Muscles move the joints, don't they???

[MissEmmyF]

This reply relates to the parts of this thread about torso rotation exercises. I took my daughter to Dr Boacie on Monday. Mostly because it had been suggested that she see a SRS specialist. My daughter's main issue is pain. He suggested PT for the pain. I asked specifically about torso rotation exercises and he said not to do that because, "it puts too much stress on the spine." He said that aerobic exercises are the best--running (?really?) and swimming. To tell you the truth he didn't seem to have much insight into the exercise aspect.

Really?? Running puts a ton of stress/pressure on the spine due to the impact. And, as Betty shared, swimming is also "bad" for people with scoliosis. Funny he recommended aerobic work over strengthening work when her weak muscles are likely causing her pain.

[LindaRacine]

This reply relates to the parts of this thread about torso rotation exercises. I took my daughter to Dr Boacie on Monday. Mostly because it had been suggested that she see a SRS specialist. My daughter's main issue is pain. He suggested PT for the pain. I asked specifically about torso rotation exercises and he said not to do that because, "it puts too much stress on the spine." He said that aerobic exercises are the best--running (?really?) and swimming. To tell you the truth he didn't seem to have much insight into the exercise aspect.

I'm guessing that's because surgeons are used to dealing with tangible results, and so far, there is no definitive research that shows that any specific exercises help or hurt.

--Linda

[MissEmmyF]

I'm guessing that's because surgeons are used to dealing with tangible results, and so far, there is no definitive research that shows that any specific exercises help or hurt.

--Linda

Well, PT has been proven to be helpful in pain management I believe. So, since she went in there complaining of pain, it seems some sort of PT strengthening regime should be prescribed...not aerobic activities that are actually detrimental to scoliosis.

[MissEmmyF]

I'm guessing that's because surgeons are used to dealing with tangible results, and so far, there is no definitive research that shows that any specific exercises help or hurt.

--Linda

Furthermore, I don't see how "running" or "swimming" would have a tangible outcome...

[betty14]

This reply relates to the parts of this thread about torso rotation exercises. I took my daughter to Dr Boacie on Monday. Mostly because it had been suggested that she see a SRS specialist. My daughter's main issue is pain. He suggested PT for the pain. I asked specifically about torso rotation exercises and he said not to do that because, "it puts too much stress on the spine." He said that aerobic exercises are the best--running (?really?) and swimming. To tell you the truth he didn't seem to have much insight into the exercise aspect.

Surgeons usually provide a written protocol, that the physiotherapist must follow after surgery, to protect the surgical areas and ensure good healing, but outside of that, they are usually not very involved, unless they work in a team setting where they interact closely with rehab staff, where there might be a detailed protocol. An average protocol might say "no such-and-such first 4 weeks", "avoid greater than X degrees of motion in this direction for 8 weeks". Each individual phsysiotherapist has a wide range of possible manual and exercise options within those guidelines. Surgeons are surgery experts, but not rehabilitation experts.

Personally, I cannot run more that a few minutes before I have to stop due to left knee pain. My thoracolumbar area moves too abnormally to allow my knee to move properly (there has been much research on running biomechanics, and I also treat many runners). As per swimming, I would never swim lengths regularly, since the heavy breathing involved would serve to further expand my rib hump area, which I do not want. When physicians suggest such exercises, they are promoting general fitness, not rehabilitation.

The doctor is likely saying that torso rotation exercise might put too much stress on the spine because it is known that discs can be injured by rotational forces. I would be concerned about anyone doing high velocity or large amplitude rotational motions for that reason as well. Slower, controlled motions are not injurious to discs however.

Cheers.
B.

[MissEmmyF]

Surgeons usually provide their written protocol, that the physiotherapist must follow after surgery, to protect the surgical areas and ensure good healing, but outside of that, they are usually not very involved, unless they work in a team setting where they interact closely with rehab staff. They are surgery experts, but not rehabilitation experts.

Personally, I cannot run more that a few minutes before I have to stop due to left knee pain. My thoracolumbar area moves too abnormally to allow my knee to move properly (there has been much research on running biomechanics, and I also treat many runners). As per swimming, I would never swim lengths regularly, since the heavy breathing involved would serve to further expand my rib hump area, which I do not want. When physicians suggest such exercises, they are promoting "general fitness", not rehabilitation.

The doctor is likely saying that torso rotation exercise might put too much stress on the spine because it is known that discs can be injured by rotational forces. I would be concerned about anyone doing high velocity or large amplitude rotational motions for that reason as well. Slower, controlled motions are a different matter.

Cheers.
B.

Aterry, in regard to what Betty says above, did your Dr. recommend you to a PT in order to help deal with the pain (in more specific ways as opposed to just running and swimming for general fitness)?

[betty14]

Yes but simply finding the muscles as through tactile stimulation doesn't mean you are working/building them. Statements like yours add to the general confusion that a brace can build muscle which is of course impossible. Braces do some or all of the work of muscle and(or) restrict muscle so muscles can only get smaller in brace. Yes/No?

If you would kindly re-read the following, as it was written by me in a previous post:

The (following) refers to standard back braces worn by some non-scoliotic people with back pain.

If you have a brace on, it touches you and presses into your tissues. Some people find this tactile stimilation very effective, reporting that "now I can really feel those muscles are there and turn them on better". This is highly relevent to working muscle.

The above was prefaced by exactly to what I was refering, and I did not use the word "build". I'm not sure how that adds to the "general confusion". You did ask, did you not, about how braces work? Before one can understand how a scoliosis brace might work, it is useful to know how a brace in general might work (ie. learn the normal before the abnormal).

Re: the last sentence in your response, I believe that static vs. dynamic bracing and potential effects on muscle were covered in post #85. As you know, no one has yet ponied up the high level research to prove these things beyond a shadow of a doubt!

Cheers,
B.

[Dingo]

slow exercise is less damaging

betty14

The doctor is likely saying that torso rotation exercise might put too much stress on the spine because it is known that discs can be injured by rotational forces. I would be concerned about anyone doing high velocity or large amplitude rotational motions for that reason as well. Slower, controlled motions are not injurious to discs however.

I'm not a physical therapist but it is my understanding that slow exercise is immensely safer for the joints than fast exercise.

It's easy to understand why.

What wears out tires on a car faster?
A) Slowly breaking into a controlled stop
B) Punching the breaks hard and skidding to a stop

Obviously B because any rapid change in movement is going to create friction and lead to damage.

I doubt very much that slow, steady torso rotation is harmful to the discs unless other problems are present.

BTW that's one challenge for small children doing physical therapy. Young kids want to do everything fast and sloppy. It takes a lot of effort to get the right, steady movement out of a little kid. On the plus side my son's coordination for PT probably doubled inside of a month. But it definitely takes patience.

[MissEmmyF]

betty14



I'm not a physical therapist but it is my understanding that slow exercise is immensely safer for the joints than fast exercise.

It's easy to understand why.

What wears out tires on a car faster?
A) Slowly breaking into a controlled stop
B) Punching the breaks hard and skidding to a stop

Obviously A because any rapid change in movement is going to create friction and lead to damage.

I doubt very much that slow, steady torso rotation is harmful to the discs unless other problems are present.

BTW that's one challenge for small children doing physical therapy. Young kids want to do everything fast and sloppy. It takes a lot of effort to get the right, steady movement out of a little kid. On the plus side my son's coordination for PT probably doubled inside of a month. But it definitely takes patience.

Wait, do you mean the correct answer then is "B" (not "A" as you said) or am I missing something?

[Pooka1]

If you would kindly re-read the following, as it was written by me in a previous post:

The (following) refers to standard back braces worn by some non-scoliotic people with back pain.

If you have a brace on, it touches you and presses into your tissues. Some people find this tactile stimilation very effective, reporting that "now I can really feel those muscles are there and turn them on better". This is highly relevent to working muscle.

I didn't recall the "turn them on better" part from your original post. Did you add is as an edit? Maybe I'm just not remembering.

The above was prefaced by exactly to what I was referring, and I did not use the word "build". I'm not sure how that adds to the "general confusion". You did ask, did you not, about how braces work? Before one can understand how a scoliosis brace might work, it is useful to know how a brace in general might work (ie. learn the normal before the abnormal).

I have no idea why scoliosis braces would differ from other braces in terms of restricting muscles and doing the work of muscles.

Re: the last sentence in your response, I believe that static vs. dynamic bracing and potential effects on muscle were covered in post #85. As you know, no one has yet ponied up the high level research to prove these things beyond a shadow of a doubt!

Static versus dynamic? Does that equate to loose versus tight? In the context of scoliosis, if it is loose, you aren't restricting the growth plates at least part of the time. The entire premise of Spinecor is faulty in this and likely other respects irrespective of what the inventors claim.

And w.r.t. beyond a shadow of a doubt, PT as a treatment for scoliosis (apart from pain) hasn't left the starting gate in terms of evidence in hand as far as I know. In decades and decades.

[Dingo]

Doh!

MissEmmyF

Wait, do you mean the correct answer then is "B" (not "A" as you said) or am I missing something?

DOH!
Thank you!
Yep, I meant B. I fixed it.

[MissEmmyF]

MissEmmyF


DOH!
Thank you!
Yep, I meant B. I fixed it.

Haha, ok, great! That is what I thought but then I was second guessing myself. Thanks!

[Pooka1]

If you would kindly re-read the following, as it was written by me in a previous post:

The (following) refers to standard back braces worn by some non-scoliotic people with back pain.

If you have a brace on, it touches you and presses into your tissues. Some people find this tactile stimilation very effective, reporting that "now I can really feel those muscles are there and turn them on better". This is highly relevent to working muscle.

This is what you wrote...

"I have also had patients who felt the brace made them "feel" their abdominals more because of the tactile stimulation."

[betty14]

I didn't recall the "turn them on better" part from your original post. Did you add is as an edit? Maybe I'm just not remembering..

The post you read that in (85), was not edited.

Static versus dynamic? Does that equate to loose versus tight? In the context of scoliosis, if it is loose, you aren't restricting the growth plates at least part of the time. The entire premise of Spinecor is faulty in this and likely other respects irrespective of what the inventors claim...

"Static" does not mean "loose" and "dynamic" does not mean "tight". Above, you state that "static" equates to "loose", which is a reason why Spinecor's premise is faulty.

Since you did not know that Spinecor is a dynamic brace, and in fact do not know what dynamic bracing actually means, I have a hard time understanding how you know so surely that their premise is faulty.

You may be qualified, having read studies, to pass on information about a lack of strong evidence to date for this treatment, but you do not have enough knowledge to say

The entire premise of Spinecor is faulty in this and likely other respects irrespective of what the inventors claim...

. The quote above (second of the three)shows that you have little knowledge of how bracing functions (and why should you have, really, since your field of study is not human physiology or biomechanics etc.)


Disclaimer:
I do not work for Spinecor, and have never referred a patient for one of their braces, and in fact have little interest in scoliosis bracing in general. However I think people should provide information and criticism within the limits of their knowledge base.

Cheers,
B.

[Pooka1]

Since you did not know that Spinecor is a dynamic brace, and in fact do not know what dynamic bracing actually means, I have a hard time understanding how you know so surely that their premise is faulty.

Are you suggesting that "dynamic brace" has a scientific definition??

What is it in your opinion and what is the evidence apart from the claims that it is "dynamic?" What EXACTLY makes Spinecor a dynamic brace other than it is not a hard brace? It seems like "dynamic" means loose enough so that you can move around a little but are restricted enough to make folks think the brace is doing something.

You may be qualified, having read studies, to pass on information about a lack of strong evidence to date for this treatment, but you do not have enough knowledge to say . The quote above (second of the three)shows that you have little knowledge of how bracing functions (and why should you have, really, since your field of study is not human physiology or biomechanics etc.)

Maybe NOBODY has the expertise that you think exists. If they did then we would know a priori whether hard braces or Spincor should or should not work.

I googled "dynamic brace." As far as I can tell, that is not a scientific term. Correct me if I'm wrong.