Torso Rotation Strength Training for Scoliosis

[Anna's mom]

I am not sure the angle or degree of movement for Anna. Our machine is also labeled 5-4-3-2-1-0-1-2-3-4-5. She keeps the machine at "4" which starts her movement past the mid-point on one side and then she rotates past the mid-point and over to the other side as far as she is comfortable. For example, if her starting point is a little to the right of the mid-point and then she will rotate to the left as far as she can go.
Not sure how many degrees this translates into. I guess I should ask our PT at the gym!

[AMom]

MedX clip & Main Line Health & Fitness

Dingo,

The prior version has an overhead cam, there is no way she can fit into the older version today, even w/ modifications and her added height.

Yes, the video clip shows what our machine looks like. (To see it without a body blocking the components, type MedX Limited and click on the one that says MedXonline.com.) No matter what we tried, we couldn't stabilize her pelvis until Feb 2011. The problem is the pads that come down on the thighs & shins. That portion of the machine slides forward toward the seat, but is doesn't come forward enough for a child. Even with foot rests and every other part fitted for her, the thigh pads would apply pressure only on her knees, which would have caused damage. We tried to modify it and several other restraint systems, but couldn't get them to work. --Until her legs (thighs) grew long enough to fit into that part of the machine, we simply had to wait it out.--

Since I know you've seen it, I can describe what has been changed.
Vertical back pads: These were remade 5" thicker
Horizontal hip pads: These were remade thicker as well
Seat: Several additional seats were made of various thicknesses so they can be traded out as she grows
Foot rests: This was made quite a bit thicker as well--I'm not in the room, but I think it was 5" also
Weight Stack: This has a counter balance on it to allow her to use the machine in the very beginning--when she couldn't move it even unweighted.

We will have to have a new set of thinner back & hip pads made w/in the next 6 months--she is growing that fast. I had thought she could stay in the back & hip pads and just move the leg restraints & foot rests away from the seat, but I didn't allow for the space between the back pad and where her arms grip the vertical rolls/ pads. It is getting snug on her arms.

To see the Variable Angle Roman Chair type in BackStrong VARC. Sorry, I don't know how to insert a link.

My PT and I have been discussing the MedX Lumbar unit, trying to decide if it will be helpful. Some of the offices scattered throughout the USA have been using them, but I can't get a good read on the results. I just looked at the Main Line Health & Fitness Link and see they are using it as well. Does anyone know what their protocols are? They are claiming they are getting a 50% reduction, but do not mention the size of the curves they are starting with or how long they are holding the curve reductions. We are in CA, so I can't go see their work. I will contact them by phone & email if you folks don't already have the info available.

[AMom]

Full Rotations

Anna's Mom,

For the purpose of the child understanding when the motion is complete, our PT has us only increase the pin when she can make the full rotation. Otherwise, my daughter would make "short" rotations more often than not. I think you said your daughter is almost 13, so she probably pays more attention to her rotations.

I just checked and "Fit Strength" online shows all of the MedX exercise equipment both with a person using them and the empty machine. This is a place that sells the equipment, not a PT office, but the pix are clear so maybe it will be useful. The "medical" versions take readings and cost $xx,xxx.xx a lot of money. We use the "exercise" version.

[Anna's mom]

Thanks AMom! I will check it out!
Although so far so good w/ what we are doing w/ the Cybex at our gym. I am still very interested in taking a look at the MedX, though. I'd like to get a feel for how others are executing the exercise! Thanks!

[AMom]

Anna's Mom

Anna's Mom,

Opps! I meant to address the Rotation info to YOU and the Pix to DINGO because he had asked which model we are using. I was not trying to suggest you (or anyone else) should change what you are doing. I had the impression that he was doing what I did when I read his son used the Cybex. --I looked up the machines to see how it stabalized the pelvis, how the body moved, and how comparable it was to what we are doing. I want to understand what he means when he says, "xyz rotations" etc. That also explains why I sent the info on the VARC. I am NOT suggesting it, just making the info available in case either of you want to see it and understand what I am talking about.

By the way, how do you insert a link to another article?

[Anna's mom]

AMom,
I didn't take your post in that way at all! I love the information!
As far as inserting a link, I just cut and paste...you could also try using the attachment icon when you reply to the thread!

[Dingo]

AMom

Do you own your MedX machine?

Dang I wish they'd produce a smaller version for kids. CYBEX Eagle.... basically same problem. It takes 2 spotters to keep Scott moving smooth.

[Anna's mom]

I have never seen this machine before...I would guess this would isolate the lumbar area a little better.
http://www.youtube.com/watch?v=2oFRB...eature=related

[AMom]

Wow, I sure talk a lot!

Anna's Mom,

Sorry to be obtuse, but what do I cut & paste? Can I take it from the body of the article or does it need to come from the box at the top of the screen?

Dingo,

Yes, we purchased the machine. Though I found one an hour & a half from my home in a doctor’s office, it would not have been practical (gas, time, & cost) to go there 2x a week for 5 years. It was easier and substantially less expensive all the way around to buy a demo in our situation. (It helped that we were able to use our medical account to purchase the unit-- hooray for tax-free dollars!) I thought we'd be able to find a VARC we could use locally, but was unsuccessful, so I bought that piece as well. I have to admit, if we decide to purchase the lumbar unit, space may become an issue.

As you know, there are advantages to having the equipment "in house." For instance, we can plan the workouts around our schedule, make simple adjustments to the timing of the workouts to allow for school functions & family vacations, start using the unit sooner because we are able to customize it, and in the long run it will cost a lot less than paying to use a doctor's unit. (There are no units available in a gym in our area.) Between her growth & the modifications to the equipment, I do not have to spot her during her workout.

The workout can take as long as an hour & fifteen minutes (if I also count the PT to address surrounding issues & icing) or as short as 30 minutes if we just do the warm-up, VARC, MedX, & icing. Even though my children are extremely active in school functions and extracurricular activities, 1 ½ to 4 hours a week is no big deal. (My comment made me curious if we were really as consistent as I thought we were so I just went & flipped through the last ten months of PT notes and found she has missed less than 1% of her workouts due to illness, school, & vacation.)

She was often tired when she had to sit or stand still for long periods of time, but the PT has strengthen her body enough so that is no longer an issue. (She has always been involved in dance, riding, swimming, & general play, but that didn’t seem to make any difference.) Improving her quality of life is reason enough to continue the program; the possibility that it might hold the curve is a bonus. Other than make her feel *comfortable, there is nothing else we can do to help her at this time.

*Since her curve has not increased during the last eight months, bracing is not appropriate and her curve is too small to require surgery. (Yes, her ortho is surprised her curve quit growing during the middle of her growth spurt.)

WOW! I sure talk a lot.

[Anna's mom]

AMom,
I'm certainly no expert, but the way I insert a link is by right clicking on the URL address and clicking "copy" and then going back to my post and right click again and this time selecting "paste". Another way is to left click on the body of an article until what you want to transfer is highlighted in blue, then right click and choose "copy", and proceed to "paste" in the same way as above.
I hope I answered your question!

[Dingo]

Here is an interesting read on what exercise does to ligaments and tendons. This directly applies to Dr. Kiester's theory on why Torso Rotation works.

Tendon and ligament adaptation to exercise, immobilization, and remobilization

While experimental studies have clearly shown that tendons and ligaments respond to exercise, immobilization, and remobilization, no theory has yet been established to explain these responses. This study attempts to establish such a theory. We apply a model used previously to describe tendon and ligament growth and development (6) to predict changes in the geometric and material properties of tendons and ligaments due to exercise, immobilization, and remobilization. The model predictions are compared with the results of experimental exercise and immobilization studies performed by other investigators, and implications for basic control mechanisms of tendon and ligament adaptation are discussed.

For both the immature and mature cases, the simulations predict increases of approximately 14 percent in the tendon cross-sectional area, modulus, and strength. Although the experimental studies provide results only for time points at the beginning and end of the exercise periods, the simulation results are consistent with the available data.

Translation: Exercise makes ligaments physically larger and stronger.

Figure 5 illustrates the effects of exercise, immobilization, and remobilization on structural properties such as stiffness and failure force as predicted by our simulations. Taking normal growth and development as the control, the effects are essentially the same for the immature and mature cases. Exercise leads to a moderate increase in the stiffness and failure force. Immobilization leads to a significant decrease in these properties, which rapidly return to normal with remobilization. Woo and colleagues (21) have proposed similar exercise, immobilization, and remobilization effects for ligament structural properties based on their experimental studies. Our results corroborate the relationships they have proposed

Translation: Exercise makes ligaments stiffer and tougher.

For the mature case, the simulations predict a significant decrease in the area, modulus, and strength during immobilization and a reversal of these changes during remobilization. These trends reflect the changes observed by Woo et al. For the immature case, the simulations predict similar rapid losses of modulus and strength during immobilization. However, because the area encounters a biological lower bound that is increasing, the tendon area increases in the immature animal despite immobilization. These predictions are consistent with the findings of Walsh et al. although the simulation predicts smaller increases in the cross-sectional area than were observed experimentally.

Translation: Immobilization (this probably applies to bracing) reduces the physical size, stiffness and strength of ligaments.

[Pooka1]

Here is an interesting read on what exercise does to ligaments and tendons. This directly applies to Dr. Kiester's theory on why Torso Rotation works.

Dr. McIntire will dope-slap me if I'm wrong but Kiester is saying the ligament is too tight, tethering the spine resulting in rotation and curvature. All these things appear to inure toards making the ligament even more resistant, more tethering, inducing MORE rotation and curvature, etc. etc.. It all is at odds with Kiester and his notions about TRS.

[Dingo]

Pooka1

Dr. Kiester believes that it's possible that deformed spinal ligaments can be "stretched out" through TRS.

...Dr. Vert Mooney's trunk rotation exercises which seem to have the unexpected consequence of stretching the right ligaments, and therefore seem to be somewhat effective.

Furthermore...

"The amount the ligaments have to stretch to stop the progression of the curve is surprisingly small."

The research I posted above shows that exercise makes healthy ligaments larger, stronger and stiffer. This combination of stretching and strengthening is clearly a double positive.

[Dingo]

Assuming Dr. Kiester is correct this simple experiment explains why Torso Rotation works while stretching and traction doesn't.

Test A
1) Run a dish towel under the sink and soak it.
2) Hold it on either end with your hands.
3) Push your hands together and squish the dish rag in between.

What happens? Water flows out of the dish rag at a moderate pace.

This time change step 3.

Test B
1) Run a dish towel under the sink and soak it.
2) Hold it on either end with your hands.
3) Ring the dish rag out by twisting it.

What happens? An increased volume of water gushes out and at a much faster rate.

When you twist a dish rag it is subjected to much greater force than pushing the ends together. In addition this force is applied in a more even manner across the entire rag.

And there you have it. A torso twist produces more force and works every cell in the ligament. A stretch is much weaker and depending on the direction you bend part of the ligament might not be significantly impacted at all.

[AMom]

Anna's Mom Update? & Dingo Arms & Seat Height

Anna's Mom,

I can't remember the date of your daughter's ortho appointment, was it in Dec or Jan? What does her curve look like this time?

Did your PT tell you what degrees the #5 . . . 5 represent on the Cybex? Is it too nosy to ask about your daughter's entire workout? How does she hold her arms when she moves through the rotations?

My PT just returned from additional training and wants to discuss it with me. I'll post if she has anything to add to the subject. I am thankful she is willing to focus her licensing hours on this subject. She is coming over on Tuesday/ 20th.

A Mom

Dingo,

I tried the rotations with a 3-count-hold on myself for six workouts/days (1x every other day). The hold feels like a rest rather than an additional workout. How does it feel/ look to you?

We've decided to add a second seat height to the MedX workout. It is the first change we've made, other than the prescribed increased weight, and I believe it to be a minor adjustment. We will alternate between the regular seat (it adds 2" to the base) and a higher seat height (it adds another 0.5" for a total of 2.5"). Though her lumbar curve remains good at both heights & her arm position remains the same, her strength is uneven at different seat heights. We had to adjust the height of her foot position to obtain the correct angle at her hips, so that is different (however the angle is the goal rather than the positioning). I am hypothesizing the additional seat position will disburse her strength. I will note if/ how her strength responds/ weight lifted.

A Mom