Torso Rotation Strength Training for Scoliosis

[Anna's mom]

My daughter went to the ortho doc in April and her curves are stable!! Her numbers actually went down 1-3 degrees in each of her curves but since that is within the margin of error, the doc said she is stable. We were so happy since at her previous visit she had progressed 7-8 degrees. Been religiously doing TRS twice a week.

[mamamax]

Anna's Mom - Very encouraging results. Congratulations!

[Dingo]

I just conducted an interview with one of the nation's top Scoliosis experts. (you can read it here) After the interview we had an exchange about torso rotation that I found helpful so I'm going to include it here.

Question) Your answer on the ineffectiveness of traction and exercise got me thinking.

"Again, exercising for hours at a time is no match for the braces on your teeth that are constantly pulling."

You are absolutely correct. When my son does torso rotation exercises he performs 3 sets of 15 on each side. The total time he spends exercising is literally a couple of minutes. I don't see how that small amount of stretching could make much difference. Could torso rotation work because of some sort of secondary action? For instance maybe this type of exercise releases hormones that stretch the ligaments in the spine? Maybe some other secondary effect? But you're right, a few minutes of exercise probably isn't enough to have a direct impact on the ligaments.

Dr. Kiester) Reasonably directed exercise is of huge impact which is why the immobilization of body bracing has such negative effects. The amount the ligaments have to stretch to stop the progression of the curve is surprisingly small. Thus a little exercise of an effective kind may even result in some reversal of the deformity. Doing a moderate force of continuous stretching (like putting braces on teeth) is when the goal is complete or near complete restitution of the normal anatomy.

[Anna's mom]

Thanks for the information! Very encouraging for us! At her previous visit, her numbers remained stable. Due to go back this month and the doc said if she is stable at this next appt. we will decrease the frequency of her f/u appts.
So far, it just seems like TRS is working for us. I find it interesting that my daughter progressed 7-8 degrees in a 4 mo. period of time and then after we began TRS 2x/wk, she's remained stable for 9 months.

[Dingo]

Thanks for the information! Very encouraging for us! At her previous visit, her numbers remained stable. Due to go back this month and the doc said if she is stable at this next appt. we will decrease the frequency of her f/u appts.
So far, it just seems like TRS is working for us. I find it interesting that my daughter progressed 7-8 degrees in a 4 mo. period of time and then after we began TRS 2x/wk, she's remained stable for 9 months.

WOW! You just made my day! I am so happy for your daughter. Keep up the good work!

Scott started about 13 months ago and he's been stable over that period. I hope to do even better this year. At only 8 years old he's so small that he barely fits into the machine.

On Saturday we are going to start a "3 count" (1... 2... 3...) at the top of each rep to increase the time his back is stretched.

[Anna's mom]

WOW! You just made my day! I am so happy for your daughter. Keep up the good work!

Scott started about 13 months ago and he's been stable over that period. I hope to do even better this year. At only 8 years old he's so small that he barely fits into the machine.

On Saturday we are going to start a "3 count" (1... 2... 3...) at the top of each rep to increase the time his back is stretched.

Anna will turn 13 this month. She was diagnosed at age 11. At each session, we do 15 reps (on the torso rotation machine) on each side four times. We just went w/ the gym's PT's recommendations for strength training those muscles and general use of the machine. She started at 20lbs 12 months ago and now is doing 30 lbs. She also uses the Roman chair 2x a week.
Hope things continue to go well w/ your son!!

[AMom]

Hi Anna's Mom and Dingo,

It looks as though your children have been stable for 9 & 13 months using TRS. My daughter has been stable for 8 months (before that she had a double digit jump in her numbers between x-rays). It is interesting that the lumbar curves are responding to this exercise--I didn't expect that to happen because of the motion involved, did either of you?

Anna's Mom, you said you are using a unit at the gym, may I ask what is the brand? And is your daughter doing any abdominal work? My daughter only fits into her unit with modifications to foot rests, seat, hip area, & seat back, so we could not have used one at the gym even if there had been one available. I am so glad your daughter is able to use the one you found.

Dingo, I think you mentioned purchasing a Cybex in an earlier post (was it the Eagle or the other one?), is that what you are currently using? I really like the idea of the "+3 count" at the top of the rotation. And, thanks for posting your interview regarding the growth rod. Though it will be too late for my daughter, it seems as though it has the potential to do a lot of good for many children.

Since my daughter (just turned 12) is using a MedX, it would be great if all three of us were using a different version of torso rotation machines, yet still getting similar results.
Warm up
Roman chair 20 reps
Rotation 20 reps each side
Stretches & Exercises
Ice pack

Positive or negative, I'll post the results of my daughter's next x-rays (scheduled in 3.5 months). Will you both please do the same?

Thanks!

[Anna's mom]

Hi Anna's Mom and Dingo,

It looks as though your children have been stable for 9 & 13 months using TRS. My daughter has been stable for 8 months (before that she had a double digit jump in her numbers between x-rays). It is interesting that the lumbar curves are responding to this exercise--I didn't expect that to happen because of the motion involved, did either of you?

Anna's Mom, you said you are using a unit at the gym, may I ask what is the brand? And is your daughter doing any abdominal work? My daughter only fits into her unit with modifications to foot rests, seat, hip area, & seat back, so we could not have used one at the gym even if there had been one available. I am so glad your daughter is able to use the one you found.

Dingo, I think you mentioned purchasing a Cybex in an earlier post (was it the Eagle or the other one?), is that what you are currently using? I really like the idea of the "+3 count" at the top of the rotation. And, thanks for posting your interview regarding the growth rod. Though it will be too late for my daughter, it seems as though it has the potential to do a lot of good for many children.

Since my daughter (just turned 12) is using a MedX, it would be great if all three of us were using a different version of torso rotation machines, yet still getting similar results.
Warm up
Roman chair 20 reps
Rotation 20 reps each side
Stretches & Exercises
Ice pack

Positive or negative, I'll post the results of my daughter's next x-rays (scheduled in 3.5 months). Will you both please do the same?

Thanks!

Yes, I would love to maintain a dialog w/ you both regarding TRS! The machine Anna is using is a very basic non-computerized Cybex machine. It is just like the other weight machines in the gym as it uses the "inserting the pin into the weight" system. (Don't know what the official name is! ) Because of this, we cannot increase her weight load only 1-2 lbs at a time. Instead we have to increase it 5lbs at a time but she will only do say 8 reps at the new "challenge" weight and then for the rest of the reps/sets revert back to the original weight. For example, right now she is doing 1 set at 35 lbs and the other three sets at 30 lbs. Originally our PT had given us some abdominal exercises, planks, etc. to do at home, but honestly all we have really kept up with are the gym exercises (torso machine and roman chair). The one exception being that she does do seated chair twists at home a couple times a week. As far as her abs go, Anna says that the torso rotation machine works her abs.
One other thing we started doing after her progression was that she started taking melatonin 3mg every night before bed. We had thought that she could be deficient and had read a study that linked melatonin deficiency and curve progression. With nothing to lose, we decided to try that also!

AMom, I was curious, your child is not in a brace, correct? Also, it sounds like the double digit curve increase your daughter experienced happen while doing TRS, right? I'm so sorry that happened. What are her measurements now? Is she nearing the end of her growth period? My daughter should have one more year to go.

Dingo, thanks for posting the interview and starting the conversation. It is because of your posts that we even tried TRS.
Thank you both for posting all of your information! Anna is due to go back to the doc this month and I will let you know how the appt. goes!

[Dingo]

Hi Anna's Mom and Dingo,

It looks as though your children have been stable for 9 & 13 months using TRS. My daughter has been stable for 8 months (before that she had a double digit jump in her numbers between x-rays). It is interesting that the lumbar curves are responding to this exercise--I didn't expect that to happen because of the motion involved, did either of you?

Anna's Mom, you said you are using a unit at the gym, may I ask what is the brand? And is your daughter doing any abdominal work? My daughter only fits into her unit with modifications to foot rests, seat, hip area, & seat back, so we could not have used one at the gym even if there had been one available. I am so glad your daughter is able to use the one you found.

Dingo, I think you mentioned purchasing a Cybex in an earlier post (was it the Eagle or the other one?), is that what you are currently using? I really like the idea of the "+3 count" at the top of the rotation. And, thanks for posting your interview regarding the growth rod. Though it will be too late for my daughter, it seems as though it has the potential to do a lot of good for many children.

Since my daughter (just turned 12) is using a MedX, it would be great if all three of us were using a different version of torso rotation machines, yet still getting similar results.
Warm up
Roman chair 20 reps
Rotation 20 reps each side
Stretches & Exercises
Ice pack

Positive or negative, I'll post the results of my daughter's next x-rays (scheduled in 3.5 months). Will you both please do the same?

Thanks!

Hi AMom!

Actually I would have expected at least "some" benefit to the lumbar region. The Med-X clamps down the hips because the lower back is strong and wants to do the work during a rotation. The clamp helps to reduce that.

My son uses a Cybex Eagle just like the machine in this video. Rotary Torso (Machine #18) I purchased it used off craigslist for I think a little over a hundred bucks. It's not nearly as good as the Med-X but Scott is too small to fit into a Med-X. But it's nice to have it in the house.

I'm glad you liked the links in this thread. I hoped they would help other kids. When I learned about TRS I realized that scientists were onto something big. But scientists spend their time doing science, not getting the word out to patients. The internet is the perfect medium for information like this. Without it I would have been lost.

Scott gets his next checkup in about a year. I'll certainly post our results!

[Dingo]

Yes, I would love to maintain a dialog w/ you both regarding TRS! The machine Anna is using is a very basic non-computerized Cybex machine. It is just like the other weight machines in the gym as it uses the "inserting the pin into the weight" system. (Don't know what the official name is! ) Because of this, we cannot increase her weight load only 1-2 lbs at a time. Instead we have to increase it 5lbs at a time but she will only do say 8 reps at the new "challenge" weight and then for the rest of the reps/sets revert back to the original weight. For example, right now she is doing 1 set at 35 lbs and the other three sets at 30 lbs. Originally our PT had given us some abdominal exercises, planks, etc. to do at home, but honestly all we have really kept up with are the gym exercises (torso machine and roman chair). The one exception being that she does do seated chair twists at home a couple times a week. As far as her abs go, Anna says that the torso rotation machine works her abs.
One other thing we started doing after her progression was that she started taking melatonin 3mg every night before bed. We had thought that she could be deficient and had read a study that linked melatonin deficiency and curve progression. With nothing to lose, we decided to try that also!

AMom, I was curious, your child is not in a brace, correct? Also, it sounds like the double digit curve increase your daughter experienced happen while doing TRS, right? I'm so sorry that happened. What are her measurements now? Is she nearing the end of her growth period? My daughter should have one more year to go.

Dingo, thanks for posting the interview and starting the conversation. It is because of your posts that we even tried TRS.
Thank you both for posting all of your information! Anna is due to go back to the doc this month and I will let you know how the appt. goes!

Anna's mom

We had the same issue on weight adjustment on the Cybex. Because of that I keep several 1 and 2 pound dumbbells near our machine. When I want to increase the weight by a pound I just pop a 1 pound dumbbell on top of the stack. That's how Scott does 14 pounds. Otherwise he could only go up by factors of 10. At age 8 that isn't going to happen, hehe.

I'm so glad you guys found this thread. If it helps even one other kid it was worth posting it.

[Dingo]

I just want to add that scientists can't definitively prove why torso rotation works. It was initially thought that TRS fixed the strength asymmetry associated with Scoliosis. But the latest research suggests that kids with Scoliosis might not suffer from any significant strength asymmetry.

Electromyographic Analysis of Paravertebral Muscles in Patients with Idiopathic Scoliosis

CONCLUSION
In the experimental conditions of this study, there are no differences in electromyographic amplitudes of erector spinae muscles between the concave and convex sides of the curvature apex in patients with idiopathic scoliosis and control volunteers.

So now I'm leaning pretty heavily towards Dr. Kiester's explanation. By a stroke of luck TRS stretches the ligaments that drive curve progression. Traction and stretching are not effective treatments for Scoliosis but somehow the weight combined with the twisting motion of TRS gets the job done.

Scott uses the 45 degree setting. Not too long ago I noticed that increasing this to 60 and 75 degrees did NOT increase the stretch. However twisting past the center point (the 0 degree mark) rapidly increased the stretch. You can test this by turning your body.

A) Turn to the right a full 90 degrees. Now rotate back to 0 degrees and look straight forward. Even though you started at 90 degrees you don't get much stretch.
B) Turn to the right just 30 degrees. Now rotate back to 0 degrees and then continue rotating even further to the left. By the time you get to -20 or -30 degrees the stretch is substantial.

A wide start point like 90 degrees doesn't add much to the stretch. In fact it might it might screw up your form. However rotating PAST the center point even if it's by just a few degrees creates an immediate stretch you can feel.

I'd be curious to know what a therapist thinks about this.

[AMom]

Dingo,

Wow, a year between doctor visits. We had that long between visits when she was 7 & 8 and then we had to go to 6 months between visits. When her curve started to progress really fast, we were changed to 4 months between visits. Since her curve has been holding steady for 8 months, the ortho agreed to let us go back to every 6 months.

I agree, it is convenient to have the equipment in the house. We have a PT who helped us with the additional Stretches & Exercises, but I think of them as being support for the MedX & Roman Chair--not as the primary workout.

I am so glad I found you two. I was certain there were other families using TRS, but still felt alone. It is nice to see what others are doing. It is even better to see similar results.

Anna's Mom,

Thank you for telling me about the melatonin, I will look it up.

No, my daughter has never been braced. And I am sorry for being unclear earlier, she has not had any increase in her curves since she began TRS. The last curve increased in the period BEFORE she begin using MedX. Her current curves are T34 & L20. She just turned 12 and has yet to begin her menarche so she isn't finished growing.

When she first started using the MedX & Roman Chair, she could only move 8lbs and was working at a 75 degree angle. We had to add very small weights to increases her workout. Now she can easily handle the 2lb increases and is at 45 degrees on the chair. I don't have any experience at a gym, so I don't know if they will allow you to bring in your own weights so your daughter can increase her workout gradually.

So your daughter is using the Cybex. When she rotates, does her upper body turn or her lower body?

Good luck on her upcoming x-ray. I hope TRS continues to hold the curve.

[Anna's mom]

AMom,
Thanks for clarifying your previous post! I breathed a sigh of relief! Sounds like we are in similar situations...12yr old daughters whose progression appears to have stopped after starting TRS!! Just to let you know, my daughter is one year post-menarche. She had her progression just prior to her menarche.

Here is the thread where I found the melatonin information. Thank you Dingo for starting yet another very useful thread!!

http://www.scoliosis.org/forum/showt...mild+scoliosis

Our daughter has always had problems going to sleep at night. We often joked about her possibly being melatonin deficient long before reading the above! Even if it does nothing for her scoliosis, it has improved her (and our) quality of life!

In regard to your question about whether her upper or lower body turns during rotation, it is her upper body. She makes every effort to immobilize her pelvis like they say to do in the studies. The only hip immobilizer our Cybex machine has is a padded area on the inside of her knees. She is to keep her knees firmly squeezed against the pad in order to make sure she is engaging her back muscles. We do our best.

I prayed and prayed for an alternative treatment for my daughter and I feel this is an answer to my prayers. I am so glad to find you and Dingo to compare notes with. I will let you know how my daughter's appt. on the 19th goes!

[AMom]

Anna's Mom,

Thank you for sharing the link, research is easier when I have a place to begin.

This means all three of our children are utilizing the same motion during TRS, two on Cybex Eagle & one on MedX. I had been wondering about the ROM setting, we didn't receive clear instructions on that. One of Dingo's recent posts addresses the issue of starting points. Our machine is marked 5,4,3,2,1,0,1,2,3,4,5. She had tried starting at -0-, but even after a month was unable to maintain good positioning so she went to -1- on each side. After several months passed, she moved to -2- on each side, and she just moved to -3- on each side this week. The machine doesn't mention the angle each number represents, but Mooney's article states the angle is increased by 18 degrees, so if the MedX units are similar, then she began at 0, 18, 36, & is now rotating at 54 degrees. Their research only measured strengths at those angles.

[Dingo]

AMom

Is your MedX machine the same as in this video? MedX Torso Rotation
That machine looks amazing.

The Cybex Eagle has 5 starting positions for each direction.

30 degrees, 45, 60, 75 and 90.

We've used from 30 to 75 but for Scott 45 degrees seems to works best. 30 is good too.

If 0 degrees is straight forward we twist past to about -15 degrees +/-. A little past straight forward is the top point for our movement.