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View Full Version : Effect of compensatory curve on main curve.



rohrer01
05-18-2010, 01:27 AM
My question is if anyone knows, or if there are any studies being done on how focusing correction on a compensatory curve might affect the main curve.

Since I have a very high thoracic curve, as you all know by now, I was thinking about an exercise program that would focus on straightening my compensatory curve, which is only 28*. This curve has progressed 12* since 1994. My Main curve has progressed 10* since then. It seems as though the compensatory curve is progressing at a slightly more rapid rate. However, the good news about it is that a 28* curve should be much easier to work with than a 46* curve. The compensatory curve is mid-thoracic rather than upper thoracic so should be easier to target.

The down side to this is when I stand up "straight" to straighten out my compensatory curve, my deformity becomes VERY obvious to all onlookers. Also, my clothing really fits badly when I stand like that. I will be having to shorten the neck height on one side of my shirts, but I've done that alot in the past already. I'll probably have to deal with the stares and the questions. But, I know many of you on here deal with that every day, I shouldn't worry about it. Vanity isn't as important to me as pain control.

I'm thinking the worst thing that could happen is my main curve could progress, but hey, it's doing that already. At least I will feel like I've tried everything (that is if I can't get the surgery).

Any input is appreciated. :)

rohrer01
05-18-2010, 06:36 AM
I've been thinking about this all night. The one thing that I'm truly afraid of is that if I stand "looking" as if I have bad posture (with my shoulders uneven) that it will put even more stress on my neck. But the curve is in there putting stress on my neck already. It's just the general onlooker cannot see it. I guess I'm just afraid of increasing the compensatory curve at my neck area by decreasing the compensatory curve in my mid-lower thoracic area. I'm just musing over this plan.:confused:

skevimc
05-18-2010, 10:51 AM
I'm not sure if there are studies looking at that specifically. However, from what I remember from the time I spent in clinic, stabilizing one compensatory curve CAN cause the other one to increase. This can be seen in thoracic curves that are stabilized with a TLSO. This stabilizes the main curve and the lower compensatory curve, but a compensatory curve can develop higher up. So the doctors and orthotists I've been around would work to control the main curve but leave a little wiggle room for the compensatory curve to.... well... compensate. They were trying to achieve a balance and let the lower curve progress instead of a higher curve develop.

This, of course, is different based on the curve and person and doctor, etc... Just telling you what I have picked up through osmosis.

rohrer01
05-18-2010, 11:01 AM
I'm not sure if there are studies looking at that specifically. However, from what I remember from the time I spent in clinic, stabilizing one compensatory curve CAN cause the other one to increase. This can be seen in thoracic curves that are stabilized with a TLSO. This stabilizes the main curve and the lower compensatory curve, but a compensatory curve can develop higher up. So the doctors and orthotists I've been around would work to control the main curve but leave a little wiggle room for the compensatory curve to.... well... compensate. They were trying to achieve a balance and let the lower curve progress instead of a higher curve develop.

This, of course, is different based on the curve and person and doctor, etc... Just telling you what I have picked up through osmosis.

So, then, I would probably be better off leaving well enough alone. I do NOT want that curve in my neck to get any worse. I'm already having neurologic symptoms in my arms and hands. I have NO idea how I could go about working on the compensatory curve in my neck since it is so directly linked to the main curve (I know the other one is, too, but isn't causing problems). Thanks for sharing what you know.:)

dailystrength
05-18-2010, 11:20 AM
Rohrer, you seem smart enough, you may want to invest in the Schroth book - it's a huge textbook-type manual for physical therapists, with many photos. I think it's worth the $50 investment - this is your life you are talking about. In light of that, $50 is nothing. I think you would learn a lot from it, about how curves affect ribs, etc. She is very, very detailed about this. I want to study it more myself; perhaps we could start a Schroth thread with our comments and discussions about it. Anyway, good for you for asking these questions. If the Schroth founder could come up with it through her own self-awareness, the answers are there for us to find as well, I feel.

rohrer01
05-18-2010, 11:31 AM
Rohrer, you seem smart enough, you may want to invest in the Schroth book - it's a huge textbook-type manual for physical therapists, with many photos. I think it's worth the $50 investment - this is your life you are talking about. In light of that, $50 is nothing. I think you would learn a lot from it, about how curves affect ribs, etc. She is very, very detailed about this. I want to study it more myself; perhaps we could start a Schroth thread with our comments and discussions about it. Anyway, good for you for asking these questions. If the Schroth founder could come up with it through her own self-awareness, the answers are there for us to find as well, I feel.

Thank you! Now I have two books to purchase.;) I'll surely get free shipping!

dailystrength
05-18-2010, 12:05 PM
Although, I read on your other post that Schroth seems to focus only on appearance - not sure what to make of that. If it means appearance of the curve, that's true as the xrays show improved curves. She does focus on de-rotation- that's why it's called 3-dimensional. Anyway, I do hope you learn from it, if you get it. I hope most of all your pain subsides, soon!

flerc
05-18-2010, 12:24 PM
rohrer01, Im trying to know in %, how many times, the compensatory curves increase until reach the same degrees as the main curve. Regrettably, I think is very reasonable what I found in same page: The curve has to be compensate with secondary curves, so that the axis of balance is maintained in the center. Referring to distinguish lateral curvature: A primary curve, which is the largest and initiating the scoliosis, and one or more secondary offset curves.
But it can happen that two curves is only then can the two are exactly alike and as you can not know which is which primary and secondary PRIMARY CURVE DOUBLE talking about, which is the ultimate evolution of a double curve, but when X-ray observed a primary curve and above or below the other curve with a Cobb angle less, means that the secondary curve is still evolving '
I know that when main curve is reduced, the secondarys reduce alone. According to physics it makes sense that the body will try to balance in that way.
I think that if old people without surgery and without following any treatment remains with only one main curve, it should not be true. I hope that.
Osteopaths seems to know about compensations and Mezieres people should also to know about it, because muscular chains seems to be envolved.

rohrer01
05-18-2010, 07:25 PM
Although, I read on your other post that Schroth seems to focus only on appearance - not sure what to make of that. If it means appearance of the curve, that's true as the xrays show improved curves. She does focus on de-rotation- that's why it's called 3-dimensional. Anyway, I do hope you learn from it, if you get it. I hope most of all your pain subsides, soon!

Dailystrength,
I hope I didn't make it sound like Schroth ONLY focuses on appearance. I don't know anything about Schroth. I was mearly restating a post I read about one case. :)

rohrer01
05-18-2010, 07:38 PM
rohrer01, Im trying to know in %, how many times, the compensatory curves increase until reach the same degrees as the main curve. Regrettably, I think is very reasonable what I found in same page: The curve has to be compensate with secondary curves, so that the axis of balance is maintained in the center. Referring to distinguish lateral curvature: A primary curve, which is the largest and initiating the scoliosis, and one or more secondary offset curves.
But it can happen that two curves is only then can the two are exactly alike and as you can not know which is which primary and secondary PRIMARY CURVE DOUBLE talking about, which is the ultimate evolution of a double curve, but when X-ray observed a primary curve and above or below the other curve with a Cobb angle less, means that the secondary curve is still evolving '
I know that when main curve is reduced, the secondarys reduce alone. According to physics it makes sense that the body will try to balance in that way.
I think that if old people without surgery and without following any treatment remains with only one main curve, it should not be true. I hope that.
Osteopaths seems to know about compensations and Mezieres people should also to know about it, because muscular chains seems to be envolved.

You and I would like to both know.

dailystrength
05-19-2010, 08:40 AM
Dailystrength,
I hope I didn't make it sound like Schroth ONLY focuses on appearance. I don't know anything about Schroth. I was mearly restating a post I read about one case. :)

:) no prob. I don't know that much about it either, but it sure is expensive and actually my coverage isn't going to cover what I thought it would (insurance) so lets just keep learning all we can with our good minds.

pmsmom
05-19-2010, 11:13 AM
My surgeon had told us that the main curve drives the others.

Since he corrected my dd's main curve (60 degree left thoracic), the others seem to be diminishing on their own.

rohrer01
05-22-2010, 11:43 PM
My surgeon had told us that the main curve drives the others.

Since he corrected my dd's main curve (60 degree left thoracic), the others seem to be diminishing on their own.

Has it been a gradual decrease or was there immediate improvement, or both? I hope you don't mind my asking. It would make a difference when I have my surgery as to how much I would let them fuse. As it stands, my surgeon wants to do a very long fusion when the time comes.:(

pmsmom
05-23-2010, 05:56 AM
Has it been a gradual decrease or was there immediate improvement, or both? I hope you don't mind my asking. It would make a difference when I have my surgery as to how much I would let them fuse. As it stands, my surgeon wants to do a very long fusion when the time comes.:(

So far, it's been gradual.

When we saw the surgeon at 3 months, all her curves (including the corrected one) measured in the 20s.

When we saw him at 6 months, the top was like 19 degrees or so, and the middle and lower ones were in the mid and lower teens.

She only had the top thoracic one fused (that was 60, so it was pretty big).

In fact, we didn't know she had a middle one til afterwards b/c the top was so big that it mased the middle curve.

Hoping your situation works out!