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Torso Rotation Strength Training for Scoliosis

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  • Principles in bone Psysiology

    Originally posted by Dingo View Post
    Mamamax



    HOLY FREAKIN' MOLY!

    Torso rotation may tell the nervous system where the abnormalities are and then the body uses OPN to repair/correct them. That might explain the entire mystery on why it works!!! HOLY FREAKIN' MOLY! (I had to say that again)

    Where is that paragraph? I can't find it.
    Dingo -

    Attached is a paper I found that may help explain some of Frost's work (which appears to have been continued throughout the last few years). I'll be away from forum for a few days but thought you would want this.

    ABSTRACT
    The view that nonmechanical agents dominate control of osteoblasts and osteoclasts and thus postnatal changes in bone strength and mass (agent-effector cells-disease) is obsolete. Nonmechanical agents include hormones, calcium, vitamin D, cytokines, gender, genetics, etc. This paradigm overlooks all tissue level features, biomechanics and relationships found after 1960. This more recent information led to the Utah paradigm of skeletal physiology, proposed by Harold Frost in 1995. The Utah paradigm's view is that mechanical factors dominate control of the biologic mechanisms that control changes in postnatal bone and mass. Nonmechanical agents could help or hinder the influence of the mechanical factors but could not replace them. The simplified scheme is as follows:


    Who is Harold M Frost: http://en.wikipedia.org/wiki/Harold_Frost
    One of the most often cited investigators in skeletal research according to Science Citation Index

    Comment


    • Originally posted by hdugger View Post
      I don't think I'd realized before that this was your entire argument - that exercise is not a solution because it must be continued in order to maintain the cure.

      You could say the same thing about many disorders - for example, people must exercise and watch their diet to maintain their weight. We are not, in the latter example, saying that stomach stapling is the only avenue because continual diet and exercise are too much to ask of people. We assume that the "natural" method of diet and exercise, even though difficult for some, is preferred to a risky surgery that forever changes the way the body operates. Certainly, we do not say that every overweight person should have their stomachs stapled - we save that for those who have been shown unable to effectively use diet and exercise to maintain a healthy weight. Same thing here - if exercise is actually effective in holding a curve, you'd strongly recommend that everyone exercise and save surgery for those for whom the exercise regime failed.
      I would say FAR more is involved with maintaining a reduction in a large curve than in anything you mentioned. It isn't even close if Hawes is typical.

      And I would add that there are people with large or agressively progressive curves who likely would not respond even to hours and hours of exercise a day. Those are similar to your stomach stapling patient example.

      As to what happens if you have a period when you can't exercise - well, you start exercising again afterward and regain the muscle tone. I'm not certain why this would be an argument for surgery.
      Well what if you had to start all over from the beginning... four hours a days for several years just to get back to the point of "only" being able to do one hour a day (This is not necessarily a fact, it is second hand)? Nobody knows.

      BTW, this is not my argument against exercise. My argument is that I don't believe we've yet found an exercise regime that will hold a curve even if followed faithfully. But, should we find one, I believe it would be offered as an acceptable alternative to surgery, just as diet and exercise are now offered as an acceptable treatment for many disorders.
      Doesn't Hawes claim to still be holding her reduction with the one hour of PT a day? Maybe not.
      Last edited by Pooka1; 12-12-2009, 09:20 PM.
      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."

      Comment


      • Originally posted by hdugger View Post
        I'd consider that recent. You suggested that a rational person would know that exercise could temporarily reduce a curve. I was saying that, in fact, through years and years of rational literature the exact opposite was stated - that exercise had no effect.
        Wait a minute. Am I wrong in assuming Schroth has ponied up radiographic evidence at points in their ~90 year existence that they reduced curves (temporarily)? I think they have.

        The problem with Hawes results are that she doesn't really know exactly what she did "right." If she had a clearly outlined set of steps that people could successfully follow, I'm certain at least some people would follow them.
        But what if everything in that 4 hour regime was required? I mean I'm sure she didn't just pick 4 hours out of the blue. I suspect she kept adding things until she saw a reduction and was at the four hour mark when it happened. And even then it took several years.

        And, to return to the topic at hand, that's why the torso rotational studies are interesting. If one could exercise for 15 minutes a day and hold a curve, I think many people would find that attractive. I know that that is not always the case, as Toni noted. But I would like to hear from more people who have tried it to get a sense of what the limits are.
        Yes I think plenty of people would find that attractive. But if Hawes had to do so much more then I wonder how likely it is that only 15 minutes of a relatively easy exercise a day could possibly work even temporarily.
        Last edited by Pooka1; 12-12-2009, 04:22 PM.
        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."

        Comment


        • Originally posted by hdugger View Post
          I'd consider that recent. You suggested that a rational person would know that exercise could temporarily reduce a curve. I was saying that, in fact, through years and years of rational literature the exact opposite was stated - that exercise had no effect.
          I think there may be a semantics problem here. I think experts might sometimes say PT has no effect meaning no PERMANENT effect. In that sense it has no benefit up against fusion. It's cumbersome to have to keep repeating the "permanently" part, something I noticed even in my short blurbs on this newsgroup.
          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."

          Comment


          • Originally posted by Pooka1 View Post
            I think there may be a semantics problem here. I think experts might sometimes say PT has no effect meaning no PERMANENT effect. In that sense it has no benefit up against fusion. It's cumbersome to have to keep repeating the "permanently" part, something I noticed even in my short blurbs on this newsgroup.
            Yes, I don't think I'd understood how you meant "no permanent reduction" before. You mean that the exercise must be continued in order to maintain the reduction. For you (I'm assuming) that's not an acceptable treatment. For me, depending importantly on the amount of time per day it took to maintain the curve, continued exercise would seem far preferable to surgery, and I'd consider both long term treatments. I'm not sure I can consider either permanent - we'll have to see how the newer hardware turns out and how exercise holds a curve.

            Is your sense that exercise is not an acceptable treatment solely dependent on the amount of time it takes? If one could hold a curve with 30 minutes a day, would it seem like a valid alternative? Or are there additional criteria?

            Comment


            • Originally posted by hdugger View Post
              Yes, I don't think I'd understood how you meant "no permanent reduction" before. You mean that the exercise must be continued in order to maintain the reduction. For you (I'm assuming) that's not an acceptable treatment. For me, depending importantly on the amount of time per day it took to maintain the curve, continued exercise would seem far preferable to surgery, and I'd consider both long term treatments. I'm not sure I can consider either permanent - we'll have to see how the newer hardware turns out and how exercise holds a curve.
              No this is apples and oranges.

              The potential problems with fusion are not holding the curve, especially with BMP for adults and low intrinsic pseudoarthrosis rates in kids. You usually get a good fusion and revisions for pseudoarthrosis are known to be low with pedicle screw constructs, especaiily in kids, as far as I know. The issue with surgery is achieving balance in three planes as it affects unfused areas and the potential need to extend the fusion.

              So even in the case of revision surgery, it is still a discrete "permanent" treatment (you are eventually discharged), unlike PT. Apples and oranges.

              Is your sense that exercise is not an acceptable treatment solely dependent on the amount of time it takes? If one could hold a curve with 30 minutes a day, would it seem like a valid alternative? Or are there additional criteria?
              First, it isn't "my" sense. This isn't my game. My lay opinion on this is worthless (though the factual material I posted, if it is factual, is not). You should instead listen to what Samdani says on that torso rotation video IN THE FACE of the 8* reduction the girl achieved.

              In re amount of time I personally would find acceptable (don't know why that's relevant to anything), I would have to think about it. But given what Hawes did, the amount of time is going to be more than I think many people will tolerate. I think Hawes is not unique in her result but rather her willingness and ability to put in so much time. When she was diagnosed, the surgical procedures weren't as good as they are now. As they get better and better, the amount of time the average person is willing to spend in daily PT will go down and down. That is my prediction.
              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."

              Comment


              • Let's try this analogy

                Let's take Type I diabetes.

                Let's assume some day there is an operation available to obviate the need for multiple daily insulin injections, maybe transplanting cadaver pancreases coupled with some slick one-time way to avoid organ rejection.

                Now. How many people would choose that operation over daily insulin injections?

                That's more of an apples to apples comparison as I understand this.
                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."

                Comment


                • Originally posted by Pooka1 View Post
                  Let's take Type I diabetes.

                  Let's assume some day there is an operation available to obviate the need for multiple daily insulin injections, maybe transplanting cadaver pancreases coupled with some slick one-time way to avoid organ rejection.

                  Now. How many people would choose that operation over daily insulin injections?

                  That's more of an apples to apples comparison as I understand this.
                  Yes, I think that's pretty good. And the answer is, I'm not sure. Certainly not all of them would get the surgery, and maybe not even 60%, based on the risks of the surgery and the risk of ongoing complications. But, that's just a guess.

                  For the scoliosis comparison, you'd have to also add into the "no surgery" group those who preferred controlling the curve themselves with no apparent medical intervention. That's a major difference between exercise and insulin shots.

                  But, we could get even better numbers just by taking an informal poll here. How many pre-surgical patients would choose an effective course of exercise if it took 30 minutes a day? 1 hour? 4 hours? How many young people might choose it to delay surgery until they were into their 40s or 50s?

                  Comment


                  • Originally posted by hdugger View Post
                    But, we could get even better numbers just by taking an informal poll here. How many pre-surgical patients would choose an effective course of exercise if it took 30 minutes a day? 1 hour? 4 hours? How many young people might choose it to delay surgery until they were into their 40s or 50s?
                    That would be interesting. I hope lots of people play.

                    While not technically "presurgical," I have a natural fusion in my lumbar that is really acting up of late. I can't stand without getting pain for more than a little while. I don't know what is going on and it isn't bad enough yet to compel me to get a radiograph... I can still ride and sit pain free. It's just standing I can't do much of without moving around.

                    Now if I was told a lumbar fusion wouldn't affect my riding and was likely a one-stop shopping deal, I would tolerate only about 15 minutes a day of PT tops to avoid the surgery. If it was a problem in the thoracic, it would be less than 15 minutes. As far as I know, most of even the old Harrington rod T fusions are stable and those people are having no issues even years out; add in pedicle screws and the decision is easier because better balance and derotation can be achieved. Balance is the game in fusion.
                    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."

                    Comment


                    • Yes, I have a similar problem (the result of being run over by a car when I was a toddler). Unless I do regular stretches, I get knee injuries that make it very difficult to walk.

                      I can't imagine what problems I'd have to suffer from before I decided to take a surgical route to fix it, but it would have to be pretty seriously worse then this - something like debilitating pain or the inability to walk. I'd do up to an hour a day gladly. But, I hate surgery. My mom choose to be virtually disabled - she walks very slowly with a walker - rather then get hip surgery. We can't be the only cowards out there

                      Comment


                      • Originally posted by hdugger View Post
                        We can't be the only cowards out there
                        No you are certainly not. That is an emotional reaction and no emotional reaction is wrong.

                        The hope is that people trying to decide have the correct, up-to-date statistics on safety and efficacy of the surgical procedure in question. And unless it is no risk whatsoever, you will always have people opting out, even those in very dire straights.

                        Surgery is not for the faint of heart and things can and do go awry but the prize is big. And some have no real choice like both my daughters. Choice is a luxury or a burden depending on how you approach it. For us it was a luxury that we didn't have. We were spared the burden of dithering in a grey area.
                        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."

                        Comment


                        • As far as I know, Martha Hawes has not published anything to show that her correction has been maintained. I believe Mamamax claims that Martha maintains her correction with 1 hour of exercise a day, but I don't know where she got that information.

                          I think there are some who would be willing to do 1 hour of exercise a day, but I doubt that many would go beyond that. And, one would have to wonder what happens if the person gets ill and can't exercise for a period of time. Do they then have to go back to 4 hours a day? Or, will they end up having to have surgery anyway?

                          The Schroth method has been around for a very long time. It seems to me that if people were able to maintain correction (with or without maintenance), it would have been published by now. There's not even an anecdotal paper on the subject. The fact that there is no long term outcome study is really the only proof I need.
                          Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                          ---------------------------------------------------------------------------------------------------------------------------------------------------
                          Surgery 2/10/93 A/P fusion T4-L3
                          Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                          Comment


                          • Okay I didn't realize much of that. I wish we could find out if Hawes maintained her reduction and how much exercise she does now.

                            I thought Hawes said she was doing an hour. If is was Mamamax then I'm going to edit that out of my posts right now.
                            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."

                            Comment


                            • I believe it's from Hawes' memoir (according to Mamamax in another topic) - "Same thing happened with Martha Hawes (who maintains her success with 1 hr of exercise daily per her memoir)"

                              Originally posted by Pooka1 View Post
                              Okay I didn't realize much of that. I wish we could find out if Hawes maintained her reduction and how much exercise she does now.

                              I thought Hawes said she was doing an hour. If is was Mamamax then I'm going to edit that out of my posts right now.

                              Comment


                              • Originally posted by hdugger View Post
                                I believe it's from Hawes' memoir (according to Mamamax in another topic) - "Same thing happened with Martha Hawes (who maintains her success with 1 hr of exercise daily per her memoir)"
                                Question for Mamamax or someone with Hawes' memoir... When was her memoir written and how long had she maintained the correct with one hour of exercise at the point of writing?
                                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."

                                Comment

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