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Guide to Back, Hip, Knee and Foot Pain


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Healthcare costs are out of control. The majority of orthopedic conditions are secondary symptoms whereas the underlying etiology is left under-treated or ignored. View this presentation to learn …

Healthcare costs are out of control. The majority of orthopedic conditions are secondary symptoms whereas the underlying etiology is left under-treated or ignored. View this presentation to learn more.

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  • 1. Preventative Orthopedics Michael E. Graham, DPM, FACFAS
  • 2. We, as a nation, have to take proactive measures to avoid a collapse of our healthcare system.
  • 3. We rely on doctors and medical professionalsto help us and to provide their expert opinion on the best course of treatment.
  • 4. The only problem is that many timesdoctors are controlled by the healthcare insurance policy writers.
  • 5. The ones who control the money control the quality of care.
  • 6. They claim to believe in “preventativemedicine” but they don’t want to pay for preventative treatments.
  • 7. This is especially true when it comes to the #1 cause of disability – disorders of the musculoskeletal system.
  • 8. “Let’s just take the insurance premiumsand temporarily make patients feel better – that’s the best way for us to maximize profits.”
  • 9. In the meantime, they hope you switchto another company, who will be stuck with the more expensive fix.
  • 10. The cumulative trauma of these untreated conditions add up over the years until theindividual is badly affected. Then it is up to Medicare to pay for the years of neglect and the “patch-up” services.
  • 11. Just like anything else, the longer youwait to fix the problem, the worse the problem gets.
  • 12. So what’s the fix?
  • 13. We need a proactive approach rather than reactionary.
  • 14. 98% of healthcare services are reactionary rather than taking pre-emptive measures to combat a disease process.
  • 15. Instead of just covering up symptoms and undertreating/ignoring the underlying cause,
  • 16. let’s pay more attention to the underlying etiology and provide better solutions.
  • 17. let’s pay more attention to the underlying etiology and provide better solutions. Let’s fix what cause the disease in the first place.
  • 18. We have to change our thinking and behaviorin order to positively affect the future of healthcare.
  • 19. In 2008, over 110 million adult US citizens complained of one or more musculoskeletal symptoms. That is 1/2 of the adult population.
  • 20. In other words: every other person over 18 years oldhas a musculoskeletal complaint.
  • 21. Chronic musculoskeletal complaints are found at a 60% higher ratethan chronic coronary & heart conditions.
  • 22. 3 out of 4 persons (69%) aged 75 years orolder report one or more musculoskeletal symptoms. So, the older we grow, the more likely we are to develop a musculoskeletal problem.
  • 23. 62 million (62,000,000) adultsreported back pain (in 2008)
  • 24. 39 million (39,000,000) adults reported knee pain.
  • 25. 17 million (17,000,000) adults 18 yearsand older reported that they havedifficulty performing routine dailyactivities of life without assistance because of their musculoskeletal complaints.
  • 26. The direct costs for treatingmusculoskeletal disease was $575 billion ($576,000,000,000.00)
  • 27. The direct costs for treatingmusculoskeletal disease was $575 billion ($576,000,000,000.00)and an additional $373.1 billion ($373,100,000,000.00) on indirect costs.
  • 28. The total costs of musculoskeletal disease to society was estimated at $950 billion ($950,000,000,000.00) in 2010.
  • 29. What is the number one reason for back pain?
  • 30. What is the number one reason for hip pain?
  • 31. What is the number one reason for knee pain?
  • 32. It all begins with the most abused andneglected part of our body - OUR FEET!
  • 33. Specifically the talus (ankle bone) on thecalcaneus (heel bone)
  • 34. When the talus is properlyaligned on the calcaneus
  • 35. a normal amount of forces are acting on the bones and soft tissuesthroughout the musculoskeletal chain.
  • 36. People with alignedhindfeet are able towalk, run or exercise without excesssuffering from faulty biomechanics.
  • 37. However,a partial dynamic displacement of the talus on the calcaneus
  • 38. leads to apathologic chain reaction of destruction. M I S A L I G N M E N T
  • 39. These abnormal forces act on the entiremusculoskeletal chain.
  • 40. This partial talotarsal dislocation iswhat leads to the development of these chronic secondary musculoskeletal symptoms.
  • 41. So we have to look atback, hip, knee and foot pain as symptoms.
  • 42. Pain is a warning signalthat something is wrong.
  • 43. If we only address the symptomswithout eliminating the source of the symptoms, then the symptoms will just reoccur.
  • 44. We can keep putting air into a tire with aslow leak, but the air will just escape and the tire will go flat again.
  • 45. We can invent all sorts of ways to put airin the tire, yet we ignore the fact that it is just a temporary fix.
  • 46. Eventually, the small hole progressively gets larger and the tire is completely destroyed.
  • 47. If we would have repaired the hole when it was smaller it would have been a much easier fix than replacing the entire wheel.
  • 48. The same is true with our bodies. It’s easier to fix a mild deformity than to wait for it to become a severe deformity.
  • 49. As the population continues to increase and the lifespan continues to grow longer,the already overwhelming costs of treating musculoskeletal diseases will become insurmountable.
  • 50. We have to change our thinking and lookto eliminate, or to decrease as much as possible, the underlying etiology.
  • 51. Not to just focus our attention only to where the pain is, but to look at the entire structure.
  • 52. Walking is the second most common conscious function of our body. Breathing is number one.
  • 53. This partial talotarsal displacementis simply ignored or undertreated. No one ever pays attention to the foundation of the body – our feet.
  • 54. Typically, someone withmisaligned feet is told they have only 3 options.
  • 55. Do nothing.
  • 56. Put an arch support under your foot(that may temporarily help with the symptoms but won’t fix the problem.)
  • 57. Reconstructive rearfoot surgery. Looks like fun, right?
  • 58. The problem with observation, or “supervised neglect,” is that whilestanding, walking, or running those excessive pathologic forces are destroying the body.
  • 59. Arch supports?Where’s the proof of hindfoot realignment? Even the best custom-fit device cannot realign and maintain that alignment of the hindfoot.
  • 60. Rearfoot reconstructive surgeryis reserved until there is so muchdestruction that there is no other option.
  • 61. Finally – it’s time for the real solution. This is the answer we have been looking for.
  • 62. What if there was a rather simpleprocedure where a stabilization devicecould be internally inserted to realign the talus back on the calcaneus.
  • 63. The normalamount of motion is restored.
  • 64. No matter if the person was going barefoot or wearing shoes, thehindfoot would still be realigned.
  • 65. This device could be used in both children and adults.
  • 66. The procedure is minimal invasive with a relatively quick recovery.
  • 67. And, if needed, this device could be removed. It’s always nice to know that a surgical procedure could be reversed, if necessary.
  • 68. Once the hindfoot is realigned thosepathologic destructive forces would be eliminated and more importantly…
  • 69. …individuals could start walking,running and exercising without being punished.
  • 70. This device would need to be time-tested and scientifically proven.
  • 71. What if I told you that this device is already being used by foot and ankle surgeons in over 25 countries?
  • 72. It has been placed in over 20,000 feetover the past 8 years.
  • 73. There are many scientific, peer- reviewed articles published on this device that include both multicenterprospective and retrospective studies.
  • 74. There have not been any serious complicationsas a result of this procedure.
  • 75. Doesn’t it make sense?
  • 76. Do your own research, look at thepeople around you, ask them what symptom(s) they have and then take a look at their feet.
  • 77. To learn more about this life-changing,problem solving procedure, please visit:
  • 78.
  • 79. Let’s refuseto just mask the symptoms.
  • 80. Instead, let’s eliminatethe underlying problem.