"Our Silent Epidemic"

                                                        Picture & Reference Guide
                                                                 
www.miketomich.com                                                                        

Part 1  
What you need to know before reading this book.
 
This publication presents the "mechanical process" responsible for muscular skeletal injuries, including; arthritis, RA, bending of bones, twisted
fingers, deformed fingers, back-neck-shoulder-hip-knee-ankle chronic pain, sciatic nerve, carpal tunnel, fibromyalgia, physical therapy, medical
operations, and death. This information presents results from our private research which identifies the most common sources of dynamic force
injuries to children and adults...that being video gaming, computers, coloring for children, and adults driving "high effort steering" vehicles which are
common in todays automotive world.  

Part 2  The Automotive Story
Page   Issue/Reference
2-7          In 2000, my physical health started deteriorating.
2-8          People Case Studies
2-12        Figure 1, 2   Deformed knuckles [from Impala Steering wheel]
2-13        Figure 4, 5   Damaging hand gripping positions
2-15        Physical therapy facility
2-15        2003 Chevrolet Cavalier driving experience
2-16       Figure 6   Seating designs of vehicles of yesteryear [before injection molding]
2-17        Figure 7   Impala seating
2-17        Figure 8   Force - Pressure of vertebra
2-17        Figure 9   Seating - Gravity - Body off perpendicular by 10 degrees
2-18        Figure 10  Disk movement due to off parallel of 10 degrees
2-19        Figure 11  Combined focus concentration of weight and forces to hips and lumbar
2-20        Written example of force delivery from the end of a finger (No chart)
2-21        Figure 12-1   Areas A and B of drivers back - supported and unsupported    
2-21        Figure 12-2   Pivot point of Areas A and B
2-23        Figure 14   Muscular system of our back        
2-25        Figure 15   Time-Effort-Shock chart identifying shock load in high effort steering
2-26        Figure 16   Destructive Forces and Vibration - identification of shock loads, dynamic forces, and vibrations
2-27        Wrist support therapies        
2-28        Figure 17   Chart identification of difference between damaging high effort steering and non-damaging low effort steering
2-29        Figure 18, 19   Commonly used damage inflicting gripping position
2-29        Cause of L-4, L-5 disk damage
2-30        Figure 20   Damage inflicted steering wheel gripping positions
2-30        Figure 21   Picture of knuckles that became bent and twisted from grasping the steering         wheel contour shown in Figure 20  
2-32        Notation-Figure 22   Drawing of parallel knuckle surfaces
2-32        Figures 23-1, 23-2   New routing of tendon on top surface of middle finger and finger         functional limitations
2-32        Figure 24   Inward bending of ring finger
2-33        Figure 25   Small finger gripping the thick steering wheel that results in permanent deformity of K10 knuckle and causes outward bending       
     of small finger
2-33        Figures 26-1, 26-2, 26-3   Pictures of small fingers bent away from hands
2-34        Figures 27-1, 27-2, 27-3   Identification of dynamic forces to thumb
2-34        Figure 27-4   Enlargement of thumb indicating degrees of deformities
2-35        Figure 27-5   Picture of deformed thumbs
2-35        Figures 28-1, 28-2, 28-3   Pictures of thumb deformities
2-36        Figure 28-4 Picture of thumb deformities
2-36        Figures 28-5, 28-6   Picture of forces causing children's thumbs to bend outward
2-37        Figure 28-7   Picture of an outward bending thumb of an elderly lady
2-37        Figure 28-8   Wrinkles on thumb identifying direction of outward bending
2-37        Figure 28-9   Inability to touch thumb to hand
2-37        Figure 28-10  Inability to touch thumb to small finger
2-37        Figure 28-11  Inability to use a damaged thumb in holding a cloth
2-38        Figure 28-12  Holding a brush with a deformed thumb
2-38        Figure 28-13  Holding a dinner fork using the tip of the thumb
2-38        Figure 28-14  New grasping position using a screw driver
2-38        Figure 28-15  New grasping position using a pair of pliers
2-39        Figure 28-16  Thumb deformities when dialing a phone
2-39        Figure 29-1, 29-2   Gripping positions that would not allow curtain cord to be pulled
2-39        Figure 29-3   Gripping position that must be used to enable pulling of curtain cord        
2-41        Figure 29-4   Common damaging steering wheel grip position
2-41        Figure 29-5   Circular bending of index and middle finger from 9-4 grasping position
2-42        Figure 30-1   Identification of thick, rough, callused skin from steering wheel grip
2-43        Figure 30-2   Enlarged view of rough, callused, skin of index finger
2-43        Figure 30-3   Picture of thick, rough, callused, non elastic skin on index finger
2-43        Figure 30-4   Picture of thick, rough, callused, non elastic skin on inside of thumb
2-44        Figure 30-5-1   Picture of palm of the right hand - area of discomfort
2-44        Figure 30-5-2   Enlarged area of the palm of the hand
2-44        Figure 30-5-3   Area of palm with pain and discomfort attributed to grasp of thick steering wheel with the tips of the fingers and palms
2-44        Figure 30-5-4   Picture of the thick, callused, skin from holding the steering wheel
2-45        Figure 30-5-5   Picture of the skin on the elbow becoming stretched
2-45        Figure 30-5-6   Picture of the excess stretched skin of the elbow
2-45        Figure 30-5-7, 30-5-8   Additional pictures of stretched elbow skin
2-46        Figure 30-6-1   Picture of the texture of a new Impala steering wheel
2-47        Figure 30-6-2, 30-6-3  Picture of Impala steering wheel with texture worn off
2-47        Insert - Finger Feathering Effect - 6 pictures of finger tips bent backwards
2-48        Figure 31   Drawing of a healthy knuckle making initial contact with contour of steering wheel  
2-49        Figure 32   Drawing of an Unhealthy Knuckle that has been conformed to make full contact with the surface of a steering wheel that is off
     parallel to natural surface of a healthy knuckle
2-50        Figure 33-1, 33-2   Picture of the small bone structure of the fingers and hand
2-50        Figure 34-1   Picture of the fingers bent and twisted to conform to unnatural steering wheel contour
2-50        Figure 34-2   Picture of fingers bent and twisted to conform to unnatural steering wheel contour.  High points of the knuckles are
     identified (commonly referred to as Bouchard's/Heberden's nodes)
2-51        Figure 34-3   Finger tips that are bent towards the thumb from holding the steering wheel in the position shown in 34-4
2-51        Figure 34-4   A gripping position that results in dynamic forces causing the fingers to bent upward as shown in 34-3
2-51        Figure 34-5   Identification of poorly designed steering wheel of a 2002 Pontiac Sunbird with a damaging high effort steering system that
     results in the finger deformities identified in 34-3
2-52        Figure 35-1   Identification of damaging gripping surfaces that are off parallel to the natural knuckle surfaces which result in twisted knuckles  
2-52        Figure 35-2   Picture of 4 knuckles that have become permanently bent and twisted from grasping the off parallel surfaces of the steering
     wheel shown in 35-1
2-53        Sphere to sphere contact (calculations)
2-54        Traumatic effects of vibration - additional emphasis on the
2-54        Three pages of children's information
2-55        Figure 36-1, 36-2   Pictures of a 3-year-old girls finger deformities from playing games using a computer keyboard and mouse
2-56        Figure 37-3   Picture of deformed fingers of a 10-year-old girl from playing video games
2-56        Figure 38-1, 38-2, 38-3   Picture of deformed fingers of a young child from playing video games on a Nintendo 64 video game player
2-57        Figure 39   Picture of permanently bent and twisted fingers of a 24-year-old young man that started playing video games as a toddler
2-58        Figure 40-1   Picture of deformed fingers of a 22-year-old lady from driving her 2003 Chevrolet Impala.
2-58        Figure 40-2   Picture of the 22-year-old lady in Figure 40-2, indicating how her fingers have curled, bent, and twisted to conform to the
     gripping position held when driving her Impala
2-59        Figure 41-1, 41-2, 41-3, 41-4   Pictures of an old thin steering wheel and latest trend of thick steering wheels
2-61        Carpal tunnel syndrome is misconceived as repetitive motion from typing
2-64        Some symptoms of health problems associated with high effort vehicles
2-66        Figure 42   One of the least damaged fingers
2-66        In summary

Pictures of Injured Drivers
2-67/68        AP-1-1, AP-1-2,   1995 Chevrolet Tahoe - Cindy - Homemaker
2-68        AP-2           2003 Mustang - Engineer
2-69        AP-3-1, AP-3-2   Chevrolet Astro Van - School Teacher
2-70        AP-4-1, AP-4-2, AP-4-3   Clair - Office work - Mercury Cougar
2-71        AP-5-1, AP-5-2, AP-5-3   Noel (20) - Office work - Ford F-150
2-72        AP-6   Male - Ford F-150 Diesel - 4x4
2-73        AP-7   Male - 1997 Chevrolet, 4x4, Jimmy
2-74        AP-8   Female - Ford - F-150
2-74        AP-9   Male - Bank worker - Neon   
2-74        AP-10   Male - Durango
2-75        AP-11   Female - Office worker - Saturn 2001 SL2         
2-76        AP-12   Male - truck driver
2-77        AP-13   Male - 40's - Physician - Jaguar
2-78        AP-14,  AP-15   Females - Office workers - Dodge Durango
2-79        AP-16-1   Male - Chevrolet Malibu and Chevrolet Jimmy
2-80        AP-16-2   Male - Chevrolet Malibu and Chevrolet Jimmy
2-81        AP-17   Female - Driver - Ford Van   
2-81        AP-18-1, AP-18-2, AP-18-3  Female - Mercury Cougar
2-82        AP-19-1,  AP-19-2, AP-19-3, AP-19-4 - Female - Various HES vehicles

Part 3   The Children's Story
Page 3
  Issue/Reference              
3-5          News paper article - comments
3-11        Becoming aware of the children's deformities
3-13        Destructive dynamic force calculations
3-18        Various controllers with vibration promotions
3-20        Promoting of damaging vibration by manufacturers on controller packaging.
3-21        Picture, controller split view, motors used for vibration are in place
3-23        Picture of the inside of a controller identifying the vibration source
3-25        Chart "CFAA-Shock Loads / Dynamic Forces" indicates the creation and delivery of the damaging dynamic forces (for video, cars, coloring,
     and other dynamic force processes)
3-28/29        Game Boy forces - Destructive forces "CF1-1, CF1-2"
3-30/31        Peening of surfaces "CF1-3, CF1-4"
3-31/32        Thumbs-unnatural forces and twisting  "CF1-5, CF1-6,"
3-32        Pictures of twisted/bent thumbs and off-center finger nails "CF1-7, CF1-8, CF1-9"
3-33        Pictures of twisted/bent thumbs "CF2-1, CF2-1-1, CF2-2, CF 2-3
3-34        Gaming gun - Unnatural forces "CF 2-4"
3-34        Pictures of twisted/bent thumbs "CF 2-5, CF 2-6"
3-35        Video controller - Unnatural forces - Front view "CF 3-1"  Dynamic forces identified
3-37        Video controller - Unnatural forces - Bottom view "CF 3-2"
3-38        Video controller - Unnatural forces - Bottom - Enlarged "CF 3-3"
3-40        Game Boy - Unnatural forces - Bottom holding view "CF 3-4"
3-41        Game Boy - Child and adult -Unnatural forces - Bottom hold CF 3-5, CF 3-6
3-42        Unnatural force identification - Grasping - Front - Video Controller "CF 3-7, CF 3-8"
3-44        Crayola forces generated "CF 4-1, CF 4-2"
3-46        Chart "CF 4-3" Identifying the generation of dynamic forces in the coloring stroke
3-47        Forces - Shock load of breaking crayon - Safe-unsafe-Coloring stroke "CF 4-4"
3-47        Picture of force zone in coloring stroke "CF 4-5"
3-48        Picture A , B, C, D Coloring grips - dynamic force in holding the coloring book in place
3-49        Pictures E, Identification of destructive dynamic forces
3-49        Picture G right hand finger deformities from coloring
3-50        Picture H left hand finger deformities from holding the coloring pages
3-50        Two finger rule
3-51        Picture J  picture identifying the various dynamic force coloring strokes
3-52        11 Pictures of  case studies of deformed fingers from video gaming
3-53         Picture of Alyssa, 3-year-old, finger deformities from computer use
3-54/55     Pictures of Nicki, 5-year-old, finger deformities from Nintendo 64 video game
3-56        Pictures of Jebb, 18-year-old, finger deformities from video gaming
3-57        Pictures of CI-1, CI-2, 24-year-olds, deformities from video games
3-58        Picture of WL-1, WL-2, 11-year-old, deformities from video games
3-59        Picture of Bob, 15-year-old, deformities from video games
3-59        Picture of Jason, 22-year-old, deformities from video games
3-60        Pictures of Jac 1 and Jac 2, 19-years-old, deformities from video gaming
3-61        Picture of Mary, young teenager, deformities from video games
3-61        Picture of Earl, 23-year-old, deformities from video games
3-62        Picture of Cody, 10-year-old, deformities from video games
3-63        Picture of Frank, 14-year-old, deformities from video games
3-64        Picture of a 17-year-old young man with deformed fingers from video games
3-64        Picture of a 23-year-old man, deformities from video games
3-65        Pictures of Chris 6, Melinda 2, Jon 5.  Deformed fingers from coloring.  

Letters  located behind Part 3

#1 Michigan Surgeon General  04-04-04
#2 Michigan Attorney General 05-24-04
#3 State of Washington - Attorney General  05-24-04
#4 United States Consumer Product Safety Commission  06-29-04
#5 Surgeon General - Michigan  02-20-04
#6 Three Michigan Legislators - letter of support  12-20-04
#7 One of Many Letters to Manufacturer's requesting their help  05-18-04
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