PT as a treatment of scoliosis

[flerc]

Kevin, do you think that that 120º case may be a degenerative case? It seems dificult to believe it, but someone said me that ostheoporosis may lead an adult to have such giant curve.. what do you think? Is it impossible to contact that woman? Certainly even in a degenerative case such fantastic reduction should to be analyzed. People of this study should to be studied.. respecting their human rights of course.

[boogaloo]

Hello scoli friends, just wanted to chime in and tell you about my progress so far.
I am now one year into intensive strenght training. It consists of 2-3 full body workouts a week. I gained 5kg and maintained my body fat level at around 12%. My training consists of squat, deadlift, pull ups, bench press, overhead press and few other isolation excercises. I am doing high rep workouts( 8-12 reps per set ) with around 70-80% of my one rep max. Reason being avoiding injury and it's easier to maintain perfect form in big compound movements like squat and deadlift.
My core strenght has improved dramatically! I still don't have any pain and my back feels stronger and less fatigued at the end of the day. I must say that deadlift is amazing excercise for building overall core strenght, if not the best.
And for me, the biggest change I have noticed is my mental state! I am happier, more confident, depressed and anxious days dissapapeared. Overall my quality of life has improved and that is the most important thing I am getting from this.
I have a question for Linda Racine. Linda, why are most if not all doctors against weight training for people with scoliosis and even for people with normal spines.
Do they really think that it is so easy to injure your back while lifting weights? It is easy if you are lifting more than you can with bad form. It is also easy to get killed by a car if you don't know to look left and right while crossing the road but it is not reason not to do it.
Weight training has good impact on bone density and core strenght which is probably the two most important things for us with scoliosis and back problems. And if you are going to watch your diet and have healthy body weight, you have done all that you can to keep yourself out of the hospital.

[flerc]

Really great!!! I was accused to be insane when I said that backpacks (of course not too much heavy) should to be something good. If gravity force is one of the causes of progression, is reasonable to think that fighting against it must to be good.

[LindaRacine]

Spine (Phila Pa 1976). 2014 Oct 15;39(22):1881-6. doi: 10.1097/BRS.0000000000000554.
Early intervertebral disc degeneration changes in asymptomatic weightlifters assessed by t1ρ-magnetic resonance imaging.
Vadalà G1, Russo F, Battisti S, Stellato L, Martina F, Del Vescovo R, Giacalone A, Borthakur A, Zobel BB, Denaro V.
Author information
Abstract
STUDY DESIGN:
Case-control study.
OBJECTIVE:
To evaluate early intervertebral disc degeneration quantified by T1ρ- and T2-weighted magnetic resonance imaging (MRI) in asymptomatic weightlifters compared with a healthy control group matched for sex and age.
SUMMARY OF BACKGROUND DATA:
Athletes consistently recruit or transfer high levels of repetitive forces through the spine, and MRI has documented a higher rate of intervertebral disc degeneration in athletes compared with matched controls. This study aims to analyze the potential role of T1ρ-MRI in the assessment of early degenerative changes occurring in intervertebral discs of young asymptomatic weightlifters compared with healthy controls.
METHODS:
Twenty-six asymptomatic young male weightlifters versus a sedentary control group matched for age and sex, both having no lower back pain nor any spinal symptoms, underwent MRI (1.5 T). Degenerative grade was assessed using T2-weighted images, according to the Pfirrmann scale. T1ρ mapping and values in the nucleus pulposus (n=130) were obtained. Differences in T1ρ value between among the groups and linear regression analyses with degenerative grade were determined.
RESULTS:
Pfirrmann degenerative grade did not show significant differences among groups. Instead, T1ρ values were significantly lower in the lumbar spine of weightlifters compared with controls (P<0.05). T1ρ values decreased linearly with degenerative grade.
CONCLUSION:
T1ρ values were significantly lower in athletes compared with a sedentary matched control group showing differences in intervertebral disc degeneration onset among individuals with lifestyle and environmental factors leading to back pain. T1ρ can be potentially used as a valid clinical tool to identify early changes in intervertebral disc on the verge of new emerging intervertebral discs regenerative strategies and treatments.

[LindaRacine]

Phys Ther. 2014 Nov;94(11):1582-93. doi: 10.2522/ptj.20130095. Epub 2014 Jun 26.
The dose-response relationship between cumulative lifting load and lumbar disk degeneration based on magnetic resonance imaging findings.
Hung YJ1, Shih TT2, Chen BB3, Hwang YH4, Ma LP5, Huang WC6, Liou SH7, Ho IK8, Guo YL9.
Author information
Abstract
BACKGROUND:
Lumbar disk degeneration (LDD) has been related to heavy physical loading. However, the quantification of the exposure has been controversial, and the dose-response relationship with the LDD has not been established.
OBJECTIVE:
The purpose of this study was to investigate the dose-response relationship between lifetime cumulative lifting load and LDD.
DESIGN:
This was a cross-sectional study.
METHODS:
Every participant received assessments with a questionnaire, magnetic resonance imaging (MRI) of the lumbar spine, and estimation of lumbar disk compression load. The MRI assessments included assessment of disk dehydration, annulus tear, disk height narrowing, bulging, protrusion, extrusion, sequestration, degenerative and spondylolytic spondylolisthesis, foramina narrowing, and nerve root compression on each lumbar disk level. The compression load was predicted using a biomechanical software system.
RESULTS:
A total of 553 participants were recruited in this study and categorized into tertiles by cumulative lifting load (ie, <4.0 × 10(5), 4.0 × 10(5) to 8.9 × 10(6), and ≥8.9 × 10(6) Nh). The risk of LDD increased with cumulative lifting load. The best dose-response relationships were found at the L5-S1 disk level, in which high cumulative lifting load was associated with elevated odds ratios of 2.5 (95% confidence interval [95% CI]=1.5, 4.1) for dehydration and 4.1 (95% CI=1.9, 10.1) for disk height narrowing compared with low lifting load. Participants exposed to intermediate lifting load had an increased odds ratio of 2.1 (95% CI=1.3, 3.3) for bulging compared with low lifting load. The tests for trend were significant.
LIMITATIONS:
There is no "gold standard" assessment tool for measuring the lumbar compression load.
CONCLUSIONS:
The results suggest a dose-response relationship between cumulative lifting load and LDD.

[LindaRacine]

J Biomech. 2014 Jan 3;47(1):24-31. doi: 10.1016/j.jbiomech.2013.10.032. Epub 2013 Oct 28.
Damage accumulation location under cyclic loading in the lumbar disc shifts from inner annulus lamellae to peripheral annulus with increasing disc degeneration.
Qasim M1, Natarajan RN2, An HS3, Andersson GB3.
Author information
Abstract
It is difficult to study the breakdown of lumbar disc tissue over several years of exposure to bending and lifting by experimental methods. In our earlier published study we have shown how a finite element model of a healthy lumbar motion segment was used to predict the damage accumulation location and number of cyclic to failure under different loading conditions. The aim of the current study was to extend the continuum damage mechanics formulation to the degenerated discs and investigate the initiation and progression of mechanical damage. Healthy disc model was modified to represent degenerative discs (Thompson grade III and IV) by incorporating both geometrical and biochemical changes due to degeneration. Analyses predicted decrease in the number of cycles to failure with increasing severity of disc degeneration. The study showed that the damage initiated at the posterior inner annulus adjacent to the endplates and propagated outwards towards its periphery in healthy and grade III degenerated discs. The damage accumulated preferentially in the posterior region of the annulus. However in grade IV degenerated disc damage initiated at the posterior outer periphery of the annulus and propagated circumferentially. The finite element model predictions were consistent with the infrequent occurrence of rim lesions at early age but a much higher incidence in severely degenerated discs.

[LindaRacine]

High-frequency loading of lumbar ligaments increases proinflammatory cytokines expression in a feline model of repetitive musculoskeletal disorder.
Pinski SE1, King KB, Davidson BS, Zhou BH, Lu Y, Solomonow M.
Author information
Abstract
BACKGROUND CONTEXT:
Cumulative (repetitive) lumbar disorder is common in the workforce, and the associated epidemiology points out high risk for lifting heavy loads, performing many repetitions, and performing movements at high velocity. Experimental verification of viscoelastic tissue degradation and a neuromuscular disorder exist for cyclic work under heavy loads. Experimental validation for a disorder because of cyclic loads under high-velocity movement is missing.
PURPOSE:
Obtain experimental verification that high-velocity lumbar flexion-extension results in significant increase of proinflammatory cytokines in the viscoelastic tissues.
STUDY DESIGN:
Laboratory experiments using two in vivo feline model groups subjected to cyclic flexion-extension at low and high velocity.
METHODS:
Seven hours after cumulative 60 minutes of cyclic flexion-extension at moderate load of 40 N and 0.25 Hz for first group and 0.5 Hz for the second group, the supraspinous ligaments of L3-L4 to L5-L6 were harvested and subjected to cytokines (interleukin [IL]-1β, IL-6, IL-8, tumor necrosis factor-α, and transforming growth factor-β1) analysis. Two-way mixed model analysis of variance with a post hoc analysis were used to assess any significant differences (p<.05) in cytokines expression level between the two groups as well as main effect and interaction with lumbar levels.
RESULTS:
Expression levels of the five cytokines were significantly increased in the group subjected to the high-frequency loading.
CONCLUSIONS:
Exposure of the lumbar spine to high-velocity flexion-extension triggers a significant increase in proinflammatory cytokines, indicating pronounced changes consistent with an acute inflammation. Further exposure to activity over prolonged periods may trigger chronic inflammation and tissue degeneration as the source of cumulative lumbar disorder.

[LindaRacine]

Is that enough evidence? If not, go to PubMed and search WEIGHT TRAINING SPINE DEGENERATION.

[boogaloo]

Thanks Linda for your answer although it's not very encouraging.
I know this is science, and I am very pro science. But, on this topic we can surely find so much contradictory conclusions that I don't even want to start with it and it makes me really angry. I am aware that deadlift and squat are very taxing on the body and the spine because of the pressure it puts on it. Because of that I am not doing any of these with weights above my 70% of my one rep max. Also I am not doing deadlift from the floor, I raise the barbell on 20cm blocks so I don't have to go that low and it's easier to maintain neutral lumbar spine. I am writing this just to help if someone is interested in doing these.
Linda, you just posted these articles and you don't have any other comment about core strenght and bone density? You think that risks outweight the benefits of weight training?
Running is bad for your knees, don't lift weights cause you will snap your back, don't play tennis cause you will mess up your shoulders... Just sit all day on your butt and you don't have any of these risks. This is absolutely retarded mentality. Human body is designed to move, run, lift and not to sit and watch tv all day.
Nevermind I will continue to do this what I am doing, not because of some research showing this or that, but because my QUALITY OF LIFE has IMPROVED and I am encouraging everyone who is reading this to do the same thing. You don't have to do weight training, find something you like and stick with it.

[flerc]

We should to know what happened with the fantastic world champion weightlifter who had a big curve, as I know it was 90º. Here there is a great bodybuilder with 70º. As I know his curve didn't progress.
What do you think may be happening with your curve? Did you measure your height? If you are taller is reasonable to suppose that you curve was reduced.

[boogaloo]

Yeah that would be great, his name is Lamar Gant and it is amazing what he achieved despite his severe scoliosis.
I think my back is stable and I don't think this will reduce my curves.

[flerc]

Yeah that would be great, his name is Lamar Gant and it is amazing what he achieved despite his severe scoliosis.
I think my back is stable and I don't think this will reduce my curves.

His case should to be studied. Sure big conclusions would arise. http://www.si.com/vault/1984/10/22/6...e-doesnt-break
I don't think that something too much extreme as this great champion does would be good. Increasing in such way the gravity force overcoming the tissues resistance and then increasing the curve don't seems to be something good.. but it seems to be a fact that strengthening exercises provokes muscular shortening.. it should to be good that convex side muscles may have then a shorter length ..
I think it should to be good for adults but not for kids. During growth, the growth itself is a toward up force that must to be used in order to redirect the curve, reducing it, so increasing the toward down gravity force don't seems to be a good idea, but who knows..
If your curve does not decrease but also doesn't increase, it would be great. Progression must to be stopped!.

[titaniumed]

The study showed that the damage initiated at the posterior inner annulus adjacent to the endplates and propagated outwards towards its periphery in healthy and grade III degenerated discs. The damage accumulated preferentially in the posterior region of the annulus. However in grade IV degenerated disc damage initiated at the posterior outer periphery of the annulus and propagated circumferentially. The finite element model predictions were consistent with the infrequent occurrence of rim lesions at early age but a much higher incidence in severely degenerated discs.

Its interesting how discs always seem to herniate in the direction of the spinal cord. It probably wouldn’t matter if they herniated in any other direction, but when they extrude or protrude and touch the spinal cord, this new type of pain becomes a serious problem and once this happens its not an easy battle. Leaning forward compresses the front of the disc and forces the disc material towards the rear in this wedge. Bending over forward and lifting weights off the floor is a great way of creating this destructive scenario.

I had 4 CT verified lumbar disc herniation’s in my 70 degree lumbar curve and currently have 2 cervical herniation’s with no scoliosis....This leads me to believe that we as scolis have underlying disc and end plate problems from the start and scoliosis is or can be the result. Forces exasperate the problem. Here is a study of interest for us. It explains a lot.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253511/

When I was younger, I led an extremely physical life, and being a life long active skier meant that my body was in very good shape. My surgeon verified this through my blood work leading into my scoliosis surgeries. Everything was great except for my spine....I abused my spine, I have no doubt about that, but I wouldn’t have changed a thing since my old skiing days were part of me and my story....I also felt great while skiing, so I kept skiing.

I have a friend that wouldn’t think about hopping on his bike and pedaling 500 miles. He would ride and compete in these long distance competitions whenever he had a chance. He had a heart attack last week and is in a coma right now. Age 62. I don’t know what to say about this....did he wear out his heart?

I have come to the conclusion that over exercise is overrated. It can be destructive, and needs moderation and direction.

I know its hard when we enjoy doing these things, we like to have fun, but its probably wise to keep these things in mind.


Ed

[Pooka1]

I have come to the conclusion that over exercise is overrated. It can be destructive, and needs moderation and direction.

My personal trainer agrees with you. He recently explained why he overcame is exercise addiction and why he uses the knowledge surrounding that to help his clients not over-train.

There was a recent article about how people from a tribe in Africa that move all day use about the same number of calories as more sedentary people. The answer is the more physically fit you get, the more efficiently you use your calories. This is one reason why exercise is not a very efficient way to lose weight. It's why I am not aspiring to be a star gym rat... diminishing returns.

[flerc]

.. backpacks (of course not too much heavy) should to be something good. If gravity force is one of the causes of progression, is reasonable to think that fighting against it must to be good.

Certainly not backpacks but shoulder pads. Backpacks generates a moment tending to move the body back towards, so the natural reactions leads the body forward, something surely not good.
If the same 'principle' works in the vertical plane, shoulder pads (with the right weight) should to lead the body upward.