Rotation what are our options

[cburger]

Hi everyone I read posts periodically but do not post often but thought I would like to ask all of you your opinion on what my daughters options could be. She is 18 and we have known she has scoliosis since she was 12. She has a 30 degree lumbar curve. She also as a level one spondlyo lethysis( Im not sure if I spelled that correctly. Her curve has not gotten any worse in the last 3 years. And her doctor does not recommend surgery. Here is our problem. The rotation has gotten much worse. I do not know the degree of the rotation. But she now has a very prominant rib hump and the other side is very indented because of this. We do not really want surgery but the look of her back really has gotten terrible. It did not look bad at all before the rotation began. I am aware that surgery is not usually suggested for a moderate curve but what about the rotation? She does have pain. She exercises alot to stay in shape and does alot of stretching exercises. Sorry this is long but what are our options to treat the rotation. What complications can occur because of the rotation? Thanks for your help. I just thought I would throw in that her gymnatics is what we think caused this problem.
Denise

[Beckymk]

I'm sorry she is having this. I'm not really sure what they would do for rotation. I would be concerned about the fact that it is causing her pain. I'm assuming she would need to see a scoliosis specialist to determine what the best course for her would be.

My DH has a big rib hump but it doesn't really bother him. On occassion it causes him pain but not a constant thing that I'm aware of.

My DD had been doing gymnastics since she was almost 5 until about 2 weeks ago. She doesn't have a rib hump at all but has 2 fairly large curves. In our case though, I'm pretty sure it's hereditary so no matter what, she was going to have this.

[Pooka1]

It's an interesting question if they will operate on a subsurgical angle in order to stop the rotation.

Why do you think gymnastics has any connection with either the angle or rotation? Is there any evidence whatsoever for that connection?

Good luck.

[Writer]

Gymnastics or the wrong exercises could conceivably be contributing to your daughter's problem rather than the solution. One of the primary issues in scoliosis is asymmetrical musculature in the back (and often elsewhere), so the patient has to beware of building up the wrong muscle groups.

Dr. Vert Mooney, a retired orthopedic surgeon, did some experiments with groups of teens using a MedX torso rotation machine, and found that it helped some of them. PM me if you'd like a copy of the study -- abstract below.

http://www.spineandsport.com/foundat.../scoliosis.asp

You could also investigate the Schroth method, which is an exercise-based physical therapy system for scoliosis. Christa Lehnert-Schroth has a section on spondylolisthesis in her book on the method, including a dozen exercises designed to reduce back pain (which she says is very common with this condition). They look simple enough to do yourself, but the author says they should be done along with a series of other Schroth exercises. For a general introduction to Schroth, see her homepage at:
http://www.schroth-skoliosebehandlung.de/

It would be prudent to have a local physical therapist or other qualified health professional supervise any exercise program for spondylolisthesis.

[cburger]

Hi Thank you for the replys,
You ask why I think gymnastics contributed to her scoliosis. Well first let me say that she did gymnastics from the age of 6 and was a level 9 gymnast when she left the sport at 14. She left the sport because of the pain and at the level of the sport it required to much time 24 hours or more per week. In her gym among her teammate 6 other girls had scoliosis. That is 6 on her optional team of 20 something girls. Her orthopedist said that she had a stress fracture on a lower vertibrae. And that it healed over badly. The curviture started at that point. Spondylio is very common among gymnasts because of the hyper extentions. She wore a couple of different braces at night for several years. But when she left gymnastics she wanted to use her tumbling skills and moved into competitive cheerleading. Here they used her skills tremendously. Mostly her fulls which is a full twisting layout combined with other skills. The twisting motion I believe is what exasperated the problem. It takes a great deal of force to twist in the air. And since she already had a problem it became worse. What we would like and I believe would help is an exercise program to build the muscles on her concave side. If she could develope those muscles I believe it could help pull the rotation back to a reasonable level. We go to Dr Warner at the Campbell clinic in Memphis Tennessee. But I can tell you Surgeons only talk about surgery. And they do not know anything about exercise or Physical therapy. I have not found a therapist or anyone that knows how to help her. I have seen exercise equipment that has helped others but no one has that equipment here. I discussed the clinic in Germany with her doctor and he said well they have better health care than we do in the United States! He was unaware of anyone here who works with kids. She needs a program that she can adapt to the gym equipment that is available to her and the gyms at home and away at college. I can't be the only ones needing this! Why is there so little out there!!

[txmarinemom]

cburger ...

While spondylolisthesis may be common among gymnasts, there is no documented link between gymnastics (or dancing ... or cat juggling) and scoliosis.

There are some gymnasts with scoliosis, and there are some people who do nothing but *read* that have it. If ONLY the link were that simplistic.

We go to Dr Warner at the Campbell clinic in Memphis Tennessee. But I can tell you Surgeons only talk about surgery. And they do not know anything about exercise or Physical therapy. I have not found a therapist or anyone that knows how to help her. I have seen exercise equipment that has helped others but no one has that equipment here. I discussed the clinic in Germany with her doctor and he said well they have better health care than we do in the United States! He was unaware of anyone here who works with kids.

Out of curiosity, you said you discussed Germany with "her doctor" ... who you said was Warner? An SRS doc, Warner, told you to take her to Germany because the care was better there?

Funny, because he specializes in kids ...

Regards,
Pam

[Writer]

In the early part of the last century, physical exercises for scoliosis were fairly widely practiced. I haven't seen a complete explanation of why the concept died out in the US. You're right, a lot of people are interested in finding conservative treatment. Building up muscles on the concave side is one of the primary emphases of the Schroth method.

Unfortunately the closest Schroth clinics to you that I know about are in Wisconsin -- see the frontpage of this website (scroll way down). It wouldn't hurt to ring them up and ask what can be done, given your location. They may have ideas that hadn't occurred to you, or me. Good luck!

[txmarinemom]

....Unfortunately the closest Schroth clinics to you that I know about are in Wisconsin -- see the frontpage of this website (scroll way down). It wouldn't hurt to ring them up and ask what can be done, given your location. They may have ideas that hadn't occurred to you, or me. Good luck!

Uh, yeah .. WI is closer than CA ...(BETall - Beatriz Torres (search the www.scoliosis.org homepage for "CERTIFIED SCHROTH PHYSICAL THERAPISTS in the U.S." ) is a Schroth practitioner ...http://www.scoliosis.org/forum/showp...3&postcount=11.

Your mileage may vary, and you may see trends that justify staying with your SRS doc or flying abroad when Schroth is available in CA and WI. I hope you're smart enough to balance the data.

Writer, for all you indignance, you've NEVER admitted how you're funded/where your interests lie. Cough it up, and mmmmmaybe I'll get off your a**. We know whose pockets BETall's interests line. Her own.

Perhaps I should call Dr. Warner and get an explanation of why he'd send any patient to Germany . That would make for GREAT research/inclusion in my book (whatever he says). It should be documented.

Maybe I'll just write to the SRS (or get my surgeon to) and ask for the truth: Did I miss enlightment by eschewing the Sch-zombies? Did I just have surgery for fun? (according to everything you two have *ever* written here, we all wasted 6-12 months in post-op recovery)

... ~yawn.

[Pooka1]

Gymnastics or the wrong exercises could conceivably be contributing to your daughter's problem rather than the solution.

Conceivable.

A flying teapot in elliptical orbit around the sun is conceivable. Do you think there is any evidence for it?

The Flying Spaghetti Monster is conceivable. Do you think there is any evidence for it?

Purple wombats on the far side of Pluto are conceivable. Do you think there is any evidence for it?

People here touting Schroth revealing their financial interests in Schroth is conceivable. But is there any evidence to believe it will happen?

We can conceive of many things. That's not the problem. The problem is evidence for these things is often totally lacking. Does it mean they are not true? No. But there is still no reason to believe them absent evidence.

[Pooka1]

In the early part of the last century, physical exercises for scoliosis were fairly widely practiced. I haven't seen a complete explanation of why the concept died out in the US.

I can guess why it died out in the US... probably related to the reason why the US grabs a huge share of the Nobels.

[Pooka1]

Cat juggling.

[Snoopy]

Denise,

My daughter is 4 years post-op. Before surgery her Scoliosis was about 46* and her Kyphosis (forward bending curve) was about 71*. She also has a Spondylotisthesis, grade II of 27% at the L5-S1 level. We never knew about her Spond. until they started treating her for Scoliosis. The Spond. has remained unchanged since her diagnosis in 2003.

Jamie was prescribed two different braces which she just wouldn't wear. She went to p.t. to strengthen her back mucsles and also exercises/stretches for her hamstrings to help with her mobility. It didn't work and she did do the exercises faithfully. Her curves continued to progress.

I took Jamie to five different doctors and although every one of them were highly respected surgeons, surgery was NEVER suggested until it was obvious her curves were progressing about 1* per month. At that rate of progression, had we left her back untreated, she would have been crippled or even suffered an early death because of her Scoliosis and Kyphosis.

Mary Lou

[Pooka1]

Her orthopedist said that she had a stress fracture on a lower vertebrae. And that it healed over badly. The curvature started at that point.

That sounds reasonable. Does anyone know if a badly healed stress fracture can cause scoliosis? And if so, will anything short of surgery ever hope to correct it?

What we would like and I believe would help is an exercise program to build the muscles on her concave side. If she could develop those muscles I believe it could help pull the rotation back to a reasonable level.

You seem to believe a lot of things on no evidence whatsoever. Faith is no virtue in this game (or any game). Ask any PT person you find for EVIDENCE that developing muscling reduces rotation. Ask for hard evidence in the form of objective medical findings or else you risk wasting a boatload of money.

But I can tell you Surgeons only talk about surgery. And they do not know anything about exercise or Physical therapy.

There's a very good reason they do this. It has to do with good evidence for surgical correction and lack of good evidence for anything else.

[cburger]

I did not mean to give the impression that Dr Warner suggested that we go to Germany. I simply discussed the treatments that are offered there with him and he agreed that we do not have those treatments available to us here in the US that he is aware of. And he said they have very good health care in Germany! By the way we like Dr Warner very much and have a great deal of respect for him. My point in this discussion is that I strongly believe that with proper exercise there is the possibility her condition could improve. And there seems to be evidence of this through the clinic in Germany and perhaps the MedX exercise equipent in California. My frustration is the lack of wide spread availability of this type of option. I certainly don't think that surgery is very necessary in many cases. But in my daughters case it is not an option because she has a 30 degree curve; therefore, other options are own only recourse. And frankly I hate the just do nothing thing! And as for the snotty comment about Cat juggling, very unnessacary. And If you read my post 6 girls on her team have developed scoliosis. That is a huge percentage! You can think what you want but the numbers speak for themselves! By the way 1 of the girls has had surgery and 1 looks like she will need it soon. The other girls have stopped progessing like my daughter.

[Pooka1]

And If you read my post 6 girls on her team have developed scoliosis.

That is nothing short of shocking.

Do they all have stress fractures of the spine?

How common are stress fractures of the spine in gymnastics?