And my whole mission is for us as a profession to embrace it. And let's leapfrog everyone and start giving the care to this age group that will change their future.
[00:12:18] Speaker B: Got it? How do you propose that we measure that? Would it be just an A to P pelvis and you're looking at the difference between the femoral head height, or are you getting, like, measuring like actual leg length?
[00:12:30] Speaker A: With the, with the, with the digital X rays now, A to P pelvis, you just easily, in three seconds, you can measure femoral head height. And 3 millimeters in below is classified as optimal. Above 3 millimeters is not optimal. But we also have done extensive studies of doing it barefoot versus orthotics in the shoes.
And so there's so much data now that we've proven how to do it. It's just. It's insane that we continue to be part of that medical model and only treat these kids when they hurt.
[00:13:10] Speaker B: Got it. Yeah. That's nuts.
So it sounds like you're pointing. I feel like a lot of people with injuries, especially with kids, they want to just blame it on overuse. So I feel like that may or may not be a component, but is that a term that you use? You talk to kids and parents about that? Like, what do you. What do you think about that?
[00:13:30] Speaker A: No, I agree.
Overuse is what's used a lot today.
But I use it a lot in combination with biomechanical faults. And when you get both involved, there's an exponentialism of abnormal loading.
And then when you have sports specialization, a pitcher, a tennis player, where you're using the same joints repeatedly, that overuse combined with the biomechanical faults, that's why I say today, musculoskeletal is the leading cost in healthcare. 20 years from now and beyond, it's going to explode. As far as joint replacements, the whole opioid crisis, loss of quality of life, pain management, Departments. That's what's coming. Because we're not looking at how to solve the problem.
[00:14:23] Speaker B: Yeah. So a quick story here.
My. So I see patients still, and I have a home practice, but everyone comes through my front porch with my outside little door. Right. Not like a regular door. It's like a porch door. And I've noticed. So I have higher volume. So there's more people coming through than maybe would be at a normal person's house. Right. And then also none of them are doing it right. So they go to yank on the handle without like turning the latch to actually, like, open the door.
Yeah. I've got overuse issue because it's getting used more. I've got a biomechanical clinical issue because they're all doing it wrong. And the handle, it's like a disaster. So it's. I have to tighten the stupid thing on it all the time. And patients are always like. They'll look at. They'll turn back and they're holding the handle in their hand because it came off like, it's a disaster. And so I just. I still don't know what the answer is. I think my next step, I'm gonna put up a little sign. But I've been. I'm super anti sign because I feel like no one reads them once. Once this. They've seen the sign a few times, they get used to it and it just does not register anymore.
But yeah, I mean, it's as simple as that. Like, they don't know how to use the handle, so it's causing a problem. And unfortunately, I think that really resonated. I've never considered it in those terms that, you know, kids are growing and their legs are not growing at the same rate. Like that makes complete sense. Why would they be?
Yeah. So we really need to pay close attention to that population.
[00:15:47] Speaker A: So that I'll give you an example. We had a patient come in when she was a junior in high school about three years ago.
And so we put orthotics in her shoes. We use orthotics for everyone because one of our studies showed that 100% of the population have varying degrees of collapse of the feet. Because I'm so architecture oriented, it's like, okay, let's fix the foundation. So I go through the process of making patients understand the importance of orthotics, number one. So at that time, we X rayed her with orthotics on, and her femoral head height was 1.5 millimeters different, which makes it normal.
She stops coming in three years later, she's a freshman in college. She's on the Division 1 track program. She's got a chronic hamstring that she cannot heal on her own. And she's been out for six weeks.
We bring her back in, we put new orthotics in her shoes, we re X ray ephemeral head height. It goes 1.5 to 12.1.
Therein lies why that one hamstring won't heal.
Okay? And that story is behind every kid out there.
So if you spent a week in my office, you'd go back to your office and you'd say, we've got to change what we're doing. We're missing all of this.
[00:17:11] Speaker B: Yeah, I'm already thinking that.
[00:17:13] Speaker A: I know, I know.
[00:17:14] Speaker B: I need to take a ride down the thru a and come hang out with you.
[00:17:17] Speaker A: Well, we would love to have you because I love it when docs visit. But here's the thing. I spent seven years in a school. I had an office in a school. And you may be familiar with Christian Brothers Academy.
[00:17:30] Speaker B: I don't think I've heard of them.
[00:17:31] Speaker A: But they're in Syracuse and they're in Albany. So it's the largest private school in upstate New York. And I had an office in the school for seven years.
And my whole mission was to make that the model. And they. Therefore, I would do every opportunity I could to educate parents that all of your kids have biomechanical faults. We will evaluate them at no cost. And I'm here once a week to be able to treat them as just standard. I mean, it's. You have to bring them in once a week. It's not necessarily for the injury, but for. And it went incredibly well. But then Covid really zapped us. And by the time I got back into school, it was all new parents, and I couldn't afford the time to stay there. But every school should have a chiropractor in the school teaching biomechanics, encouraging these exams. My goal is for every kid in the country to get this exam before the season starts. And until we do that, these kids are flying without a net, and nobody has a clue what injuries are coming.
[00:18:36] Speaker B: Got it? Yeah. So why.
Why do you think the system tends to wait for a problem instead of prioritizing prevention?
[00:18:46] Speaker A: Well, because it's the same as in pro locker rooms. The athletic trainer and the orthopedist are in charge. That's their model. That's what they do. That's what they know. And the whole system is set up for that. Because insurance is set up for that.
So everything is set up for that. Nobody knows that there is an alternative approach.
And that's why I feel like I'm out on the corner screaming. I've written hundreds of articles, I've given hundreds and hundreds of seminars. And you feel like you're not making any progress, but I'm sure there's an impact from it. But if, if we as a profession could embrace this, I just think that we as a profession could change the course of history.
[00:19:33] Speaker B: Sure.
[00:19:33] Speaker A: It's that impactful.
[00:19:35] Speaker B: Yeah. So you've mentioned the age 12 to 13 a few times now. So two questions.
How early do you think these imbalances start? And is there a optimal age or an age where maybe someone would be too young to be evaluated?
[00:19:53] Speaker A: Great question. Again, we're asymmetrical when we're born.
And I say from the moment that child stands, abnormal loading is starting to accumulate. And again, the many years I've been in practice, I've learned little quips of how I make people understand what I'm trying to say without going into detail. I say, and then you have had a pathway of banana peels your entire life, and here you are today.
So the age of 7 is when we start with orthotics and we take 1x ray femoral head height. The age of 12 is when we do our full structural fingerprint exam because the child is developed at that point. We've got 16 point exam with four standing biomechanical X rays.
[00:20:45] Speaker B: Okay, got it. Do you shoot films in your office?
[00:20:47] Speaker C: I do.
[00:20:48] Speaker B: Okay. I don't see how this could work. I mean, you could do it if you had. I have something.
[00:20:52] Speaker A: But you see, we, we have, we've got this concept in our profession that don't X ray. And, and I say that's, that's tantamount to the medics not doing blood tests.
[00:21:03] Speaker B: Yeah.
[00:21:03] Speaker A: You know what I mean? And I gave a talk to the graduates of Northeast Chiropractic College, I don't know, three, four months ago, and I talked about the importance of X rays and I showed them femoral head height and the whole thing. And one of them come up to me and said, would you talk to our radiology department? Because they tell us not to take X rays.
So we have an identity crisis in our profession. But I can tell you this. We've got a marking system for our X rays that applies to every X ray series you take. And it's as simple as this, Dr. Steph, we know what a normal lord out of curve is in the neck. If it's not that, there's abnormal loading.
[00:21:46] Speaker B: Yeah.
[00:21:47] Speaker A: So we have that for the 4x rays that we take. Every patient has abnormal biomechanical loading that is either not symptomatic yet or is going to be symptomatic.
[00:21:58] Speaker B: Got it? Yeah. I went to. Well, it was NYCC at the time, so that's where I went to school. And I'll never forget, I had a patient once that was coming into clinic, and they had called ahead of time and they needed an X ray. And I was so excited because I was like, oh, my God, I get to take an X ray of someone. This is amazing. But I think it was something weird. Gonna be like their foot or something. It wasn't like a spine.
[00:22:19] Speaker A: It wasn't even spinal.
[00:22:20] Speaker B: No.
[00:22:21] Speaker A: Well, here's what happened to me. I went to national college, and we had. We had intense radiology.
So the day I graduated, I got an X ray system, started X raying the day I graduated. I've been in practice 47 years now, so I had this massive database. But in addition to that, I had the luxury, the opportunity to lecture for nine years with Terry Yocum, and I lectured 55 times with him, and I heard the same lecture 55 times, but I learned something different at every one.
And I'm here to say that imaging, X ray and mri is. Is the key to the future, and no one has embraced it. And if we can embrace that, we will change the concept of how to evaluate people, and we will become the authorities in evaluating and caring for people.
[00:23:16] Speaker B: Yeah. I don't know if I'll say his name correctly, but I've been reading Peter Attia. He has a book out, and he talks about that, you know, he's a medical doctor, and he.
You know, we have all these regulations, like, wait to get a.
You know, you wait to get this imaging until you're this age, and you're gonna wait for a DEXA until you're 60 or whatever it's supposed to be. And he's like, it's way too late. Like, we're. We're just finding things way after the fact, and it's way harder to help people after things have taken hold. So this is not a foreign concept. And, yeah, it is frustrating, I think, as a practitioner, when we do know, let the truth here, where if you can get ahead of something, you're going to help prevent a problem.
I think people in our profession who are against X raying, you know, I think they would say, well, if it's, you know, if it's indicated clinically. Well, there comes a point at which we have to use our evidence that we see in front of our eyeballs and in our everyday practice and, and what we know about the human body and how it works.
I think some of those people are, they're just picking a hill to die on and they're just, just, I don't know that they have the background to.
Is there really the evidence to say that it's harmful to, to do these things for people in the face of the information that you garner from them to be able to help prevent a problem? So it's hard, it's hard to measure something that you prevented. And maybe that's where the issue lies. But when we see it happening all the time, and if we can see that it stops when you do these certain things.
Yeah.
[00:24:54] Speaker A: Well, you have. I go back to. If you remove lab testing from medics, where does healthcare end up? And yet we know that medical evaluate or medical approach to musculoskeletal is. I mean, it's foolish to think that there's any type of logic to that. So no one has ever really created the musculoskeletal approach. And I think that's what I've done is created a system that's backed by massive data, that's backed by eight peer review medical journal research papers. We've done all the studies and now we have all of the system, the testing, the interpretation, the communication to the patient so they understand it. We as chiropractors have just the most wonderful toolkit to be able to address what we found on those tests.
And that is what will protect and prevent. Now, do I have proof? Well, I do on my sixth paper and I tell this story and this is what my upcoming book will tell about too.
I bought a professional basketball team for the sole purpose of governing the locker room because I know that I can't have that clout in another locker room.
So the team is the Albany Patroons, which are the most storied minor league professional organization ever, because Phil Jackson, who is the winningest coach in NBA history for championships, he won his first championship with the Albany patroons. So in 2020, at the press conference, I said the reason I'm taking ownership isn't for business purposes. It's so that I can govern what the protocols are in the sports med department.
So the players came into camp, we examined them, x rayed them, orthotics, lifts if needed, treated them twice a week, and at nine Games in Covid hit.
So we had nine games with no injury. Now we couldn't get back to playing again under this system till 2023. So we were able to show in 2023, 11 players, 32 games, one player missed two games.
And the sixth paper published explains all of the details of how we got to that point. And those are unprecedented numbers in pro sports.
[00:27:25] Speaker B: Cool. If someone wanted to read some of your research, how might they be able to find it?
[00:27:30] Speaker A: If they go to drtim mags.com up in the right hand corner. And I'm not a web guy, so I have to explain it the way I would. There are two little horizontal lines. If you click on that scroll down will occur published studies. All. All eight of them are right there.
[00:27:48] Speaker B: Nice. I love it.
So question the exam that you do, the structural fingerprint exam with the imaging. And we've kind of obviously talked about the imaging here, but are you doing this? You're doing the imaging standing, right?
[00:28:05] Speaker A: Correct.
[00:28:06] Speaker B: I mean, even if any film I've ever taken, even the cervical films, I always write standing on the order because I mean, I want to see what we're spending most of our time upright and when we're being functional, trying to do stuff, we're upright. So I want to see things through that lens. But is there any other reason why you would prefer standing versus, you know, laying down that often medical community would default to.
Or it's just obvious.
[00:28:31] Speaker A: Well, first of all, why. Why do they do it? Recumbent. They do a recumbent because better control of the patient. They aren't concerned with what gravity shows and they aren't looking for biomechanics. So it doesn't matter. But I tell patients you're a victim of gravity and aging and stress.
And number two, as human beings, as architectural structures over time, we're victims of compression. And where does the body compress? Where do we lose height? We lose it in the joints, the discs. So therefore, which takes us maybe down a little different tangent. And it's not necessarily the kids, but we have five spinal decompression systems in our office.
Because compression in the spine is an epidemic in our country. The medics call. You've got arthritis. Here, take some ibuprofen or whatever. However that those joints that are wearing, they fit right into the chiropractic lexicon because they've lost mobility, the loading is abnormal. And we want to get life back into those joints which decompression does. So we want to see what you look like standing because we Use biomechanical measurements as an architectural structure. Are you symmetrical? Are you level? Are your centers of gravity good? And where is the wear and tear? And those issues apply to every patient that we X ray.
[00:30:02] Speaker B: So how does, how would you say your clinical decision making is impacted by the imaging? So, for example, do you ever have patients where they don't have that, that difference between the femoral heads? It's less than 3 millimeters. So you wouldn't recommend orthotics or is everyone getting orthotics? Because, you know, is there like a foot exam involved here too? And you're doing something different to support the foot itself? Not necessarily correct for that femoral head difference.
[00:30:31] Speaker A: So here's the situation. I lectured for 20 years for foot levelers. I claim, and in my seminars, I claim I've sold more orthotics than anyone in history. Okay? I've never had anybody refute it. So until they do, I'm going to say I've sold more than anybody. And then what I did my fifth paper, that is on my website. We examined 1001 patients feet, and we concluded that those thousand and one patients, every one of them had varying degrees of collapse of parts of their feet.
Secondly, we learned that as we age, feet continue to collapse.
So therefore, knowing that musculoskeletal is the leading cost, I don't even examine the feet anymore. We start with orthotics, and then we look at femoral head height, because the feet in the collapse of the feet and leg length govern femoral head height. If we fix the feet, the only variable is femoral head height. So that will tell us on that X ray. Now, yes, we get people that are under 3 millimeters, but they have orthotics. And now we set up our treatment program.
Now that we know they're balanced, now we set up our treatment program. Program.
[00:31:49] Speaker B: Got it.
How do you feel about heel lifts? Because I feel like a lot of docs are just going to see an imbalance with femoral heads, one leg longer than the other, whatever, and they, they just want to go right to a heel lift, whether that's in conjunction with or separate from an orthotic. So.
[00:32:06] Speaker A: Well, we, we, yeah, we use heel lifts. Probably 70% of our patients with, with orthotics. However, I will have that rare patient that doesn't want orthotics or they wear a shoe that doesn't tolerate an orthotic. I'll recommend a heel lift, but that's, that's very, very rare. But I can see the Logic in it.
[00:32:27] Speaker B: Interesting.
Okay, next question.
Especially with kids, their feet are growing. So whether it's kids or adults, you can answer both. But how frequently might you recommend. Let's start with kids. How frequently do they need to get new orthotics? Because I could see, I mean they're grow out of their clothes like, you know, they're growing like weeds sometimes. So how frequently do they need new orthotics or what, what might you recommend in terms of how frequently they need to be replaced?
[00:32:55] Speaker A: Right. And again, I think, I don't know this for sure, Dr. Steph, but I think I see I've seen more kids over the years than anyone and I think I've recommended more orthotics than anyone. So I always say they will wear them out before they outgrow them.
[00:33:12] Speaker B: Okay.
[00:33:13] Speaker A: So when they're active in sports, I recommend between one and two years. Every kid is different as far as how rough they are on their shoes. But we recommend a full orthotic and a cleat orthotic because many sports have cleats. So that's a three quarter orthotic. So therefore they're not wearing the same orthotic full time. But generally one to two years is how often you shift should. And I, I frame it as an investment in your child to minimize. And, and let me take it back a step because we're missing one key element here. I have a graphic that I now use that I developed. It is a, it looks like a skeleton almost, but it's, it's an asymmetrical skeleton and we named it Actuary Alex.
Alex, Male, female actuary.
That structure has a cost attached to it before it dies.
And that cost, it's going to start out with injuries, it's going to move into joint problems, it's going to then move into joint replacement, it's going to move into disabilities, it's going to move into loss of quality of life until the person dies and it's hell getting old. So we want to use that, that name to educate parents. Your child has a cost attached to it and that cost is going to be more than your generation is paying.
So therefore, as an investment on the front end, every year to two years, we want to have new orthotics put in the shoes.
[00:34:45] Speaker B: Got it. So I'm going to throw you a curveball here because it hasn't been mentioned yet, but what do you ever care for kids or teenagers, whatever? What about dancers? Because that is a sport and I think it can be pretty rigorous. But, but A. I mean, do you have any comments here? But also, they especially like, if it's ballet, they can't wear an orthotic in that shoe. Right. So what do we do about that?
[00:35:11] Speaker A: Well, it's the same as swimmers, it's the same as wrestlers. So there are sports that don't. Would never tolerate an orthotic. But that's only.
So you can't wear it, but you can wear it the rest of your life. And you wear it when the other eight, 10 hours that you're up and about.
[00:35:28] Speaker B: Okay, perfect.
[00:35:29] Speaker A: It's an automatic that you get it. And I know there are going to be times you don't wear it, but you know, it's a ratio. You want to have it in the. When you're in that situation of walking, standing as much as possible.
[00:35:40] Speaker B: Got it. Okay, perfect.
So I think you might have touched on this, like drawing a distinction with parents to get them to understand the difference between treating symptoms versus caring for structure.
It's not just the financial investment. There also might be like a time investment. They have to come in to see you and all the things. So how do you overcome or explain that to patients in general or parents?
[00:36:09] Speaker A: Well, first of all, parents will do anything for their kids. I think. Wait, notice that.
[00:36:16] Speaker B: But will they do anything for their kids or are they more likely to do anything for their pets? Pets.
I feel like people will spend anything on their pets.
[00:36:25] Speaker A: They will.
See, in New York, you can't adjust pets.
[00:36:29] Speaker B: Well, yeah, I didn't mean for chiropractic, but. But I mean, I don't have kids, so I'm not trying to say I would put my pet before my kid.
[00:36:36] Speaker A: No, but that's very true.
But, but kids are in the same category. So parents will take bullets for their kids more than they will for themselves.
All right, now, with that being said, I will make a statement here that I believe to be true.
The overwhelming programming that the current system has on the public, which is what is my insurance cover, if I don't hurt, I don't have time.
That dominates what my educational logic tries to do.
So I have said to parents endlessly, and that's why I ultimately went into the school. I got approval to go into the school to make it easier for parents. But I say once a week until they graduate, that's when they're not injured. Once a week until they graduate. And I have families that stick to it. Most families can't and don't because you don't have kids. I'll tell you this. There's no schedule busier than a family that has kids in middle school, high school.
[00:37:42] Speaker B: I don't know how they do it.
[00:37:43] Speaker A: Yeah. It's insane. Yeah. So it's. It's. But I constantly give that message once a week until they graduate. And some do.
Most don't, but they call back when the kid's injured. Now you get them back into it again. But I say, I'm out here alone singing this song. If we as a profession could come out with the new standards of youth sports, people would listen. You know what I mean? Because there's so, so many people now have an interest in youth sports from an economic point of view. There's so much money to be made.
[00:38:18] Speaker B: That's interesting. How. How is there money to be made? I don't know if you can explain that.
[00:38:23] Speaker A: Yeah, well, think of equipment.
Think of cost to be part of a league. Think of tournaments. AAU parents are spending more money than they've ever spent in their life, and everybody wants to a piece of that.
[00:38:38] Speaker B: Yep.
[00:38:39] Speaker A: So in that, again, is only growing. And that's why I say what has lagged behind is the sports medicine department.
[00:38:47] Speaker B: Yeah.
[00:38:47] Speaker A: And kind of one of the missions that I've been on. Dr. Bennett Amalu back in. I don't even remember the year he. He was a Nigerian pathologist in Pittsburgh, and he wanted to prove that repeated hits to the head would cause injury and damage and personality changes. And so ultimately, he went up against the NFL. They didn't want that information out there. He beat.
[00:39:15] Speaker B: I feel like I've heard this story.
[00:39:17] Speaker A: Yeah, it's in the movie Concussion. He beat the NFL.
And now concussion protocols are part of every organization in the country. But if you think about it, Dr. Steph, that's from here up.
There are no protocols from here down. And that's what I want my protocols to become, those protocols, because we've got the proof. I have far more evidence than Dr. Amalu had, and we've got everything in place. We just need to get chiropractors aligned with it and have a system where they can become part of it. Trained, certified, they're on the website.
And I think it would explode.
[00:39:55] Speaker B: So here's a crazy question, too. So I think part of what we would need to get something like that going would be the support and resources of one of our colleges or like having it be part of our education.
And so that being said, though, what do you think of. Because you just mentioned Pittsburgh, the new chiropractic program that they are rolling out, not that we know anything about it. But the idea of a major large university having a chiropractic program that wasn't a chiropractic program, specific school. Do you have any thoughts on that?
[00:40:26] Speaker A: Well, it, you know, you say chiropractic, it's almost, I've thought about it like a new profession, you know, because I don't want to, I don't want to try and steer chiropractic and BJ Palmer and the philosophies of all of those, you know, forefathers to come into my system. But I say we have to progress with the times and the needs of the public.
So I do think that some school would do well to create a physical medicine profession that uses imaging, that uses, you know, pre injury approach and then uses all of the tools to, to treat in rehab even before injuries. Now one of the things I'm doing and I'm, I'm marketing it to pro sports and I know one of these days with all I have, somebody's going to agree to it is the development of an injury prevention department.
And I say a pro team that has, let's say a pitcher that's making $50 million a year to develop a prevention department would cost one to $2 million a year.
And think of the advantage, no stress.
The players are evaluated, they come in for treatment all season.
The fixed cost, they would now not be in the injury department as much. So the injury department would go way down. The economics of the team and the state would go up because teams now can be more competitive because they're not losing key players. So you know that that's going to happen. I'm being very slow in approaching it because having worked with the Giants, I understand how to get it to that level. I just am kind of building this ship, hoping that I can get people come on board with me because there's a lot of young excited chiropractors and sports is the biggest thing out there.
[00:42:23] Speaker B: Yeah.
[00:42:23] Speaker A: Being a Bills fan.
[00:42:25] Speaker B: Right, right. Also, we have a lot of hockey around here. I feel like it's got to be the same by you for like youth sports.
[00:42:31] Speaker A: It is.
[00:42:32] Speaker B: And I'm just imagining like, can you put an orthotic in a hockey skate?
[00:42:36] Speaker A: Yeah, that's where a cleat orthotic or a hockey orthotic or a skate orthotic. It's the same three quarter orthotic.
[00:42:43] Speaker B: Ah, okay, cool. Do you actually have kids that do that?
[00:42:47] Speaker A: Oh yeah, yeah, we have a lot of them. That's what we do. I mean we treat so many kids and I Don't even care what sport they play.
My conclusion now, after all these years is we'll put you into your sport safer and with better chance of not getting hurt than if you didn't come in.
[00:43:05] Speaker B: Got it. I like it. Now, do you have a recommendation on best orthotics to purchase? Where to get them is. You know what's. Because there's so many different ones out there. What do you have a recommendation on that?
[00:43:18] Speaker A: I, I do, but I, I'm not going to tell you.
[00:43:23] Speaker B: So that's okay.
[00:43:24] Speaker A: No, but I'll tell you why. There's reasons why I'm not going to tell you. But here's what I will say. I will say this. Now, my research has proven that you don't need custom orthotics, okay? So they should be more available to people. There's many over the counter orthotics out there because less expensive. Now you say, well, how did you conclude that? And I'm going to give you the analogy. The most important measurement in the body is femoral head height. No custom orthotic company out there has ever talked about looking at femoral head he height. They try to fix everything in the foot. The foot is the victim of an imbalance in weight distribution.
So therefore we want symmetry in both feet, but we then want the X ray to determine if there's a femoral head height difference, leg length difference.
So I use the analogy. If you have a front end misalignment of a car, you don't buy custom tires, you fix the misalignment and buy tires.
[00:44:28] Speaker B: Got it?
[00:44:30] Speaker A: Okay.
[00:44:30] Speaker B: I wouldn't have known not to do that.
[00:44:33] Speaker A: Well, no, but I say that no one has ever come out and said that. But no one's ever done the research or seen as many people as I've seen over the years. And it's a major statement because you don't need custom orthotics.
[00:44:46] Speaker B: Interesting. Yeah. I feel like there is a sense out there, at least among the profession, that you really do.
So I'll tell you. You know, I don't have a way to do custom orthotics for my patients, but I also wouldn't have thought that a non custom orthotic could be, I don't want to say good enough, but just as good, if not better. So.
[00:45:04] Speaker A: Well, there's, there's varying degrees. So there's inexpensive and more expensive.
But the, the goal with the feet is to create symmetry. So there are even shoes and sandals out there that have really good arch support in there and there are times I'll say to a patient, okay, if you want to keep that, that's fine, because you're creating symmetry of the feet. That's the goal.
[00:45:26] Speaker B: Yeah. What would you say to the people who are a big fan of like, no shoes, no orthotics, all the barefoot stuff out there?
[00:45:37] Speaker A: Again, I believe I'm an expert in this. And one of the reasons I'm an expert in this, for 30 years I have sponsored a team of Kenyan runners. So I have my own team of East African runners, which is where this concept originated.
And in the end, everyone has varying degrees of imbalances in the feet that are translated, transferred up the body to an increased Q angle of the knee, to a greater femoral head height difference. So if you run barefoot, you're ignoring all of the biomechanical imbalances that exist.
And, and that's. You can't do it. So I have all of my Kenyan runners wear orthotics.
[00:46:23] Speaker B: Okay, got it. That's neat. I don't know how you do some of these things. You've got. You've got stuff all over the place. I love it.
[00:46:31] Speaker A: I'm busy.
But you know what? Here's what it is. It's a passion. It's a mission I've been on and I absolutely love it. I can't wait to get to work in the morning.
I, I do a lot of writing, I do a lot of reading, and it's just, I've been blessed in a life that I truly love.
And, you know, you, you help people. You love it. You know, when you help somebody, it's a, it's an, you know, a joy you can't describe.
[00:46:56] Speaker B: Yeah. That's why, you know, I practiced full time for 14 years, but I came to Chirotouch and I just didn't.
I wasn't ready to hang up my hands, I guess. And so it was funny. I was like, well, we'll just see. Whoever comes to see me is fine. So I let. I just, I didn't. I don't have a website, I don't have business cards. I don't advertise.
[00:47:15] Speaker A: Yeah, you're like the old time doc.
[00:47:18] Speaker B: Yeah, we're actually joke. My practice is like a speakeasy. Like, you need the, you need the secret password to get in or the secret knock on the door.
But so, you know, and that's the thing. I was just like, well, I'll just take care of whoever comes see me. And it's been three years now. Over three years. And, and they're still coming. So you know, it's, it is nice to keep, to keep doing things and still keep a hand in that even if it isn't like my full time gig. So anyways, back to the kids. So question. What is one thing that you would want every parent of a young athlete to understand?
[00:47:54] Speaker A: They have the ability to change their child's life in, in the most incredible way if they would, if they would not follow their pattern of thinking. They're robots. They follow the pattern of thinking and then they ask the pediatrician, what do you think? The pediatricians have no clue. So I would love all parents to recognize the massive importance of preserving the kids biomechanics which again, you know, it's an uphill battle. But what will do it is the media.
The media will change that. And if, that's why I say if we can get numbers, if we can get media writing about it because it has such an impact on society. I mean, you'll change health care. If you could get this to become larger nationally, you would change the future of health care in this country.
It's that big.
[00:48:50] Speaker B: What about coaches? So I often will get a parent and they'll bring their kid in and got hurt at me practice or game or whatever and coach said to do X, Y or Z. And I'm always like that's not what you should be doing. But so what could coaches be doing.
[00:49:06] Speaker A: To make things coaches see that's a category unto itself because coaches, the parents look to the coach.
So the coaches are very influential people. But if you look at the history of coaches in sports medicine, most coaches know that the doctors don't know and that the doctors will just take the athlete out. So I've always said two weeks off is not a treatment recommendation. But that's what docs will do to protect themselves. But coaches know that the docs don't know. So what's happened is the coaches have kind of become the docs because they think they know more than the other docs and they probably do, but they don't know enough by any means.
So they can be a challenge. So either you have the light switch on where they're open to it, it or the light switch off where they think they know everything.
And that's a challenge too. But that's one that, you know, if we could put together a healthier organization within our profession, we'd have a coaches educational program to educate them. Because if you think about it, Dr. Steff, if I'm the coach of a football team and I have you, Dr. Steph, taking care of my quarterback off hours.
That will reduce the risk of him being injured.
I would encourage him to go to you. Yeah, because it's not interfering in my schedule, so. But they just don't know. And that's the type of education we need to get to these coaches.
[00:50:40] Speaker B: Yeah, that would be interesting. You know, if there's chiropractors listening, I know a lot of us will that do have kids. Our kids are playing sports often. So those would be interesting conversations for, for our parents who are kairos maybe to have with their.
With their coaches, I think, or see what inroads they can make maybe to help there.
[00:51:00] Speaker A: Well, and again, I. I easily could put together that program because I've dealt with probably hundreds of coaches over the years and I can tell immediately it's a switch on or off.
[00:51:10] Speaker B: Yeah. All right, well, you're on it. We've assigned it to you.
[00:51:13] Speaker A: Okay, throw it over here. I've got nothing going.
[00:51:16] Speaker B: Perfect. Perfect.
All right, good. So as we start to wrap up, I just want to zoom out for a moment. So we talked about biomechanics, imaging, parents, prevention, coaches.
But at the heart of this is protecting kids and helping them stay healthy. And I think a lot of our focus and parents and the kids and the coaches focus is often on, you know, that kid being able to continue in their sport and be successful. But it's also is like you've said, going to be better for healthcare in the long run and preventing issues as they age. I have a quick story I want to share. So I had a patient a few years ago now who did I do CrossFit when I go. And so she was in our gym doing CrossFit. Teenager, very healthy, good movement, very good at it. And long story short, she ended up going sledding on like New Year's Day and hit a big bump. And when they landed after the bump, her back started hurting a lot.
And so they came in to see me.
Long story short, again, they. She has a. She had a spondylolisthesis. I forget at what level. You know, there's no way to know if it was the sledding that literally did it. Was it there before and it was just exacerbated? I don't know. But it was obviously very acute. So I tend to think maybe that sledding situation was the problem.
But it was tough because I knew these people and I knew it was like their dream. And her dream to the CrossFit Open was coming up. It was in like a Month later. Right. Or a month and a half after New Year's, whenever that was this year or that particular year. And she obviously wanted to, to do that because she wanted to see how far she could get. And I had to tell her that she couldn't and it sucked. But you know, they were crying in the office. It was very upsetting. But I told them, I'm like, it's not about like CrossFit this year or like your sport this year, it's about you doing this next year and the year after that and the year after that. And if you do this this year and you ignore these signals that your body is sending you, you might, you know, that could be a problem with you moving forward even worse than kind of what you've got now. So thankfully they did follow my advice. They did continue getting care. They did see went to Partners in Medical community for advice there, which really was. They may have gone to pt, I don't remember. But anyways, she, she did take the season off. She was still working out and exercising, but not to any level of intensity really.
And she made essentially full recovery.
She's participated in the open every year since. She's now in college and still doing CrossFit, CrossFit competitions. She's gearing up for this year. So I think making sure parents have that big picture view of the future and, and trying to explain that to kids because they especially struggle, I think to. Because they're young and they don't have that perspective.
I think that's really important.
So.
[00:54:18] Speaker A: Well, it's, it's interesting and I'll be very brief, but that's the story Terry Yocum told 55 times and he. His whole lecture lectures on spondylo. So here's what an additional piece of that puzzle which would have helped you because you said I don't know if it's a, it was acute, but I don't know if it was. He calls it active or inactive.
[00:54:39] Speaker B: Yeah.
[00:54:40] Speaker A: An MRI would have given you that answer.
[00:54:42] Speaker B: Yeah.
[00:54:43] Speaker A: And it would have shown edema. And if there's edema, that means it just happened and it's a three to four month time frame to resolve it. If there's no edema, the spondylo is not the cause of the problem. That's a piece of the puzzle that he taught me and now I've used many, many times because it's such a common condition in kids.
[00:55:04] Speaker B: You know, I'm wondering if we did get. I'll have to go back and look now.
[00:55:08] Speaker A: Yeah, yeah.
[00:55:09] Speaker B: I'm curious.
[00:55:09] Speaker A: Yeah. A stir image would show if there's edema in the pedicles, then you know, it's a new injury, and therefore it's three to four months. And he recommends a Boston overlap brace.
Three to four months.
[00:55:25] Speaker B: So I gotta go back and look now? It was like, seven years ago, so I might not be forgetting, but I'm gonna look it up this afternoon.
[00:55:31] Speaker A: Yeah, yeah, but that's what it is. So when. When I have an acute low back come in as a kid, I immediately get an mri. I want to.
[00:55:38] Speaker B: I pass an image like a film or. And you go straight?
[00:55:41] Speaker A: No, I take X rays. Okay. But a lot of times you'll have no spondylo. There's no pars defect. However, there is edema in the bone, and he calls that a pending spondylo. There's no pars defect, but you have to treat it the same as an active spondylo. Three to four months off.
[00:55:59] Speaker B: Got it.
[00:56:00] Speaker A: I like that. And that's another condition that chiropractors are unaware of, that Terry has done all the work. I've been the beneficiary of learning. But we need to get that information out to other docs as well.
[00:56:12] Speaker B: Yeah.
[00:56:12] Speaker A: A lot of work ahead of us.
[00:56:14] Speaker B: Yeah. So on that note, if someone wants to learn more about your work or your organization, Sepoya, where should they go?
[00:56:23] Speaker A: Well, they can email me Dr. T@doctor Tim Mags.com. they can go to the website. We have a massive amount of information, but we are going to be creating a network of doctors now that we're, you know, really getting this thing off the ground. So if they contact me or Chirotouch and let them know, Chirotouch can let me know. We'll put them on the list and keep them posted as we develop this program.
[00:56:46] Speaker B: I love it. So it's Dr. Tim Mags2GS.com, right?
[00:56:51] Speaker A: Yes, Dr. Tim Mags.com.
[00:56:53] Speaker B: Perfect. All right.
[00:56:54] Speaker A: And I want you to come down and I want you to spend a day with me.
[00:56:57] Speaker B: I know I have to figure we'll have to ask for permission for me to get away from Chirotouch for a day.
[00:57:02] Speaker A: Oh, Chirotouch. I would like Kyro Touch to. To pay for you to come down.
[00:57:07] Speaker B: Oh, well, yes, let's.
[00:57:08] Speaker A: We can bring that up so you can go back and give them a report of. Of what you think.
[00:57:14] Speaker C: Think.
[00:57:14] Speaker B: Yeah, I can do that. We'll have to find out. All right, cool.
Yeah. Well, thanks for joining us today. I love the work that you're doing.
And thanks for coming to share this with our listeners.
I love the info.
[00:57:28] Speaker A: Well, I'll say this, you did a spectacular job. I never have people ask me the right questions. You asked all the right questions. You're one step ahead of me.
[00:57:35] Speaker B: So. Yeah. And just so everyone knows, we. I have never talked to you before today. Today, actually.
So, I mean, I know I do know of you because of. For various reasons. So. But that's really funny. Thank you. I appreciate that.
[00:57:50] Speaker A: Thank you very much.
[00:57:51] Speaker B: Yeah. So if you're a chiropractor or a parent or maybe even a coach that wants to learn more about Sepoya and how this proactive model is being brought to communities across the country, visit Dr. Tim Mag's website, Dr. Tim mags.com back/C, P, O Y A. That's how you spell sequoia.
To explore its mission and resources.
Thanks for listening to this episode of Chirocast, brought to you by Chirotouch. We appreciate you being part of this conversation and we'll see you next time. And big thanks to Dr. Tim Meggs.
[00:58:24] Speaker A: Thank you, Doug.
[00:58:25] Speaker C: Thank you for joining us on this episode of Chirocast, Insights for Modern Chiropractors, brought to you by ChiroTouch, hosted by Dr. Stephanie Brown, produced by Debbie Brooks, editing from Matthew Dodge. Our theme song, House 5 is from Scott W. Brooks. If you enjoyed today's show, don't forget to like, link and subscribe. We appreciate your support and we'll catch you next time.
