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  1. #1
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    Is Physical Therapy Effective?

    I have received physical therapy over the years for my scoliosis. One surgeon I consulted says physical therapy is ineffective.

    Does anybody have comment about this? Can physical therapy be a cure? Can it stave off further curvature indefinitely?
    Last edited by Tina_R; 12-08-2019 at 11:27 AM.

  2. #2
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    Quote Originally Posted by Tina_R View Post
    I have received physical therapy over the years for my scoliosis. One surgeon I consulted says physical therapy is ineffective.

    Does anybody have comment about this? Can physical therapy be a cure? Can it stave off further curvature indefinitely?
    Physical therapy seems to work in some cases for pain but has never been rigorously shown to stop progression permanently. Because some curves stop on their own even at a high degree of curvature, it is going to very hard to show PT stops progression. That doesn't mean it hasn't stopped progression in certain individuals. It just means it is hard to show.

    A yoga woman (Linda or Ed will remember her name) claims yoga stabilized her curve but I don't think she has ever ponied up serial radiographs to prove that. Also a physiatrist published a paper about a specific yoga move (side plank IIRC) decreasing curves but was not clearly written in my opinion. Any decreases in curves thru PT is going to be dependent on continually doing the PT.

    Another woman, a plant pathologist named Martha Hawes, who appears to have had JIS managed over YEARS to decrease her T curve a bit. In my opinion, the breathing exercises she did to expand her rib cage was what drive her spine a little straighter as opposed to anything else she tried and she tried A LOT. She was posting updates every 5 years for a while but has since stopped doing that. Not sure why.

    I hope Linda and Ed comment.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  3. #3
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    I'm a strong believer in PT for pain control, especially in terms of core strengthening to reduce or eliminate low back pain.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  4. #4
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    Quote Originally Posted by Pooka1 View Post
    Physical therapy seems to work in some cases for pain but has never been rigorously shown to stop progression permanently. Because some curves stop on their own even at a high degree of curvature, it is going to very hard to show PT stops progression. That doesn't mean it hasn't stopped progression in certain individuals. It just means it is hard to show.

    A yoga woman (Linda or Ed will remember her name) claims yoga stabilized her curve but I don't think she has ever ponied up serial radiographs to prove that. Also a physiatrist published a paper about a specific yoga move (side plank IIRC) decreasing curves but was not clearly written in my opinion. Any decreases in curves thru PT is going to be dependent on continually doing the PT.

    Another woman, a plant pathologist named Martha Hawes, who appears to have had JIS managed over YEARS to decrease her T curve a bit. In my opinion, the breathing exercises she did to expand her rib cage was what drive her spine a little straighter as opposed to anything else she tried and she tried A LOT. She was posting updates every 5 years for a while but has since stopped doing that. Not sure why.

    I hope Linda and Ed comment.
    "Because some curves stop on their own even at a high degree of curvature, it is going to very hard to show PT stops progression. That doesn't mean it hasn't stopped progression in certain individuals. It just means it is hard to show."

    This tells me that most of the time it can be seen that PT does NOT halt progression.

    Why aren't there more rigorous studies? I don't understand the science being satisfied with sloppy papers. If there is a hint that some PT might work, why aren't they trying to find out what works and what doesn't and documenting it? There are probably a lot of people who don't want surgery who would volunteer for studies.

    "Any decreases in curves thru PT is going to be dependent on continually doing the PT."

    Isn't that the definition of a cure? If you removed the rods from your fused spine, wouldn't curvature return as well? In both cases the spine still wants to curve, but something is counteracting it. In my case it was probably stronger, tighter muscles pulling against the curve.
    Last edited by Tina_R; 12-09-2019 at 04:41 PM.

  5. #5
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    Quote Originally Posted by Tina_R View Post
    Why aren't there more rigorous studies? I don't understand the science being satisfied with sloppy papers. If there is a hint that some PT might work, why aren't they trying to find out what works and what doesn't and documenting it? There are probably a lot of people who don't want surgery who would volunteer for studies.
    Two reasons in my opinion...

    1. PT outfits like Schroth are already raking in so much dough that they don't need evidence. They just rely on a large number of people who will try anything to avoid surgery damn the lack of evidence.

    2. There is nobody who would want to fund this research. The Schroth people have been experimenting on thousands of people without telling them that is what they are doing. Schroth's grandson, an orthopedic surgeon, tried for 10 years on about 30,000 people to show it worked. It didn't and he gave up and now uses bracing exclusively in kids. In adults, I don't know if he is still pushing Schroth for anything except pain. Very rarely researchers have gotten small funding to study things like torso rotation. But those were small studies and one researcher, now deceased actually double published some data seemingly to make it look like there was more data than there is. To date, only 35 people by 2 researchers have been studied who were using torso rotation.

    "Any decreases in curves thru PT is going to be dependent on continually doing the PT."

    Isn't that the definition of a cure? If you removed the rods from your fused spine, wouldn't curvature return as well? In both cases the spine still wants to curve, but something is counteracting it. In my case it was probably stronger, tighter muscles pulling against the curve.
    The point is rods are not usually removed and it is very hard to do PT the rest of your life as you yourself experienced. Illnesses alone might prevent it.

    You probably did get some straightening if your curve was not stiff that was completely done through building up muscle. But muscle can never straighten the structural component of the curve.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  6. #6
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    Quote Originally Posted by Tina_R View Post

    Isn't that the definition of a cure? If you removed the rods from your fused spine, wouldn't curvature return as well? In both cases the spine still wants to curve, but something is counteracting it. In my case it was probably stronger, tighter muscles pulling against the curve.
    I'm just curious, but my understanding is that once the spine is actually fused (not the operation; when the bone actually forms where the discs used to be), it's not likely to curve again -- it's just one long bone at that point. They leave the rods in because there isn't any reason to do surgery to take them out, not because they're needed to keep the fused portion straight or anything.

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    Quote Originally Posted by Concerneddad View Post
    I'm just curious, but my understanding is that once the spine is actually fused (not the operation; when the bone actually forms where the discs used to be), it's not likely to curve again -- it's just one long bone at that point. They leave the rods in because there isn't any reason to do surgery to take them out, not because they're needed to keep the fused portion straight or anything.
    That is generally true for the most part but there have been a few studies of what happens if the rods are removed. There is some loss of correction, mainly in the transverse plane (rotation) if I recall correctly. But this is not in the same category as the complete loss of correction due to stopping PT.

    I consider fusion a cure because of this. PT is no cure because it is virtually impossible to maintain despite motivation to do so due to things like illness.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  8. #8
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    Quote Originally Posted by Pooka1 View Post
    That is generally true for the most part but there have been a few studies of what happens if the rods are removed. There is some loss of correction, mainly in the transverse plane (rotation) if I recall correctly. But this is not in the same category as the complete loss of correction due to stopping PT.

    I consider fusion a cure because of this. PT is no cure because it is virtually impossible to maintain despite motivation to do so due to things like illness.
    I was wondering about rods being removed. There are conflicting things written about it. I have heard that they are only important until the spine fuses and not needed after that. Then I have heard the opposite.

    If I knew all the things about fusion that I know now, first hand and from reading, I would be so motivated I would gladly do PT for the rest of my life if it helped. A few days of typical illnesses like the flu wouldn't stop me. If I was unmotivated then it was because, as I said, I did not see the gravity of the situation, how relentless scoliosis is and how bad it can get.

    PT is not a cure at present, no, because it hasn't really been studied as a cure rather than a mere pain reliever.

    Fusion is the best thing they have so far, but the "cure" is almost worse than the disease for some people. Pain, numbness. Degenerative disease in adjacent segments. Loss of flexibility forever. Maybe I'll feel differently when I recover, IF I ever suitably recover.
    Last edited by Tina_R; 12-10-2019 at 05:31 PM.

  9. #9
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    Pt

    Quote Originally Posted by Tina_R View Post
    I have received physical therapy over the years for my scoliosis. One surgeon I consulted says physical therapy is ineffective.

    Does anybody have comment about this? Can physical therapy be a cure? Can it stave off further curvature indefinitely?
    I was told by Dr Gupta to do PT to strengthen core etc. Canít really comment about curvature but over the years was told to do PT. This year it helped me to a certain level then pain continued afterwards so much that I am now only going to pool. I donít know how much of the pain is from Scoliosis or the arthritic condition of my spine. Even doing exercises in pool increases pain.

  10. #10
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    I have been prescribed PT over the years. It was probably to relieve pain but with one therapist the exercises appeared to do more than that.

    My primary curve is down low, making one hip visibly higher than the other. One therapist gave me exercises that were asymmetrical - they acted on muscles on one side of the body and not the other. Strengthening and stretching them.

    (Is this what most people get when they get PT for scoliosis? It makes sense because our spines are asymmetrical.)

    Several weeks in I was with my therapist and looked in the mirror. I was astonished to see that my hips looked much more even, almost level. I pointed this out to her and she sounded glad and a bit surprised.

    I didn't appreciate the gravity of my situation then. On my own I got complacent and stopped doing the exercises then forgot how to do them. The curvature returned, I don't remember how fast. Then it got worse. Years have passed, the therapist is long departed, no good records were kept to document her full name and what exercises she prescribed.

    I can't help wondering if I had I continued exercising, could I have kept my scoliosis at bay and avoided surgery?

    I am not encouraging anyone to expect their curvature to be straightened solely by physical therapy. None of my other physical therapists had similar success with me. But I don't think what I saw in that mirror was my imagination.
    Last edited by Tina_R; 12-09-2019 at 04:24 PM.

  11. #11
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    Quote Originally Posted by Tina_R View Post
    I have been prescribed PT over the years. It was probably to relieve pain but with one therapist the exercises appeared to do more than that.

    My primary curve is down low, making one hip visibly higher than the other. One therapist gave me exercises that were asymmetrical - they acted on muscles on one side of the body and not the other. Strengthening and stretching them.

    (Is this what most people get when they get PT for scoliosis? It makes sense because our spines are asymmetrical.)

    Several weeks in I was with my therapist and looked in the mirror. I was astonished to see that my hips looked much more even, almost level. I pointed this out to her and she sounded glad and a bit surprised.

    I didn't appreciate the gravity of my situation then. On my own I got complacent and stopped doing the exercises then forgot how to do them. The curvature returned, I don't remember how fast. Then it got worse. Years have passed, the therapist is long departed, no good records were kept to document her full name and what exercises she prescribed.

    I can't help wondering if I had I continued exercising, could I have kept my scoliosis at bay and avoided surgery?

    I am not encouraging anyone to expect their curvature to be straightened solely by physical therapy. None of my other physical therapists had similar success with me. But I don't think what I saw in that mirror was my imagination.
    It's unlikely that PT actually changed your scoliosis curve(s). What most likely happened is that your pain was causing you to carry the soft tissue of your hips unevenly. PT exercises can (and should) fix the soft tissue problem.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  12. #12
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    Quote Originally Posted by LindaRacine View Post
    It's unlikely that PT actually changed your scoliosis curve(s). What most likely happened is that your pain was causing you to carry the soft tissue of your hips unevenly. PT exercises can (and should) fix the soft tissue problem.

    --Linda
    Well, it wasn't the soft tissue I noticed. The hip bones themselves were uneven, one higher than the other. I can't be sure that the spine itself relaxed its tight curvature, because I really couldn't see it, but I assumed so. It would have taken an x-ray to verify this.

    By soft tissue, do you include muscle? I suppose it's possible if muscles were larger and more developed on one side due to the exercises they could push a hip bone up or down. Without affecting the spine, maybe.

    I've never had what I would call real pain, more like extreme fatigue on one side, and only after walking.
    Last edited by Tina_R; 12-10-2019 at 02:46 PM.

  13. #13
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    Quote Originally Posted by Tina_R View Post
    Well, it wasn't the soft tissue I noticed. The hip bones themselves were uneven, one higher than the other. I can't be sure that the spine itself relaxed its tight curvature, because I really couldn't see it, but I assumed so. It would have taken an x-ray to verify this.

    By soft tissue, do you include muscle? I suppose it's possible if muscles were larger and more developed on one side due to the exercises they could push a hip bone up or down. Without affecting the spine, maybe.

    I've never had what I would call real pain, more like extreme fatigue on one side, and only after walking.
    Yes, soft tissue includes muscle.

    If a hip is high, it can be because of a spine curvature, leg length discrepancy, or because your musculature is protecting a painful area. If you stretch and release the soft tissue, it can cause the high hip to drop. Massage can do the same thing. Remodeling of the actual bone, if even possible, would probably take years.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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