Originally posted by rohrer01
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How can you "exercise" a ligament? They are what hold bone to bone. If they are like rubber bands, it's because the make-up of them has the wrong ratio of proteins, there's no fixing that. I can see strengthening muscles to help with some things. But the primary function of muscles are to enable us to move. Don't get me wrong, muscles DO give the body support, but pretty atrophied people can still walk and move normally. The tendons attach our muscles to our bones, so if the tendon is stretchy, too, that would also create a problem. You can't just go in and fix a faulty mixture of proteins. Muscles can only do so much. It also seems logical to me that if too much muscle mass were obtained it could create more weight, giving gravity a chance to pull harder on the faulty ligaments. Remember there is no attachment of muscle to ligament, so the ligaments are basically on their own.
I do have a personal example. It may show that muscle strength "may" help with some areas. I have a HAGL lesion in my shoulder. That is where the humeral ligament is completely ripped off the long head the the humerus (arm bone) where it goes into the shoulder socket. I have to do shoulder strengthening exercises to "hopefully" give my shoulder support and keep it from dislocating. However, there are two more humeral ligament heads that are still attached. Even so, I have to be very careful not to move my arm in certain ways, otherwise it may dislocate. That's what happened to me last year. All of the dislocations caused my shoulder to protect itself and fill up with scar tissue which made it impossible for me to move my arm very much at all. Now that this is "fixed", I'm at risk for more dislocations. So far I haven't dislocated it because I'm very careful. But the muscle strengthening isn't a cure. If I were to get atrophy in those muscles for some reason I'd be right back to dislocating again.
I don't know how you could really apply this to the spine, though. There are so many tiny muscles surrounding the spine. Exercising those muscles would mean you would have to contract them which would bend you in different ways. This bending may be counterproductive to the ligament issue since the ligaments and muscles would have to be stretchy enough to allow contraction of the muscles on the opposite side. It's not like doing bicep curls where you can build a super huge bicep. People with super huge biceps often can't straighten their arms out to the degree of people with smaller ones. The muscle bulk prevents hyper-extension. It would be more like if the normal action of the elbow allowed you to curl your arm both forward AND backward. How would you stabilize the ligaments in the elbow in that case? The spine bends in a 360o rotation. That's a tough one to overcome. Maybe you could work in one plane only, but then I could see the problem cropping back up in another plane. It would be like a dog chasing its tail.
Am I making any sense?Be happy!
We don't know what tomorrow brings,
but we are alive today!
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Originally posted by rohrer01 View PostSo what does this say about treatment for people with this kind of scoliosis? I think it was Pooka1 who mentioned a long while back that someone totally corrected under general anesthesia? I suppose you could brace them, but they'd have to be braced FOREVER if there were an underlying connective tissue disorder. Maybe that's why they took both kinds of x-ray when I was a kid?Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
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Surgery 2/10/93 A/P fusion T4-L3
Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
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Originally posted by rohrer01 View PostHow can you "exercise" a ligament? They are what hold bone to bone. If they are like rubber bands, it's because the make-up of them has the wrong ratio of proteins, there's no fixing that. I can see strengthening muscles to help with some things. But the primary function of muscles are to enable us to move. Don't get me wrong, muscles DO give the body support, but pretty atrophied people can still walk and move normally. The tendons attach our muscles to our bones, so if the tendon is stretchy, too, that would also create a problem. You can't just go in and fix a faulty mixture of proteins. Muscles can only do so much. It also seems logical to me that if too much muscle mass were obtained it could create more weight, giving gravity a chance to pull harder on the faulty ligaments. Remember there is no attachment of muscle to ligament, so the ligaments are basically on their own.
I do have a personal example. It may show that muscle strength "may" help with some areas. I have a HAGL lesion in my shoulder. That is where the humeral ligament is completely ripped off the long head the the humerus (arm bone) where it goes into the shoulder socket. I have to do shoulder strengthening exercises to "hopefully" give my shoulder support and keep it from dislocating. However, there are two more humeral ligament heads that are still attached. Even so, I have to be very careful not to move my arm in certain ways, otherwise it may dislocate. That's what happened to me last year. All of the dislocations caused my shoulder to protect itself and fill up with scar tissue which made it impossible for me to move my arm very much at all. Now that this is "fixed", I'm at risk for more dislocations. So far I haven't dislocated it because I'm very careful. But the muscle strengthening isn't a cure. If I were to get atrophy in those muscles for some reason I'd be right back to dislocating again.
I don't know how you could really apply this to the spine, though. There are so many tiny muscles surrounding the spine. Exercising those muscles would mean you would have to contract them which would bend you in different ways. This bending may be counterproductive to the ligament issue since the ligaments and muscles would have to be stretchy enough to allow contraction of the muscles on the opposite side. It's not like doing bicep curls where you can build a super huge bicep. People with super huge biceps often can't straighten their arms out to the degree of people with smaller ones. The muscle bulk prevents hyper-extension. It would be more like if the normal action of the elbow allowed you to curl your arm both forward AND backward. How would you stabilize the ligaments in the elbow in that case? The spine bends in a 360o rotation. That's a tough one to overcome. Maybe you could work in one plane only, but then I could see the problem cropping back up in another plane. It would be like a dog chasing its tail.
Am I making any sense?
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Okay, I reread that thread, mostly. I do remember it. You were saying something "similar" to what I just asserted. The difference being that I'm talking about individuals with connective tissue disorder. You can't change the make-up of faulty tissues throughout the entire body. So the conversation was on the premise that the connective tissues (tendons and ligaments) were of normal make-up of proteins.
Dr. McIntyre basically said that the tendons and ligaments allow us movement and that the muscles are what hold us upright.
If that were true then the "atrophy theory of bracing" would be true and kids curves would worsen after bracing, which doesn't happen very often.
Then he backpedaled a little bit when you started talking about this SSS system and he gave more credit to the underlying structures, such as the discs, bones, and ligaments. He basically said that if you cast an arm or a leg that after a time the muscles, tendons, and ligaments need to be rehabilitated because the ligaments shorten and the muscles atrophy. (This did happen to my shoulder and it had to be gradually stretched out - but my recovery was amazingly fast.)
If that were true in scoliosis, bracing would not only halt progression but eliminate the curve altogether.
So here we have it. NO ONE is quite sure. So by referencing a case where there seems to be an underlying connective tissue disorder, I was merely suggesting another possible CAUSE. Of course this is not the cause in everyone. But in light of Pooka1's comment:
How will any change in the curve between standing and laying down ever be relevant to letting a person avoid surgery? We have a person on this group who worked out a lot and she had two large NON-structural curves. She STILL needed surgery if only to hope to save her lumbar.
But Linda's comments below about hysterical scoliosis and the other case mentioned by Pooka1 seem contradictory IF and only IF the one Pooka1 mentioned did, in fact, have hysterical scoliosis:
Most peoples' curves flatten out somewhat when the patient lies supine. It's also hysterical or functional scoliosis if the curves flatten completely.Sharon was talking about a UCSF patient from many years ago. There was no need to brace her. She was woken up, probably given a PT prescription, and walked away.
Makes me wonder if both cases WERE hysterical scoliosis and IF they were, why was one sent home with PT and one fused surgically? OR was there a connective tissue disorder on one of the patients and not the other? These would be good things to know and investigate with regard to idiopathic scoliosis. As far as my experience goes, no one ever checked my flexibility, other than to touch my toes so they could look at my back. I never had my flexibility checked until I was an adult with pain. As an adult I was told I was loose jointed. Shouldn't that be something that they check for before labeling someone with IS? Or does it even matter.
I just can't see how stretchy ligaments can be overcome. In the areas of my spine where I was actively moving as a child, I used to be straight. The area that curved was an area of the spine that can't be exercised. Muscles in and around the shoulder girdle can be exercised, but those around the spine itself can not. So if there were indeed loose connective tissues, I can see why it would collapse there. It would be a rare occurrence, which is the case with me.
I need to stop. I'm having a brain full of contradictions!!! If hysterical scoliosis could be treated with PT, like Schroth, why couldn't two non-structural curves be treated the same way? I'm not saying the girl made the wrong choice. Maybe they would have to keep up the PT for life, which many people don't want to do. I don't know. My head is going to explode. I know that MY curve is stuck where it is. I'll probably take it to my grave.Last edited by rohrer01; 02-04-2014, 02:45 PM.Be happy!
We don't know what tomorrow brings,
but we are alive today!
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Rohrer! Let me try to clear this up.
The case of probable hysterical scoliosis was what Linda mentioned... they put the girl under, the curve disappeared. She was woken up and sent home. Another probable case of hysterical scoliosis was that girl who ended up at a chiro place instead of with a surgeon so the chiros of course ignorantly took credit for curing her curve when she was in fact talked out of it. The chiros probably never at any point realized the curve wasn't structural. They had her case up on their web site for a while but took it down eventually. Maybe they were getting hammered over not being able to help anyone else with a 60* curve reduce it to 15* in a month. LOL.
http://www.scoliosis.org/forum/showt...nth&highlight=
Chiro has never brought a 60* curve down to 15* and especially not in a month so we know the curve wasn't structural.
The other case I discussed was a woman with two large non-structural curves. She is on the group and was fused about two years ago. She agreed to have her T curve fused to try to save her lumbar from getting structuralized. It was a VERY unusual case! I have never read anywhere of someone with two large non-structural curves like that.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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Originally posted by Pooka1 View PostRohrer! Let me try to clear this up.
The other case I discussed was a woman with two large non-structural curves. She is on the group and was fused about two years ago. She agreed to have her T curve fused to try to save her lumbar from getting structuralized. It was a VERY unusual case! I have never read anywhere of someone with two large non-structural curves like that.Be happy!
We don't know what tomorrow brings,
but we are alive today!
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Originally posted by rohrer01 View PostSo do you know if this woman had hysterical scoliosis? If not, HOW could someone have two non-structural curves without it being hysterical? That's why I brought up the connective tissue disorder because I couldn't think of any other reason to have two non-structural curves. It doesn't make any sense.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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Which is the definition of hysterical scoliosis?: A) frontal curve not present in the absence of gravity force.
B) forntal curves without rotation. C) long flexible C-shaped curves? D)curves with normal vertebral shape E) Any combinations of previous definitions
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Originally posted by rohrer01 View PostDr. McIntyre basically said that the tendons and ligaments allow us movement and that the muscles are what hold us upright.
If that were true then the "atrophy theory of bracing" would be true and kids curves would worsen after bracing, which doesn't happen very often.
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You can google various definitions of hysterical scoliosis but they all involve non-structural curves that can be resolved via anesthesia or just talking it out and so are irrelevant to scoliosis cases which involve structural curves. The two cases discussed on the group were both large C curves involving the whole spine it seems. One resolved with anesthesia and the other with talk (although she was doing chiro).
As rare as hysterical scoliosis is, the one case on the forum of the doubly false false double might be even rarer yet. It is not structural but doesn't appear to be hysterical.Last edited by Pooka1; 02-05-2014, 10:25 AM.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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Originally posted by rohrer01 View PostHe basically said that if you cast an arm or a leg that after a time the muscles, tendons, and ligaments need to be rehabilitated because the ligaments shorten and the muscles atrophy. (This did happen to my shoulder and it had to be gradually stretched out - but my recovery was amazingly fast.)
If that were true in scoliosis, bracing would not only halt progression but eliminate the curve altogether.
Certainly shorten ligaments and muscles could explain many things.
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Originally posted by Pooka1 View PostYou can google various definitions of hysterical scoliosis but they all involve non-structural curves that can be resolved via anesthesia or just talking it out and so are irrelevant to scoliosis cases which involve structural curves. The two cases discussed on the group were both large C curves involving the whole spine it seems. One resolved with anesthesia and the other with talk (although she was doing chiro).
As rare as hysterical scoliosis is, the one case on the forum of the doubly false false double might be even rarer yet. It is not structural but doesn't appear to be hysterical.Last edited by flerc; 02-05-2014, 11:51 AM.
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Originally posted by rohrer01 View PostDoes hysterical scoliosis and non-structural curves (where no structural curve exist) go hand in hand? Can a hysterical scoliosis lead to a structural curve?Last edited by flerc; 02-05-2014, 12:51 PM.
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