Torso Rotation Strength Training for Scoliosis

[dailystrength]

Great question - has me pondering much. We have a few Physical Therapists here. I hope they will respond.

You all are so smart - I don't have time to do all this research; I am so encouraged by these discussions.

I wanted to add that spinal flexibility I would think would allow the spine to ease back into a better position, rather than be cramped into a curve. Just my intuition but we women gotta listen to it!

[hdugger]

I think the double-edged sword is that flexibility allows the spine to move more freely, but there's no guarantee that it will decrease rather than increase the curve. Our resident researcher recommends increasing muscle strength along with increasing flexibility to nudge it in the right direction

[dailystrength]

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

[Dingo]

Another assymetry

More evidence that assymetry in the muscles of the spine play a role in Scoliosis

Spine (Phila Pa 1976). 2003 Nov 15;28(22):2535-9.
Asymmetry of premotor time in the back muscles of adolescent idiopathic scoliosis.

STUDY DESIGN: In 38 patients with adolescent idiopathic scoliosis (AIS), the correlation between left and right differences in premotor time (D-PMT) of back muscle and clinical findings were analyzed.
OBJECTIVE: To investigate the clinical relevance of back muscle D-PMT in AIS.
SUMMARY OF BACKGROUND DATA: There have been numerous studies investigating back muscle asymmetry of AIS by EMG, but to date, no studies have measured D-PMT in back muscles.
MATERIALS AND METHODS: D-PMT in the back muscles measured in a similar manner as that in the extremity muscles was assessed in 10 nonscoliotic teenaged girls and 38 AIS patients. The correlation between back muscle D-PMT and four factors (age, Risser sign, Cobb angle, and progression of deformity) was investigated.
RESULTS: The D-PMT values of back muscle at all levels in the control group were within +/-5 ms, but those in 20 of the 38 AIS patients were more than 5 ms. D-PMT at the lower-end vertebra level was strongly correlated with progression of deformity, but not with age, Risser sign, and Cobb angle. All five patients with D-PMT of more than 10 ms at the lower-end vertebra level had progressive deformity.
CONCLUSIONS: D-PMT in back muscle at the lower end vertebra level in AIS correlated closely to the progression of scoliotic deformity, thus suggesting that this phenomenon is associated with the progression in AIS.

Premotor Reaction Time

The interval from the presentation of a stimulus to the initial changes in the electrical activity of a muscle.

[Dingo]

Paging Dr. McIntire

Skevimc

Paging Dr. McIntire!

I wonder if you have an opinion on this. According to the study in the post above children with AIS have back muscles that fire at different rates. Does this predict strength asymmetry in the paraspinal muscles? The fast side starts any motion without help from the slow side which suggests that it has to do more work. In addition once the slow side gets moving it has inertia to help it out. Because of the extra workload would the fast side grow stronger than the "lazy", slow side? Does that theoretically make sense?

Interestingly enough your study found strength asymmetry in children with AIS. I wonder if the fast side was always the strong side.

[skevimc]

Skevimc

Paging Dr. McIntire!

I wonder if you have an opinion on this. According to the study in the post above children with AIS have back muscles that fire at different rates. Does this predict strength asymmetry in the paraspinal muscles? The fast side starts any motion without help from the slow side which suggests that it has to do more work. In addition once the slow side gets moving it has inertia to help it out. Because of the extra workload would the fast side grow stronger than the "lazy", slow side? Does that theoretically make sense?

Interestingly enough your study found strength asymmetry in children with AIS. I wonder if the fast side was always the strong side.

Thanks for the link and question.

I've been thinking about this concept over the last couple of days. First, I would say that it's not a fast response on the convex as much as it is a slow response of the concave side (am I remembering that correctly?). How that would affect strength I'm not sure. My hypothesis is that the concave side is the weak side. Some other people have stated that the convex side is the weak side and is why there is increased EMG activity on the convex because it's trying to 'keep up' with the stronger concave side. I disagree because the concave side musculature has a phenotype of atrophying muscle similar to that of astronauts returning to earth...

I've read a few other studies looking at EMG ratios and they found something similar at the lower end vertebrae and linking it with progression. It's pretty interesting. I'll certainly include this type of measurement in the future.

[Pooka1]

I've been thinking about this concept over the last couple of days. First, I would say that it's not a fast response on the convex as much as it is a slow response of the concave side (am I remembering that correctly?). How that would affect strength I'm not sure. My hypothesis is that the concave side is the weak side. Some other people have stated that the convex side is the weak side and is why there is increased EMG activity on the convex because it's trying to 'keep up' with the stronger concave side. I disagree because the concave side musculature has a phenotype of atrophying muscle similar to that of astronauts returning to earth...

I don't know if it is relevant but all horses have a convex and concave side and training them takes this into account in trying to even them out.

They have more trouble lengthening their concave side which might be consistent with a weakness on the convex side or more likely a stiffness on the convex side. In fact convex sides of the horse are referred to as the "stiff" side. My horse's right side in concave and his left side is stiff.

[rohrer01]

The only thing I have to add to this is that my mother took me to a D.O. who was going to "get rich" finding a cure for scoliosis on me (gosh I hope he didn't charge her to use me as a guinea pig!). Anyway, he did neuromuscular electrical stimulation on the convex sides of my curves. I did improve 3*. For whatever that is worth it kept me out of the OR. They were just waiting like vultures for me to progress one more degree to hit the magical 40. That's what it was back then.

The study Dingo cited does seem to suggest that this is more a disease of the nervous system to me. Some very good things to think about.

It's late, I'm in pain and my meds are just kicking in. So if what I'm saying is irrelevant or off topic, please excuse me. I'm going to bed.

[Dingo]

nervous system

Rohrer01

The study Dingo cited does seem to suggest that this is more a disease of the nervous system to me. Some very good things to think about.

Scoliosis is not fully understood but it appears to be a nervous sytem disorder that for some reason alters the way muscles work. This in turn leads to a curve in the spine.

Obviously some new discovery could overturn that hypothesis but that's the direction the latest research points.

After decades of slow progress scientists are finally making rapid headway on this disease.

According to Dr. Alain Moreau...
INAUGURATION OF A WORLD-LEADING MUSCULOSKELETAL DISORDERS LABORATORY

“we are now, for the first time, in the exceptional position of being able to foresee the eradication of the disease in the very near future with the development of the first drugs within ten years' time.”

A word of caution. Even if a Scoliosis cure is developed in the next ten years it will still have to go through the FDA which will take another ten years. But it seems to me that our grandchildren will only know what Scoliosis is because they read about it in history books... assuming kids still use books in 20 years.

[skevimc]

I don't know if it is relevant but all horses have a convex and concave side and training them takes this into account in trying to even them out.

They have more trouble lengthening their concave side which might be consistent with a weakness on the convex side or more likely a stiffness on the convex side. In fact convex sides of the horse are referred to as the "stiff" side. My horse's right side in concave and his left side is stiff.

I know you've mentioned horses before but this is the first I'm noticing this concept. That's pretty interesting. I looked at a few sites and it seems like most horses have this curve (also right convex which is also interesting). Could it have anything to do with the horse bending a bit to keep their back feet from hitting their front feet? I only ask that because I notice when my dogs trot/canter(??) on the beach in front of me they'll be a little crooked and I notice that it allows their back feet to perfectly straddle their front feet.

At any rate, this is the first sort of 'naturally' occurring spine curve animal model that I've ever heard of. Granted, it's not scoliosis. But horses also aren't bi-pedal. I wonder what would happen (hypothetically of course) if a horse with a stiff and hallow side were to walk around on its back legs. It kind of follows the idea that scoliosis isn't in other animals because no other mammal is solely bi-pedal. Humans have a unique biomechanical situation. We get to stand upright, but at what cost. Anyway... pretty interesting stuff.

[Pooka1]

I know you've mentioned horses before but this is the first I'm noticing this concept. That's pretty interesting. I looked at a few sites and it seems like most horses have this curve (also right convex which is also interesting). Could it have anything to do with the horse bending a bit to keep their back feet from hitting their front feet? I only ask that because I notice when my dogs trot/canter(??) on the beach in front of me they'll be a little crooked and I notice that it allows their back feet to perfectly straddle their front feet.

That's a good hypothesis! I think you should test it.

Actually the back legs do not straddle the fronts. Sometimes they will interfere with the fronts and that is called forging and it is a big problem as the horse can seriously lame itself not to mention pulling the shoes off and such.

I don't know the reason for convexity/concavity but have heard it might be related to how they lay in the womb. Most horses are concave/stiff in one direction which you state it is right convex which is opposite my horse. That said, my horse had a serious orthopedic problem that although has been successfully rehabbed may have affected this. ETA: Further thought on convexity/concavity in horses is NOT due to how they lay in the womb but rather it is just a consequence of having a split brain like all mammals. So each half controls the opposite half of the horse.

The idea behind dressage training at least is to get the horse perfectly even laterally. Horses are trapezoids where the hind legs are naturally wider than the front legs. They all start out with some degree of crookedness wherein they are not placing the hinds the identical distance to the side of each front when viewed from the front. They travel crooked with haunches one way or the other or they are popping a shoulder or something. Correct training allows the rider to position the shoulders or the haunches such that they are straighter and straighter. Straight is when the inside legs are perfectly aligned. Later, as the horse strengthens, the hinds travel closer to each other so the horse travels even straighter. The inability to get the horse straight is arguably the reason why most riders never make it out of the lower levels.

Sorry if that was too much information but I think it is relevant.

At any rate, this is the first sort of 'naturally' occurring spine curve animal model that I've ever heard of. Granted, it's not scoliosis. But horses also aren't bi-pedal. I wonder what would happen (hypothetically of course) if a horse with a stiff and hollow side were to walk around on its back legs. It kind of follows the idea that scoliosis isn't in other animals because no other mammal is solely bi-pedal. Humans have a unique biomechanical situation. We get to stand upright, but at what cost. Anyway... pretty interesting stuff.

Yes it isn't really a scoliosis because it isn't genetic. Sorry, just kidding.

I don't think it is a curve in the spine. Rather I think it is a habitual way of moving that takes the least amount of effort. Absent strength training, all horses will throw their haunches usually to the inside of a circle and usually more one way that the other (more when the concave side is towards the inside). Once the rider learns to control the shoulders and haunches with their seat and other aids and once the horse develops sufficient strength, then straightening and straight travel where the inside legs are on the same track is possible.

[skevimc]

That's a good hypothesis! I think you should test it.

Actually the back legs do not straddle the fronts. Sometimes they will interfere with the fronts and that is called forging and it is a big problem as the horse can seriously lame itself not to mention pulling the shoes off and such.

I don't know the reason for it but have heard it might be related to how they lay in the womb. Most horses are concave/stiff in one direction which you state it is right convex which is opposite my horse. That said, my horse had a serious orthopedic problem that although has been successfully rehabbed may have affected this.

The idea behind dressage training at least is to get the horse perfectly even laterally. Horses are trapezoids where the hind legs are naturally wider than the front legs. They all start out with some degree of crookedness wherein they are not placing the hinds the identical distance to the side of each front. They travel crooked with haunches one way or the other or they are popping a shoulder or something. Correct training allows the rider to position the shoulders or the haunches such that they are straighter and straighter. Straight is when the inside legs are perfectly aligned. Later, as the horse strengthens, the hinds travel closer to each other so the horse travels even straighter. The inability to get the horse straight is arguably the reason why most riders never make it out of the lower levels.

Sorry if that was too much information but I think it is relevant.



Yes it isn't really a scoliosis because it isn't genetic. Sorry, just kidding.

I don't think it is a curve in the spine. Rather I think it is a habitual way of moving that takes the least amount of effort. Absent strength training, all horses will throw their haunches usually to the inside of a circle and usually more one way that the other (more when the concave side is towards the inside). Once the rider learns to control the shoulders and haunches with their seat and other aids and once the horse develops sufficient strength, then straightening and straight travel where the inside legs are on the same track is possible.

Not TMI at all. Really very interesting. Especially the habitual way of moving. Kind of like when your mom says "if you keep making that face it will freeze like that". But seriously.. The strength training, straightening, etc... Kind of neat from a rehab point of view. Reinforces to me how awesome muscles are.

As far as testing it , I came across several kinematic studies of horses. So I'd imagine the study has already been done to some extent. Scientists will study ANYTHING.

[Pooka1]

Reinforces to me how awesome muscles are.

I take it as axiomatic that someone who does a PhD in muscle physiology will find muscles "awesome."

Scientists will study ANYTHING.

Yes they will. At this point, I will do any study that presents itself no matter how rarefied let's say. I have a horse to support.

[Dingo]

Before and after x-rays

An 11 year old girl (now 12) began torso rotation strength training approximately 1 year ago. Late today her mother e-mailed me the before and after x-rays. I put them together into one picture. This one is worth 1,000 words.

Before and after x-rays (1 year)

[LindaRacine]

An 11 year old girl (now 12) began torso rotation strength training approximately 1 year ago. Late today her mother e-mailed me the before and after x-rays. I put them together into one picture. This one is worth 1,000 words.

Before and after x-rays (1 year)

That is just so beyond ridiculous. A year worth of exercise to make an 11 degree curve, that had a snowball's chance in hell of progressing, into nothing. Wonder what the cost per degree was.