torso rotation

[gerbo]

http://www.scoliosisjournal.com/content/2/1/9

This article is of some interest as it confirms the possible contribution of muscle asymetry in the etiology of scoliosis. No, lets be clear, it confirms the existence of a muscle asymetry, with a weakness of rotation towards the concave side confirmed. It is other studies (the Vert Mooney studies, which I quoted before http://www.medxonline.com/downloads/articles/measuredresistanceinscoliosis.pdf) which suggest that dealing with this assymetry (torsorotation exercises) can help to stabilise a curve.

some observations;1) it is suggested that the assymetry could (additionally?) be due to nonmuscular factors (soft tissue, bone, ligament deformity) and indeed I have often wondered whether the observed improvements could be due to the improved flexibility of the spine as a result of the very specific exercises, rather than the equalising of muscle strength

2) it is good to see that attempts are made to increase our understanding of the condition and the various factors contributing to it

3)despite celia's cynism about financial motivations of surgeons; Marc Asher is a spinal surgeon with a large stake in a company producing implants, but still he is looking at possibilities to deal with scoliosis in a non surgical fashion

[Celia Vogel]

....despite celia's cynism about financial motivations of surgeons; Marc Asher is a spinal surgeon with a large stake in a company producing implants, but still he is looking at possibilities to deal with scoliosis in a non surgical fashion


:o :o :o How pray tell did I get into this discussion????! LOL!!!! I have never accused Dr. Asher of being financially motivated. It was with a very heavy heart that I reported doctors might be financially motivated based on *my* observations.

[RugbyLaura]

Oh dear, I wish I understood these things better :confused: Is it a sort of chicken & egg senario? Did the muscle asymmetry cause the scoliosis or was it the opposite? Either way, will strengthening the weaker muscles help? Surely it can do no harm.... I'd like to hibernate (with Imogen) for 50 years and wake up when there is an answer. Mind you, who knows what state the world will be in by then?

Re the doctors alleged motivation.... whilst their true calling is, I am sure, driven by altruism I expect there is some money in the budget for research. Imagine the fame & fortune to be gained through finding a "cure"! ;)

Laura

[gerbo]

celia, as you know, it was a bit of a "tonque in cheek" remark. Still; mr asher would loose a considerable source of income if he would "discover" an efficient non-surgical way of treating scoliosis. (not that i think he will, at most this is just a small part of the jigsaw)

laura; the correct question would be (as nobody can answer the question as you put it); does the muscle asymmetry serve to stabilise the curve, or could it contribute to it getting worse?? I believe it is the latter, specially as both dr mooney and dr asher have shown (in a small group of patients admittingly, so results need to be looked at with lots of care) that treating the inbalance (strengthening the weaker side) appears to be preventing progression.

[structural75]

I realize, as you put it, that there is no definitve answer to the question as Laura asked... however there were a couple of thoughts I had in regards to it.
Still; mr asher would loose a considerable source of income if he would "discover" an efficient non-surgical way of treating scoliosis.As would many, many Drs if they chose to consider things that already exist. ;)

laura; the correct question would be (as nobody can answer the question as you put it); does the muscle asymmetry serve to stabilise the curve, or could it contribute to it getting worse?? I believe it is the latter, specially as both dr mooney and dr asher have shown (in a small group of patients admittingly, so results need to be looked at with lots of care) that treating the inbalance (strengthening the weaker side) appears to be preventing progression.

As a generalization, I believe it is actually the asymmetry in muscular tonus that is preventing the curve from worsening, at least at a faster rate... as the bodies own self-regulatory/adaptive and autonomic response to the lateral deviation. If you were to examine the anatomy and function of the soft-tissue/muscular region in question here it is very clear that if both sides, concave and convex, maintained the same tonus levels then the spine would be drawn further to the concave side... because it not only has the hypothetical 'balanced' tonus to match the convex side, but it also has the ever present force of gravity acting downward on it... and we all know that when something leans off-center from a vertical plum with gravity it incurs forces that will continue to push it in that direction... i.e. - gravity.

And keep in mind that the muscles on the concave side of the curve act to 1) extend the spine 2)rotate the spine 3) bend the spine to the same side they are located on. This last one is very important here. If you increase the tonus (i.e. - force of pull within the muscle) of the muscles on the concave side, you will encourage further side bending to that side... i.e. - Increase the concavity.

In scoliosis you will always find an uneven tonus in the muscles along the spine, left vs. right. As a curve progresses that tonus discrepancy will usually increase.. I'd love to see a study documenting that correlation. It is a functional response of our nervous system to slow or stop the curvature as best it can on its own. Conversely, as a curve is 'straightened' you will see the tonus between the two sides begin to equalize again as it becomes more appropriate and functional to do so. A slight bend of the spine will permit a more balnced tonus to exist without detriment moreso than a more moderate or severe bend would. As the moderate/severe bend does not want the concave musclature 'toning up' or else it would draw the spine further into the bend... as that is the action of those muscles on that side.

Either way, will strengthening the weaker muscles help? Surely it can do no harm.... Please don't assume that... I mean this sincerely. It certainly could cause more harm if not properly understood. If someone began doing sideways sit-ups (laying on the side and lifting the torso off the floor) on the concave side of their curvature because they 'heard'/'believed' it was weaker after reading one of these studies... they will surely make matters worse.

So I think a big concern I have in these studies thus far is that they are inconclusive as to the actual reason behind the increase of tonus on the concave side corresponding with a reduction/stability of the curve. All they show is that by doing torsorotation exercises the curve may stabilize/reduce and tonus on the concavity side increases. It doesn't show at all that the reason for these results is due to a strengthening of the concave muscles, but rather just that it is a consequence of the actions performed... which is also somewhat obvious that muscles being utilized during torsorotations are going to increase in physiologic strength... that's kind of a no-brainer, pardon the sarcasm.

This brings me to one of Gerbo's points:
some observations;1) it is suggested that the assymetry could (additionally?) be due to nonmuscular factors (soft tissue, bone, ligament deformity) and indeed I have often wondered whether the observed improvements could be due to the improved flexibility of the spine as a result of the very specific exercises, rather than the equalising of muscle strength
I strongly agree with Gerbo's suspicions/theory here. By doing torsorotations one is inevitably creating length and mobility where it is limited, thereby getting length in the concave soft-tissue/etc. and ultimately reducing/slowing/stopping the curvature.... thereby allowing for a change in tonus of said musculature.

Sorry to make this another one of my usual long-winded repplies... but it really pains me to think that someone might go out and start 'strengthening' the cancavity of their curve only to learn the hard way that maybe these inconclusive studies are being misinterpreted.

Aside from my genuine concerns about the interpretation of these studies, I do agree that it's good that people are looking into other factors involved with this condition.

[RugbyLaura]

Thank you, Structural, for your reply. It was only long winded because it needed to be :) Unfortunately I only understood about half of it :confused: I think I need a PowerPoint presentation :D

The message I got was "leave it to the professionals". In my daughter's case the professionals (for once it seems) agree; sadly they agree that she will need fusion one day, it's just a matter of time & trying to hold the curve until she's grown as much as possible. Occasionally I find myself clutching at straws and/or being seduced by new possibilities.....

Thanks again,

Laura
ps Gerbo, how did it go today?

[structural75]

In contrast, female adolescents with idiopathic scoliosis in
the current study showed significant weakness in the neutral position and the two pre-rotated
positions to the concavity in comparison to the mirror trunk position. Although the strength
asymmetry could be the result of either weaker concave side or stronger convex side, the
comparison between healthy female adolescents and the scoliotic patients showed weakness
associated with idiopathic scoliosis in low force contractions to the concave/left sides, but no
difference between two groups to the convex/right sides. After reading this study in its entirety, I did not find ANY conclusions or statements drawn about the "concave side being weaker"... only that rotation "towards" the concave side was weaker, ...which is very different in that the muscles responsible for rotation toward the CONCAVE side lay on the CONVEX side of the spine with the exception of the internal obliques (which again, if you "strengthened would result in making the concavity worse). Meaning that the convex musculature would possibly be the "weak" culprits, not the concave side musculature as has been suggested. Or that the chronic shortening of the tissues on the concaved side (thus inducing the sidebend and rotation) is providing excessive resistance against the rotation to the concavity (as that tissue needs to lengthen and release for the rotation to occur).

I realize that it is the 'other' studies that suggest 'strengthening' the concave side to address this asymmetry, but that does not correspond with the findings of this study... Which merely points out the weakness "towards" the concavity, not within the concaved side itself.

I do agree with the other studies in that strengthening towards the concave side would be very useful, but not strengthening the concave side itself.

So again, misinterpreting or misunderstanding the conclusions of this and other studies could be very detrimental. I think Laura put it best, "leave it to the professionals". And even then, get a second and third opinion. ;)

p.s. - Laura, sorry for the added confusion... I know that probably didn't help matters.

[Bish]

For once structural I think I may agree with you. There was a lot of focus on right torso rotation when i went to the clear institute. I think it's bologna. As a matter of fact i think it could do damage. I have a right thoracic, left lumbar curve and I get alot of pain in between the curves in my spine. I think right torso rotation could be contributing to an already existing hyperextension in the spine due to the curve/rotation.
As far as attaining muscle symmetry to obtain correction, I think it is the exact opposite. I also believe muscle assymetry is a reaction to the curve. I think if your spine is curved you WANT muscle asymmetry to better support your spine. Assuming that is i geuss, your curve is structurally related instead of a RESULT of muscle asymmetry, although this type of scoliosis seems far and few between. Here is a strange thought/ theory. Most people are of the premise that we want to develop the weaker side.(Which appears not to work) How about concentrating on developing the over developed compensatory muscles to help push the spine back. If and when that happens, the weaker side will begin to take over as a reaction to the spine being straighter.
The crappy thing is the more I get to know, the less it seems I know what to do! Bish

[structural75]

Dave,
Thank goodness... I don't think I have the energy for another debate.

I have always wondered how the torsorotation exercises are addressing the two rotations in an S curve.??? Where the lower curve rotates one direction and the upper curve rotates the opposite way to counter it. How do the torsorotations isolate each of these opposing rotations? Do you do them to one direction? How do you only rotate the thoracic spine for instance without rotating the lower spine and feed into its rotation? It seems this would be very difficult, if not impossible to do on the machine.

I would tend to think the torsorotations would only be applicable for C curve type scoliosis (single curve, thus single rotation)... for that reason.

Since you have direct experience, what are your thoughts/experience on this?
Structural

[trcylynn]

I'm a little confused as well. This article/study was measuring/studying rotation- as in the rib/hump problem/feature of scoliosis correct?

Also (sorry if I mis-quote) what did you mean by not strengthening the concave muscles themselves but the ones that support it or push it (again sorry for the mis-quote).

So if I have a left lumbar curve (as in when I bend over and you look at my back you see a "c") and rotation to the right (as in my right ribs stick out further then my left) what exercises would be appropriate. I was under the same theory that strengthening my right side of my back would help. I can tell my muscles are imbalanced because I am constantly working my left side (I flex my left side inward all day so that you cannot tell how bad my curve is). When looking at my back you can see muscle definition on the left and flab/skin on the right. I used to do plank positions (for the abs/obliques) on my right side (so that I would flex my right as I do my left) but from what I read I'm understanding that this could actually be worsening the curve?

I also try to do back extensions and back exercises because I notice it helps with the pain. But lately I've noticed any time I do a back extension or try to work my lower back my left muscles take over and my right muscles do not work as hard- is there a way to focus on the right? should I focus on the right?

I am thoroughly confused.

Thanks,
Tracy

[structural75]

Hi Tracy,
I'm a little confused as well. This article/study was measuring/studying rotation- as in the rib/hump problem/feature of scoliosis correct?No, it was using EMG to test the strength of the muscles during rotation. It wasn't measuring rib hump/rotational degrees... it gave the degree of rotation as markers for the starting and ending position of the movements.

Also (sorry if I mis-quote) what did you mean by not strengthening the concave muscles themselves but the ones that support it or push it (again sorry for the mis-quote).The muscles on the concave side of the spine are not the ones that rotate the spine to that side... The muscles on the convex side actually rotate the spine toward the concave side. So in your case for instance, the muscles on the right side of your lumbar spine (the concave side) are actually shortened to begin with and lacking tonus. They cannot contract much further and if they did they would pull your spine into further rotation and sidebending alike... making the curve/rotation worse.

The muscles on the convex side (left) are hypertonic (more toned/stronger) because they are working very hard to resist further sidebending to the right and fighting the rotation to the left as well. So you would first need to begin lengthening the right side so that the spine can come out of its sidebending and rotation as well as strengthen the left side more to assist that process. Over time the right side which has shortened soft tissues and less active will become more active as the spine lengthens/straightens (this is the premise, not everyone can achieve correction as we know. But utilizing this premise/fact will certainly work in your favor to slow, stop or reduce the curve.)

I hope that doesn't confuse you more. A lot of the soft tissue patterns in scoliosis are counter-intuitive... which is what makes it a challenge to understand and treat effectively.

I realize that you notice the overdevelopment of the left side but that has to be that way in order to prevent the spine from getting worse. You're also noticing a hump and the appearance of more muscle because the transverse process of the vertabrae (bony part that sticks out to the sides) are being moved posterior/back on the left due to the rotation... and forward/anterior on the right, causing the appearance of less musculature or a 'sunken' region.
I also try to do back extensions and back exercises because I notice it helps with the pain. But lately I've noticed any time I do a back extension or try to work my lower back my left muscles take over and my right muscles do not work as hard- is there a way to focus on the right? should I focus on the right?Stop focusing on strengthening the right side. It will only make matters worse. Those muscles are inactive for a reason. Again, you're fighting your bodies functional response to the scoliosis... What you want to do is focus on lengthening the right side... open it up... stretch it. Do rotations to the right in the lower spine (i.e. - sit on a chair or the floor and rotate right looking over your right shoulder... reach your left arm across your body in the front and hold onto the outside of your right knee.) Something like that would be far more beneficial than side plank on the right... strengthening the right, etc.... .

Don't get discouraged... it's easy to misunderstand these things... and I know it's even more difficult when you read studies like this and they get misinterpreted/misunderstood... Dealing with this condition takes more knowledge than just reading and analyzing studies... they're useful but it's a god example of the fact that one needs to know far more than what the 'conclusions' are saying. This is not something that I feel should be managed without proper guidance from not just an educated Dr./PT/Physio?whatever... but an exceptional one.

I give you a lot of credit Tracy for being so proactive and motivated to help yourself.. Please don't get discouraged by this... just try and get some really great guidance to move forward. I support your efforts 100%.

Kindly
Structural

[Bish]

Well I am not 100% sure but I think the premise is this. If I am right thoracic and left lumbar and was perscibed a right torso rotation (with focus on full extension right with resistance), my thoughts would be that the rotation would have a positive effect on the left lumbar and a negative on the right thoracic, because you are rotating in the direction of the existing rotation. But! I think with the thoracic vertabrae having limited mobility because your ribcage is attached, the hard right rotation may be acting against the distortion of the vertebrae in relation to the ribs,and the attempt is to re-align the two. I think it doesn't work because that stress is taken up in the vertebrae in between the two curves. That's my geuss but what do I know. Hahah! Dave

[structural75]

Dave,
Not much time to reply, but... The thoracic spine, despite the ribs being attached, has much more range of motion in rotation than the lumbars do. This is dictated by the angulation of the facets in the respective regions. The lumbar spine facets are angled in the sagital plane which allows for greater range of motion in flexion and extension whereas the thoracic facets are angled more in the coronal plane which permits a lot of rotation.

Doing the torso rotations to the right would positively influence the left lumbar curve but, as you said, negatively influence the thoracic... And because more rotation takes place in the thoracic, the rotations will more likely be taking place there before the lumbars move.

[trcylynn]

Thanks Structural,

I have a few more questions.

I visited the specialist yesterday to go over my MRI films (and ask questions I forgot to ask the first time). My 3rd to last disc (before the sacrum bones?) is degenerative. He said the rest of my spine looks ok. He also said my rotation is more severe than my curve. Is that normal? I thought the rotation occured because of the lateral curve but if my rotation is more severe how did that happen?- well maybe not how did it happen but is it common?

I have an appointment with a PT next week. I just recently moved to this area but the PT came recommended from my doctor who is said to be one of the best. (maybe everyone says that though).

Is there something I should look for/watch out for with the PT to evaluate how much he/she really knows? I don't have to commit to this PT and can choose someone else but I don't know who else I would go to.

As far as doing things on my own- Yoga to help stretch/lengthen and rotation (I believe there are some twist poses I have from yoga as well) but focus more so turning/twisting to the right than the left correct?

Thanks again for the help/advice.

~Tracy

[structural75]

Tracy,
He said the rest of my spine looks ok. He also said my rotation is more severe than my curve. Is that normal? I thought the rotation occured because of the lateral curve but if my rotation is more severe how did that happen?- well maybe not how did it happen but is it common?Yes, that's easily a possibility. Rotation is coupled with sidebending/lateral flexion of the spine but it isn't necessarily proportionate to the bend. In fact, one can have what is called a roto-scoliosis in which there are minor bends coupled with moderate to severe rotations... in those cases the rotations are the most important issue to address. Often you'll see rotations increase as the bends decrease from correction (usually bracing)... This is in large part due to the fact that the soft-tissue restrictions involved holding the spine in the bend are not specifically addressed with a brace and therefor as the spine attempts to straighten out from the bracing forces the restriction in the soft-tissue remains but simply changes its effect on the spinal mechanics... causing a rotation because it is still shortened asymmetrically despite the lessening of the curve.

Also keep in mind that the spine can rotate purely by itself, without bending.

Is there something I should look for/watch out for with the PT to evaluate how much he/she really knows? I don't have to commit to this PT and can choose someone else but I don't know who else I would go to.
You'll have to prepare your questions in advance and be weary if their only approach is to "strengthen" the spine/abdomen. This is not a customized and adequate approach, it's the generic PT type of protocol... Look for one, if need be, who integrates and impliments strength, stretching, balance/coordination type work, proprioceptive activities... etc. The work you do should also be asymmetric, if you find yourself doing exercises that don't speak more to one side or area more than another then ask them why they're not doing it differently. Keep in mind, not everything will entail asymmetric work, but some of it certainly should.

Hope that helps somewhat,...it's difficult and questionable for me to give any specific advice to your particular situation over the internet... This is obviously not the appropriate place for treatment. Just be sure to ask questions when you have them and don't be afraid to question something if it doesn't feel right or make sense to you... You are in charge of your body and you have the right to know and understand why you're doing things.

Best to you,
structural

[structural75]

The rotations in the spine comes from the lack of tension in both side of the spinal rotators , the paraspinales , ileocostalis muscles. Both sides are weaker. The diaphragm muscle also contributes to expand your concaves area specially in the transcitional vertebraes at level lumbar 1 and 2 .For rotation to occur there must be a difference in tension, unequal, from left to right sides. Whether they are weak or not is usually a secondary functional response, unless the scoliosis is caused by a neurologic deficit of the CNS. If both sides had "lack of tension" equally then it would result in fexion of that portion of the spine. So there is always a disproportionate value of strength/potential in the case of a fixed rotation... one could say they are both weaker but it is the relative relationship that is important here. Also the multifidi and rotatores are significant in this scenario, moreso than the phasic 'movers' of the spine iliocostalis, longissimus, spinalis (superficial paraspinals). They need to be addressed as well but the postural holding of the curve is coming from these deeper more intrinsic slow twitch muscles. The others mentioned are responsible for gross movement while these deeper layers stabilize the vertabrae during the movement.. they also are most influential on the static postural stabilization of the spine - i.e. 'holding the curve'. So you can force correction focusing on these phasic, rather than tonic, muscles... but you also need to get change/length in the deeper tonic ones to have the greatest effect and stability.

BETall, I noticed you are frequently following up my posts with recommendations to Scroth.... I don't mind at all, but are you in disagreement with my recommendations/opinions? Are you a Scroth PT?

Best,
structural

[Rayknox]

structural,
Whose theory is this?
So if your bicep is stronger than your tricep you have to strengthen your tricep to get a straight arm?

[structural75]

Ray,
"Whose theory is this?" ... Do you mean mine or the others regarding strengthening? I'm not sure I understand what you're asking... 'My theory', which is hardly my own theory but more a concept and principle thing based on anatomy and biomechanics utilized by many other folks, is to essentially add length/balance to the spine/body before worrying about strength discrepancies. So to your question on the biceps being stronger, we'll also assume it's shorter in relative length as well causing the elbow to chronically be flexed, I personally would lengthen the biceps to create balnced tension across the elbow joint.

What others have put forth, and what you commonly hear with a PT approach is to strengthen the "weak" muscles. What we're not understanding is that the "weak" muscles are weak for a very functional reason. So the question to ask ourselves is: Is strengthening the "weak" muscles beneficial or harmful, or inconsequential?

[RugbyLaura]

Hi Guys,

Does anyone here have anything to say regarding inversion tables? (see adolescent / other thread).

Thank you,

Laura

[Bish]

Well I am sure a couple of others will have something to say, but here is my two cents regarding inversion machines. I did have one but it was taking up too much space so I got rid of it.I still do have gravity boots but they are trickier. It gave me limited very temporary pain relief. The theory I have heard floating around as to why it would not be of value in a scoliosis patient, is that a patient with scoliosis generally will have a reduced natural sideways curvature (kyphosis and lordosis) due to (or maybe even a cause of) the lateral curvature in the spine. If the spines natural curvature is already reduced, how can agressive traction only positively effect the lateral curve and not the natural curve of the spine?This is the question. Also there appears to be little or no scientific evidence suggesting it can do anything in a scoliotic patient. Of course knowing that I tried it myself. Hahah.What the heck, go to the store and try it out in the showroom once a day for a week. See if you can get the salespeople all wound up. Best of luck. Bish

[RugbyLaura]

Thanks Bish, do you mind if I copy this onto the other thread?

Laura

[Rayknox]

structural,
I need to get you a copy of the reasoning behind the TAMARS treatment. It used to be on the web but I would need to search again for it. I do have hard copy and I can get that if need be. It makes much more sense than the PT approach about muscle imbalance etc. I am not going to start another war with other practitioners as that is all these forums seem to be, but you will find this approach very refreshing.
ray

[structural75]

Laura,
I would agree with Bish on the inversions table use. It will not only affect the lateral curvature (temporarily) but also the primary and secondary curves of the spine (kyphosis and lordosis). Some people have found it to be relieving of their discomforts temporarily and others not. People have to judge its benefit individually.

This is something to check with your doctor about if one were to think of using it as it should not be used by people with certain conditions that sometimes accompany scoliosis (chiari, etc.).

It may be useful for general decompression of the spine, specifically the assisted rehydration of the discs. But be aware that it is a general affect and that it may place strain on other regions of the spine/pelvis (sacroiliac joints/or hips, knees ankles.

It probably won't do anything in the long-run for the scoliosis, but for some it may help manage some degree of their pain they experience throughout the day. It could possibly also slow any degenerative disc scenarios, but of course that's hard to quantify as is most 'preventative' measures/disciplines.

Final thoughts, use with caution and individual discretion... inversion tables are not for everyone.

Hope that helps in some way.
structural

[gerbo]

my "feeling" is that loss of flexibility of the spine, which inevitably must be happening when scoliosis develops, is not a good thing and counterproductive and gentle stretching (by trained professionals I hasten to add) might just help the spine to respond better to the corrective forces provided by a brace. One wonders whether the mild (??) traction provided through an inversion table would have a similar beneficial effect. Traction before a brace is applied, to obtain optimum correction, is not an unusual practice, principle seems the same to me.

[structural75]

The effect of traction is reversed once we resume our normal upright stance in gravity. To have a positive long-term effect with or without bracing it would have to be utilized every day. And because it is a generalized approach, it difficult to predict or know whether the areas that need the lengthening are being targeted or if it is also lengthening the already overstretched areas. The latter is quite likely as those areas often prove to be less resistant to the stretching forces... the areas that need it most are often very stubborn and have developed a 'stronger' resistance/hold against such forces.

Scoliosis definitely can create a loss of flexibility... but I do feel that it isn't the overall flexibility that is of utmost importance but the mobility/flexibility/balance of tension between the left/right and fron/back, etc. ....There are specific regions that need to be brought into or toward relative balnce/length with the opposing overstretched regions.

Of course, all of this is also just a mechanical/static pitcure and approach... inversion tables that is. One must affect change in the nervous systems function through active movement to re-educate the sysytem and develop new firing patterns and such. If you simply invert on a table you're doing nothing to achieve this... It is also limited in that we don't function, neurologically speaking, upside down... so there's no proprioceptive benefit from being invertd that can be transfered to standing on our feet in the upright position, orienting to gravity neurologically.

I think the computerized traction tables (horizontal) would provide the most benefit because the forces involved are monitored very specifically. Whereas the force provided on an inversion table is essentially ones body weight and traction is occuring from the ankles on up... vs. the traction tables which have one strapped in at the pelvis and particular points around the torso, which enable it to limit the traction effect to the spine alone.

Just my thoughts...
structural

[gerbo]

I am sure Structural that you agree that one approach doesn't exclude the other. Personally I believe that where it might well be the kind of factors which you describe which play a big part in the development of scoliosis, but by the time the scoliosis has become apparant and noticable it could well be that it is very localised and maybe even pure mechanical factors which prevent the spine from straightening again, even resisting the rather brute force of a brace. I am quite sure (but anybody, feel free to correct me)that spinal surgeons need to cut some of the connective tissue/ ligaments surrounding the spine prior to inserting metalwork, in order to straighten the spine out enough. I'd imagine that similar structures could well be preventing the spine from straightening through conservative means, and what follows would be that active attempts to increase the flexibility of the structures involved must be beneficial, if only to give the balancing out/ neurological reprogramming you advocate, a chance to succeed. The consensus seems to be; the more flexible the spine, the more chance there is that any given treatment will be succesful, ergo; increasing flexibility must be a valid part of treatment.

with regards to the inversiontable, and this is me arguing purely theoretically, if traction is considered beneficial, and considering we do not all have access to computerised traction tables; it might just provide us with an easily available and applicable "do it yourself" version.

anyway, our new osteopath will discuss this with some of her "seniors" (professors from osteopath-school), I'll be awaiting her opinion with interest

(structural; aren't we having a lovely civilised discussion ;) ;) )

[structural75]

Gerbo,
Indeed we are. ;)

I think I'm in agreeance with you here Gerbo... I didn't mean for my previous post to suggest that inversion tables had no benefit.. in fact I'm pretty certain I didn't suggest that. I was only pointing out some of the 'finer' points of its use, to suggest that it is not applicable to everyone, and of course, effects will vary from one person to the next.

I only mentioned the computerized version as it is much more precise and controlable. I have no biased on which one someone uses (obviously the computerized table treatment is administered by a doctor, not something you buy for home use).
Personally I believe that where it might well be the kind of factors which you describe which play a big part in the development of scoliosis, but by the time the scoliosis has become apparant and noticable it could well be that it is very localised and maybe even pure mechanical factors which prevent the spine from straightening again, even resisting the rather brute force of a brace.With you completely on that Gerbo. That was what I was getting at by commenting on the "specific" areas of restriction. The more specific one can be at freeing these regions up, the more likely the success of treatments being utilized. The neurologic component that I was "advocating" had to do with micromovements while these regions were being 'freed, lengthened, stretched'... activating/de-activating regions neurologically while you're encouraging effects... through whatever means. So I agree 100%, flexibility is of utmost importance in any treatment, and the more precisely you can work with the flexibility of specific regions the better. :)

[gerbo]

you should have said that in the first place :D

oh no, agreement reached, no more heated discussions, no more arguments, no more fights, what will become of us?? :D :D

[RugbyLaura]

Surely this must mean that rigid bracing is anti-productive? :eek:

Nice to see everyone getting on so well. Hopefully this will continue even when you next disagree :p

Laura

[gerbo]

i think it means that rigid bracing is likely to be more effective if attention is paid to these factors and that active measures are taken to maintain/ increase flexibility and musclestrength and coordination. Just bracing and nothing else (as seems to be common practice in the UK) is less likely to be effective.

[Rayknox]

structural
quote
'The more specific one can be at freeing these regions up, the more likely the success of treatments being utilized. The neurologic component that I was "advocating" had to do with micromovements while these regions were being 'freed, lengthened, stretched'... activating/de-activating regions neurologically while you're encouraging effects... through whatever means. So I agree 100%, flexibility is of utmost importance in any treatment, and the more precisely you can work with the flexibility of specific regions the better.'


You are describing TAMARS treatment.!!

[gerbo]

note to myself; ask "our" osteopath what she knows about TAMARS.