Scoliosis Part 2
14 July 2019
In this second part on idiopathic scoliosis, I’m going to talk about what happens to the spine.
It is the nature of the anatomy of the spinal joints that whenever the spine bends to the side, it also induces rotation. This twisting causes stiffening. Imagine taking a towel and rolling it lengthways. Now hold it at each end. You have a little stiffness, but you are able to bend in all directions comfortably. Now continue twisting it and it will become rigid and lose its flexibility. This is what happens in scoliosis, particularly if the middle of the curve is in the thoracic spine and the ribs are involved. In addition, a big curve in the thoracic spine can affect lung function.
Early diagnosis is key. Idiopathic scoliosis is very difficult to reverse without surgery but is much easier to prevent from worsening. It is very manageable if treated early.
The main time where idiopathic scoliosis occurs is between the ages of 9-14 when the child is growing quickly.
You can do a quick assessment at home by having them bend forward from the hips and checking to see if their pelvis is level and their spine is straight and generally look for uneven hips and shoulders.
We advise children between the ages of 10-14 to be checked twice a year for scoliosis.
We run a back to school free screen in January in which we look at growth and posture before the school year begins. We are now introducing a free growth check in July for children aged 10-14. This means that twice a year your child is screened for scoliosis and other growth problems that happen during this period.
The Importance of Movement
arent or sibling), then we start to get rudimentary use of our upper limbs, then we learn to lift our head and role onto our stomach, and now we can use our arms to push ourselves up and our neck muscles to support our head. Then we start to get stability in our trunk muscles so that we can sit and start to reach out, and then we are crawling, toddling and eventually running.
In other words we go through a sequence of learning where we move with increasing complexity, from simple reflexes to the ability to stabilise ourselves against gravity and then the ability to perform complex volitional activity such as eating or running.
This means that if we need to restore movement, say after an injury or an illness, we need to think in terms of this hierarchy, reflexes - stability - complex movement.
Humans are unique in that we have a complex postural system that enables us to stand upright on two unstable pins, that's why it takes us three years to learn to walk efficiently. But it is under constant stress and it's ability to perform this task starts to deteriorate as we age unless we take steps to keep it in top condition.
In research published in Queensland: Falling is not just for older women: support for pre-emptive prevention intervention before 60 (J.C Nitz and N.L Low Choy 2008), the researchers assessed women between the ages of 40 and 80 for the risk of falling. 8% of women in their forties, 14% in their 50s, 25% in their 60s and 40% in their 70s had fallen in the previous 12 months. In addition, the risk of falling increased significantly if the woman had other health problems.
Their conclusions was that for women over 40 years old, the number of illnesses increase the risk of falling and the risks increased still further if they were over 60. Preventative program participation aimed at maintaining good health appears vital to prevent falls.
To put it another way, our stability starts to drop in our 40's. Falls are a natural consequence of reduced stability but they are not the only consequence. The early consequences are less efficient use of posture which leads to stiffness and back pain.
So, in order to perform any meaningful activity, we must first be stable. Stability is really the ability to maintain balance while we shift our weight. When it starts to drop it means that we have less ability to generate momentum to move forwards. And if we are unable to generate as much momentum, then our step gets shorter, and if our step gets really short we require a stick to help support ourselves. Thus our ability to move becomes compromised.
So as we get older we get stiffer and less stable, which leads to weight bearing changes. It also leads to restriction in movement. It's important therefore to not only keep mobile but also work on keeping yourself stable. Exercise that can help this includes dance, yoga and Tai Chi. It is also important to work on your posture. Posture is basically how well you control your relationship to the ground and how efficiently you are able to shift your weight in order to generate momentum.
Perfect Posture Program
If you want to lean more about posture and how to keep yourself mobile and pain free, then we have an educational program that maybe for you. Our Perfect Posture Program has been developed from 25 years of rehabilitation of chronic back pain, and 10 years of measuring balance and analysing posture with computerised posturography. The purpose of the program is to teach you how your postural system works, so that you can use it in any situation, whether you are standing at a meeting, sitting at your desk or putting your child in the back of the car. This six week program is suitable for anyone who wishes to improve their posture from children aged eight and above, right through to seniors.
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