Triggerband Web Journal

I am determined to objectively and realistically present the scope of benefits Typaldos Manual Therapy (TMT) offers patients. These are amazing treatments, but they obviously have limitations.

TMT will not repair cataracts, reduce anxiety, ease the pain of an ingrown toenail, or finish off a lingering infection. TMT will definitely fix sprained ankles, will probably resolve chronic loss of shoulder abduction, and might help recover from stroke-induced paralysis.

From what I have observed, about half of all musculoskeletal injuries can be healed solely by correcting fascial distortions. And most of the remaining half will heal significantly, though not completely, from the application of TMT. Common non-fascial causes of acute injury include fractures, neurological damage, and inflammation.

Furthermore, about one third of chronic pain and loss of motion can be resolved with TMT. And another third can be improved with TMT, in cases such as fibromyalgia and post stroke spastic paralysis. The last third, which TMT cannot help, could be from arthritis, osteoporosis, and numerous other chronic diseases affecting the joints, muscles, or nervous system.

Keep in mind that correcting fascial distortions is the only thing Typaldos Manual Therapy does. And not all fascial distortions can be corrected using TMT. Even so, it is very fortunate that most can be treated effectively using manual therapy. Otherwise, the fascial distortion model would point out the problem without offering any solutions. What difference does it make what is causing pain if nothing can be done about it?

Our tendency, when we study a certain disease process in depth, is to believe that particular disease is more prevalent than it actually is. Likewise, when we are familiar with a certain treatment method, we begin to think it can cure or at least help almost every condition. Especially when we have economic incentives to sell a product or therapy, our supporting claims can become unrealistically broad.

Thus, patients and doctors become desensitized to outrageous claims. So when something comes along that really is great, they prudently approach it with skepticism. Even worse, some patients and doctors are willing to accept any and all claims, no matter how ridiculous. They quickly become imbalanced in their thinking and extreme in their practices.

Evidence-based medicine, supported by a body of carefully-scrutinized research, was designed to avoid warrantless claims. However, research has largely become a racket because of undue business interests and inherent bias in the researchers. Drug companies are among the few private entities that have funds to conduct double-blinded placebo-controlled studies. And federal research funds seem to be offered primarily to advance the careers of research scientists.

Good Idea, Problematic in the Real World

Most states require regular car inspections to make sure vehicles are in safe operating condition. This is a good idea, right? Nevertheless, some states have done away with car inspections. The reason is that corruption defeated the original purpose. Auto repair shops were passing cars easily without actually looking at them; or they were coercing customers into contracting unnecessary repairs.

Medical research as it now exists may be heading toward a similar demise. Doctors, pharmaceuticals, and insurance can support anything they want with “valid” research, by picking and choosing the studies they wish to present. When no favorable studies exist, they simply conduct their own. Even when their claims have so little merit that their own researchers balk, they can report that results are inconclusive. This inserts enough ambiguity into an area of prior consensus to justify deviation.

A Functional Research System

There is no substitute for the ability to think logically, rationally, and reasonably. Healthcare professionals and administrators must learn to think this way, or even a good system like evidence-based medicine will fail in practice.

Typaldos Manual Therapy diagnoses fascial distortions, treats them specifically, and produces consistent and measurable results. If that is not enough to get TMT accepted, then the healthcare system needs to change. Some promoters of TMT want to conduct a study that will prove its efficacy. I have hesitated to support a study of this nature, because it will not add to the body of knowledge. It will waste resources proving something that should be readily apparent.

So I advocate a new research system; one that is functional rather than academic. The core difference is that this research system will be subject to the requests and demands of doctors in practice. At present, researchers are the ones telling physicians how to do their job. In the new system, physicians will report to research scientists the difficulties they have in practice, and ask them to find better explanations and more effective therapies. When researchers find theories and treatment modalities that prove effective, doctors will adopt them, and researchers will then move on to the next challenge doctors have presented them with.

For this functional system to work, physicians, researchers, and administrators must be able to recognize whether treatments are effective. Otherwise, researcher scientists will get bogged down doing long and unproductive data analysis, conducting studies designed to prove claims that advance agendas, rather than discovering new, better therapies that offer patients immediate results.

How can we know whether treatments and theories work? By asking ourselves, are they logical, rational, and reasonable? And, ultimately, do the results support the claims?

Alexander Typaldos, JD

There are a lot of people who recognize problems in the healthcare system and agree there needs to be major changes. So why haven’t they happened yet? Lower prescription drug costs, access to affordable health insurance, and removing corporate interests remain little more than a Christmas wish list. This is because supporters of healthcare reform are too focused on pushing their agenda, while failing to provide real alternative solutions. What healthcare professionals, politicians, and the American public see are two competing agendas (reform and status quo) which promise about equal cost to benefit ratios.

I have mentioned before the supreme importance of mindset and philosophy in healthcare issues, but I think readers lose me in the process. If I were to spend half this article railing against corporate interests in healthcare, many would join me with “Good, say it like it is!” and “That’s what they deserve to hear!” If the bulk of the article talked about medical advances in the past 50 years and contrasted the quality of healthcare in America with the poor quality in developing nations, others would respond with “Yeah, what is everyone complaining about?” and “Be glad you’re an American.” However, if I tell you the truth – that healthcare’s biggest obstacles are faulty mindsets in practice, management, and public expectations, the majority of readers seem to be at a loss what to make of it.

The Hippie Movement

In the 1960s, many young Americans recognized the corruption in business, government, and religion – the overwhelming hypocrisy shadowing every American institution. Disgusted with society’s leaders who comprised the “establishment,” hippies launched a countercultural revolution. They listened to rock music, tried drugs, engaged in “free love,” and studied eastern religions.

Now let me ask you, did the hippie movement work? “What do you mean?” you might respond. What I mean is did the hippies solve the problems of corruption in business, government, and religion that led them to rebel against authority? I think recent political and corporate scandals reveal that corruption is probably more rampant now than during the 1960s, even while former hippies are running a large number of American institutions.

So why did the hippie revolution fail? It failed because it was never designed to succeed. The purpose was to advance a cultural agenda rather than solve America’s problems. Now, as then, our nation faces real challenges. Before we get angry and rail against anyone, we need to ask ourselves these questions: Do I have something better to offer? If I don’t like the way problems are being handled, then do I have a realistic plan to solve these problems more expediently?

No More Agendas

Whether it is insurance coverage for alternative therapies, medical malpractice reform, access to quality care for low income patients, or preserving physician salaries, neither the healthcare system nor society at large needs another agenda. And this is where mindset becomes important. If your goal is merely to advance an agenda, you will try to defeat your opponents (those with competing agendas) and likely end up in a stressful state of deadlock. Even if your agenda succeeds, it fails when it brings only change, not improvement. And opposing forces will immediately plan to undo your changes, robbing you of the peace of mind you have worked so hard to achieve.

If your goal, on the other hand, is to improve the current situation, you will take initiative to seek solutions with an open mind. You will encourage a cooperative environment instead of a combative one. You will be sensitive to the concerns of doctors, patients, and any other interested party. And you will work to find a structure that addresses these concerns, while rewarding good practices and discouraging bad ones.

The result will be a new system – a better way of doing things – within which those who hold agendas will continue to advance them. But, importantly, they will not attempt to undo the changes made because the changes are agenda-neutral. For example, in a dictatorship one might advance their agenda by flattering or bribing the dictator. In a democracy, one might advance their agenda by lobbying congress or running for political office; but they will not attempt to change government into a dictatorship so they can apply the previous methods – it is of no consequence to their agenda.

My Agenda-Free Goal

I want to create a healthcare system that serves patients’ needs by curing their diseases, not managing them. I would like healthcare to be affordable and uncomplicated. And I would like physicians and other healthcare professionals to be rewarded with seeing good patient results, in addition to healthy salaries.

If this can be accomplished in a private system, that is fine. If a form of national healthcare is necessary then I support making a change. Ultimately, though, the biggest gains will come by addressing the heart of the issue – improving treatments themselves. And that depends primarily on medical philosophy, as I will continue analyzing in this journal.

Alexander Typaldos, JD

Take a cross section of the upper arm, away from the joints, and what do you have? There is skin, fat, blood vessels, lymph vessels, nerves, muscle, bone, and fascia. If I missed anything, let me know. So an injury to the arm can cause damage to a limited number of structures.

We can see the skin, so we know when it is damaged. Treatment for physical trauma to the skin is also straightforward, involving sutures and grafting. Subcutaneous fat is a deep layer of skin, held in place by fascia. Fat acts as a cushion during injury, protecting nerves and blood vessels that run through it.

Blood vessel damage causes bruising, and typically does not require intervention unless major vessels are severed. This may come as a surprise, but muscles do not have a macro anatomical structure apart from fascia. Every skeletal muscle, bundle and individual fiber is surrounded by fascia. This is not my opinion. It is established – though frequently overlooked – anatomical science. Therefore, the only injury that can occur to muscle, independent of fascia, is at the cellular level.

This leaves bone fractures, nerve damage, and fascial distortions as the primary culprits in upper arm injuries. Fractures are easily diagnosed with x-rays, and more or less complicated to treat, depending on severity of the injury. Fractures do cause pain and loss of motion. However, pain and loss of motion frequently occur in injuries without fractures; and often persist after fractures heal. Logically, these symptoms must have other causes as well.

Nerve damage is a tricky condition to deal with. The nature of nerves, controlling sensory functions and movement, makes their destruction oftentimes difficult to detect and treat. Fortunately, nerves can repair and regrow without treatment. Signs of nerve damage include muscle weakness, pain or loss of sensation, tingling “down-stream” from the injury, and involuntary movements (twitching).

When an upper arm x-ray is negative, bruising and swelling are reduced, strength is present but motion is restricted, and the patient experiences pain when the arm is in certain positions, what do we have? I suggest, by default, that we have fascial distortions.

A Common Sense Approach

The fascial distortion model may seem radical when compared with current schools of thought, notably orthopedics, osteopathy, and chiropractic. However, its anatomical basis is not radical at all. Instead, it is logical common sense.

Lest you doubt the above analysis, the nail in the coffin is that the treatments designed to correct fascial distortions work. Dr. Typaldos demonstrated his confidence in the model and treatments when he gave seminars, by asking doctors to bring him their most difficult patients with musculoskeletal injuries and chronic pain. This risk was calculated, because he knew that the hardest patients would have already been treated for all other possible problems, leaving them with fascial distortions by default. Then he fixed patients on the spot in front of large audiences.

Some doctors who attended his lectures accused Dr. Typaldos of arrogance for these displays. But how else could he break through their faulty way of thinking about musculoskeletal injuries?

Orthopedic analysis illogically removes fascial distortions from the mix of potential contributors to pain and loss of motion, and expands the scope of the other possibilities to encompass 100 percent of all injuries. Orthopedists would be honest if they acknowledged they know the causes of about half of all injuries, while the other half leaves them stumped.

Alexander Typaldos, JD

Whenever progress meets convention there is conflict. We see it manifested in many ways; for example, the construction of a new highway through an established neighborhood. Resistance swells and rational thought retreats. Appeals to the advantages of progress are met with entrenched attitudes and adherence to tradition. Over long periods of time progress can occur. However, it is at a very high cost to those involved in the endeavor. In the field of medicine the results of this type of conflict have been painful and personal.

During the 1840s, an Austrian doctor named Ignaz Semmelweiss noticed that women who delivered their babies in a clinic with midwives had a low incidence (1-3%) of childbirth fever. Whereas women who delivered with assistance from interns, who performed autopsies concurrently with the delivery, caught fever up to 18% of the time.

In 1843, Dr. Oliver Wendell Holmes, writing on childbirth fever and noting similar results, stated he would rather have his family members delivered “unaided, in the stable, by the manger side” rather than be exposed to the “vapors of this pitiless disease.” Both men advocated that doctors wash their hands between patients, as a simple and effective means of preventing disease.

Dr. Semmelweiss developed a chlorinated lime solution interns used at the obstetrical clinic in Vienna. As a result, incidents of childbirth fever decreased drastically, to only 1-2%. Nevertheless, both doctors faced ridicule from their contemporaries. You see, the germ theory was years away and doctors simply would not believe that they could be the source of transmission of a fatal disease.

Dr. Semmelweiss urgently sought support from obstetricians in the European community. But all he found was skepticism. He showed them his results, and invited them to duplicate the same results in their own practices. When they refused his request, without reason, he called them “irresponsible murderers.”

He became so obsessed about the matter that fellow physicians, and even his own wife, concluded he was mentally imbalanced. Eventually they relieved him of his position at the Vienna General Hospital and admitted him to an insane asylum in Hungary, where he died 14 days later, at the age of 47.

As tragic as this story is for Dr. Semmelweiss personally, it was much more tragic for the millions of women who needlessly died after childbirth. The prevailing ignorance stemmed from a universal, decided rejection of clear evidence. Ignorance ran so deep that hand washing did not become accepted medical protocol until 50 years later.

A Recurring Theme

The situation above might seem extreme, but it is not. Today, as in the 1800s, attitudes exist that are comfortable for the possessor but incompatible with rational and reasonable thinking. What about hypothyroidism, which is grossly under-diagnosed and untreated in the traditional medical field? Then there is chronic Lyme disease, where doctors who prolong treatment are harassed by regulatory boards who sincerely believe they are serving the public good. Meanwhile, patients continue to suffer.

During the 1970s and 80s, many women experienced puzzling symptoms of sudden onset fatigue and muscle and joint pain. Nothing was known about this new perplexing disability. Scores of women were told it was “all in your head,” stress, or any number of burden-shifting explanations. Now we know that Chronic Fatigue Syndrome and Fibromyalgia are bona fide ailments – physical manifestations of myriad factors robbing women (and sometimes men) of their health and wellbeing.

Cherilyn Typaldos