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  1. #1
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    Torso Rotation Strength Training for Scoliosis

    Torso rotation therapy has been repeatedly found to be effective for the treatment of Scoliosis. There are links floating around about this therapy in various new and ancient threads. I decided to post all known links here. If you know of any study or anecdotal information that is either pro or con please post it here for other parents.

    September-17-2008 - News Story with Video: MedX torso machine reduces 8 year old girl's curve from 14 degrees to 8 degrees.
    Roger Schwab: "We've seen it work on almost every case that we've had."
    Main Line Health and Fitness Scoliosis page

    May-24-2010 - Before and after x-rays: 10 months of Torso Rotation Strength Training
    An 11 year old girl used TRS therapy for one year to treat her Scoliosis. The mother e-mailed me the x-rays and I combined them into one picture.

    Therapy is based on these 3 torso rotation strength training studies. All 3 studies found that torso rotation strength training stopped curve progression in all small and moderate curves. Many curves were reduced.

    February 2003 - Study: The Role of Measured Resistance Exercises in Adolescent Scoliosis
    16 of the 20 patients demonstrated curve reduction, and although some fluctuation occured, none of the remaining 4 patients had a persistent increase in curve. No patient required surgery or bracing.
    2006 - Study: Trunk rotational strength training for the management of adolescent idiopathic scoliosis (AIS).
    Seven adolescents with AIS (5 female 2 male; mean 14 yrs +/- 2.6 yrs; mean Cobb 28 degrees +/- 6 degrees range 20 degrees -37 degrees) underwent four months of supervised trunk rotational strength training, and repeat strength test. Four individuals showed reduction (>5 degrees) in their original curve, and 3 remained the same (+/-5 degrees).
    July 2008 - Study: Treatment of adolescent idiopathic scoliosis with quantified trunk rotational strength training: a pilot study.
    Patients received a 4-month supervised followed by a 4-month home trunk rotational strength training program.
    Quantified trunk rotational strength training significantly increased strength. It was not effective for curves measuring 50 to 60 degrees. It appeared to help stabilize curves in the 20 to 40-degree ranges for 8 months, but not for 24 months. Periodic additional supervised strength training may help the technique to remain effective, although additional experimentation will be necessary to determine this.
    2000 - Study/Report: A Preliminary Report On The Effect Of Measured Strength Training In Adolescent Idiotpathic Scoliosis
    Myolectric activity was asymmetric in both sides and in abdominal and paraspinal muscles of all patients. These asymmetries were corrected completely with torso rotation, which was associated with significant strength gains.
    March 2007 - The Journal Of Musculoskeletal Medicine
    Photocopied Report: Dr. Vert Mooney: Exercise For Managing Adolescent Scoliosis
    We combined this experience with that of a physiotherapist in New Zealand who was using the same equipment and the same protocols for a total of 31 patients with adolescent scoliosis. The mean curvature was 29.5 degrees (range 10 to 50) when treatment started and 25.1 degrees (minimum decrease, 4 and maximum decrease 43) when it concluded. ...None of the patients worsened.
    In most cases the curvature can be reduced. Brief exercises performed twice a week are adequate. Braces are not necessary.
    May-18-2006 - Thread: Gerbo asks Dr. Vert Mooney a few questions about Torso rotation and the longterm effects of this therapy
    Gerbo:
    Similarly to what i asked a year ago, are you still following your initial study group and has stabilisation been maintained?
    Dr. Mooney:
    I have followed some and stabilization has been maintained.
    December 2 - 2011 Interview
    I just conducted an interview with one of the nation's top Scoliosis experts. (you can read it here) After the interview we had an exchange about torso rotation that I found helpful so I'm going to include it here.

    Question) Your answer on the ineffectiveness of traction and exercise got me thinking.

    "Again, exercising for hours at a time is no match for the braces on your teeth that are constantly pulling."

    You are absolutely correct. When my son does torso rotation exercises he performs 3 sets of 15 on each side. The total time he spends exercising is literally a couple of minutes. I don't see how that small amount of stretching could make much difference. Could torso rotation work because of some sort of secondary action? For instance maybe this type of exercise releases hormones that stretch the ligaments in the spine? Maybe some other secondary effect? But you're right, a few minutes of exercise probably isn't enough to have a direct impact on the ligaments.

    Dr. Kiester) Reasonably directed exercise is of huge impact which is why the immobilization of body bracing has such negative effects. The amount the ligaments have to stretch to stop the progression of the curve is surprisingly small. Thus a little exercise of an effective kind may even result in some reversal of the deformity. Doing a moderate force of continuous stretching (like putting braces on teeth) is when the goal is complete or near complete restitution of the normal anatomy.

    March 2011 - Article by Physical Therapist Scoliosis Success Story

    We received a call from a woman, whose 16 year old daughter was suffering from scoliosis. Her curvature had been measured between 40-41-degrees in April 2010.
    The protocol was simple: One set of exercise to either side, starting with the weaker of the two. She was to go to muscular fatigue if possible on the weak side, or up to the point where I was satisfied with her effort and concerned that mechanics would break down. In most cases, this meant approximately 7-8 reps, and attempting to move slowly and smoothly. As with all novices, the 'control' aspect is difficult - and particularly with an exercise as demanding as the MedX Torso Rotation.
    Come late-November, she visited the doctor and her curvature was tested. The results, as we hoped, were positive: a 6-degree improvement (from approximately 40-degrees; 15% less curve).
    Last edited by Dingo; 10-17-2013 at 12:47 AM.

  2. #2
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    I think I read somewhere on the forum that these types of exercises are more helpful for someone with thoracic scoliosis vs. lumbar scoliosis, right? In other words, the exercises target the muscles higher up in the back and not as much in the lower portion of the back?

  3. #3
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    torso rotation

    MissEmmyF

    The MedX machine stabalizes the pelvis to ensure that the work is done by the back and not the hips. It makes sense that this therapy might be more effective for thoracic curves than lumbar curves, however I'm not sure if that's the case. Torso rotation appears to be effective for virtually any curve of 40 degrees +/- or less. Somehow this therapy must affect the entire back.

    Main Line Health And Fitness uses other machines that target the rest of the back and they say they're reducing curves by up to 50%.

    Most exciting is that MLME/MLHF has developed a specific protocol utilizing both the Med-X Torso Rotation and Lumbar Extension machines as well as several complimentary Med-X and Nautilus exercise machines.
    All children with AIS have trunk rotational strength asymmetry. In English that means one side of the back is stronger than the other. IMHO any machine or exercise that addresses that problem is probably helpful.

    Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study

  4. #4
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    thank you, very interesting...i wonder how many gyms have this type of MedX equipment? and, even if they do, i wonder how many of the trainers at the gyms know how to use them properly to help people with scoliosis?

  5. #5
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    I'm not an expert but...

    MissEmmyF

    If you scroll to page 4 of this study you can see the results of Torso Rotation on a variety of different curve types.

    I would call around but I imagine that any large gym would have a MedX or comparable machine. I know that pelvic stabilization is important so if the machine doesn't have that feature it may not be as effective. If you read page 3 of the Mooney study it explains how they used the machine to treat Scoliosis. I don't think it requires any special knowledge or ability and it only takes about 30 minutes per week.

    I think a MedX machine costs roughly $6,000 or so. That sounds like a lot until you consider that a brace can cost a third to half that amount. Plus when you reach skeletal maturity you can sell your MedX to someone else. Good luck trying to do that with a custom fitted back brace.

  6. #6
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    I actually called the phone number from the Main Line Health & Fitness website (in PA) and spoke with one of the customer service representatives (at least I think that's what she was?). I asked if she knew of any other gyms or physical therapy offices that offer the same scoliosis program but closer to me (in CT)? She didn't know, so she gave me the email address of the Director at MLH&F...I just emailed him, so I'm waiting for him to reply...

    I know you do similar exercises with your son using a ball - I'm wondering if this could be as effective as using the MedX torso rotation machine (assuming of course that the pelvis stays in one location and doesn't move)...

  7. #7
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    When I was in college I got a membership to a Y that had a torso machine- it was not the same as shown- very generic- but I held my pelvis in place and facing straight ahead. The machine worked my obliques so well and my back felt great! I unfortunately have not found this machine anywhere at the gyms I belong to now...

    I tried creating my own torso rotation strength training by using the pulley system they have at the gym and trying to keep my hips forward and rotate from my trunk but I worry that using a cable is using more of my arm strength than core strength.

    One of my PTs had me doing something similar where I would hold my back straight (as in flex my obliques and abs so that my back looked straighter) then I would bend to the side (holding it "straight") and rotate- it was one of the hardest things I've ever done and I didn't use any weights!

    My back is feeling and looking awful again so I think I need to invest my time in training it like I used to. Just the bonus of aiding the pain was enough to keep me motivated at the time.

  8. #8
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    one note on my son's strength training

    One note on my son's strength training

    Although I'm completely sold on torso rotations, nightly stretching and the balance board I'm still working out the bugs on Scott's strength training. Our goal is to make his left side as strong as his right and the front of his body as strong as his back. How we we do that may evolve over time.

  9. #9
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    Quote Originally Posted by Dingo View Post
    One note on my son's strength training

    Although I'm completely sold on torso rotations, nightly stretching and the balance board I'm still working out the bugs on Scott's strength training. Our goal is to make his left side as strong as his right and the front of his body as strong as his back. How we we do that may evolve over time.
    Understandable. I'm impressed you were able to come up with such a comprehensive program for a 5 year old - not to mention the fact that he is motivated enough and likes it enough to continue doing it each day! That's awesome.

  10. #10
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    Quote Originally Posted by trcylynn View Post
    When I was in college I got a membership to a Y that had a torso machine- it was not the same as shown- very generic- but I held my pelvis in place and facing straight ahead. The machine worked my obliques so well and my back felt great! I unfortunately have not found this machine anywhere at the gyms I belong to now...

    I tried creating my own torso rotation strength training by using the pulley system they have at the gym and trying to keep my hips forward and rotate from my trunk but I worry that using a cable is using more of my arm strength than core strength.

    One of my PTs had me doing something similar where I would hold my back straight (as in flex my obliques and abs so that my back looked straighter) then I would bend to the side (holding it "straight") and rotate- it was one of the hardest things I've ever done and I didn't use any weights!

    My back is feeling and looking awful again so I think I need to invest my time in training it like I used to. Just the bonus of aiding the pain was enough to keep me motivated at the time.
    Hmmm, good to know, thanks for sharing. I suppose a generic torso rotation machine (compared to a MedX brand torso rotation machine) is better than nothing! Unfortunately, I don't belong to a gym right now, so I'll have to start looking around to see what's out there.

  11. #11
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    Oblique abdominal training

    I've done reading that suggests that the oblique abdominal muscles might be a muscle group that children with Scoliosis could focus on.

    It is well known that children with AIS have muscle asymmetry. Put simply one side of the back and one side of the abs are stronger than the other (left vs. right). This is one reason that Dr. Mooney became interested in torso rotation strength training.

    The oblique abdominals are one of the most important muscle groups that rotate the torso.

    2007 - Study: Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study
    Multiple muscle groups are involved in rotating the trunk. Among the most important muscle groups for trunk rotation are the oblique abdominal muscles. It is possible that the measured strength asymmetry is a result of altered biomechanics of the oblique abdominal muscles due to the asymmetrical torso.
    It's possible that even without access to a MedX it may still be beneficial to strength train the oblique abdominals.

    Here is a video of a woman working her oblique abdominals with an exercise called the Side Plank.

  12. #12
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    Study from The Netherlands

    Another study that suggests that Dr. Mooney's theory of symmetrical strength training is sound.

    February 2006 - Study - Geometric and electromyographic assessments in the evaluation of curve progression in idiopathic scoliosis.

    In the natural history of idiopathic scoliosis, SGV (remaining growth) and EMG (muscle imbalance) ratio at the lower end vertebra are prominent risk factors of curve progression. The asymmetric (imbalanced) muscle activity is associated with increased axial rotation, which in its turn is associated with increasing Cobb angle and diminishing kyphosis.
    Translation: The more growth that remains + the greater the muscle imbalance = more spine rotation which in turn leads to a larger cobb angle.

    Obviously this is an average of 105 kids. Every spine "breaks" a little differently.

    Dr. Douglas Kiester told me essentially the same thing. First the spine rotates and then growth pushes out the lateral curve.
    Last edited by Dingo; 06-22-2009 at 10:08 PM.

  13. #13
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    The "Plank"

    I just got a private message from a mom who tried the plank with her daughter.

    She said that her daughter had no problem performing the exercise on one side. Then she tried the other side and had significant trouble staying up. Her pelvis kept rocking back and forth. She called the difference "drastic".

    Although most people (including myself until recently) haven't heard of this phenomenon scientists are well aware of it. Just 30 minutes of strength training per week can correct this completely and in theory it could have a positive impact on Scoliosis.

    Imagine that muscles on one side of the spine are pulling with 10 pounds of force and the muscles on the other side are pulling with 7 pounds of force. This imbalance goes on 24/7 for a lifetime. It doesn't take a lot of imagination to see that curve progression might result from this. In fact it's hard to imagine how this wouldn't create a curve.

    I would love to test this on my son but he is on vacation until July 2.
    Last edited by Dingo; 06-24-2009 at 12:42 AM.

  14. #14
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    Quote Originally Posted by Dingo View Post
    Dr. Douglas Kiester told me essentially the same thing. First the spine rotates and then growth pushes out the lateral curve.
    And yet my one kid has a curve measured as high as 40* with virtually no rotation.

    How is that possible under Kiester's hypothesis?

    I look at my kid's back. It doesn't look like it is progressing either in angle or rotation. It seems locked at ~40*. I am going to ask the surgeon what the maximum bend a unrotated spine can achieve. It just may be ~40*.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

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


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  15. #15
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    I've just ordered an Ab machine, to try it out. I will let you all know what I think!

    And that is a very wise point, hdugger. Along with flexibility exercises, I must always make a point to do strength-building, also. Thanks again; excellent point.

    **Udated 5/5: sent the ab machine back - it was way too big to try to put together! haha
    Last edited by dailystrength; 05-05-2010 at 08:37 PM.

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