torso rotation exercises

[Jinseeker]

Sorry, but i do not see an attachment or text from your post gerbo.

[Celia]

Do you mean the Vert Mooney article ? If so here is a link. It's the 4th article from the bottom on the left hand side of the page entitled: "The Role of Measured Resistance Exercises......."


http://www.corespinalfitness.com/research/index.php

[gerbo]

Sorry, but i do not see an attachment or text from your post gerbo.

or take this route;

go to www.medxonline.com , > medical rehab equipment >research articles> "role of measured resistance exercises in idiopathic scoliosis".

does that work for you?

[Sherie]

to me it is quite clear that it is rotation towards the concave side, which usus paraspinal muscles on concave side, which is weaker.

This may be obvious to everyone else, but I want to make sure I'm understanding this. Which curve are we talking about here? Without having done these exercises, I don't know what area these exercises target.

if you cannot find the specific medx equipment close to wear you live, try to find a gym with a torsotwist or torsorotation machine of any make, that better then nothing i think. Homeexercises are a nonstarter in my opinion as they are unlikely to target the right type of muscles as precise as the equipment does.

Have you ever looked into buying a torsotwist machine for your home? I've seen them on the internet but didn't know if these would function the same way.

One more question to you Gerbo (I ask you because you seem to have done all your homework ), my daughter has a classic s-curve (right thoracic, left lumbar). She is interested in playing tennis in high school. Being a right handed player, I think this will cause her right thoracic curve to worsen based on the discussions we have been having about the concave side being the weaker side and vice versa. Does this sound logical to you? I don't want to discourage her from playing therefor I think she needs to do some strength training on the left side to compensate. If the torso rotation is for lumbar curve, which is what i think it's for, do you know of any machines for the spinal muscles in the thoracic area? This has been worrying me for a while and I haven't been encouraging her to play because of this but I haven't told her not to either. Thanks.

[gerbo]

This may be obvious to everyone else, but I want to make sure I'm understanding this. Which curve are we talking about here? Without having done these exercises, I don't know what area these exercises target.

A disclaimer first, I am only doing these exercises because i believe, on the evidence available, that they will help my daughter, and none of the information which i think is relevant in our situation might apply to other people

Now the question; my daughter only has one (thoracal) curve so i have never have to think about double curves, and how this applies to them. However, i assume that in double curves it must be possible to identify what the primary curve is, and which one is a secundary. That being the case i would assume you want to target the primary curve as much as possible.

if you look at the article you'll see that he used this on patients with curves on all different levels

From my understanding and observations, the twisting movement of the torso uses amongst others the paraspinal muscles well up to at least mid thorax level, not so much the lower lumbar muscles. For these vert mooney used another set of exercises using a "roman chair", basically a backextension machine

Have you ever looked into buying a torsotwist machine for your home? I've seen them on the internet but didn't know if these would function the same way.

i did look but couldn't find any.

My main concern is that the experiment was done on a specific make; i.e the "MedX". This one is not available in the UK. Looking at pictures of the equipment used i gathered that it wasn't much different from other makes, but corresponding with the medx firm, i was told that specific for the medx is that it fixes the pelvis when doing the exercise. Other makes do not do this, you are just sitting on a seat without pelvis fixation when doing the twisting movement. It did appear to me that the fixing of the pelvis is important to ensure that as much as possibler the target muscles are used to provide the twisting movement. I do this by holding her pelvis with my hands and indeed it was notice how specially in the beginning the pelvis tried to twist and thereby distort the required movement.

The other problem is that most eqipment is designed for adults and even the unweighted resistance was initially very difficult to cope with for my daughter. However it was obvious at the beginning that turning to the concave side required much more effort and was much more difficult for her. She has now "caught up" and can go either way with equal effort required, which makes me believe we have at least balanced out the muscles, and so taken away one factor that could have a deteriorating effect on the curve.

Being a right handed player, I think this will cause her right thoracic curve to worsen based on the discussions we have been having about the concave side being the weaker side and vice versa. Does this sound logical to you? I don't want to discourage her from playing therefor I think she needs to do some strength training on the left side to compensate. If the torso rotation is for lumbar curve, which is what i think it's for, do you know of any machines for the spinal muscles in the thoracic area?

tough one, yes logically one would think that right handed players could make their right sided thoracal curve worse, i think there is something about that in the introduction to the article

as indicated, torsorotation definitely does not tartget mainly the lumbar curve, more the higher lumbar/ mid thoracic level. We actually have also added a "seated row" to the routine, which targets muscles higher up.

lots to it as you can see, and once again, you have to work out what you think is best for your daughter, "don't take my word for anything".

Still I did have quite authorative advice that any exercise could only be good and the beauty of the torsorotation is that is is very well controlled and it is symmetric, so you avoid predominant use of the already stronger side which i would think tends to happen in less focussed "general" exercise

[Sherie]

Gerbo,

Thanks for taking the time to reply to my posts, seems that you're the only one trying this out so your experience is invaluable. I agree that correcting the imbalances in the muscles can only be beneficial in stabilising the curve.
I think I'll look into hiring a personal trainer to help us develop a program for her based on these discussions.

Sherie

[Sherie]

more contradictions


I casually mentioned to Sheena's chiro. yesterday that I might find a personal trainer for her, he nearly blew a fuse. He has a legitimate concern that the exercises won't be done properly and may adversely affect her. I agreed and asked for suggestions, he reluctantly agreed to put together some exercises she could safely do (we'll wait and see). But what I'm really confused about is that he said in her lumbar curve the weaker muscles are on the convex side??? He said the paraspinal muscle is stretched out on the convex side and pulled tight on the concave side (this goes along with the Schroth article I mentioned earlier). I need to get a book on muscles, I think we may be discussing 2 different sets of muscles, some that run parallel with the spine, therefore would be stretched on the convex side and another set that is perpendicular to the spine which would be tight on the convex side. Does anyone know if this is true? I guess that is why it's safer to do the exercises to both sides. I also read Mooney's article thoroughly and he said the in the 2 patients with an S-curve, the concave side of the lumbar curve was weaker and thus, the convex side of the thoracic curve was also weaker (basically the whole right side of the torso), completely contradictory to what the chiro. says.
Her chiro is very knowledgable about scoliosis and he did perform some muscle testing on her, so I have to believe what he's saying is correct.
If I can get the exercises from him, I will pass them along and we can see how they compare to Mooney's program.
I also discussed the tennis dilemma with him, he agreed that it could aggravate the thoracic curve but is going to think about it and get back to me. I'm not sure I want her to play now anyways (Dr. Mooney did make a reference to it in his article).
Anyone else as confused as me?

[Celia]

I think the chiropractor is confused, but don't let that sway you

[gerbo]

I agree that the situation with regards to muscle strength is confusing, the beauty of the torsorotation exercises is that these are symmetrical exercises, which means that you are not going to overtrain one side over the other. What you might find out that initially it takes more effort to turn towards one side (in our case the concave) which must mean the required muscles must be weaker. Inherently, even with simetrical exercises those concave muscles had to work harder, were therefor trained harder and eventually caught up with the strength of turning towards the convex side (actually, we cheated and did initially twice as much towards the concave side to allow that side to catch up quicker)

I do not think anybody has ever measured strength differences between both sides (now there is a nice little project) but emg differences have been well established (but does higher emg amplitude means higher strength??) and also interestingly there are biopsy studies which have established that muscle fibres on the concave side are different than those on the convexside (relatively more quick firing but easier exhausted type on the concave side)

interesting as well, these emg differences are associated with progression of scoliosis, i.e. in stable scoliosis they are not present. Now, whether they therefor occur as a consequence of the worsening scoliosis or are actually a contributing factor is the 10- million dollar question. To me it seems clear; if you can stop progression by dealing with emg diffences; they must be a contributory factor.

and yes, i do think we might be talking about different sets of muscles; where i can imagine that the small ones, running between the vertebrae, or close to them, might get stretched, I cannot imagine that this would apply to the much larger postural muscles, not running directly close to the spine, but much more important to posture control

i agree that exercises do need to be done careful ,and i asked mine and other orthopaedic surgeons for advice, and the general opinion was "it could not do any harm"

Ask your chiropracter (or maybe not) how does the published evidence of his methods compare to the published evidence re torso rotation??

I am getting carried away here, so leave it at this, hopefully you can make some sense out of it

gerbo

[Sherie]

I've been thinking on this all week, read a few more articles (one of them substantiated my Chiro's point of view) and have been wondering what to do. It makes sense that if you can't perform as well on one side as you can on the other, that it's obviously the weaker side. Common sense, I like that! So I think you're right, Gerbo, any exercise is probably going to be good especially if it's done symmetrically. Sheena's not very athletic (very artistic) so I'm certain it's better than sitting all day doing nothing. Now, when will they invent home equipment especially for the scoliotic? Wouldn't that be great! Thanks again for your input, I appreciate that you've taken the time to really educate yourself and actually are doing these things and not just talking (like me) . I'm going to keep pestering our dr. for the exercises he would recommend. Have a great day.
Sherie

[gerbo]

Now, when will they invent home equipment especially for the scoliotic

is there not a fairly local gym where you live with the right equipment?

I must say i would not trust a series of exercises developed by somebody who doesn't believe in the underlying principles.

I know of one other orthopedic surgeon who is working on torsorotation. He initially also had a hometreatment group working with elastic bands. This turned out not to work and currently he only uses proper torsorotation (resistance) equipment.

I am just saying, if you want any chance of succes, don't just go for any exercise, but try to mimic the approach in the article as close as possible.

best wishes

gerbo

[Sherie]

We got the exercises yesterday (surprise!). They are fairly easy, not very challenging, but designed for both curves. It's a series of exercises that are to be repeated 2x/day. Not too sure how effective they'll be, but there are some good stretches.
It's not that he doesn't believe in exercise, he doesn't want us pushing too fast, too hard. You would have to hear his whole philosophy to understand (it's way too much to get into). I don't necessarily agree with everything, but then again, I'm not an expert and have only been researching this for a few months. There are so many unknowns, I hate to admit it, but it's easy for dr's to play on our fears, fear that we won't do the right thing or that we do the wrong thing. I am waiting to see the proof in the pudding, if she achieves some correction and stabilizes, then we'll know something is working. If you've seen some of my other posts, you'll know that she is undergoing several types of therapies. They take approx. 2 hours, 3x/week that's why I'm reluctant to go to a gym because of the amount of time we are already spending away from home. Depending on how she progresses, we should be able to gradually cut back on the # of times we go over the next 6 months.

How often are you going to the gym and how long does it take? If I remember correctly, in Dr. Mooney's study, they were only going a few times a week for about 15 minutes? Is that sufficient? We could squeeze that in.
Thanks, Gerbo.

[gerbo]

cannot but agree that it all can get a bit too much with all the different things we are trying to do for our children. Clearly we all are trying so many different things because we are all desperate to "do something", and there is just nothing out there that we know will work for sure.

We eventually dropped the home exercises we had been given by a PT for this reason, it all became unmanageable for our daughter and we were worried that it would put her of altogether.

We are sticking to the torsorotation, cause at least it has a small evidence base, and also indeed as it doesn't take too much time, in our case about 30-45 minutes twice a week (could be less, but we have added a few exercises to the regime, one for shoulderblades as one was sticking out, and one for abdominals, as they were evidently very weak)

swimming is the other exercise we do, for general strength and flexibility and fortunately she loves that

and than there is the 10 hours of dance/ ballet a week.........

[Sherie]

I joined a gym today, we're going Sunday for a fitness plan. I'm excited to get started. The manager took me for a tour and showed me the torso rotation machine. He said it's a new version. The upper body is stationary and the lower body turns, I tried it and it really works the lower lumbar area. which is Sheena's worst curve. Isn''t your daughter doing rowing exercises for the shoulder blades? Sheena has that problem also. They also have yoga and pilates, have you tried that yet? I heard both are great for stretching.

I am just hoping this is not all a waste of time (the therapy), on the other hand, I am happy that we are at least being proactive about it, better than sitting around waiting to see what happens next.

I don't think I would have done this without your input, Gerbo, so thanks so much. If you have any more advice, keep me in the loop.

Sherie

[Celia]

Oh..... I just remembered ! In the event that anyone is looking for one of the Medx torso rotation machines used in the Vert Mooney study, there is a link to facilities that carry these machines - scroll down to the bottom of the page and click on facility locator and then enter your State/Province. I've seen these machines and they're VERY impressive looking


http://www.corespinalfitness.com/facility/index.php