Torso Rotation Strength Training for Scoliosis

[hdugger]

I'm in agreement about the quacks. It's both infuriating and heart-breaking.

Maybe I'm mistaken, but I believe there have been significant breakthroughs (although definately not cures) in exercise-based scoliosis treatments. Just a few years ago, when my son was diagnosed, all I read is that "no exercise treatment has ever reversed a curve." Now, what I read is "exercise has not been shown to have a lasting effect" So, somewhere in those intervening few years, exercise *has* been shown to reverse curves (although, again, not permanently). Even so, reversing signficant curves is an advance, and it's changed the question from "how do we reduce a curve" to "how do we hold the reduction." In my opinion, that's a huge step. It's nothing like a cure, but it is an advance.

[Dingo]

Karen Ocker

Those are good links. This paragraph stood out for me.

Physicians believed that long periods of "muscle weakness" could cause scoliosis. Diseases like polio, and infections that affected the chest muscles were noted as causes for muscle weakness in the back. Weak muscles on one side of the spine, it was thought, caused the strong muscles on the other side to pull the spine out of alignment. Some physicians in the early twentieth century believed this theory and attempted to strengthen the muscles in a patient's back. While keeping the muscles strong was good for the spine, it did not improve curvature or prevent progression.

I think those doctors diagnosed the problem as uneven muscle strength because it made the most sense. Why else would the spine curve in a particular direction if it wasn't being pulled? That's not to say there aren't other explanations but that one is the most obvious. I think the problem they ran into was that they didn't have the equipment available to test their hypothesis or solve the problem even if they were right.

Today it is widely accepted that children with Scoliosis do indeed have strength asymetry. The muscle fibers on the right and left side of the spine are different. (Source) Whether that's a cause or consequence of Scoliosis is not definitively known. In my opinion the Torso Rotation studies suggest that it's the cause. If you read the abstract from the frog study it shows that muscle imbalances lead to deformed growth.

[Dingo]

hdugger

So, somewhere in those intervening few years, exercise *has* been shown to reverse curves (although, again, not permanently).

No longterm study has ever been done on Torso Rotation Strength training. If the cause of Scoliosis is muscle imbalance this therapy should remain effective as long as exercise is continued. Obviously after growth is complete a child could stop exercising.

[Dingo]

Karen Ocker

Here is another study on the subject of muscle asymetry and Scoliosis.

2006: Geometric and electromyographic assessments in the evaluation of curve progression in idiopathic scoliosis.

The natural history of patients with idiopathic scoliosis was analyzed radiographically and electromyographically in a prospective longitudinal study.

The changes in radiographic geometric and EMG variables between the first presentation and consecutive 4-6-month follow-up periods were analyzed in 105 patients with idiopathic scoliosis.

CONCLUSIONS: In the natural history of idiopathic scoliosis, SGV and EMG ratio at the lower end vertebra are prominent risk factors of curve progression. The asymmetric muscle activity is associated with increased axial rotation, which in its turn is associated with increasing Cobb angle and diminishing kyphosis. The combination of these variables provides insight in the physiologic and 3-dimensional biomechanical evolution of the natural history of curve progression in idiopathic scoliosis.

Like the frog study they found that muscle imbalance leads to deformity. That doesn't mean there isn't something neurologically wrong because there is. But the final link in the chain appears to be some sort of muscle imbalance that pulls the spine out of alignment as it grows.

I understand being wary of kooks on the fringe who make ridiculous, unscientific claims. But this is a direction that mainstream researchers are looking.

[Dingo]

Although there is a lot of evidence that muscle imbalance either causes or plays a part in Scoliosis there isn't definitive proof.

But you have to ask yourself, why wouldn't muscle imbalance cause Scoliosis? Not long ago Japanese women would bind their feet. This would create a force that altered growth and over time caused deformity. Tell me this picture doesn't remind you of Scoliosis.Topiary is another example where an unnatural force is applied to a growing plant to create deformity. Check out these bushes. Some African tribes used rings to deform the necks of women. I guess some guys in Africa think this is hot.
If you think about it there are plenty of examples where an unnatural force combined with growth leads to deformity.

It's actually no surprise that 100 years ago scientists suspected that muscle imbalance was the cause of Scoliosis. They might not have understood how it worked or how to test their hypothesis but it was an obvious possibility.

[mamamax]

I'm in agreement about the quacks. It's both infuriating and heart-breaking.

Maybe I'm mistaken, but I believe there have been significant breakthroughs (although definately not cures) in exercise-based scoliosis treatments. Just a few years ago, when my son was diagnosed, all I read is that "no exercise treatment has ever reversed a curve." Now, what I read is "exercise has not been shown to have a lasting effect" So, somewhere in those intervening few years, exercise *has* been shown to reverse curves (although, again, not permanently). Even so, reversing signficant curves is an advance, and it's changed the question from "how do we reduce a curve" to "how do we hold the reduction." In my opinion, that's a huge step. It's nothing like a cure, but it is an advance.

Well said hdugger - I see you are an Oregonian :-) My favorite state - hope to retire there. There certainly have been advances in non-surgical methods of managing the condition. Surgical methods or non-surgical methods, there will always be a place for both based upon individual needs. I'm very pleased to see the advances that have been made in both since I was 20 something (40 years ago). The "right" exercise is key, and we are learning more about that every day.

[mamamax]

Great thoughts Dingo & I'm with you on all that - Neuromuscular rehabilitation = better balance & maybe a lot more :-)

[Dingo]

Did somebody say Oregon?

I'm pretty sure that Northwest Spine Management in Portland offers Torso Rotation for Scoliosis.

[mamamax]

I think they do Dingo. Should be taking a trip out that way in the next year or so to visit family ... will stop by.

[hdugger]

That's interesting, Dingo. I'll let my son know about it.

We love it here, Mamamax. We're transplanted Californians (and, before that, transplanted New Yorkers), but Oregon is much more our (slow) pace.

[Dingo]

Medicine Ball Torso Rotation

This exercise might be beneficial for kids with Scoliosis. It works the paraspinal muscles, it's good for coordination and it's easy for young kids to do.

I had my 6 year old try this and he could do it safely, without difficulty. We used a 2 pound medicine ball that looks like a basketball. We modified this exercise slightly by placing a small disc behind his back. We used the disc to hold the ball. This ensured that he turned the same distance each time and when he switched direction he did the same amount of work.

I felt his back as he was doing this exercise and it significantly engaged the paraspinal muscles.

I should add that if an exercise is painful your child should stop. Pain or discomfort is a built in warning system that something is wrong. If a parent wants an expert opinion they should see their Doctor or a Physical Therapist. I am neither a doctor nor a PT.

[txmarinemom]

Although there is a lot of evidence that muscle imbalance either causes or plays a part in Scoliosis there isn't definitive proof.

But you have to ask yourself, why wouldn't muscle imbalance cause Scoliosis? Not long ago Japanese women would bind their feet. This would create a force that altered growth and over time caused deformity. Tell me this picture doesn't remind you of Scoliosis.Topiary is another example where an unnatural force is applied to a growing plant to create deformity. Check out these bushes. Some African tribes used rings to deform the necks of women. I guess some guys in Africa think this is hot.
If you think about it there are plenty of examples where an unnatural force combined with growth leads to deformity.

It's actually no surprise that 100 years ago scientists suspected that muscle imbalance was the cause of Scoliosis. They might not have understood how it worked or how to test their hypothesis but it was an obvious possibility.

I think the obvious question here (given your theory) is if unnatural force is so predictable, why doesn't the unnatural (to US) force of bracing succeed more (or maybe at all?)?

[Dingo]

txmarinemom

I think the obvious question here (given your theory) is if unnatural force is so predictable, why doesn't the unnatural (to US) force of bracing succeed more (or maybe at all?)?

I didn't come up with the theory of asymmetrical muscle development. That's what researchers are investigating, and I read what they publish.

[txmarinemom]

I didn't come up with the theory of asymmetrical muscle development. That's what researchers are investigating, and I read what they publish.

I was referring to your examples. Did the read you read link foot binding and topiary with "asymmetrical muscle development"?

[Dingo]

txmarinemom

I think bracing does help. I assume the reason it fails so often is because kids for completely understandable reasons don't want to wear their brace.

In Dr. Moreau's Scoliosis patent he shows that bracing lowers Osteopontin levels. I assume that Osteopontin is a marker for inflammation. Pushing the spine back towards zero degrees reduces the inflammation.

[00165] A distribution of AIS patients across the predefined cut-off zones was also performed prior to being treated with bracing and after bracing. Eight patients were tested a certain number of months after bracing, namely for each of patients #1 to 8: 7, 7, 8, 22, 22, 22 and 26 months after bracing, respectively. Figure 16 shows that prior to being treated with bracing (Panel A), 63% of these patients were in the red and yellow zones. A significant shift towards the green zone (<700ng/mL) was observed, which is consistent with the trend observed in surgically treated patients, as presented in Figures 13 -15.

Surgically treated children also showed a dropoff in OPN.

[00163] Panel B of Figure 15 show that red zone patients who were treated surgically experienced a decline in OPN concentrations in the blood. 75% of the surgically treated patients fell into the green and yellow zones (800 ng/mL or less).