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  • #16
    Originally posted by BETall
    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

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    • #17
      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?

      Comment


      • #18
        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?

        Comment


        • #19
          Hi Guys,

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

          Thank you,

          Laura
          UK based Mum of Imogen, 38 degree curve at 9 years old. SpineCor since 15/6/07, 31 degrees in brace.
          10th December 07 - 27 degrees, 23rd June 08 - 26 degrees, Feb 09 - 24 degrees, Aug 09 - 35 degrees, Jul 10 - 47 degrees, Dec 10 - 50+ degrees.
          Surgery due to take place early December 2011 at the RNOH, England.

          Comment


          • #20
            Hi there

            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

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            • #21
              Thanks Bish, do you mind if I copy this onto the other thread?

              Laura
              UK based Mum of Imogen, 38 degree curve at 9 years old. SpineCor since 15/6/07, 31 degrees in brace.
              10th December 07 - 27 degrees, 23rd June 08 - 26 degrees, Feb 09 - 24 degrees, Aug 09 - 35 degrees, Jul 10 - 47 degrees, Dec 10 - 50+ degrees.
              Surgery due to take place early December 2011 at the RNOH, England.

              Comment


              • #22
                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

                Comment


                • #23
                  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

                  Comment


                  • #24
                    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.

                    Comment


                    • #25
                      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
                      Last edited by structural75; 07-18-2007, 12:07 PM.

                      Comment


                      • #26
                        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 )

                        Comment


                        • #27
                          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).
                          Originally posted by Gerbo
                          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.

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                          • #28
                            you should have said that in the first place

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

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                            • #29
                              Surely this must mean that rigid bracing is anti-productive?

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

                              Laura
                              UK based Mum of Imogen, 38 degree curve at 9 years old. SpineCor since 15/6/07, 31 degrees in brace.
                              10th December 07 - 27 degrees, 23rd June 08 - 26 degrees, Feb 09 - 24 degrees, Aug 09 - 35 degrees, Jul 10 - 47 degrees, Dec 10 - 50+ degrees.
                              Surgery due to take place early December 2011 at the RNOH, England.

                              Comment


                              • #30
                                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.

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