Sunday, December 8, 2013

Scoliosis Exercise - Are Weak Muscles The Cause?

One of the most common misconceptions I find among the general public in regards to understanding idiopathic scoliosis is they feel the condition is somehow due to weak spinal muscles or curve progression can be halted by strengthening spinal muscles through general scoliosis exercises. Both of these concepts couldn't be any further from the truth.While it is true that spinal muscle strength does become unbalanced in moderate to severe scoliosis spines, this is a secondary adaptation to the structural curve in the spine, and not the cause of idiopathic scoliosis. This is confirmed by normal EMG studies in early stage scoliosis patients that later show hyper-tonic muscles on the convexity of the curvature a substantial amount of time after the curve as already progressed. Therefore, it is a secondary adaptation and not the cause of, nor the reason for scoliosis curve progression.The muscles aren't weak, they are discoordinated.Idiopathic scoliosis is primarily a neurological condition that has it primary effects on the spinal column. Essentially the brain's postural feedback mechanisms aren't working correctly and they don't set off any "red flags" in the brain's automatic postural control centers. No alarms going off in the brain's automatic postural control centers means the muscles aren't directed to self correct the abnormal posture and the spinal curve (scoliosis) is the result. It would be similar to the brains cardiac system having a malfunction causing the heart muscle to beat irregularly. The young child with this genetic predisposition for idiopathic scoliosis will have a postural control center that isn't functioning correctly so the body position isn't symmetrical where the brain and body don't seem to be communicating very well.Environmental influences, especially biomechanical forces, work as scoliosis curve accelerators.While early stage scoliosis appears to be the result of a genetic under-development of the automatic postural control centers in the brain, the reason some curves progress to a severe degree appears to be largely dependent on both genetic and environmental influences...especially bio-mechanical influences like head position, hip rotation, and certain activities (ballet, gymnastics, etc). This would explain the significant increase in likelihood of curve progression in scoliosis spines with a cobb angle larger than 20 degrees versus scoliosis spines with a cobb angle less than 20 degrees. There seems to be a very strong correlation between increased rotation of the spine when the bending and translational component seem to reach 20 degrees or higher. The more these environmental factors interact with the poor sensory integration system (posture control mechanism) the worse the scoliosis becomes like pouring gas on a lit flame.No one is arguing the value of good core strength and stability, but it probably plays little to no role in the development of, nor the progression of idiopathic scoliosis curve progression. The only scoliosis exercise based rehab program that will have any true effect on the spinal curvature is one that is specifically designed to "re-train" the automatic postural control centers in the brain. Successful alternative scoliosis treatment will effectively strengthen the posture control mechanism not try to strengthen a weak muscle.

Dr Brian T Dovorany and Dr Clayton J Stitzel specialize in alternative scoliosis treatment for both children and adults. Their "scoliosis boot camp" and "early stage scoliosis intervention" programs are gaining interest from around the world. Dr Stitzel is a past director of the CLEAR Scoliosis Institute and Dr. Dovorany is an active member of the CLEAR Institute Advisory Board and Adva

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