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Thread: Case study: Non-surgical reversal of scoliosis in a mature adult

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    Case study: Non-surgical reversal of scoliosis in a mature adult

    Many NSF forum members will know the name of Dr. Martha Hawes, a plant physiologist at the Univ. of Arizona who was diagnosed with scoliosis as a pre-adolescent but refused surgery. Instead, she worked with an osteopath and other non-surgical practitioners. She has written articles about her treatment, one of them in the NSF newsletter The Spinal Connection (vol 18, no. 1, 2002). She has also collaborated with NSF president Joe O'Brien on scoliosis-related publications. Her book Scoliosis and the Human Spine is sold through the NSF Store: proceeds benefit the NSF. Now she has published an update to her accounts of her own treatment.

    http://www.scoliosisjournal.com/cont...-7161-4-27.pdf

    Synopsis of her results:

    Increase in height: 2 cm between 1990 and 2005

    Improved pulmonary symptoms: Vital capacity in 1996 = 1.6 liters (71% predicted), 2005 = 3.99 liters (115%). Relief from respiratory symptoms including dyspnea and recurrent respiratory infection was maintained.

    Improvement in torso symmetry: In 1992, there was a 12+2 cm difference between the left and right hemi-thorax at maximum inhalation, and a 10+1 cm difference at maximum exhalation. By 2005, reduction to 2+2 cm and 1 +1 cm, respectively. Rib prominence reduced from 18 +3 to 11 +2 degrees.

    Increase in sagittal plane Cobb magnitude: Cobb angle of the sagittal thoracic curvature increased from 17+2 degrees in 2001 to 33+3 degrees in 2005.

    Decrease in coronal plane Cobb magnitude: From 1990 through 2005 the magnitude of Cobb angle for the primary thoracic curve declined by >10 degrees.
    Last edited by Writer; 12-16-2009 at 02:43 AM.

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    Hi Writer
    i believe you will find a discussion of Hawes results & a thorough debate in the "torso rotation strength training" thread....

    jess

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    Quote Originally Posted by Writer View Post
    Many NSF forum members will know the name of Dr. Martha Hawes, a plant physiologist at the Univ. of Arizona who was diagnosed with scoliosis as a pre-adolescent but refused surgery. Instead, she worked with an osteopath and other non-surgical practitioners. She has written articles about her treatment, one of them in the NSF newsletter The Spinal Connection (vol 18, no. 1, 2002). She has also collaborated with NSF president Joe O'Brien on scoliosis-related publications. Her book Scoliosis and the Human Spine is sold through the NSF Store: proceeds benefit the NSF. Now she has published an update to her accounts of her own treatment.

    http://www.scoliosisjournal.com/cont...-7161-4-27.pdf

    Synopsis of her results:

    Increase in height: 2 cm between 1990 and 2005

    Improved pulmonary symptoms: Vital capacity in 1996 = 1.6 liters (71% predicted), 2005 = 3.99 liters (115%). Relief from respiratory symptoms including dyspnea and recurrent respiratory infection was maintained.

    Improvement in torso symmetry: In 1992, there was a 12+2 cm difference between the left and right hemi-thorax at maximum inhalation, and a 10+1 cm difference at maximum exhalation. By 2005, reduction to 2+2 cm and 1 +1 cm, respectively. Rib prominence reduced from 18 +3 to 11 +2 degrees.

    Increase in sagittal plane Cobb magnitude: Cobb angle of the sagittal thoracic curvature increased from 17+2 degrees in 2001 to 33+3 degrees in 2005.

    Decrease in coronal plane Cobb magnitude: From 1990 through 2005 the magnitude of Cobb angle for the primary thoracic curve declined by >10 degrees.
    Thank you for posting this Writer.

    This 26 page follow up helps answer questions and dispel some myths about the case of Martha Hawes.

    Table 2 which shows cobb measurements (using three comparative methods) from 1990-2005 clearly shows a progressive reduction in curvatude - hdugger reports from a recent email to Martha, that she continues to maintain her correction with 1 hour of exercise daily (as is outlined in her memoir).

    Table 1 outlines her methods of treatment - none of which involve 4 hours a day of exercising for years and years - a myth that I'm glad to see set to rest in this report. From 1964-1974 she used calisthenics for about 30 minutes daily; 1974-1991Calisthenics, stretching, plus aerobics (biking, jogging) 60 min daily; 1991 Deep tissue massage 60 min daily; 1992-2001 Daily home mobilization exercises (no strengthening or aerobic) + some other intermittent therapy; 2001-2005 daily mobilization, strengthening & aerobic exercise 40-50 min daily.

    The work of Martha Hawes not only demonstrates that contrary to past opinion, adult curves can be reduced significantly through non surgical methods - and that reduction can be maintained.

    One may only speculate: If we have this well documented case report - how many undocumented cases exist?

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    Quote Originally Posted by jrnyc View Post
    Hi Writer
    i believe you will find a discussion of Hawes results & a thorough debate in the "torso rotation strength training" thread....

    jess
    Yes, thanks for the pointer. I'm aware of that thread, but a lot of forum members are unlikely to read 23 pages of discussion before they find the reference. I started a separate thread for this article because I believe it is a milestone publication by a major figure in scoliosis research and deserves its own discussion page.

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    Good point on stuff being hard to find in that thread. I'm posting some notes about the report here:

    * She may have had JIS rather than AIS - asymmetry noted by age 6, 45 degree curve by age 11. Based on the bulk of JIS reports I've seen, it's very likely she would have progressed to surgery.

    * She may have some mild connective tissue disorders. At the least, she mentions pectus excavatum which, along with scoliosis, is seen in some connective tissue disorder.

    * Based on the age at which she was diagnosed at 45 degrees, it is equally interesting that she managed to maintain her curvature without progressing.

    * She lays out in report a fairly clear summary (on page 5) of the exercises she performed when young to maintain her curve.

    I also note that the hours per day required by Hawes (and Elise Miller, as described in other threads) must necessarily include a large amount of time spent trying to figure out what exercises to do as well as time doing exercises which likely had no effect on the outcome. Therefore, we do not yet have a sense of how much exercise per day is necessary until we know exactly which exercises are actually reducing/maintaining the curve.

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    From the 2009 paper on Hawes...

    Table 1 outlines her methods of treatment - none of which involve 4 hours a day of exercising for years and years - a myth that I'm glad to see set to rest in this report. From 1964-1974 she used calisthenics for about 30 minutes daily; 1974-1991Calisthenics, stretching, plus aerobics (biking, jogging) 60 min daily; 1991 Deep tissue massage 60 min daily; 1992-2001 Daily home mobilization exercises (no strengthening or aerobic) + some other intermittent therapy; 2001-2005 daily mobilization, strengthening & aerobic exercise 40-50 min daily.
    From the previous article:

    http://www.scoliosis.org/resources/s...on_spr2002.pdf

    From January 1993, one of the authors (WJB) provided instruction, support, and evaluation of posture and movement. Sustained pressure applied directly to muscle spasms, or manual traction to stretch the torso,was used by the patient to relieve pain as needed ( 4 h daily through 1997).
    Okay so she did this for FOUR hours every day for FIVE years. The daily effort spent on this component of her treatment is the ONLY one left out of the table and is therefore conspicuous by its absence. I don't know why it was omitted from the table.

    And I don't know why the dates for the various treatments don't match exactly between the two papers. Seems strange.

    Hawes is a plant science professor and therefore NOT a nut. I will give her the benefit of the doubt on any differences between the two papers.

    But let's not go on saying the 4 hours a day for years is a myth, shall we?
    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."

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    Good point, Pooka. It's interesting that she relies so heavily on massage/manipulation during what appears to be the period of greatest reduction to the curve. I believe Elise Miller mentioned extensive use of massage (but, I'm not certain - just a vague memory).

    Have their been other studies that point to role of massage? Or massage + exercise?

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    Martha Hawes

    Martha Hawes is a hero.

    I am very surprised that exercise is beneficial after skeletal maturity but Martha's report indicates that it is. Good for her. Obviously if physical therapy helps adults it should be even more beneficial for children. I guess that explains the torso rotation studies.

    According to this study of 48 children curve patterns can change.
    April 2008: Curve pattern changes in idiopathic scoliosis

    In this study, changes in curve patterns suggest that idiopathic scoliosis is not a fixed deformity, but a dynamic process especially in patients younger than 10 years.
    Last edited by Dingo; 12-16-2009 at 02:54 PM.

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    Quote Originally Posted by Dingo View Post
    I am very surprised that exercise is beneficial after skeletal maturity but Martha's report indicates that it is.
    I'm shocked, but heartened. We're racing the curve on my son - hoping that something either halts the progression (good enough) or turns it around (fantastic) before he hits the surgery trigger mark.

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    Quote Originally Posted by hdugger View Post
    I'm shocked, but heartened. We're racing the curve on my son - hoping that something either halts the progression (good enough) or turns it around (fantastic) before he hits the surgery trigger mark.
    hdugger,

    I was looking at these side shift exercises you mentioned as perhaps something my daughter could use to make sure she doesn't progress when she stops wearing her brace. I thought you might be interested in this study as it says that four of the skeletally mature people in the study had at least a ten degree reduction in their curves. At least this can be added to your list. These results are from doctors, so I personally would trust their Cobb angle measurements.

    Also, it's very interesting to me because apparently these side shift exercises were originally desribed by Min Mehta and I personally believe she is an inspired scoliosis specialist.


    SIDE SHIFT EXERCISE FOR IDIOPATHIC SCOLIOSIS AFTER SKELETAL MATURITY

    T. Maruyama; T. Matsushita; K. Takeshita; T. Kitagawa; K. Nakamura; and T. Kurokawa

    Department of Orthopaedics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173 8605, Japan


    Side shift exercise was originally described by Mehta. Since 1986, we adopted it for the treatment of idiopathic scoliosis. Outcome of the side shift exercise for the patients with idiopathic scoliosis after skeletal maturity was evaluated retrospectively. Fifty-three patients with idiopathic scoliosis whose curve was greater than 20 degrees by the Cobb’s method were included in the study. All the patients were treated only by the side shift exercise and their treatment was started after skeletal maturity. Skeletal maturity was diagnosed by Risser’s method as either grade IV or grade V. The study comprised five men and forty-eight women. Twenty-six patients had thoracic curve, eight had thoracolumbar curve, and nineteen had double major curve. Patients were instructed to shift their trunk to the concavity of the curve repetitively while they were standing and to maintain the side shift position while they were sitting. In double major curve, larger curve was the subject of the treatment. The average age at the beginning of the treatment was 16.3 years (range, 13 to 27 years), and the average age at final follow-up was 19.8 years (range, 14 to 33 years). The average follow-up period was 3.5 years (range, one to 11 years). The average Cobb angle at the beginning of the treatment was 33.3 degrees (range, 20 to 74 degrees), and the average Cobb angle at final follow-up was 32.2 degrees (range, 10 to 73 degrees). Curves of four patients decreased 10 degrees or more. Most of long term follow-up studies reported that untreated idiopathic scoliosis progressed even after skeletal maturity. Although the follow-up period was much shorter, results of the present study suggested that the side shift exercise was a useful treatment option for the management of idiopathic scoliosis after skeletal maturity.

    The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.

    http://proceedings.jbjs.org.uk/cgi/c...-B/SUPP_I/22-d

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    A hero?

    [QUOTE=Dingo;87778]Martha Hawes is a hero.

    Not sure how this makes her a hero. In my book, this makes her extremely lucky--and rare.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

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    That's very interesting. Thanks, Ballet Mom. Does anyone have access to the full text of the article? I'm trying to see what the initial curve was like in the 10 who reduce their curve, since I'm trying to making data points only for reductions in "significant" curves (which I'm roughly defining as over 35 degrees).

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    hero

    leahdragonfly

    Not sure how this makes her a hero. In my book, this makes her extremely lucky--and rare.
    Very few people posess either significant, critical thinking skills or a strong work ethic. Martha Hawes has both. She used these traits to help not only herself, but everyone else with the same affliction. That makes her a hero.
    Last edited by Dingo; 12-16-2009 at 06:34 PM.

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    Mighty Hawes :-)

    I count her as hero also. As Dingo stated: Very few people posess either critical thinking skills or a strong work ethic. Martha Hawes has both. She used these traits to help not only herself, but everyone else with the same affliction. That makes her a hero. I agree.

    Prior to the published work of Martha, what were we told about adult curves? We were told that there was nothing, absolutely nothing (non surgical) that could reduce them. And now, for the first time in history, we have a documented case that continues to hold correction. I have a feeling we will see continued follow ups throughout the years from her - hopefully, this will be the tip of the iceberg in years to come.

    I have heard anecdotal reports of such things, maybe many of us have. Happened with my daughter in fact - a scientifically undocumented small curve disappearing after obtaining pilaties certification and becoming an instructor as a young adult. Maybe such reports are not so rare - but to find an older adult (40+) doing this, scientifically documenting it, and publishing the information - opens the door for more in a place where the literature has been so woefully lacking.

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    Quote Originally Posted by Pooka1 View Post
    From the 2009 paper on Hawes...

    From the previous article:

    http://www.scoliosis.org/resources/s...on_spr2002.pdf

    Quote:
    From January 1993, one of the authors (WJB) provided instruction, support, and evaluation of posture and movement. Sustained pressure applied directly to muscle spasms, or manual traction to stretch the torso,was used by the patient to relieve pain as needed ( 4 h daily through 1997).

    But let's not go on saying the 4 hours a day for years is a myth, shall we?
    The myth has been - that Martha engaged in 4 hours daily of vigorous exercise for years and years. That has been said many times in this forum.

    This paper clarifies that the 4 hours of exercise was passive in nature (traction and sustained pressure applied directly to muscle spasms - and not vigorous (or active) as in aerobics, etc.

    I think this distinction is an important one to make for the years 1993-1997.

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