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Thread: Torso Rotation Strength Training for Scoliosis

  1. #106
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    Quote Originally Posted by Pooka1 View Post
    I find your casual insouciance towards laying out the facts that people likely most want to know like is the correction permanent very troubling.

    You know or should know that folks are looking for long term solutions. Read Mamamax's posts. They are instructive and representative. Exercise, since health problems may interfere with it, is not a long term solution if you are hospitalized and can't exercise and lose all your hard won improvement.

    Do you ever consider those things? Not everyone can maintain an exercise regime every damn day for the rest of their life and it isn't necessarily due to being lazy for chrissake.


    Nope, I never consider those things!


    Actually, I have an education in rehabilitaion science with 9 years of clinical practice, and have taken dozens of courses on manual and myofascial therapy, therapeutic exercise, interdisciplinary management, clinical skills development, and evidence based practice. I attended a achool with a self-directed learning philosophy and have spent many hours as a student and clinician scouring Medline and related databases.

    I have learned to combine the best available evidence with what is known from the basic sciences and my own and others' clinical experience, and refer to other disciplines when I am unable to help. That is called evidence based practice.

    Because you are not a health care provider (that I know anyway) it is likely that your point of view is informed only by one factor, which is the literature. The research is an immensely important part of the picture, obviously, but it is incomplete in 2009 and often flawed, with need for further study in many areas. The research needs to be combined in the real world with all the other factors to provide care to real individuals that need help now.

    I am in no way casually dismissing facts. However I often feel from your style of writing that you casually dismiss people who use a therapautic exercise approach to manage their scoliosis pain and deformity.

    If you would read my post again, you will see that it does not try to argue that the woman's curves are permenantly reduced. I try to be very careful with the language I use, as you are correct in your belief that many people "lay people, I'll call them", do in fact misinterpret some of what they read, and draw erroneous conclusions.

    Regarding my phrase of "physical laziness" - many poeple with chronic pain (myself included) have at one time or another put off doing their exercises using the following excuses:

    "I'm too tired"
    "I'm too depressed to bother"
    "I don't know where to even start, my situation is so bad"
    "I'll do an extra good job tomorrow"

    I have used all of these myslf, even nowadays, when my pain is well managed and my deformity reduced (as long as I do my 2-3 hours per week of corrective excercises). Part of my job is to help people overcome these barriers to success.

    Also, if you read again how I define my personal phrase of physical laziness, you will see that it does not include people who are physically unable to exercise, a catergory that most hospitalized patients (unless they are at a rehab hospital) fall into.

    If there is anyone else out there that has read my 40-odd posts and agrees with your assessment that I am one of the people who is "lightheartedly unconcerned" about facts (I had to look that one up, do you carry a thesaurus with you or what?), then please let me know that I have done a poor job communicating.

    Unrelated to scoliosis, I want to add that you have posted on more than one occasion that religious comments should not be used anymore. You were obviously angry when you wrote that last bit, but perhaps you could use non-R-words next time to express yourself? Maybe take a prominant athiest's name in vain instead?

    B.
    Bettina:
    - 34 year old physiotherapist
    - main curve of 3 is mid-thoracic convex, approx 37 d.
    - my goal: to stay as upright, strong and painfree as I can, as long as I can.

  2. #107
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    Extra extra! Facts not needed for pooka1!

    Quote Originally Posted by Pooka1 View Post
    Some of us non-yoga instructors have families and non-exercise-related careers.

    Newsflash for certain exercise professionals.

    How many times have you posted that one should not make assumptions!

    And yet here you are ASSUMING that this particular yoga instructor does yoga for forty hours per week, just because Linda Racine THINKS she is a full time instructor who may work 40 hours per week.

    Possible alternatives:

    - she COULD spend the classes instructing others via demonstrations, and walking about the group correcting the postures of the exercisers much of the time. (this is what most instructors do, as they have to focus on the client's workout, not their own).

    - she COULD run the studio, and actually only teach a class or two per day

    Honestly, I am ashamed of you right now! And pointing this out to me as a news flash! Really!!!

    If you'd like to know the answer to the question - how many hours per day does she exercise? - why don't you ask her, and then get back to me with a fact, not an assumption.

    Is there a smilie for shame because I need it right now. B.
    Bettina:
    - 34 year old physiotherapist
    - main curve of 3 is mid-thoracic convex, approx 37 d.
    - my goal: to stay as upright, strong and painfree as I can, as long as I can.

  3. #108
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    Quote Originally Posted by betty14 View Post
    And yet here you are ASSUMING that this particular yoga instructor does yoga for forty hours per week, just because Linda Racine THINKS she is a full time instructor who may work 40 hours per week.
    No, I actually know her. And, I know she works full time. I just don't know if she works 40 hours a week. It could be more.

  4. #109
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    @betty14

    I apologize if I misunderstood your writing.

    You certainly don't need a PhD to understand the literature or even do valuable research.

    But you do have to be trained in research techniques, study design, and approaches that avoid or minimize errors in interpretation.

    It is almost impossible to be clear enough when folks don't have the requisite training. See my thread on the thread on Fix's site about rod breakage in minimally invasive fusion for a textbook example. Fix, a doctor of chiro, knows what he knows but CLEARLY doesn't know thing one about surgery. Yet he is leading people into ignorance in a blind leading the blind fashion and scaring the hell out of folks.

    Despite your 40 odd posts here, I can bet a significant fraction of folks here still don't realize that PT, while effective for pain in some cases, is NOT a permanent treatment for decreasing curves in mature spines though I think it is an open question for growing spines just like bracing is an open question.

    Again, it's almost impossible to be clear.

    And last, I don't think it is realistic that most people can exercise enough over the long term just considering hospitalizations and other exigencies without even getting into "laziness." That was my point. I had a ruptured ectopic. They cut my ab muscles. I couldn't stand up straight for the longest time much less exercise. Other people have other conditions. Women get pregnant. How do these people feel when their hard won gains are loss in a relative blink of the eye? It's almost setting them up to fail as much as the kids who wore braces for years who still needed fusion.

    Life is short.
    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."

  5. #110
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    @betty14 redux

    By the way, just to be clear, what is your opinion of the respective evidence cases for decreasing curves permanently via:

    1. surgical fusion?
    2. PT?
    3. bracing?

    Mamamax keeps trying to suggest variously that all is unknown or all these approaches are on an equal evidentiary footing as I understand her posts (and I am NOT claiming I do).

    Do you agree all three treatments are on a equally known or unknown evidentiary footing in terms of permanently decreasing curves?

    Or is there a real difference between:

    1. on the one hand let's say a particular surgical approach or particular surgical hardware which is being improved so fast based on the results of the previous generation of approaches and hardware that there is hardly ever time to establish a long term study,

    2. and on the other hand, let's say bracing and PT, some of which have been around for almost 100 years, where there is still no real evidence of permanent curve reduction?

    Wouldn't it be wrong to elide that very real difference for a lack of long-term studies?
    Last edited by Pooka1; 07-20-2009 at 06:40 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."

  6. #111
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    Quote Originally Posted by mamamax View Post
    My question was : say someone, anyone is incapacitated for long period of time - muscles atrophy. Are you saying that those with spinal fusion will be immune to the effects of that?
    Define a "long period of time". I was up walking the day after surgery, recovered solo and walked an AIDS 5K at 33 days post-op. No one I know would consider that "incapacitated". Neither would they consider my release from all but 3-4 restrictions at 4 months post-op "incapacitated".

    Surely I wasn't "incapacitated" when I returned to sliding on the ballfield at 7 months?

    It's funny to hear someone who hasn't had surgery ~describe~ surgical effects. At least I've BEEN where you are. You're simply projecting.

    The erector spinae can atrophy after fusion (they can also - and often do - in a brace, BTW ... *any* brace ... *any* age), but the effect from atrophy in a FUSED patient would be PAIN, not correction reversal.

    Unfused, braced *and* "seasoned" (with poor muscle tone to start)? Possible curve progression.

    The erector spinae can also be strengthened (for pain relief) by exercises in a fused OR unfused patient ... regardless of how "seasoned" that patient is.

    Pam
    Last edited by txmarinemom; 07-19-2009 at 10:53 PM. Reason: removing superfluous bbcode tags ...
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  7. #112
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    Hello Pam -

    You are quoting me (out of context) regarding a conversation I had with Sharon - which we have finished. So - I'm not going to comment on your comments

  8. #113
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    Curvatude 101

    No curve progression in Schroth patients 3 years after treatment
    This preliminary study begun in 1989 included 181 scoliosis patients, average age 12.7 years, average Cobb angle curvature 27 deg, average risser sign 1.4, average follow-up 33 months. Results of the preliminary study were compared to natural history as known from literature. For the worst-case analysis additionally a questionnaire was sent to the non-repeaters treated at the same time (1989 and 1990) as the patient sample, using essentially the same inclusion criteria. Results showed no curve progression (increase in curvature of 5+ deg/yr). The lack of progression of the 181 patients from the preliminary study and the 116 questionnaire patients together exceeded natural history even if all drop-outs were considered failures. Weiss HR, Lohschmidt K, el-Obeidi N, Verres C. "Preliminary results and worst-case analysis of in patient scoliosis rehabilitation." Pediatric Rehabilitation 1997 Vol. 1(1): 35-40.

    Schroth reduces abnormal curves by over 30% and increases lung capacity
    Out-patient Schroth therapy of 50 patients at the Physical Therapy and Rehabilitation School, Hacettepe University, Ankara, Turkey, reduced average Cobb angle from 26.1 to 17.85 deg in one year. Vital capacity increased by 420 ml. Otman S, Kose N, Yakut Y. "The efficacy of Schroth's 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey." Saudi Medical Journal (9/2005), vol. 26(9):1429-35.

    Book dispels common misconception that exercises do not help correct scoliosis
    Despite nearly 90 years of Schroth therapy in Germany, conventional Anglo-American medicine still commonly asserts that physical exercises have no effect on scoliotic curvature. In her book, Dr. Martha Hawes reviewed the pertinent clinical, peer-reviewed literature in English and demonstrated conclusively that there is no scientific basis for this belief. The articles sometimes referred to as sources for this claim do not in fact make and support it with evidence. In contrast, Hawes found a growing literature in English testifying that properly designed exercises can have a positive effect on scoliotic curves. She devotes pages 99-105 of her book to a discussion of the Schroth program. Martha Hawes, Scoliosis and the Human Spine, Tucson, West Press, 2002.

    Reference: http://www.schrothmethod.com/studies.html

  9. #114
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    Quote Originally Posted by txmarinemom View Post
    Define a "long period of time". I was up walking the day after surgery, recovered solo and walked an AIDS 5K at 33 days post-op. No one I know would consider that "incapacitated". Neither would they consider my release from all but 3-4 restrictions at 4 months post-op "incapacitated".

    Surely I wasn't "incapacitated" when I returned to sliding on the ballfield at 7 months?
    I think Betty knows the rate of muscle loss/atrophy after stopping exercise. In horses it is about two weeks or even less in my estimation.

    I had Dengue Fever at one point while living in Puerto Rico. I was so sick that I don't even fully remember some of that time. I would say I could not have exercised in a meaningful way for at least a month and likely more. Let's assume at the time I had been desperately exercising for 10 years to hold my curve to avoid surgery. I wonder how much ground I would have lost? How much of that would be a permanent loss?

    Maybe I'm unusual but I think it is highly unrealistic to expect long term exercise to hold a curve if only because folks can't always exercise long term through no fault of there own. And when you layer on other sicknesses that aren't so severe and days when you hurt too much to want to exercise, it just seems unrealistic. But what do I know?
    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."

  10. #115
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    Quote Originally Posted by betty14 View Post
    Unrelated to scoliosis, I want to add that you have posted on more than one occasion that religious comments should not be used anymore. You were obviously angry when you wrote that last bit, but perhaps you could use non-R-words next time to express yourself? Maybe take a prominent atheist's name in vain instead?
    I meant to answer this before but forgot.

    Yes I take your point.

    I forget that not everyone sees blasphemy as a victimless crime as I do.
    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."

  11. #116
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    Quote Originally Posted by leahdragonfly View Post
    Hi Betty,

    I find your posts fascinating and informative. Would you mind elaborating on your comment about post-menopause worsening of scoliosis? Is this common? If so, what is the reason.

    Thanks!
    Thank you, leahdragonfly; here's some info for you on that:

    After the hormone changes around menopause, in addition to plain old age-related changes that can sometimes also cause problems, you've probably heard about increased rates of osteopenia and osteoporosis in women. And women with scoliosis usually already have some reduction in bone density even at young ages. The weakened vertebral bodies lose height, leaving less space for the surrounding tissues, and weakening of the spine can cause a curve to get somewhat worse (the extent to which this is due to more bone deformity vs. further winding down due to loss of muscle support, I'm not sure). A fracture in an osteoporotic scoliotic spine understandably could also make a curve worse. When I say "worse" I mean either curve progression or greater pain and disability.

    Some people without a history of scoliosis could develop degenerative scoliosis later in life, but that type of scoliosis has several features different from AIS.

    There is good evidence to show that osteoporotic women can improve strength, function, slow bone density loss, and reduce the risk of fracture by doing certain high load strengthening exercises.

    Applying what is known about "normal" aging spines to scoliotic aging spines obviously isn't an apple to apple comparison, but no research called "aging women with scoliosis and ostepenia who do strength and curve corrective exercise compared with controls" exists, to my knowledge.

    How old are you now?

    Sincerely, B.
    Bettina:
    - 34 year old physiotherapist
    - main curve of 3 is mid-thoracic convex, approx 37 d.
    - my goal: to stay as upright, strong and painfree as I can, as long as I can.

  12. #117
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    Quote Originally Posted by Pooka1 View Post
    I think Betty knows the rate of muscle loss/atrophy after stopping exercise. In horses it is about two weeks or even less in my estimation.

    Losses can occur in 10 days, although studies show that various fiber types can show losses slightly faster or slower.


    Quote Originally Posted by Pooka1 View Post
    I had Dengue Fever at one point while living in Puerto Rico. I was so sick that I don't even fully remember some of that time. I would say I could not have exercised in a meaningful way for at least a month and likely more. Let's assume at the time I had been desperately exercising for 10 years to hold my curve to avoid surgery. I wonder how much ground I would have lost? How much of that would be a permanent loss?
    You may be thinking too rigidly about what defines muscle loss. Yes, muscle fibers may grow smaller, so brute strength may be lost. However "muscle memory" - by which I mean the motor programming that allows the scoliotic person to adjust their body into a corrected alingment is not lost very fast at all. Once you learn a skill, you tend to keep it (this is well documented). The person who has learned to ride a bike can ride quite easily after a 10 year break from biking, and the person who has learned the skill of self adjusting posture does not just lose it.


    Quote Originally Posted by Pooka1 View Post
    Maybe I'm unusual but I think it is highly unrealistic to expect long term exercise to hold a curve if only because folks can't always exercise long term through no fault of there own. And when you layer on other sicknesses that aren't so severe and days when you hurt too much to want to exercise, it just seems unrealistic. But what do I know?
    Not everyone can manage such a program, and people should be encouraged to make their own decisions about how to handle their scoliosis.


    Quote Originally Posted by Pooka1 View Post
    Let's assume at the time I had been desperately exercising for 10 years to hold my curve to avoid surgery.
    The thing is, many people exercising to help their backs are not doing it avoid surgery. No surgeon would recommend surgery for me, for example.

    Also, I doubt very much that any person would "desperately exercise" for 10 years. If I felt desperate, I likely could never find the motivation to even try an exercise approach. You need to enjoy or at least be sufficiently pleased with the results to continue.

    B.
    Bettina:
    - 34 year old physiotherapist
    - main curve of 3 is mid-thoracic convex, approx 37 d.
    - my goal: to stay as upright, strong and painfree as I can, as long as I can.

  13. #118
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    Quote Originally Posted by LindaRacine View Post
    No, I actually know her. And, I know she works full time. I just don't know if she works 40 hours a week. It could be more.
    Hi Linda:

    I wonder if you would be willing to ask her a two questions if it's not too much trouble, to get the facts straight?

    1. how many minutes per day, or hours per week does she spend doing exercise to specifically self-treat her spine?

    2. based on her history, how much does she feel is the minimum that she needs to exercise per day to maintain her status.

    If you'd rather not, that's OK. In that case, perhaps you could give me contact info?

    Thanks, B.
    Bettina:
    - 34 year old physiotherapist
    - main curve of 3 is mid-thoracic convex, approx 37 d.
    - my goal: to stay as upright, strong and painfree as I can, as long as I can.

  14. #119
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    please delete
    Last edited by betty14; 07-20-2009 at 08:04 PM. Reason: thought better of it
    Bettina:
    - 34 year old physiotherapist
    - main curve of 3 is mid-thoracic convex, approx 37 d.
    - my goal: to stay as upright, strong and painfree as I can, as long as I can.

  15. #120
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    Quote Originally Posted by betty14 View Post
    (I had to look that one up, do you carry a thesaurus with you or what?)
    That was pretty funny. I've had to refer to a dictionary a few times on this forum as well. Too bad I've taken the SAT's decades ago because I bet my score would go up a couple of points after participating here.

    The problem is, I could see perhaps using "equipoise" in a sentence, but "insouciance"? Nah

    On an unrelated topic for Sharon: I drove right by the NPR StoryCorps trailer in Rochester Sunday morning and thought of you.

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