Hey, everybody, did ya miss me? I know I would cuz everyone needs a little awesome in their life, and I provide more than a little, right? I thought you’d say yes. Anyways, about a month ago I asked people if they wanted me to write about anything specifically, and someone suggested scoliosis. I don’t have scoliosis, nor do I know anyone that does. Sure, I could have done some research and came up with some pretty good information, but I am WAAAAY too lazy for that, and I wanted to provide you all (ya’ll) with some first hand knowledge.
So instead, I thought I’d give you all a little treat. I’ve asked a real life, certified, highly educated, and golly-gosh, just an all-around good guy, physical therapist to write a guest post. The crazy bastard actually said yes!! Everyone, say hi to Mike Scott.
Continuing with my lazy theme, I’m going to cut and paste directly from his “About Me“ page on his website:
“I am a physical therapist in the Boston area focussing on orthopedics and sports medicine. I also have a major interest in strength and conditioning and its relationship with rehabilitation. With this blog I hope to help inform people of the rehab world while also bringing some entertainment to the masses.“
Mike and I share a lot of the same beliefs when it comes to prehab/rehab and weight training in general so I knew I could count on some great information. I’ve asked him to give a brief intro on what scoliosis is, how severe it can be, and what it’s like to live with it. I’ll stop blabbering now so you can actually get to the good stuff!
Take it away, Mike…
Dave, first I want to thank you for involving me in such a great site. I think that the brutally honest “suggestions” and information that you provide are fresh and deserve a look from anyone interested in the fitness industry. [Editors note (that's me): Contrary to popular belief, I did not pay him to say that.]
Now, let’s get to the topic at hand: Scoliosis. Scoliosis may be more prevalent than you think with roughly 3% of the population of the USA having the condition, and those are only the cases that are reported. In many instances, Scoliosis is not severe enough for someone to notice or report. Scoliosis is a condition of the spine where instead of having a straight vertical alignment, the vertebrae are aligned in an “S” or “C” shape at one or many levels. You can either be born this way (congenital), develop the curve(s) secondary to a disease process or accident (acquired/neuromuscular), or the condition can appear for no known reason at all (idiopathic), the latter being the most prominent cause.
For most, Scoliosis is a benign condition, typically being noticed during adolescence, and continually monitored into young adulthood. Depending on the severity of the curve(s) treatments include monitoring and general physical activity, bracing, or surgery. Surgery is reserved for those whose curves are greater than 45 degrees, and are causing physiological changes and most often difficulty breathing.
As stated earlier, people do not usually know they have Scoliosis, and it is typically discovered during routine check ups at school or in the doctor’s office. However, symptoms usually include low grade back pain due to uneven musculature, a noticeable rib hump with forward spinal flexion, or uneven hip, shoulder, and leg alignments
For patient’s living with moderate Scoliosis, less than a 25 degree curve, management of associated back pain will include general exercise and monitoring by a doctor. Exercises should focus on correcting asymmetrical musculature that would promote dysfunctional movement patterns, as well as stretching out tight muscles. If a patient presents with a “C” curve they will want to focus on stretching the muscles on the inside of the “C” while strengthening the muscles on the outside of the “C”.
The same approach is also taken with patients who receive a brace for their medical management. There are many types of braces, some of which patients wear all but one hour a day, and some that patients only wear to bed. Regardless of the type of brace, exercises are typically recommended as well. In my own experience, depending on the age of the patient, adherence to a brace schedule is usually poor to moderate. Most people feel that the braces are too uncomfortable, or too restrictive, especially during athletic activity. Once a person’s skeletal system has matured and shows no changes in growth, braces are usually discharged.
As stated earlier, surgery is only performed on severe cases, in which exercises, and bracing have not been useful in slowing the progression of the curvatures of the spine. Surgery is done to straighten the vertebrae commonly with Harrison Rods (metal rods kept in place with screws)put in place to prevent the return of the curves. This surgery and rehabilitation is extremely painful and leads to the restriction of movement of the person’s spine for the remainder of their life.
Most people with Scoliosis do not find it very limiting, especially in their athletic endeavors, unless they are required to wear a brace or undergo surgery. I often recommend that patients with Scoliosis take part in varying activities that will promote the overall strength of their back and trunk muscles leading to more symmetrical movement patterns. Often I will specifically recommend yoga as well to teach patients poses/stretches to improve tissue length leading to as optimal an alignment as possible.
Strength training is another activity that I will highly recommend to all patients. This does not mean I want people to take up Olympic lifting as a second job, but generalized strength training does help promote improvements in movement and spinal alignment when done properly and under knowledgeable supervision. When working with patients/clients with scoliosis anatomical hip, back, and shoulder alignments have to be considered when observing form. If someone’s leg lengths are significantly different due to their curve(s), “correct” squat form will not be typical. As always safety is the number one concern.
There are not any specific precautions that someone with minimal to moderate Scoliosis should adhere to while taking part in activity. Bothersome motions, which are typically the end ranges of flexion, extension, or rotation, should be avoided, but other than that it is very important for people with Scoliosis to live an active life. As with many conditions, I cannot stress the importance of being exposed to varying activities. We are starting to see more overuse injuries in the youth population, and patient’s with Scoliosis need to also take part in a wide range of activities to prevent tight muscles from getting tighter and stretched muscles from lengthening.
A final recommendation that I make a to my patients with Scoliosis is to avoid prolonged positions. Because people with Scoliosis are usually diagnosed when they are of “school age”, this is a very difficulty recommendation to adhere to. When these “school aged” patients sit all day, their tight muscles are allowed to tighten more and the muscles that are constantly on stretch are becoming longer. If these people come home from school and continue to sit on the couch or in front of the computer they will only continue to promote the pathological spinal alignments.
I hope this review of a common but not well understood condition opens your eyes. If you work with or are the parent of adolescents be on the lookout for the symptoms of Scoliosis, because as with many pathologies, the sooner treatment is administered, the better the outcomes.
So there you have it. I haven’t asked him about this yet, but if there’s enough interest and people and want to know more about this subject, maybe….just maybe….I can see if he’d be interested in writing a more detailed follow-up. Of course, that will depend on all of you to leave comments below so we know how interested you are.
Once again, thanks a lot, Mike. And for everyone reading this, please check out his site. It is loaded with good info, and it’s on my list of regularly read blogs. Alright, I’m out. I’ve got some Figure Skating to watch….er something like that.