What is SOSORT up to lately?

[Pooka1]

Preliminary program for their 2010 meeting...

http://www.saac.chu-sainte-justine.org/pages/2010/PreliminaryProgram_SosortV3.pdf

I think the "Mark W. Mornings" is a misprint of Mark W. Morningstar, evidence-based chiro guy.

Lenke is apparently talking.

[tonibunny]

That's interesting, I thought Mark Morningstar was something to do with the Clear Institute, but it looks like he works with the Pettibon Institute instead. Does anyone know the difference between the two please? There must be a difference because one of them was suing the other a while back.

[Pooka1]

It's interesting that, despite the pending law suit, that Morningstar and the Clear chiros are cordial and publish together.

The main difference I see is that Morningstar is claiming to be evidence-based but Clear is not.

[joyfull]

Has anyone seen Clear's latest newsletter?

[Pooka1]

Has anyone seen Clear's latest newsletter?

I haven't. Is there something interesting to discuss in it?

[beauvais]

Dr. Morningstar works with my entire family and is wonderful. My understanding is that Pettibon and CLEAR are similar, but that Pettibon emphasizes more long-term work and effect than CLEAR (no 2 week clinics or anything), but I'm not totally clear, so I emailed the link to Dr.Morningstar and am hoping he'll expand a bit on this forum.

[skevimc]

It's also interesting to see that Weiss is absent. Even if he will attend but isn't presenting, that is still somewhat uncharacteristic.

On a total side note, whenever I see Manuel Rigo's name I always say it in the voice of the character from Ghostbusters II that Peter MacNicol played.

"He is Vigo! You are like the buzzing of flies to him! "

It's an obscure reference. And I know it's Rigo and not Vigo. Doesn't make it any less funny for me. :)

[Pooka1]

It's also interesting to see that Weiss is absent. Even if he will attend but isn't presenting, that is still somewhat uncharacteristic.

On a total side note, whenever I see Manuel Rigo's name I always say it in the voice of the character from Ghostbusters II that Peter MacNicol played.

"He is Vigo! You are like the buzzing of flies to him! "

It's an obscure reference. And I know it's Rigo and not Vigo. Doesn't make it any less funny for me. :)

I like your sense of humor. Sardonic. :)

[Beatriz Torres]

It's also interesting to see that Weiss is absent. Even if he will attend but isn't presenting, that is still somewhat uncharacteristic.

On a total side note, whenever I see Manuel Rigo's name I always say it in the voice of the character from Ghostbusters II that Peter MacNicol played.

"He is Vigo! You are like the buzzing of flies to him! "

It's an obscure reference. And I know it's Rigo and not Vigo. Doesn't make it any less funny for me. :)

Hans R. Weiss MD . Orthopedic Surgeon , and Physical Medicine Rehabilitation is in his new clinic offering to patients from abroad his " Best Practice " and Physio-logic program in Gensingen , Germany.
www.scoliosis-dr-weiss.com

[Pooka1]

Hans R. Weiss MD . Orthopedic Surgeon , and Physical Medicine Rehabilitation is in his new clinic offering to patients from abroad his " Best Practice " and Physio-logic program in Gensingen , Germany.
www.scoliosis-dr-weiss.com

Someone from Europe came on here and said Schroth was still a fringe treatment even in Germany. And it's been around ~90 years.

[spiritofbamboo]

Someone from Europe came on here and said Schroth was still a fringe treatment even in Germany. And it's been around ~90 years.

Its still there. Horray!!!
I think one of the reasons it is "fringe" is because when some one decides to do that program, they must be totally committed and dedicated to the process. Most people are not up to the challenge. They want the easiest way to deal with "the problem." It is easy to give up when things are challenging and "hard". For many it is easier to have someone "fix" the problem.
The Schroth method of Physical Therapy for Scoliosis is sound in theory and practice, intuitive, individually applied and yet rigorous in its foundation. It helps scoliotic patients function better, even if the curves are not entirely straightened out. There is no claim that it cures scoliosis, but it does improve function and posture. (Look at the images in the book.) This kind of a program demands from the participants total involvement and responsibility for the results. Only a certain number of people with scoliosis will succeed with the program because it is too hard for a greater number of patients.

Which sounds more enticing? Do exercises for the rest of your life to maintain or reduce the curves, or get a brace for a couple of years and then be done, or have surgery and not have to worry about it for the rest of your life? And then what do the long term outcome studies show?

Why do you think Schroth exercise program is not a viable and good way of approaching non-surgical intervention? Lack of appropriate studies and statistics only means that the studies haven't been funded and/or done. It doesn't mean that the work is not valid, successful, or a good alternative.

[Pooka1]

Most people are not up to the challenge.

Do they tell you this BEFORE you commit and write the check or after you commit and write the check? Do they tell people the actual attrition rate of people who couldn't keep up with the program? You say "most" can't do it. What if it s 90%? Should they tell people that up front or not?


There is no claim that it cures scoliosis[...]

I think this will come as news to some folks.


Only a certain number of people with scoliosis will succeed with the program because it is too hard for a greater number of patients.

What is that number that succeed? Is it 10%? More or less?


Which sounds more enticing? Do exercises for the rest of your life to maintain or reduce the curves,

Are they admitting that you have to exercise the rest of your life? Or do they claim for kids at least that using Schroth and perhaps a brace through the growth spurt is sufficient and the exercises can then be stopped? I think it will come as news to some that they say you have to exercise the rest of your life. I doubt a single person would sign up if they said that. What if you can't exercise due to illness? Do you lose all the benefits (and all the money)?


Why do you think Schroth exercise program is not a viable and good way of approaching non-surgical intervention? Lack of appropriate studies and statistics only means that the studies haven't been funded and/or done. It doesn't mean that the work is not valid, successful, or a good alternative.

Well, look at the points upthread. But also if something has been around for ~90 years and worked, don't you think there would be oodles of evidence on their website, it would spread by word of mouth alone, it would be the most popular treatment, and surgery would be a thing of the past? We don't obtain those results though. I'm skeptical.

[hdugger]

I think it will come as news to some that they say you have to exercise the rest of your life. I doubt a single person would sign up if they said that. What if you can't exercise due to illness? Do you lose all the benefits (and all the money)?

Raising hand in proxy for my son - yes, he'd be willing to a bit of exercise every day in order to maintain his curve. I think, when we had a show of hands earlier, there were several (including Linda and Pam) who would have been willing to do up to 1/2 hour of exercise a day if it both held the curve and reduced the pain.

On the effects of illness, I think we can only hypothesize. My hypothesis is that, if the exercise holds the curve, then having to stop exercise would start the curve progression at that point. So, if you had a 50-something degree curve and you'd held that for 10 years, then stopping exercise would put you back on that gradual 1 degree a year progression (assuming that, for some reason, you could never start exercising again). Assuming you *could* start exercising again, you'd halt the progression again at whatever point you re-started the exercise.

But, this is obviously hypothetical. It's *possible* (although I don't know by what mechanism) that your curve would be silently progressing all the while you were exercising and then, when you stopped after 10 years, you would already be 10 degrees further along. Again, I can't figure out what physiological mechanism would cause this to happen, but I have to consider it as a possibility.

[bas2101]

In my daughter's case, no one ever said, or even remotely suggested that Schroth would cure her scoliosis. I have never heard of any Schroth patient receiving this advice. So, really, hearing this would be much more surprising to me than being told Schroth is not a cure.

Since my daughter is braced, and many adolescent Schroth patients are, there is no way to tell what Schroth has done versus bracing; she did have a 8-10 degree reduction. However, over the last 6 months she has hardly done any Schroth; not only does her back look worse, but she has been a bit out of breath during exercise. It was always made clear to us that in order to maintain a reduction, decent posture, and normal lung function, she would have to continue Schroth (most importantly after bracing terminates) for the rest of her life. I do not know if all Schroth patients receive this advice, but considering the magnitude of my daughter's curve (now 60T), it was the advice we heard. I imagine kids with greater reduction who get below a certain degrees, would not have to exercise their entire lives. Schroth is hard to keep up. But, for those who chose to, I highly suggest it.

[Pooka1]

Raising hand in proxy for my son - yes, he'd be willing to a bit of exercise every day in order to maintain his curve. I think, when we had a show of hands earlier, there were several (including Linda and Pam) who would have been willing to do up to 1/2 hour of exercise a day if it both held the curve and reduced the pain.

That rings a bell. And that assumes 1/2 a day will hold the curve which is hypothetical only at this point. I would not doubt it would make a big dent in the pain though. So the question is with the evidence case IN HAND, would Linda, Pam or the others embark on it (prior to their surgery of course). I question that anyone would do that NOW.

On the effects of illness, I think we can only hypothesize. My hypothesis is that, if the exercise holds the curve, then having to stop exercise would start the curve progression at that point. So, if you had a 50-something degree curve and you'd held that for 10 years, then stopping exercise would put you back on that gradual 1 degree a year progression (assuming that, for some reason, you could never start exercising again). Assuming you *could* start exercising again, you'd halt the progression again at whatever point you re-started the exercise.

But, this is obviously hypothetical. It's *possible* (although I don't know by what mechanism) that your curve would be silently progressing all the while you were exercising and then, when you stopped after 10 years, you would already be 10 degrees further along. Again, I can't figure out what physiological mechanism would cause this to happen, but I have to consider it as a possibility.[/QUOTE]

I guess the main problem is we don't even know if consistent Schroth can hold off progression even though it probably helps pain.

[Pooka1]

In my daughter's case, no one ever said, or even remotely suggested that Schroth would cure her scoliosis. I have never heard of any Schroth patient receiving this advice. So, really, hearing this would be much more surprising to me than being told Schroth is not a cure.

Since my daughter is braced, and many adolescent Schroth patients are, there is no way to tell what Schroth has done versus bracing; she did have a 8-10 degree reduction. However, over the last 6 months she has hardly done any Schroth; not only does her back look worse, but she has been a bit out of breath during exercise. It was always made clear to us that in order to maintain a reduction, decent posture, and normal lung function, she would have to continue Schroth (most importantly after bracing terminates) for the rest of her life. I do not know if all Schroth patients receive this advice, but considering the magnitude of my daughter's curve (now 60T), it was the advice we heard. I imagine kids with greater reduction who get below a certain degrees, would not have to exercise their entire lives. Schroth is hard to keep up. But, for those who chose to, I highly suggest it.

Okay I stand corrected. I have not gotten that impression from the testimonials except from the adults who are doing it only for pain relief. But like you state, I would like to know what they are telling patients who haven't had their growth spurts and have somewhat smaller curves. Are they telling them exercise and wear the brace for a few years and then walk away?

I'm very sorry your daughter's curve is still progressing. Maybe when she is done growing it will slow down?

[hdugger]

That rings a bell. And that assumes 1/2 a day will hold the curve which is hypothetical only at this point. I would not doubt it would make a big dent in the pain though. So the question is with the evidence case IN HAND, would Linda, Pam or the others embark on it (prior to their surgery of course). I question that anyone would do that NOW.

I'm not certain I understand that. What adult with a pre-surgical curve and in some pain *wouldn't* try an alternative method? In their case, it's not even an alternative (since they're pre-surgical) - it's the only method. So, do you settle on a course of long-term pain meds, or do you try some kind of structured exercise? I'd guess that, if it were covered by insurance, *most* people would try it.

Am I missing some risk here? Other then cost, why wouldn't you try it and see if it helped? Even if there were no chance that it would hold the curve, what's the downside to trying it for pain relief?


I guess the main problem is we don't even know if consistent Schroth can hold off progression even though it probably helps pain.

Yes, that's exactly the problem. There are certainly some tantalizing results, but there's been so little research that we don't have any idea what kinds of curves it holds.

But, again, if you're an adult with a pre-surgical curve, there's no risk aside from cost. If you try it and it doesn't diminish the pain, then you stop. If you try it and it diminishes your pain but your curve continues to increase, then you get the surgery you would have had anyway. And, if you try it and your curve holds and your pain stops, then you've found a lower risk alternative to surgery.

[Pooka1]

I'm not certain I understand that. What adult with a pre-surgical curve and in some pain *wouldn't* try an alternative method? In their case, it's not even an alternative (since they're pre-surgical) - it's the only method. So, do you settle on a course of long-term pain meds, or do you try some kind of structured exercise? I'd guess that, if it were covered by insurance, *most* people would try it.

Am I missing some risk here? Other then cost, why wouldn't you try it and see if it helped? Even if there were no chance that it would hold the curve, what's the downside to trying it for pain relief?

Your hypothetical included that it was a given that it would both hold the curve and help with pain. Those things are not known yet with Schroth. I don't know if they would do 1/2 hour a day for some possible pain relief and an unproven and really unknown ability to hold the curve. That last part doesn't apply to Pam because her curve held at ~50* for about 2 decades and might have done so the rest of her life.


But, again, if you're an adult with a pre-surgical curve, there's no risk aside from cost. If you try it and it doesn't diminish the pain, then you stop. If you try it and it diminishes your pain but your curve continues to increase, then you get the surgery you would have had anyway. And, if you try it and your curve holds and your pain stops, then you've found a lower risk alternative to surgery.

Yes but the attrition rate is apparently extremely high. It's like how it is theoretically possible to avoid progression during the growth spurt by confining kids to bed for 2 years. It's physically possible but the cure is worse than the condition.

[hdugger]

Your hypothetical included that it was a given that it would both hold the curve and help with pain. Those things are not known yet with Schroth. I don't know if they would do 1/2 hour a day for some possible pain relief and an unproven and really unknown ability to hold the curve. That last part doesn't apply to Pam because her curve held at ~50* for about 2 decades and might have done so the rest of her life.

I guess I'm saying that it's pretty easy to find out. And, if you're in pain, you're likely trying things already to ease the pain. So, why not try something that might also hold the curve. Again, I hate to be dense, but I don't see any reason why you wouldn't (other then cost).


Yes but the attrition rate is apparently extremely high. It's like how it is theoretically possible to avoid progression during the growth spurt by confining kids to bed for 2 years. It's physically possible but the cure is worse than the condition.

But . . . it's only in your example that the cure is worse then the condition. 1/2 hour of exercise a day clearly does not equal being confined to bed for 2 years. Exercise isn't awful - it's just a little tedious. People don't drop out of regular exercise because it's onerous (as in your hypothetical) - they drop out because they get busy with other stuff. So, again, what have they *lost* by trying. What's the downside?

[Pooka1]

I guess I'm saying that it's pretty easy to find out. And, if you're in pain, you're likely trying things already to ease the pain. So, why not try something that might also hold the curve. Again, I hate to be dense, but I don't see any reason why you wouldn't (other then cost).



But . . . it's only in your example that the cure is worse then the condition. 1/2 hour of exercise a day clearly does not equal being confined to bed for 2 years. Exercise isn't awful - it's just a little tedious. People don't drop out of regular exercise because it's onerous (as in your hypothetical) - they drop out because they get busy with other stuff. So, again, what have they *lost* by trying. What's the downside?

I guess I just question whether many people will even try if it isn't guaranteed to work for pain. It's hard to get motivated for exercise when you are not hurting; I wonder how many people will do so when they are in pain rather than lay down. My lumbar hurts sometimes and the last thing that sounds good at that point is PT! I don't want to even move.

And for all we know, much of the attrition rate might be driven by not only this issue but the issue of the pain not being relieved enough to justify a 1/2 hour of daily of PT.

Hey! I'm just guessing and extrapolating from my situation. And I don't have nearly the amount of pain most other people here likely have. Or at least it is probably more intermittent.

[hdugger]

I guess I just question whether many people will even try if it isn't guaranteed to work for pain. It's hard to get motivated for exercise when you are not hurting; I wonder how many people will do so when they are in pain rather than lay down. My lumbar hurts sometimes and the last thing that sounds good at that point is PT! I don't want to even move.

And now, for a brief message from our medical researchers . . .

bad, bad, bad girl! Get out of that bed *right* now! It's only going to make it much worse in the long run.

Seriously, according to everything I've read, anything other then a very brief bed rest is the worst thing you can do for most back problems. Of course, ignore this advice entirely if your doctor has recommended bed rest for your back problems. Otherwise, I demand that you get up right now and start walking around.

. . . we now return to our previously scheduled discussion.

We haven't actually gotten to the key critique of my recommendation, which is how you decide if the structured exercise regime you're trying is likely to do anything for either pain or progression. Unfortunately *all* we seem to have is some anecdotal evidence. Schroth *appears* to help with pain (based on the anecdotes), and some as-yet-to-be-named mixture of various exercise program seems to help hold the curve (or, at least, reduce it in some cases which we assume means that it's holding it in other cases). But, while exercise *in general* seems to have some affect on pain/progression, which exercise to do *specifically* is still way up in the air.

[Pooka1]

And now, for a brief message from our medical researchers . . .

bad, bad, bad girl! Get out of that bed *right* now! It's only going to make it much worse in the long run.

Seriously, according to everything I've read, anything other then a very brief bed rest is the worst thing you can do for most back problems. Of course, ignore this advice entirely if your doctor has recommended bed rest for your back problems. Otherwise, I demand that you get up right now and start walking around.

Hey! I'm not actually complaining about my lumbar. You sort drew that out of me using that voodoo that you do. :D

All I really care about is that, to date, it never hurts when I'm riding I guess because that is like sitting and sitting doesn't trigger the pain. And I ride pretty much every day these days.


. . . we now return to our previously scheduled discussion.

We haven't actually gotten to the key critique of my recommendation, which is how you decide if the structured exercise regime you're trying is likely to do anything for either pain or progression. Unfortunately *all* we seem to have is some anecdotal evidence. Schroth *appears* to help with pain (based on the anecdotes), and some as-yet-to-be-named mixture of various exercise program seems to help hold the curve (or, at least, reduce it in some cases which we assume means that it's holding it in other cases). But, while exercise *in general* seems to have some affect on pain/progression, which exercise to do *specifically* is still way up in the air.

Very nuanced response there. :)

Look, I think knowing that surgery for pain alone has a pretty bad track record might help swell the PT ranks. But it can only work so much I think before folks just start using drugs. And for the kids not in pain, DON'T DO DRUGS!

I don't think the bottleneck is deciding which PT program... they are probably all similar i their ability to address pain. The problem is the attrition rate. There are some reasons for the high attrition rate of Schroth and likely other PT modalities that was reported upthread. We can only surmise what those reasons are.

[mamamax]

Hans R. Weiss MD . Orthopedic Surgeon , and Physical Medicine Rehabilitation is in his new clinic offering to patients from abroad his " Best Practice " and Physio-logic program in Gensingen , Germany.
www.scoliosis-dr-weiss.com


Hi Bea - Thanks for this posting. Have you any idea what Dr. Weiss is up to now that he is in practice for himself? I would imagine his time would be somewhat freed up for projects he otherwise would not have had time for. Will be interesting to watch what he does in the near future. I wrote to him recently looking for some clarification regarding Formetric terminology - he was quite friendly and referred me to a friend of his. I really appreciate what he has added to the literature.

[mamamax]

Dr. Morningstar works with my entire family and is wonderful. My understanding is that Pettibon and CLEAR are similar, but that Pettibon emphasizes more long-term work and effect than CLEAR (no 2 week clinics or anything), but I'm not totally clear, so I emailed the link to Dr.Morningstar and am hoping he'll expand a bit on this forum.

Hi Tina - Did Morningstar get back to you? I'd like to know more too. He actually participates on another forum that I also belong to .. seems very intelligent, well educated & well spoken.

[hdugger]

Very nuanced response there. :)

Look, I think knowing that surgery for pain alone has a pretty bad track record might help swell the PT ranks. But it can only work so much I think before folks just start using drugs. And for the kids not in pain, DON'T DO DRUGS!

I don't think the bottleneck is deciding which PT program... they are probably all similar i their ability to address pain. The problem is the attrition rate. There are some reasons for the high attrition rate of Schroth and likely other PT modalities that was reported upthread. We can only surmise what those reasons are.

Well, it requires a lot of nuance :)

I suspect that all PT is not equal. In fact, I suspect, since we've seen reductions in people using such different methods, that it's probably some simple set of exercises that's shared among the different effective methods that's actually making a difference. OR, it's some kind of awareness of how they're holding their body all the time. Either way, I don't think 30 minutes a day is necessary - I think it's probably a few simple exercises plus the added awareness. But, without knowing exactly *what* is making a difference, it's hard to cut the time down substantially.

[mamamax]

In my daughter's case, no one ever said, or even remotely suggested that Schroth would cure her scoliosis. I have never heard of any Schroth patient receiving this advice. So, really, hearing this would be much more surprising to me than being told Schroth is not a cure.


My brace provider (Dr. Lamantia) is certified in Schroth through the German Clinic and appears on their list of providers. He never in any way ever suggested that Schroth (or my Spinecor brace) was a cure either - I don't recall anyone ever saying that. Unfortunately I don't live close enough to his NYC office to participate in a workshop ... but I'll get there one day!

[mamamax]

Its still there. Horray!!!
I think one of the reasons it is "fringe" is because when some one decides to do that program, they must be totally committed and dedicated to the process. Most people are not up to the challenge. They want the easiest way to deal with "the problem." It is easy to give up when things are challenging and "hard". For many it is easier to have someone "fix" the problem.
The Schroth method of Physical Therapy for Scoliosis is sound in theory and practice, intuitive, individually applied and yet rigorous in its foundation. It helps scoliotic patients function better, even if the curves are not entirely straightened out. There is no claim that it cures scoliosis, but it does improve function and posture. (Look at the images in the book.) This kind of a program demands from the participants total involvement and responsibility for the results. Only a certain number of people with scoliosis will succeed with the program because it is too hard for a greater number of patients.

Which sounds more enticing? Do exercises for the rest of your life to maintain or reduce the curves, or get a brace for a couple of years and then be done, or have surgery and not have to worry about it for the rest of your life? And then what do the long term outcome studies show?

Why do you think Schroth exercise program is not a viable and good way of approaching non-surgical intervention? Lack of appropriate studies and statistics only means that the studies haven't been funded and/or done. It doesn't mean that the work is not valid, successful, or a good alternative.

Great posting - we don't get lot of people here with first hand experience with Schroth so I'm always glad to see someone like yourself adding to the conversation. Agree with what you say about statistics and studies etc ... it is very frustrating to me to wait for the literature to catch up with current reality. I have the book you spoke of and there is a lot of great information in it. Have you been to the clinic in Germany? Would love to here more about your experience with it.

[mamamax]

I suspect that all PT is not equal. In fact, I suspect, since we've seen reductions in people using such different methods, that it's probably some simple set of exercises that's shared among the different effective methods that's actually making a difference. OR, it's some kind of awareness of how they're holding their body all the time. Either way, I don't think 30 minutes a day is necessary - I think it's probably a few simple exercises plus the added awareness. But, without knowing exactly *what* is making a difference, it's hard to cut the time down substantially.

Martha immediately comes to mind as I read this. Where was she last we asked? At 45 min a day? I do wonder if less time would be just as effective. She really is something to watch - publishing every four years, and not hitting an end point yet. I guess any exercise heightens body awareness, so exercise specific to scoliosis would not be any different - and could be unique to each individual. Will be looking to see what SEAS brings to the table this year at SOSORT .. looks like a few PTs are participating this year as well.

[Lorraine 1966]

I know in my case, considering the pain I am in any form of exercise would be impossible. I have tried swimming and PT and the next day am in agony. So as an adult who is in pain, Schroth would not work for me.

[LindaRacine]

I'm not certain I understand that. What adult with a pre-surgical curve and in some pain *wouldn't* try an alternative method?
One who had tried several other alternatives without success.

[mamamax]

I know in my case, considering the pain I am in any form of exercise would be impossible. I have tried swimming and PT and the next day am in agony. So as an adult who is in pain, Schroth would not work for me.

Hi Macky - The Clinic in Germany does work with patients who have had fusion - the exercise is modified. Schroth is fairly gentle exercise so maybe it would not cause you the day after effect that swimming or PT does. Writer would have more information. I'll try to find a web link for you.

[Beatriz Torres]

Hi Macky: I own a Left thoraccic scoliosis with a fusion and being a pain free after learning, practising and attending education with the Schroth Method in Germany with Mrs. Christa Lehnert- Schorth PT, Hans Weiss MD in his new program PhysiOlogic and in the Asklepious Klinic.
Once I have learned how to derotate my spine activily, I decompress and do three specific movements in order to, elongate and movilize with tinny movements the apex of the curves, I do not need to exercise 1/2 an hour . I am very much into ergonomics, isometrics and applied common sense during ADL ( activities of daily living ) like using the mouse on the left hand even so I am a right hand person . This " method " it is working for me. What is important is that I am cognitive and in control of my curves, at this moment , with improve vitality, increase lung capacity and " feeling " a ray of hope for good health every day