Law of Tissue Tolerance – The Key to Staying Uninjured

Dr. Tim Maggs

We athletes and active people are a peculiar sort… highly irrational much of the time. We tend to always want it our way, despite the lunacy in this thinking. ‘Doc, I can’t believe my hamstring is injured.’ ‘Well, running 50 miles a week in racing flats can do that.’ ‘But I’ve never had this before.’ ‘Well, you do now.’ ‘I have a huge race in three weeks I’ve been training for.’ ‘Mother Nature could care less about your racing schedule.’ ‘Doc, you need to help me get better.’ ‘Ahh! Please Lord, give me just one rational patient.’

Regardless of what we want, the laws of physiology and stress will always dictate our outcomes. Many patients act like I made the rules for healing. Not so, I only spread the news and help patients hear what they need to hear to get better quicker. Dr. Jeff Spencer, Lance Armstong’s chiropractor for seven years during the Tour de France once said, “The body doesn’t care what you think, it only cares what you do.”

Dr. Maggs’ Law of Tissue Tolerance – “When the loading of a tissue exceeds the capacity of that tissue, compensatory physiological changes occur.”

Every tissue in the body has a tolerance level. That tissue can be muscle, tendon, ligament, cartilage, or bone. The goal in life is to increase all tissue tolerance as much as possible so when the varying stresses of life hit, from training to slipping on banana peels to aging, you’re prepared.

When a stress is greater than the tolerance of the tissue it’s affecting, there will be a defensive response by that tissue. If it’s muscle, there will be a reactive constriction (strain) or if severe enough, a tear of the fibers. If it’s bone, there will be inflammation of the bone (bone marrow edema, bone bruise or stress reaction), and if severe enough, there will be a stress fracture. When it’s cartilage (meniscus) there will be tears and when it’s discs, there will be bulging and herniations. When it’s ligaments, they stretch (sprains) and when severe enough, they tear. When it’s tendons, they strain until they rupture. In the end, the causes are all the same, the stress exceeds the tolerance of the tissue.

Unfortunately, not enough doctors or therapists are familiar with the biomechanical imbalances that underly these injuries, and therefore, only treat the resulting injury, not the base cause of the injury. The question every individual or athlete should be asking is, “How do I increase my tissue tolerance?”

Increasing Tissue Tolerance – There are many ways to increase tissue tolerance. The most obvious is to balance and mobilize our structures. Exams must look at overall mobility and areas of restriction, the collapse of the feet, leg lengths as well as standing, biomechanical x-rays. Identifying the structural imbalances and improving weight distribution imbalance is the first step in raising tissue tolerance.

Five Steps We Use To Help Patients Improve:

Orthotics – The feet are the first step in balancing the body. Research shows that all people have some degree of imbalance in their feet that only worsens over time. Based on this research and our many years of experience, we don’t even test the feet anymore. We just recommend orthotics which will help support and create symmetry of the feet.

Standing Pelvic X-Ray – Research has shown that 62% of the population have imbalanced hips even after orthotics are put in the shoes. The hips should be no more than 3mm different in height, and this x-ray will provide that measurement. If the hips are greater than 3mm different, then an appropriate lift should be placed under the orthotic on the lower hip side.

Chiropractic care – Today’s society has been thoroughly miseducated. We’ve been trained to only seek treatment once we’re hurt. This approach is insane. Chiropractic care mobilizes joints of the spine and pelvis, joints that, especially for runners, are under continual stress and demand. These joints oftentimes fixate and create an environment ripe for injury. Mobilizing these joints on a continuum will keep all tissue working at a much higher level before injury occurs. Add some cold laser therapy and spinal decompression to that treatment, and I call that ‘gold standard care.’

The Stick or Foam Roller – Our muscles are like sponges. With increased activity, they produce and accumulate toxins, or trigger points. These toxins congest a muscle making it less flexible and more vulnerable to injury. With daily application of the stick or foam roller, we can keep toxins eliminated while increasing blood flow (food and oxygen) to the muscles. Once rolled, a healthy stretching program is now more effective.

Nutrition – There’s no getting around it, nutrition will be a major part of injury prevention. Whether it’s weight management, blood sugar, fried foods or nutritional supplements, this helps injury prevention. We now have available the ability to use blood tests to create individualized nutrition programs. Remember, you can lead a horse to water…

In the end, injury prevention requires work and investment. If you only react, injuries are most likely in your future. The five tips above are a wonderful place to proactively reduce injuries.

Dr. Tim Maggs (drt@drtimmaggs.com) has been a chiropractor in private practice for 45 years in Upstate NY. He has specialized in the diagnosis, treatment, and investigation of sports injuries throughout his career, some of it from his own injury experience. Tim, his wife Trudy, and four sons are runners, bikers, and actively involved in fitness and a healthy lifestyle.