Triumphant in his battle against testicular cancer and a win in the prestigious Tour de France, cyclist Lance Armstrong is a catalyst in the need to demonstrate the relationship between faulty biomechanics, microtrauma and disease.

Cyclist Lance Armstrong's recent victory in the Tour de France was thrilling. The athlete's triumph over cancer has equally been an inspiration to us all. What's more, Armstrong's miraculous recovery unearths the need for aggressive, on-going research into causes of this disease. Testicular cancer is not uncommon in bikers. Evidence is mounting which points to excessive, repetitive microtrauma due to a spinal imbalance and a malaligned pelvis, as a cause.

PERFORMANCE INCREASES FOLLOWING ADJUSTMENT

Leg length insufficiency results in a loss of power and endurance when the human "motor" is not properly aligned. According to research conducted by NUCCA practitioner John Dunn, D.C., and Ivan Glymph, B.S. of Tallahassee, Florida's Fitness Edge Human Performance Laboratory', athletic performance increases following an upper cervical adjustment. Their pilot study of cyclists shows a significant increase of 5%. Also revealed is the fact the pedal stroke loses efficiency if the pelvis is malaligned because the stroke is not "round" due to the "short" leg. The leg length insufficiency causes a pistonlike action instead of an electric motor effect that is round and smooth.

In the past, the "short" leg has been addressed with cleat shims, saddle, pedal or crank adjustments, but the best results have been attained by adjusting the cervical spine of the cyclist. This restores the spine and pelvis to the vertical axis and eliminates the "short" leg.

The CompuTrainer (Fig 1) is a computerized stationary trainer to which a standard bike may be mounted. Its load generator is capable of creating accurate loads at the rear wheel of up to 750 watts.

The Spin Scan is a function of the CompuTrainer which measures torque applied to each crank arm, at every 15 degrees of rotation and is displayed on a television monitor as a bar torque graph for one full crank revolution. (fig. 2) The SpinScan display also shows the power split percentage between the left and right legs.

The Heartrate (HR) Lactate Threshold (LT) (blood level of 4 ml./dl.) and the rate of perceived exertion (R.P.E.) (Borg scale) are closely monitored to show any changes in performance.

INCREASE IN EFFICIENCY

The increase in efficiency following the upper cervical adjustment implies that a cyclist could ride longer at his or her maximum (L.T.) until fatigued. More power is applied throughout the entire 360 degrees at crank rotation when the legs are even because the spine and pelvis are in alignment. Their study shows a measurable improvement in performance directly related to the improved biomechanics. Subsequent studies suggest that the improvement continues with time as the body adapts to the newly aligned position. This takes place only if the adjusted position "holds" and stabilizes . Balance of the skull is key to stabilization. The Anatometer findings and leg length measurements will indicate if another adjustment has to be made. The post x-rays will indicate if the line of drive or headpiece support has to be altered.
The Academy of Upper Cervical Organizations has convinced the World Health Organization (W.H.O.), the Agency for Health Care Policy and Research (A.H.C.P.R) and 24 other organizations that post x-rays are a recognized standard of care. This is a recent breakthrough for the upper cervical practitioners. Post x-rays reveal what has taken place and how to proceed further because they can be reliably and accurately replicated in clinical practice.1 The learning curve is shorter now because of the advancements in imaging and biomechanics.

Leg length discrepancy is the common denominator behind excessive, repetitive microtrauma whether running or biking. It is interesting to find that it is the long leg hip 2 that becomes arthritic and is the side of the stress fractures on runners in 73% of the cases.

LEARN FROM POST X-RAYS

We measure leg length supine with the shoes on and determine whether an adjustment is needed. If we see more than 1/8 inch leg insufficiency, it is a sign of the spastic contracture of an upper motor neuron lesion and warrants further investigation that may include the Anatometer, four-quadrant scale, hip calipers, plumb line S.E.M.G. thermography or x-ray. These tools are only as good as the operator who must be trained by an expert in the field. You can learn from your post x-rays once you learn to take them and analyze them properly.

The biomechanical implication of mild leg length inequality has not been fully recognized. The spastic musculature responsible for the functional leg insufficiency remains hypertonic, even while wearing orthotics or heel lifts. This means a torqued pelvis and microtrauma on one side even while seated.

STORY FAR FROM OVER

More research is needed to demonstrate the relationship between faulty biomechanics, microtrauma and disease. After one of the greatest triumphs in sports history, Lance Armstrong is devoting his life to the Lance Armstrong Foundation for Cancer. His story and the need for continued research in this area is far from over.

The Vertebral Subluxation in Chiropractic Practice Guideline has been incorporated into the National Guideline Clearinghouse and is available in its entirety on its website: (www.guide.gov). It can he ordered from:

The Council on Chiropractic Practice
2950 N. Dobson Road, Suite 1
Chandler, Arizona. 85224

REFERENCES
1. Ivan D. Glymph, B.S., Investigating the Effect of Upper Cervical Adjustment on Cycling Performance, Vector 1999 Volume 2 number 4
2. McCaw S. T, Bates B. T. Biomechanical Implications of Mild Leg Length Inequality Br. S. Sport Med. 1991 25 (1): 10-13
3. Seeman, D. C. A Reliability Study Using a Positive Nasium to Establish Laterality Upper Cervical Monograph 1999: S (4) 7-8

Dr. Patrick Foran graduated from CMCC in 1959, and has been an upper cervical chiropractor for forty years. He has been a guest lecturer at CMCC and appeared on the Lifetime Television Network Series "The Alternative Medicine Show".