The Cause of Gareth Bale’s Injuries

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Gareth Bale is the world’s most expensive soccer player to date. He was transferred in 2013 from the British team Tothenham to the Spanish powerhouse Real Madrid for a world record 139 million US$.

In 4 seasons, Bale has suffered 12 major injuries, resulting in 44 missed games and 256 days without been able to train. He is currently injured and unfit to play.

The majority of Bale’s injuries affect the muscles and tendons of one leg and the muscles that stabilize the pelvis and hips.

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The majority of Bale’s injuries affect muscles and tendons of one leg and the muscles involved in stabilizing the pelvis

What is the reason for these injuries?

Journalists have given their explanation: it is just a chronic bad luck that haunts him and bad athletic conditioning. Real Madrid has even accused of negligent physical training and fired one of his coaches – the 3 times Champions League winner Carlo Ancelotti.

A player who is regularly injured in postural muscles and tendons and mainly on the same side cannot just suffer chronic misfortune. There must be something else behind. Bale’s problem is not bad luck; it is rather a problem in his body that is not working properly and needs to be solved.

Why are Bale’s injuries concentrating on the left side? Why is it always muscles and tendons?

Bale gets injured because his body is not straight. It’s clear, it does not take a genius to figure it out. Just look at one of his pictures.

bale cranial mandibular analysis

Gareth Bales suffers from a postural collapse driven by a sinking skul. Lack of sufficient dental height on the left side causes the mandible to twist towards the left, the upper cervical vertebrae to to get misaligned,  the skull to sink forward and laterally towards the right. As a consequence, the whole spine gets twisted. The baricentre of the head is not centered on the body’s center of gravity.

It is a textbook case. Lack of sufficient dental height on the left side causes Bale’s mandible to twist towards the left, the upper cervical vertebrae to to get misaligned,  the left TMJ to be jammed, the left TMJ disk to be displaced medially, the skull to sink forward and laterally towards the right. As a consequence, the whole spine gets twisted. The weight of the head is not centered on the axis of the spine and on the body’s center of gravity.

The extent of the structural misalignment is even more evident when you compare Bale’s picture alongside his team mates Cristiano Ronaldo and Benzema – world class athletes with a remarkable cranial symmetry.

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Bale’s misaligned mandible, head and neck as compared to his team mates remarkable cranial symmetry.

The axis of the plane of occlusion of Bale is not aligned with the axis of the skull and cervical vertebrae.

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The axis of the plane of occlusion of Bale is not aligned with the axis of the skull and cervical spine.

Rx Evidence of TMJ-Mandibular Treatment

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And this is how we treated a case with very similar symptoms to the ones Gareth Bale is suffering from.

In the following pictures, you can see how 7 months of splint therapy can change the bone structure supporting the dental arches, maxilla, mandible, skull and cervical vertebrae.

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This patient suffered from chronic neck and back pain, difficulty in phonetic expression, broken voice, Chronic Fatigue Syndrome and neurological problems including difficulty to focus and concentrate. 7 months of treatment resolved all the symptoms. Before resorting to splint therapy, this patient had tried many sorts of treatment, traditional and alternative medicine, with no improvement in his condition.

The pictures on the left were taken before the treatment. Pictures on the right were taken 7 months later. All the described symptoms had disappeared.

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This is the Rx evidence of the result of 7 months of treatment with a Gelb-Rectifier dental splint of a patient with very similar symptoms to Bale’s. Splint therapy can align the mandible and the upper cervical vertebrae and reduce the jamming of the left TMJ and rotation of the skull. In the end the baricentre of the head will sit in the middle of the axis of the spine.

And here below, you can appreciate a model of how the skeletal structure and alignment was modified.

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With Gelb-Rectifier splint therapy it is possible to recover the asymetric lack of dental height, unjam the left TMJ and align the mandible an upper cervical vertebrae. In the end, the baricentre of the head will reover its centered position aligned with the axis of the spine.

Mandibular misalignemt caused by asymmetric lack of sufficent dental height brings about multiple bio-mechanical consecuences. Let’s analyze them.

Inside Bale’s Jammed Left TMJ and Displaced Disk

The TMJ (Temporo-Mandibular Joint) is the joint that connects the mandible to the head.

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The TMJ is the joint that connects the mandible to the head

The TMJ has a cartilage-meniscus that is normally referred to as TMJ disk. Bale’s uneven and asymmetric dentition forces the head of the left mandibular joint backwards and up, squeezing the TMJ disk out of its physiological position towards the front (anterior displacement)  and the inside (medial desplacement) or outside (lateral displacement) of the joint.

In the following pictures you can find examples of MRI images of TMJ derangement.

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MRI of anterior displacement of a TMJ disk. Anteriorly displced disks produce a ¨click¨ sound when they recover their right physiological position.

Anteriorly displced disks produce a ¨click¨ sound when they recover their right physiological position. I would not be surprised if Bale’s left TMJ clicks when he opens and closes the mouth.

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MRI of medial (towards the inside) displacement of a TMJ disk. Medially displced TMJ disks produce neurological symptoms such as Dystonia, Parkinson’s, and Tourette’s as they irritate and interfere in the normal function of the trigeminal nerve.

Medially displced TMJ disks produce neurological symptoms such as Dystonia, Parkinson’s, and Tourette’s as they irritate and intefere with the normal function of the trigeminal nerve. This is not (yet) Bale’s case. But the pressure on the TMJ disk and trigeminal nerve is definetely already causing  an imbalanced propiocetion of the alignment of the body and the spine with respect to the position of the head.

Bale’s Twisted Upper Cervical Vertebrae

Every time Bale clenches his teeth, chews or swallows, his twisted mandible is transmitting torsion forces on his upper cervical vertebrae. As a result, the two upper cervical vertebrae C1 (or Atlas) and C2 (or Axis) get twisted and misaligned with the base of the skul. The technical term for this condition is “subluxation.”

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The first two cervical vertabrae C1 (Atlas) and C2 (Axis) are subluxated and out of alignment with the base of the skull and the rest of the spine.

The Axis and Atlas allow the skull to move: forward, backward, left, right, up, down, sideways and tilt. When they are subluxated (out of their physiological position), the skull can not move freely and center its weight on the cervical spine.

Moreover, the Axis acts as the pivot point of the rotation of the mandible.

Courtesy of Dr. Lee. Functional Treatment of Dystonia

A twisted mandible caused by uneven dental occlusion will push the Axis and Atlas out of position every time teeth clench or chew.

And the following is an RX evidence of subluxation of Atlas and Axis.

Courtesy of Dr. Lee. Functional Treatment for Dystonia

Descending Twisting Strain on the Spine

Subluxation of the Atlas and Axis brings about a descending effect that twists the whole spine, all the way down to the pelvis.

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Subluxation of the upper cervical vertebrae bring about a descending twisting strain on the whole spine, all the way down to the pelvis.

The final result of a distorted and twisted TMJ, Atlas, Axis and mandible is that the weight of the head falls out of the center of gravity of the body, twisting the spine in the process.

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The weight of the head is out of the center of gravity of the body causing muscle strain, umbalance and compensatory torsion of the spine and pelvis.

Gareth Bale is at Phase 2 of Postural Collapse Driven by a Sinking Skull

In order to get a complete analysis of the process that brings about torsion of the spine through mandibular missalignment and lack of sufficient dental height on one side, you can read our post on Phases of Lateral Postural Collapse.

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The 4 phases of lateral posturla collapse driven by a sinking skull that does not find sufficient support on one side of the dental arches. Gareth Bale is at phase 2.

All human beings (the professional model, the athlete, the farmer, the office worker, etc.) are imbalanced, mostly to  the one side or the other. Some more, some less. Certainly the degree of asymmetry differs from case to case. There are people who because of their asymmetry remain disabled, people who all in all succeed in living a dignified life, and finally there are those who succeed in becoming life-long athletes. It all depends on the extent of the asymmetry.

The first thing that shows up with a loss of symmetry of the dental arches is asymmetrical work  of the masseter and temporal muscles (levator muscles of the jaw).

With the removal of dental height on the left dental arch, the skull loses its support on the left side. Conversely, the support of the skull remains unchanged on the right side.

In the picture, a reduction of dental height is carried out on the left dental arch. As a result the masseter muscle shortens, forcing the mandible to twist in order to find contact between the dental arches. As we have already said, teeth have to which counterbalance the force exerted by the masseter and temporal muscles. The result is that the skeleton, no longer perfect, begins to take on the aspect of a common asymmetrical skeleton.

Given the lack of dental height on the left side, the skull begins to give way somewhat on the left side as it is being pulled downward by the masseter and temporal muscles. Falling to the left, the skull alters its inclination in respect to the axes of reference and the cervical spine.

With an inclination to the left the skull begins sinking truly in this direction. As it sinks the musculature on the right extends, pulling the right shoulder towards it, which begins to rise. As a result, the entire right side of the body (left in the picture) raises itself, causing the pelvis to rotate in a clockwise direction.

The rotation of the pelvis draws the leg up and changes the arch support of the right foot.

Symptoms in Phase 1 are very mild. Muscle tension is not excessive, for which reason psychological tension is also limited. With progression of the fall of the skull we pass to Phase 2.

Phase 2

During Phase 2 we start to observe the first changes that take place in other parts of the skeleton. The descending nature of this phenomenon starts to become apparent.

phase2

In Phase 2, due to the effect of the masseter and temporal muscles, the skull continues its clockwise rotation, changing its inclination in respect to the blue vertical line and comes closer to the jaw (to the left), there where it lacks support.

Due to the alteration of the inclination of the skull, which moves from right to left, the right shoulder is drawn upward. The skull pulls the right shoulder towards itself because it is kept at that point through the participation of the rhomboid muscles and those of the neck.

The entire right side begins to tense up and as a result increases the clockwise rotation of the pelvis.

The first significant difference in Phase 2 in regard to Phase1 is to be found in the inclination of the jaw, which tends to come nearer to the skull there where it lacks dental height.

The entire jaw lifts itself momentarily only in this phase as it is pulled upward by a skull which is trying to remain straight on its vertical axis.

We can say that Phase 2 is an aggravation of Phase1. The significant difference remains the change in inclination of the jaw, which defers to the skull.

What is Happening to Bale’s Body?

Here below you can find animations that reproduce the full 4 phases of the process of postural collapse of the skeletal structure on different planes and its relation with the height and shape of the dental arches (marked in red in the animations).

This is what is happening to Garreth Bale’s body.

When TMJ-mandibular umbalance triggers postural collapse, the spine undergoes a twisting process. Unless the umbalance is treated, the spine continues to twist. Patients with similiar bio-mechanical umbances may end up developing Dystonia. and neurological symptoms.

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How to Cure Bale’s Injuries for Good?

It is obvious that Gareth Bale will continue to get injuries that will cripple his career as a professional soccer player unless he treats his underlying problem.

The bio-mechanical treatment of Gareth Bale’s problem is easier than treating a patient suffering from Dystonia, but is based on the same mechanism: centering and lifting the skull on the cervical vertebrae by means of dental splints that produce orthopedic forces that transmit the power the chewing muscles to stretch and align the Atlas, Axis and TMJ.

A detailed explanation of the working of splint therapy to treat and reverse postural collapse can be found in the post Principles of Splint Therapy.

The goal of splint therapy is to produce orthopedic forces that will progressively stretch and realign the upper cervical vertebrae (C1 – Atlas- and C2 – Axis) with the axis of the spine and the skull.

In the next picture you will see RX evidence of how the orthopedic forces produced by splint therapy can realign the upper cervical and eliminate pathologic compression strain on the brain stem over a period of a few months.

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The following picture describes how we  use orthopedic forces acting on dental occlusion to stretch and un-jam the upper cervical area.

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A Gelb-Rectifier dental splint uses the princples of lever machanics and a fulcrum to convey the forces of chewing muscles to stretch the upper cervical and TMJ. The harder the patient clenches, the further he will offload and stretch the TMJ.

TMD molar lever

A Gelb-Rectifier dental splint uses the princples of lever machanics and a fulcrum to convey the forces of chewing muscles to stretch the upper cervical and TMJ. The harder the patient clenches, the further he will offload and stretch the TMJ.

The treatment for Bale includes:

  • A modified Gelb-Rectifier indexed lower splint that covers molar and premolar teeth.
  • Registration  of the splint’s bite directly in the mouth in the phonetic “O” position to achieve functional muscular symmetry and the Gelb 4/7 position of the condyles within the TMJ .
  • Registration of cusps on fresh Polimporh or self curing resin of inner molar and premolar cusps every 2 weeks.
  • Gradually increse vertical dimension (the height of the teeth) in the back of the mouth with new registrations of the splint every two weeks to lift the skull and straighten the spine.
  • Bale should use the splint to sleep and while training-playing matches for a year.
  • Upper ALF to promote cranial motion.
  • At the end of the year, when the correct alignment of the neck and skull is achieved, dental prosthetics should be done to adjust to the new position.
gelbrectifier

A modified Gelb-Rectifier is a lower dental appliance built on a base splint (manufactured by a dental lab) and covered with a thin layer of Polimorph, a material that melts at 66 degrees Celsius and is solid at body temperature. A new bite is registered every 2 weeks onto the soft polimorph with the splint directly in the mouth. While registering the bite, the patient should close the mouth with the shape that comes from speaking the leter “O” to achieve the Gelb 4/7 position of the condyles within the TMJ.

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The ALF (Advacned Light Force appliance) is a thin wire anchored to upper first molar and canine teeth. it produces very gentle but constant orthopedic forces that can expand the palate and level the maxillary bones by acting on palatal sutures.

Why Don’t the Medical Services of Real Madrid Know How to Treat Bale?

That is a very good question. Real Madrid is the most laurate soccer team in the world and counts with world class medical professionals. They should know about bio-mechanical treatments and dental splints to increase athletic performance and reduce risk of injuries. Real Madrid is the biggest sport team in the world by revenues.

Yet there seems to be nobody at Real Madrid that understands and diagnosed correctly Bale’s injuries and is knowledgeable of splint therapy to correct bio-mechanical imbalances.

It is worth noticing that many top atlethes and teams have been using dental appliances for decades.  For example, in the next picture you can see how Steph Curry, MVP of the NBA basketball league, uses a dental splint.

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Many top athletes and teams use dental splints to increase force, alignment and prevent injuries. Why does Real Madrid not?

And it is also well known that athletes who have a remarkable cranial symmetry have longer careeres and do not suffer from as many injuries. Please see some of the examples below.

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Usain Bolt is the 30 year old reigning world and Olympic champion in the 100 and 200 metres. He has excellent biomechanical, cranial, mandibular and neck symmetry.

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Giuseppe Rossi is an international soccer striker who played for the italian national team and top Spanish and Italian teams. His carreer was crippled by 3  surgeries on his right knee and multiple muscle injuires on his right side. The reason for the repeating injuries on the same side is apparent by looking at the bio-mechanical imbalance marked in the picture.

Moroever, the famous soccer team AC Milan created in 2002 a ground breaking medical program called Milan Lab. At the head of it, Dr. Meersseman applied principles of bio-mechanics and splint therapy to manufacture dental splints that correct dental-mandibular imbalances for top players. The results have been nothing short than amazing.  The Milan Lab bio-mechanical programme enabled Paolo Maldini and Alessandro Costacurta to play into their 40s, with Serginho and Cafu not far behind.

“Paolo Maldini was written off at 32 and he played another nine years,” Meersseman says. “And I remember when Cafu came in, somebody called me up – I won’t say who – and said I know for sure he is gone. He played another four years at a very high level.”

So… when will Bale and Real Madrid get serious about treating the cause of Gareth Bale’s injuries? They can contact me if they need help and advice.

2 thoughts on “The Cause of Gareth Bale’s Injuries

  1. one question about this case is why you didn’t recommend a crossbite splint? I would have thought cross-bite would speed up the untwisting? And if you used crossbite would you assume that single skull is rotating left that to get it to rotate right you would lock in outer cusp on right side of splint and inner cusp on left side?

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    • also, why wait for two weeks between registrations? I would have thought he can go much faster than that at the beginning? Is there important reasons in your view to wait longer despite the fact that things will have moved quite quickly?

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