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stephanieC
10-28-2007, 08:05 AM
Hi all,

I have been all around this forum reading up on many things. Very informative and interesting. :) I have noticed in some areas the talk of a secondary curve created after bracing. Is this common? Does it happen only with spine cor or has it happened with the hard braces too? What about the vertebral stapling procedure? Is a possibility or a liklihood?

Also, what is meant by "structural" curve as opposed to "functional" curve? And why would a secondary curve be considered not important? I think I read that somewhere.

Lots of questions, what can I say, I'm new to this. :o

Stephanie
Daughter, Michela, at 26 degrees. Currently waiting for appointments to consult on spinecor and VBS.(both appointments are this week.)

Celia
10-28-2007, 10:26 PM
Stephanie,

Since you have an appointment with two orthopaedic doctors this coming week, I'm sure they'll give you an accurate description but since you asked... When a child is diagnosed with scoliosis, usually a single curve is visible on the radiograph. Double major curves are rare. Single curves are common with very young children and as they get older, a secondary curve develops as the body tries to stay balanced and this secondary curve is called a compensatory curve. Usually it's flexible and will fully correct on a side bending x-ray. However with time a compensatory curve can become fixed because the vertebrae undergo morphological and structural changes becoming irreversible if there is little growth left. I haven't come across too many people who have worn the Spinecor brace so I can't comment on the statement that children who wear the Spinecor brace develop secondary curves. In my own daughter's particular case, I believe what happened was a shoulder tilt which wasn't even prescribed for her curve classification caused a kink to develop in the neck area. Anyway... that's a different story.

This whole thing is about balance and any doctor who scoffs at the idea of an elastic strap orthosis having any impact whatsoever on a scoliotic curve lacks a basic understanding of the importance/relevance of posture on scoliosis - particularly in the early stages when it is possible to reverse the deformity and structural damage to the vertebrae is minimal. The spinecor brace is ideal for small curves and children who wear it have virtually no restrictions whatsoever.

stephanieC
10-29-2007, 08:37 PM
Thanks Celia,
I did get that same answer from the ortho I saw today. She said Michela had a T9-L2 26 degree curve with a T2 -T8 compensatory curve. She recommended bracing. She said to take Michela to the orthotist and let her see the different options available to her and choose herself what best works, as compliance would be better this way. Spine cor will be one of her choices. I had already spoken with the orthotists office so I know that he has done some spine cor before and is very familiar with the Docs. in Montreal.


I was a bit uncomfortable with the fact that the Dr. did not seem to feel one brace was better than the other. This bothered me because the philosophy between the different braces is fairly significant. I am sure that if we brace, it will be spine cor. I agree with the philosophy behind that brace and it seems like the most "livable", but I will let my daughter explore a bit and hear what she has to say on the subject.

Interesting was this doctors opinion of vestibular testing. She believed it to be a good idea with juvenile onset scoliosis. I actually took Michela to a "screening" for vestibular imbalance today at a physical therapy facility. She was a positive for "some" signs. Interesting to me, I will investigate this more. Anyone familiar??

My second daughter, Shannon, had an x ray done for evaluation. She is 7 and has some rib prominance on the left side. Her spine is perfectly straight!!! :) :) She only has a small pelvic rotation that at this point, according to the doctor, is not significant for anything. Shannon will get a follow up x ray in 6 months.

This doctor did not have much to say on the topic of vertebral stapling, as she has not had any real experience with it. She did say however, not to rush into surgery, at least until I am sure the scoliosis will progress. Then I asked her the liklihood of it progressing...she said highly likely....go figure :(

It looks like only Michela will go to Shriners on Friday for a consult for the stapling procedure.

Anyway, that's where we are at today.
Stephanie

rtremb
10-29-2007, 10:23 PM
I may be wrong but I am under the impression the only brace available which can actually permanently reduce curves is the Spinecor. It works best on smaller curves. The hard braces hold curves where they are and after discontinuance of wear the curves return to the pre-braced level. Is this right Celia? Also the Spinecor does not cause muscle atrophy which is a high possibility with hard bracing.
In reading about scoliosis some state that pelvic rotation (or pelvic tilt) is one cause of scoliosis - I wonder if there is a way to work on that now for Shannon with something like physiotherapy or exercise or yoga before curves might develop?
Ruth

Celia
10-30-2007, 07:42 AM
When I was researching which brace to go with that's exactly what I read. I'm not sure about the Cheneau brace combined with physiotherapy and what the long term results are and I'm sure there are a few exceptions with rigid bracing when children are braced early on and not when the curve is in the advanced stages. For the majority of cases I think the best that can be hoped for with rigid bracing is to maintain the curve at pre-brace levels, not to mention a lot of the negatives associated with rigid bracing i.e., rib cage compression, muscle atrophy etc. etc..... It was really difficult for me not to want to go with the Spinecor brace after reading that some children were completely cured of their scoliosis after two years of wearing the brace. How could I not want that for my own child????

WNCmom
10-30-2007, 09:08 AM
I just want to add that the pelvic issue is what we've run into as well. We just started some serious message therapy for Sidney with a therapist who has worked on both my husband and me (we feel she is a true healer) and she is doing myofascial (sorry--I don't know how to spell it) release on him. She says the pelvis is a huge issue in scoliosis and this will help his muscles allow his spine to get back to a better position. Right now, she says, his pelvis is really out of whack. I know I'm not explaining this well, but it makes so much sense to us. This is not Rolfing, but I think it is related. If his muscles are tightly holding everything in place, the brace will not work as well, we believe. My husband was present during the session yesterday and with my son lying on his stomach, he could see with his untrained eye how much Sidney's pelvis shifted during the body work.

structural75
10-30-2007, 08:42 PM
WNCmom,

Yes, myofascial (and other fascia - ligaments, joint capsules, etc.) work is a technique derived from the larger, more complex forms of work of Osteopathy and Structural Integration (a.k.a. -Rolfing). The latter two disciplines work with a global premise and understanding of human structure, form and physiology, and a variety of other forms of fascia in addition to the muscular fascia.

Yes, the pelvis will almost certainly be deviant from it's normal positioning either as a result of the scoliosis or a possible contributer to it in some cases... Which would usually coincide with a structural leg length discrepancy if it were causal. Freeing up the pelvis to adapt to the straightening of the curve (the intention of the brace) is imperative for optimal results/effect. The legs play an important role in this as well, considering that the soft tissue/fascia of the leg is attaching to the pelvis from below. Therefore the whole body is involved in scoliosis, it's not just a condition involving the spine, ...it never is. I think it's great that your massage therapist is using myofascial work to address the pelvis as well... All too often we only hear about scoliosis treatment involving work with the spine... a major flaw in treatments.

It is the fascial network (including myofascial, or muscular fascia as it refers) that ends up committing the bones to the scoliotic whole body pattern. To change the pattern, if it is possible in each case, the fascial network must be addressed because that is what is committing the body to the pattern. (barring neurologic deficits or bony malformations as a primary cause of course)

structural

WNCmom
10-31-2007, 08:49 AM
I appreciate the detailed explanation, Structural. I only hope that in my 12-year-old son's case, it is possible to affect the pattern he's in with such advanced curves. We shall see--we plan to see her weekly. She also gave him a few simple exercises to do daily to support what she does. I think she'll also be working with his legs.

You seem to be very familiar with MFR. The treatment was on Monday and on Tuesday Sidney (who tends toward the melancholic) said he was in a really great mood--so good that he was worried it would go away. I have a friend who told me that MFR gives her a feeling of psychological release as well as physical, so I'm wondering--could the MFR be at least part of why Sidney was feeling so good? Any experience with this?

structural75
10-31-2007, 10:08 AM
WCNmom,
Sorry this one's so long... :o
Yes, absolutely... This is not uncommon with many forms of bodywork but in particular with fascial/myofascial work because it is literally changing the body's function, balance and alignment... which translates to greater ease in movement, less stress physically and psychologically and improved sense of well-being. I thank you for mentioning this because so many children with scoliosis battle with underlaying psychological issues, especially when having to wear a brace (which is necessary). It can do a great deal for them on the psychological level alone that more 'mechanical' methods don't address or acknowledge.

Relaxing muscles as in massage therapy is a good start but muscles develop high tonus and tension as a functional response to the orientation of the whole structure and various primary and compensatory patterns that arise from injury, illness, occupational strains, postural habits, etc.. So the relaxation response will only last for so long until the system re-asserts it to function as best it can again. This is why massage tends to be needed on a regular basis for relief.

MFR is a step in the right direction as far as changing those imbalances, but in and of itself it is not a whole systems approach whereby practitioners are taught how to 'see' and distinguish those imbalances... it's just a soft tissue technique... Therefore 'where' it's used is in the body, and 'when', is far more important than the technique itself. I think your current MFR can be of good use for your son... I would continue with it as long as he's benefiting from the work on any level. If you were to want to address his pattern/curve/etc more specifically I would encourage going to an SI practitioner who is specifically trained to address structural patterns. They'll know precisely where and how to go about working with it to achieve the best 'possible' results.

This effect you described is true in MFR and especially with whole system approaches such as Rolfing/Structural Integration. I thought you might find this summation of research on Rolfing/SI interesting as it pertains to the psychological aspect of change.... MFR can certainly have the same effect because it is similar in terms of technique, accept that it doesn't aim to balance the structure as a whole in relation to gravity or have the overall premise and principles of such to guide it. ...It searches for 'tight' fascia and releases it. It is a technique, rather than a technique with guiding principles for intervention. Valuable none-the-less!

Positive Psychological changes

* Beryl Jolley (1960) ascertained that certain positive psychological effects could be attributed to Rolfing. His findings indicate a more positive attitude, improved social intelligence, improved form perception, and fewer psycho-somatic complaints.
* Doris Davis (1969) postulates that Rolfing effects certain aspects of the body along with certain of the corresponding body image of subjects taking part in a Rolfing class. Davis concluded for her group that Rolfing "produced measurable changes in the physical structure, behavior, and subjective self-perception for all of the nine models studied."
* Julian Silverman (1973) gathered subjective personality data using the Welsh Anxiety scale, which indicated a decrease in anxiety after Rolfing, particularly in demonstrating the integral relationship between the human organismís sensory and muscular systems.
* Robert Lieber (1974) attempted to evaluate the possible relationship between changes in self-esteem and self-concept with changes in postural alignment as a result of Rolfing. Lieberís findings indicate that as a result of Rolfing there was a definite postural change, and this related to changes in self-esteem and self-assurance.
* Norman Beckett (1974) conducted a study on the psychotherapeutic value of Rolfing. He concludes "that measurable psychotherapeutic benefit does result from Rolfing, particularly in the personality variables measuring self-perception and self-awareness."
* Long (1976) investigated changes in body image between a group of Rolfed persons and a group of persons participating in Gestalt therapy, type of psychotherapy. His findings indicate that the Rolfed group produced more measurable change in body perception and overall psychological sense.
* Richard Wandler (1972) gave a personal account of how Rolfing affected three children classified as "autistic." He reported that the children showed a great deal of improvement and maturation from the process.

Rolfing Children

Three year pilot study in Philadelphia, PA conducted by a group of Rolfers led by Robert Toporek, 1978; monograph "The Promise of Rolfing Children" reported on this study published in 1981. Each child's photograph before Session 1 and after Session 10 and some two and three years later were shown. A summary of results gathered from interviewing the parents and Rolfer's comments documented the changes. Result: This pilot study with children demonstrated that:

* Dramatic improvement in the childrenís physical, psychological and behavioral patterns had occurred.
* Consistently parents reported the children had increased confidence, better verbal expression, more self-control and less destructive behavior.
* Rolfing is an effective means to address conditions such as cerebral palsy or scoliosis.







Research Review
University of California Los Angeles

Dr. Valerie Hunt, director of the Movement Behavior Laboratory at UCLA and Dr. Julian Silverman, Research Specialist of the California Department of Mental Hygiene, tested subjects before and after Rolfing for changes in neurological control of the muscles, for variation in responses to stimuli and for biochemical changes. They stated that after Rolfing "carriage was more erect and with less obvious strain to maintain held positions" and that Rolfing also "Creates a more efficient use of muscles, allows the body to conserve energy, and creates economical and refined patterns of movement."

At the UCLA Department of Kinesiology a five year study was conducted again by Dr. Valerie Hunt and colleague Dr. Wayne Massey; "A Study of Structural Integration from Neuromuscular, Energy Field and Emotional Approaches" completed in 1977. There were measurements before and after Rolfing of anxiety states, brain hemisphere activity, energy field photography, DC recordings of energy flow in electrical voltage readings, EMG recordings from sixteen separate muscles, electromyograms of neuromuscular patterning of energy, and electronic auric field study. This study produced many results, difficult to summarize adequately in a brief statement. These are a few of its findings:

* Evidence of changes in ways of processing data and the nature of thought processes that ensue
* Emotional calmness; decrease in anxiety state
* Improved social interaction
* Feelings of well being
* Memory recall
* Enhanced ability to access different states of consciousness
* Increasing right hemisphere brain dominance when needed for right brain activity
* Greater physical skill
* Greater movement efficiency
* More energy; less fatigue
* Improved neuromuscular balance
* Greater energy flow and balance distribution of energy

University of Maryland

"Rolfing significantly reduces chronic tension, changes body structure and enhances neurological functioning."


Research conducted between 1962-1976

Physiological Changes

* Ida Rolf and R.G. Taylor (1962) conducted a study to determine the degree of metabolic changes which occur as a result of Rolfing. The conclusions drawn were that "all indices show consistent appropriate changes" and "an immediate and lasting shift in the homeostatic equilibrium" in both blood samples and the Cameron Heartometer measurements.
* Julian Silverman (1973) conducted a psycho-physiological study indicating significant differences in EEG response, which suggests "increased sensitivity and receptivity to environmental stimulation and significant increases in organization of the sensory information processing system."
* Roger Theis (1969) measured the vital capacity (of air) in persons being Rolfed. He found that some subjects increased their vital capacity by 33 to 66 percent over control values.


This site may give you a little better understanding of the realm your working in.

http://rolf.org/about/index.htm

structural

jillw
10-31-2007, 10:44 AM
Wow structural, that must have taken a long time to find and put all that information together. thanks.

structural75
10-31-2007, 10:57 AM
Jill,

Not a problem... You can find reviews of studies on SI/Rolfing already gathered together in several locations... just a couple of clicks.

WNCmom
10-31-2007, 11:35 AM
Ditto from me, Structural.

Just want to add one thing. In talking with our message therapist today (making the next appointment) and describing Sidney's improved mood, she mentioned that she was sure he is in pain, but given the time it has taken to develop scoliosis up to this point, he may not conciously notice it because he lives with it all the time. The MFR work done two days ago may be causing him to feel "better" ( more normal). Sidney has rarely complained about back pain; I had not thought he had any. Silly me! It's a relief to me to know that he is likely getting relief from MFR.

structural75
10-31-2007, 12:07 PM
WNCmom,

That's often the case for most of us, at some point in our lives or throughout, especially with highly physical stresses of scoliosis. We all build some degree of tolerance to pain or distress gradually over time. It often happens so slowly that it goes under our 'radar' and becomes a part of our natural physical identity... In other words, we perceive our physical state, even with discomforts, as the 'norm'... and it isn't until a different state of being is felt that we recognize the point we had reached and level of discomfort we were in, primarily because we had nothing 'better' to compare/contrast it to.

Your son's lucky to have parents who are open to providing him with something like that. I'm sure it helps him on many levels.

structural