Anyone have any experience with Scoliosis? Anyone have any experience with Scoliosis?

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Thread: Anyone have any experience with Scoliosis?

  1. #1
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    Default Anyone have any experience with Scoliosis?

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    I just found out a few weeks ago my son has it. I had been planning on taking him to the gym with me so we could workout together, but since I found this out I put the idea on hold till I could talk to a specialist about it. We went to see the orthopedist on Friday and she said he has two curves one minor one up at the top near his neck and another in his lower back which is 33-35 degrees. From what I had read before we went this one in the 33-35 range is major not quite enough for surgery, but still high he will be 17 in June and I think he still has a small bit of growing left to do so it may or may not get worse. I expected once I heard the degree of it for her to give him restrictions on what he can or can't do. I specifically asked her about lifting and weights and she said it was fine and that as long as his MRI came back clear ( which we are doing tomorrow) to make sure there isn't anything else wrong that he would have no restrictions. That sounds great to me, but I am still worried. Do you think I should talk to her again to make sure she understands how intense real weight training actually is and ask her specifically about squats and deadlifts? I want him to be able to do this and I do believe that making him stronger and improving his bone density will help him ( it won't fix the problem I know that ) but hopefully by making his body stronger overall it will lessen the impact of this disease on him as he ages which is my goal. So after all of that my question is does anyone here have scoliosis and what degree is your curve and what issues have you had or has anyone coached anyone with this and what did you see? Any help or advice would be greatly appreciated. I am not trying to get you to overrule his doctor just looking for someone who has been there.

  2. #2
    Paul Horn is offline Starting Strength Coach
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    I don't have it but I have coached people who do and we haven't had any issues. I've heard similar reports from other coaches on this board. I'll open up this thread and see if anyone who does have it wants to chime in. In the meantime, here's a pretty cool article you might find relevant.

  3. #3
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    Short version: someone with scoliosis or similarly serious joint issue can do the lifts and get strong, but they may need to begin with another version of the lift, start with lower weights and progress them more slowly than someone with a completely healthy body. This person needs coaching.

    Long version:
    Forgive the length of this, I find that when people understand the principles behind something, it makes it easier for them to be motivated to do stuff about it.

    I speak from experience of my own fucked-up mutant back, which Paul can testify to since he saw me standing with a shim underfoot and Rip commenting to the whole room on the unevenness of my nipples while I deadlifted at a seminar last year. Ripís usual comment is that the only thing to do with a guy like me is give him a vasectomy and remove him from the gene pool, but I already produced a son so he was too late and here we are. And Iíve had several personal training client with this and related issues.

    Everyone has asymmetries Ė chiropractors, physiotherapists etc talk of an ideal posture which in fact nobody has. Iím right-handed, is this left-right imbalance an issue which requires medical attention? And right-handed people will tend to have stronger left backs Ė because they carry bags, kids and groceries on their left side, leaving their right free to open doors etc. Medical problem? As well, almost everyone has a slight scoliosis in their upper back, as the spine moves around to give space for the heart. So the question is not whether someone has asymmetries, but whether these are gross enough to cause pain or hinder movement, or threaten to do so in future.

    Scoliosis is of two kinds, functional and structural. A functional scoliosis is when the muscles on one side are overly-developed and pull the spine out, you get this with tennis players, rowers and so on. A functional scoliosis may be completely resolved with exercise Ė just make the weaker side stronger.

    A structural scoliosis is where the bones themselves are out. One leg may be longer than the other, this pushes the pelvis up on one side, then twists the lower backís spine, and so on. Or the acetabulum (the ďsocketĒ part of the ball and socket joint of the hip) may be forward on the left and back on the right, so that the thighs sit unevenly, which then flows on, etc. Or maybe the spine is just twisted like a pretzel. Each structural scoliosis is different. A structural scoliosis can be assisted with various medical interventions like shoe lifts, surgery, etc Ė and can never be resolved with exercise.

    However, it can be minimised with exercise, and its bad effects mitigated. Certainly itíll get worse if the person is sedentary. For the person with joint issues, exercise is not optional.

    A structural scoliosis or other issue basically means some part of the body isnít pulling its share of the load, and other parts kick in to take it over, ďcompensationĒ in the phrase of the medicos. A compensation is a good thing, if those muscles didnít compensate the scoliotic spine would simply fall apart. If the spine twists to the left, you get the muscles of the left back much more developed than those of the right. So we want to strengthen that weak side. Well, this is what we have low-bar back squats for, and all that good stuff.

    However, we need to remember three things: an injury or health condition means weaker tissues, and load and age both amplify asymmetries.

    Every tissue has a breaking point, with previous injury of condition that breaking point is lower. But we still train it, because damaged tissue is the same as healthy tissue, it adapts and gets stronger if you ask it to. Itís simply that damaged tissue is starting from a lower point and has lower limits than healthy tissue.

    A chainís only as strong as its weakest link, pull too hard and you break the chain. If youíve had a rotator cuff impingement, that tissue is quite simply weaker than it could be. Maybe when you bench 100kg for work sets itís fine, one day you max out and do 120, the next day the pain is back. It wasnít 100 hurt you, it was some number between 101 and 120, but because you maxed out you donít know where it was.
    But before tissue breaks, if you give it a chance and listen, it starts screaming at. So if you worked steadily from 100 to 102.5 to 105 and so on, at some point before the 120 breaking point, itíd start complaining to you. Letís say you hit 112.5 and it hurts, okay you back off to an easy 80 and build up again, this time it hurts at 115, great, youíve made progress Ė like I said, damaged tissue adapts and gets stronger, too. Maybe next time you build up it hurts at 115 again, okay youíve reached your limit for a while, try something a bit different Ė go from bench press to close-grip and see how that goes. Itís a process which is never finished.

    Load amplifies asymmetries. If I stand up with 100kg, from the front at least I look nice and straight. If itís 180kg, then thereís a distinct leftward lean, and my right arm is basically touching my trunk. The danger here is that while my left back muscles might be able to handle their fair share of 180kg Ė half the load Ė they canít handle it all by themselves, itíd be like my trying to pull 360kg. So when Iíve hurt myself lifting, it usually wasnít the weaker side, it was the stronger side. But again, it wonít be that I go by 5kg jumps from 100 to 180 and then suddenly at 180 with no warning things snap, maybe around 150-160 things start hurting. Well, thatís my limit for the moment.

    Lastly, age amplifies asymmetries. That dude in your office hunched over his computer who when he comes around the corner you see his ostrich head appear before the rest of him, when heís 70 heíll basically be a hunchback. In this as in so many other things, barbells slow the ageing process. Even if you canít make things better, you can slow down how much worse they get.

    When I was in my 20s I was in the Army, and while I was a mediocre soldier my poor performance was not due to my crappy back. While doing that I lifted, and got to decent lifts. In my 30s I became sedentary, at one point I did essentially nothing for 18 months. Last 6 months of that I woke up most mornings with my whole back seized up, it took 20-40 minutes of walking around and stretching before I could function for the day.

    I went back to lifting, and not knowing better I jumped straight back into lifting and progressed the resistance quickly. This meant that my back seized up between every set of squats, deadlifts and chin-ups, more stretching helped. Stupid as this was, after 4-6 weeks it eased off. Nowadays if I go a couple of weeks without lifting I start getting problems. If I lift regularly thereís no problem, my back might get stiff after hours at a desk or in a car, but thatís the same for everyone so who cares. Now in my 40s Iíve been up to some decent but non-athletic lifts and the backís not really an issue, the asymmetry is mostly cosmetic.

    Knowing what I know now, I would have advised myself to start with something like Dan Johnís Intervention 101 Ė goblet squats, planks, bat wings, hip hinges and farmerís walks. You do that for anywhere from 3 weeks to 3 months depending how bad the back issue is, then you have a good movement foundation to take to barbells. Why? Again, injury means weakened tissue, a chainís only as strong as its weakest link, but injured tissue adapts like healthy tissue does, and load amplifies asymmetries. So we find versions of the movements the person can do without a big load Ė if a goblet squat or plank hurts someone then everyday life will kill them anyway, thereís no additional risk there.

    After that you go to the barbells, and progress the resistance weekly rather than by session.

    The movement is more important than the load. Get the movement right and the load will come. By "movement" I mean something in the squat family - whether you low-bar, high-bar or front squat is much less important than that you squat. Medicos offer us corrective exercises, but generally speaking the best corrective is correct movement.

    The SS method offers an outstanding way to teach correct movement. There are certain mistakes which almost everyone makes when theyíre first learning to squat, etc, and the SS coach knows how to correct these. But a person with a history of injury will because of their compensations have a bunch of other mistakes they make, so here we need a coach with experience and a keen eye.

    For example, lots of people round their back on deadlifts and squats, but the person with scoliosis will lean to one side, or corkscrew their hips as they come up. The typical coach will watch the lift from the side to see lower back etc rounding, but if youíre dealing with scoliosis then you need to do the full walkaround. If theyíre twisting around too much then you just drop the load to one they can handle without the twisting being too offensive to the coachís eye and lifterís spine.

    My experience is that with a quick progression of weights, lots of people will have all sorts of odd aches and pains pop up. I believe that the big moving muscles like the quads adapt very quickly, while the smaller stabilising muscles like the quadratus lumborum adapt more slowly. This is doubly true of someone with gross asymmetries which cause pain or hinder movement. So you progress more slowly, giving time for those smaller stabilisers to adapt. If something flares up, back off and build back up.

    But you still do the movements, and you still progress.

    I think that about covers it.

  4. #4
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    One of my children was diagnosed with scoliosis 2 years back and has been in treatment at a CLEAR center near where we live. The spinal curves have stayed the same through a 4" growth spurt. It involves daily exercises after an initial 2 week intensive therapy.

    http://www.clear-institute.org/
    Last edited by JasonJelinek; 04-28-2014 at 08:44 PM.

  5. #5
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    I was diagnosed with scoliosis several years back by my chiropractor. I always wondered why one shoulder looked visibly lower than the other, and it turns out I've got a curve in my lower back, upper mid back, and neck.

    Since I started lifting, I have found it necessary to use a foam roller, tennis ball, and back buddy frequently to work on trigger points and such. I tend to get odd pain in my lower right back (and hip area; always worse after squatting), and regularly get trigger points in my upper right traps (always worse after deadlifting or cleans). Regular chiropractor visits and massage therapy work the best if you can afford it, but for poor folks nothing beats a foam roller, tennis ball, and back buddy to hammer out trigger points.

  6. #6
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    Thanks for all the good information. I appreciate it. I am hoping he can start next week with me. Right now he is completely sedentary. He sits around with his friends and plays video games which is about to stop. I have always been pretty lenient with my sons because they have never been in trouble and do excellent in school. It always seemed bizarre to me because in school I was a bit lazy with my school work, but I always wanted to be outside doing something and playing sports. I tried to get them interested when they were younger with little league and football, but they just had no interest in it and I didn't want to be like some of my friend's parents growing up and force them to play when they did not want to. He isn't exactly thrilled about going to the gym, but I told him its 3 days a week and he is going. I also told him I am not doing it to punish him but that I want him to get stronger so that maybe it will lessen the adverse effects of this as he ages. I am just worried about him.

  7. #7
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    if a goblet squat or plank hurts someone then everyday life will kill them anyway, thereís no additional risk there.
    Great post, sir. Thank you. My wife had a scan after a lumbar disc injury years ago which showed, among other things, a very slight scoliosis. Even after a great deal of healing and strengthening, the images of that scan hang in her head, making motivation difficult at times.

  8. #8
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    I have some insight on this.

    I had an anterior/posterior T1-L2 spinal fusion in the summer of 1998 when I was 18 years old to correct severe Kyphosis, and moderate scoliosis.I had 98 degress of curvature, and surgery was the only viable treatment option for this debilitating condition. See surgery before and after video below.
    http://youtu.be/BLi5cPlIlpc



    Before the surgery I played very competitive hockey and alpine skied.I was forewarned that a life of sport post op would be extremely unlikely at best. After I lost roughly 50 pounds from atrophy during the year post op, I turned to basic barbell training and kettlbell exercises to rehab my skeletal shortcomings. I am 16 years post op, pain free, and ski 60 days per year. I have skied 800 days over the last 11 years, pain free.



    Here is what they won’t tell you. The medical community is unquestionably at the forefront of improving quality of life, and mitigating the risk of an untimely death. These bright doctors are nothing short of impressive. However, they have greater interests to protect than to run the risk of putting your son in jeopardy to better understand the effects of strength training for pain management and correction of a serious spine disorder. The orthopedic medical community and the patients it serves would never take on such an appropriate investigation because the patient wouldn’t sign up in the first place. Not to mention the risk doctors aren’t willing to accept on a rehabilitation method in which the benefits are speculative in general. The data will never exist.



    This is all assuming that he will have surgery in the first place, which it doesn’t sound like he will progressively get worse. But regardless, what should your son do? I know for certain, that it’s probably a bigger risk to not strength train. No guarantees. But if I/we are right, strength training with appropriate progressions will reduce the likelihood your son becomes debilitated. Look up Wolf and Davis’s law on tissue adaptation. Realize that strong is better than weak regardless of physical shortcomings, and maybe more important for people with a diagnosis.
    All of this said, I have had to spend years under the bar to learn the lessons that have kept me bulletproof. Conventional deadlifts have spared my spine because I am fairly good at hinging, getting tight, driving with my legs, getting my shoulders over the bar, etc. Sumo deadlifts irritate me. Squats have been hit or miss. They sometimes irritate my SI joints. I don’t know why. Bench and Press work great. Kettlebell swings and get-ups have really helped with my mobility.



    All said, I have a best conventional pull of 390 at 180 pounds. I am nothing to write home about. Pretty good from where I have been though.
    Closing thought: Spinal fusion surgery results are all over the place (if it comes down to this). Afterall, the tissue above and below the fusion are prone to degeneration because of the new larger moment arm that is the fused section. Everyone I have spoken to that has had fusion surgery, and that lives in a complete state of pain and disrepair DOES NOT strength train.



    Here is a video of me skiing this last epic ski season here in Vail. I post this as an encouragement for your son. This is not a death sentence!
    http://youtu.be/yN4sqgmnXa4

    Keep us posted and best of luck!
    Last edited by Resurrected; 04-30-2014 at 01:39 PM.

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