Cosmetic defect or cause of disability?
By scoliosis, many understand all sorts of changes in posture in the form of stooping, hunched back, drooping of one shoulder relative to the other, etc. Often they are not given due attention and do not take care of the health of their spine or their child:
“It can’t be cured” “Who doesn’t have back problems now” “It will go away with age”...
But is it true that they can be ignored?
Normally, the spine has 4 curves: 2 lordosis (directed forward) and 2 kyphosis (directed backward). They increase the stability and mobility of the spinal column. There should be no bends to the side, otherwise it will not be able to perform a supporting function and ensure full body movements.
Scoliotic disease is a progressive, lateral curvature of the spine, which appears during a period of active growth and is accompanied by deformation of the chest, pelvis and disruption of the internal organs: lungs, heart, genitourinary system, etc. It develops as a result of changes in the shape of the vertebrae, their displacement forward/ back, left/right and rotation (torsion).
If the curvature of the spine is not accompanied by torsion, then this is not scoliotic disease, but scoliotic posture. It is formed due to low physical activity, incorrect body position when sitting, and poor physical development.
In Russia, the incidence of the disease in children and adolescents reaches 20%. According to statistics, by the end of school, every second child has manifestations of deformity. About 8–9% of these patients become disabled in childhood and almost 12% by the age of 28.
Such sad statistics are caused by the fact that scoliotic disease begins in childhood, develops very quickly, and it is almost impossible to cure it completely - you can only stop it. In teenage girls, the disease manifests itself 3–4 times more often than in boys, and progresses more actively due to the physiological characteristics of the female body.
In the early stages of the development of the disease, physical therapy and other conservative methods provide a good therapeutic effect - below we will look at which ones.
In advanced cases, correction of the curvature can only be achieved through surgery. Such operations are very traumatic, require a long recovery and also do not guarantee a complete recovery - the operated patients necessarily receive a disability group.
Thus, correct and timely diagnosis plays a major role in determining the prognosis of the disease and the treatment approach.
Why do a plank for scoliosis on both sides?
Although scoliosis is asymmetrical, as scientists have noted, disturbances in muscle function occur on both sides. The concave side is overstressed, but not strong.
By pulling the top of the head up and twisting the tailbone forward, the plank perfectly stretches the vertebrae, and does this at all angles. When doing a stand on the convex (weak) side, you should try to raise your pelvis and body as high as possible from the floor, forming an arch.
When you next stand on the concave side, focus on maintaining a straight (parallel to the floor) position.
Then you need to repeat the plank on the convex side with maximum lift.
Reasons for development, types and manifestations
The most favorable time for the development of spinal curvature is the period of active growth of the child at 6–12 months, at 6–8 years and during puberty at 10–14 years. The curvature progresses as the child grows - the younger he is, the more the skeleton can become deformed and the more this will affect his quality of life. Research into the causes of the development of this deformity for its prevention is one of the most pressing medical problems that has not yet been solved.
Playing sports does not prevent spinal curvature. A guaranteed method of prevention is regular medical examinations. In the clinic, quality “Quality of Life” can be examined by qualified specialists and the development of severe consequences can be prevented.
Causes
Previously, curvature of the spine was associated with incorrect posture - the child begins to sit crookedly at the desk and this leads to deformation. But today it has been proven that this is not so: the spine is curved not because the child is sitting crookedly, but on the contrary - the child is sitting incorrectly because he has a curvature. But the exact cause of the development of lateral curvature has not yet been established.
In the mechanism of development of scoliotic disease, doctors have identified one pattern - a discrepancy between the rate of skeletal growth and muscle growth. Those. The child's bones begin to grow faster than the muscles. This leads to weakness of the muscle corset, ligaments and the inability of the spine to maintain the correct position.
Recent studies have found that in scoliosis, the spinal cord grows faster than the spinal canal in which it is located. This leads to torsion of the vertebrae and the development of lateral curvature of the spinal column.
In 80% of cases, the cause of the development of vertebral torsion and curvature remains unknown. Such curvatures are called idiopathic.
In the remaining 20% of cases, the development of the disease can be triggered by the following factors:
- incorrect position of the child in the mother’s body during pregnancy; — congenital anomalies of the development of vertebrae and ribs; - birth injuries; — pathology of metabolism that is involved in the growth and development of bones; - diseases of the nervous system and musculoskeletal system, for example, polio, cerebral palsy, rickets; - injuries, burns and accidents, especially if they lead to shortening or loss of a limb; - severe diseases of internal organs suffered at an early age, for example, pneumonia; — surgical operations; - stress and psychological trauma, for example, due to conflicts in the family, at school, etc.
Kinds
If scoliosis develops as an independent disease, it is called structural.
If it appears as a result of another pathological condition, for example, radiculitis or different leg lengths, then it is called postural.
The Quality of Life clinic pays special attention to determining the type of spinal curvature - its shape, location, time of occurrence and severity. This affects the treatment tactics for each patient: the choice of methods, exercises, and course duration.
According to the number of arcs and shape, the curvature is: - 1 arc - C-shaped; — 2 arcs — S-shaped; — 3 arcs — Z-shaped.
According to the section in which the spinal column is curved: - cervicothoracic; - chest; - thoracolumbar; - lumbar; - lumbosacral.
By time of occurrence: - infantile (appears before the age of 3 years); - children (3–5 years old); — teenage (from 10 to 17–18 years); - an adult, when the skeleton has already stopped growing (from 18–24 years old and even older).
By degree of severity (depending on the angle of the arc of curvature): I - up to 10°; II - 11–25°; III - 26–40°; IV - more than 40°.
Manifestations
The first thing people pay attention to when there is a curvature of the spinal column is the deformation, or rather, the cosmetic defect that it causes. The patients themselves or their parents begin to notice that they have asymmetry: - one shoulder has become higher than the other; - the pelvis is distorted; - one arm seems longer than the other; - the shoulder blade or ribs protrude strongly on one side; - different distances between the waist and arms; - one nipple is higher than the other, etc.
The second is the appearance of back pain. Many people believe that pain is always present with a curvature, but this is not true. It occurs more often in patients over 20 years of age, and children complain about it extremely rarely.
If the deformation is already affecting the functioning of internal organs, then patients may complain of shortness of breath, heart problems, kidney problems and other related symptoms.
Signs of spinal curvature appear when the disease is already actively progressing and has reached the second or higher degree of severity. It is quite difficult to recognize it at the very beginning, and without special tests and x-rays it is completely impossible.
The earlier the correct diagnosis is made and treatment started, the more favorable the prognosis. Therefore, it is important to be attentive to your health and the health of your children - not to engage in self-examination and self-medication, but to turn to specialists.
Diagnostics
It is not enough to simply see when examining a patient or his x-ray that the spine is curved. Moreover, at the early stage of the disease there will be no visible changes, and only a professional will notice the initial signs.
During diagnosis, the doctor determines a number of signs on which medical tactics and prognosis depend: - which part of the spine is curved; — from which vertebra the curvature began; - whether it is directed to the left or to the right; - does it have one arc or several; - which of the arcs was the first and many other signs.
Doctors at the Quality of Life clinic recommend examining your spine every 3 months if you or your child have been diagnosed with scoliosis. Timely diagnosis and correction will help you improve your posture and live a full life.
Let's consider the mandatory elements of high-quality diagnostics.
Survey
When communicating with the patient or his parents, the doctor finds out: - what complaints bother him (the presence of pain, asymmetry and other symptoms); - how long ago did they appear; - how quickly they progress; - what methods were used to treat the disease and what the effect was.
Perhaps the patient has diseases that can cause curvature, or his family members also have problems with the spine - all this is important for making the correct diagnosis and prescribing treatment measures.
Inspection
The doctor examines the entire musculoskeletal system, from head to toe, and performs special tests to look for signs of curvature.
Adams test - the patient leans forward, touching his hands to the floor and without bending his legs. This way you can determine the slightest asymmetry of the back.
During an external examination, the doctor can see: - asymmetrical shoulder blades, shoulder girdles, waist and pelvis; - deformed chest; - tilt of the torso to the side of the curvature.
Radiography
X-ray examination allows you to accurately determine the shape and location of the curvature, its severity, and also see changes in the structure of the vertebrae, intervertebral discs and the location of internal organs.
An X-ray of the spine is necessary to conduct important diagnostic tests, based on the results of which the doctor determines the severity of the disease:
— Determination of the Cobb angle or angle of curvature. The doctor finds the upper and lower vertebrae, between which the spine is curved. Draws perpendicular lines through them and at their intersection obtains the angle of the scoliotic arc. The magnitude of this angle is the severity of the curvature.
— Raimondi test to determine the rotation and torsion of the vertebrae. The doctor measures the vertebrae with a ruler and uses a special table to calculate the rotation index using these measurements.
— Additionally, an X-ray of the pelvis is prescribed to perform the Risser test. From the image, the doctor determines the degree of ossification of the pelvis (from to 5), and from it, judges how formed the spine and the skeleton as a whole are. Grade 5 according to Risser means that it is no longer growing. The degree of maturity of the spinal column directly affects medical recommendations and treatment prognosis.
The effectiveness of treatment is also monitored using x-rays.
Also, if necessary, the doctor can prescribe laboratory blood tests, kidney ultrasound, MRI, CT.
Exercise therapy is the main method for correcting spinal curvatures
Conservative treatment methods, when prescribed correctly and in a timely manner, help to avoid surgery, disability and maintain a normal quality of life. But their use is possible only on the recommendations of a doctor, individual for each patient.
Despite many years of studying the problem, there is still no universal method that is equally effective for everyone. One patient benefits well from physical exercise in combination with massage, another from mechanical therapy and breathing exercises, and a third from swimming and kinesitherapy.
The doctor selects a complex for curvature correction, taking into account the characteristics of each patient: age, gender, general condition, physical development, the factor that provoked the curvature, its location and severity.
The doctors at the Quality of Life clinic have the most effective and modern methods to slow down the development and reduce signs of curvature: osteopathy, manual techniques, a complex of exercise therapy (gymnastics, mechanotherapy, SEAS, PNF, etc.).
Physical therapy is the main method used for scoliosis in children and adults. The variety of exercise therapy means allows for a comprehensive approach to solving the problem.
Objectives of physical therapy:
— Strengthening the muscle corset to support the spinal column in the correct position and form normal posture.
— Correction of deformities of the spine, chest, pelvis, legs that appeared as a result of the disease.
— Improving the functioning of the lungs, heart and other organs whose functions are impaired due to deformities.
— Increasing the overall tone of the body, its strengthening and healing.
Exercise therapy includes active physical exercises, passive techniques and a pedagogical approach for deformity correction. It is important that the patient is involved in the treatment process and responsibly follows all the doctor’s recommendations.
Let's consider long-known, but no less effective, and new methods of physical therapy that help stop the progression of the disease and improve the quality of life of patients.
Physical exercise
Exercise therapy exercises are effective for any degree of curvature and are aimed at achieving certain goals.
General restoratives are aimed at: - improving the general condition of the patient; — strengthening the musculoskeletal system; - development of strength, endurance and balance.
Special exercises are aimed at correcting deformity: - reducing the angle of curvature; — normalization of physiological kyphosis and lordosis; - return to the symmetrical position of the head, shoulders and pelvis; - strengthening the muscles of the back, abdomen, arms and legs.
The set of these exercises depends on in which part of the spine the curvature is, the magnitude of its angle, whether it is directed to the right or left. These factors influence the starting position in which each patient should perform the exercises - this will vary from patient to patient.
During the treatment process, it is important to form the patient’s habit of holding his back correctly. To do this, he must constantly repeat the correct body position while sitting, lying and standing. Exercises in front of a mirror help with this.
Massage
Massage techniques in the form of dosed pressure, stroking, rubbing, kneading, vibration perfectly complement physical exercises and are used in combination to correct spinal curvatures.
Objectives of massage: - improve blood circulation and lymphatic drainage; — activate metabolism; — remove fatigue after physical education; - reduce pain; — strengthen muscles, relieve their overstrain; - improve the patient’s emotional state.
Depending on the strength, pace and time, massage has different effects on nerve endings and has a stimulating or calming effect on the nervous system.
The nervous system sends appropriate signals to other organs and tissues, causing responses in them, for example, an increase or decrease in muscle tone.
Kinesitherapeutic methods of exercise therapy
These methods use physical activity and natural movement as a tool to treat and recover patients from illness.
Principles of motor therapy for spinal curvatures:
— Attention not only to the area in which the curvature is present, but to the entire spine and the body as a whole. Impact only on the curvature zone can lead to correction of deformation in this zone and its appearance in another.
— Restoration of proprioception — the patient has enough resources of his own for recovery. The doctor’s job is to help implement them using a set of correct movements.
— Restoration of the respiratory function of the lungs — due to deformation of the chest, the volume and completeness of respiratory movements are impaired. This leads to respiratory failure, especially during exertion. The doctor helps the patient, using special exercises and positions, to increase the amplitude of respiratory movements, create a new breathing pattern and stop chest deformation.
At the Quality of Life clinic, doctors use modern methods that have proven themselves especially well in the treatment of diseases of the musculoskeletal system:
— PNF therapy is a relatively new kinesitherapy exercise therapy technique. Its essence lies in the fact that each patient has unrealized motor potential, which can be used to increase functional activity and recover from diseases.
There is a functional connection between the nervous system and muscles - the nervous system sends a signal to perform the desired movement, the muscles react to this signal - they perform the movement. In diseases of the musculoskeletal system, this connection is disrupted.
The goal of PNF is to restore the broken connection with the help of special manipulations, return the patient to the ability to move normally, and correct skeletal deformities.
— SEAS gymnastics is another modern method of exercise therapy. Its therapeutic effect is based on self-correction.
Based on the examination and x-rays, the doctor determines the position in which the patient’s spine is in the most correct position. Then he selects a set of exercises that help maintain this posture and strengthen the muscle corset. Over time, regular training forms a certain pattern of movements in the patient, aimed at maintaining the correct posture throughout the day.
— The REDCORD system is a method of exercise therapy based on suspension therapy.
The patient performs exercises on a special installation, which brings him closer to a state of weightlessness. In this state, it is easier to do exercises, and the volume of movements performed is greater.
The effect is achieved through competent influence on deep muscles and redistribution of the load on the musculoskeletal system. Regular training helps to unload the muscles, strengthen them, form the correct movement pattern and correct curvature.
At the Quality of Life clinic you will receive qualified assistance. Our specialists use modern techniques and take an individual approach to each patient.
All these methods make it possible to achieve the main goal of exercise therapy - to stop the development of curvature and reduce the degree of its manifestation. Remember, if scoliotic disease is not treated, over time the deformation will lead to the development of severe, irreparable complications from the nervous system and vital organs, up to and including profound disability.
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What exercises are prohibited
For scoliosis of any degree, strength and acrobatic exercises should be completely avoided. Sharp turns, jerks, somersaults and heavy lifting place excessive stress on the diseased spine, which can result in a fracture of the vertebral body, rupture of the fibrous ring in the disc, or pinched nerve.
Under the influence of stress, a vertebra may become displaced and a nerve in the spine may be pinched.
The list of prohibited exercises includes:
- jumps (long, high, in place, as well as jumping from a height);
- rotation of the body in a vertical position;
- exercise “bridge”, somersaults and twisting movements;
- exercises with weights, barbells, dumbbells;
- handstand and headstand;
- acrobatic exercises on parallel bars;
- squats, especially with weights;
- fast run.
This also includes most team games: football, hockey, basketball, tennis. It is prohibited to engage in boxing, figure skating, snowboarding and other sports where the spine is subjected to heavy loads. This ban fully applies to dance sports, horse riding and cycling.
Sports prohibited for scoliosis
There are exercises, the limitation of which depends on the degree of scoliosis. For example, with the first degree, you can run, with the exception of speed races and long cross-countries. In the second degree, running is also allowed, but only over short distances and at a moderate speed; the best option is jogging or standing still. Those diagnosed with grade 3 or 4 scoliosis are strictly prohibited from running.
With scoliosis of 2 degrees, jogging is allowed
Prices for orthopedic sports shoes
Partial limitation concerns yoga. Asymmetrical twisting exercises or excessive arching of the spine and joints are prohibited for any degree of the disease, but stretching exercises, on the contrary, are encouraged. Exercises to strengthen the muscles of the back and shoulder girdle, relaxation, and breathing exercises are also beneficial. True, the more severe the form of the disease, the more yoga movements are prohibited, and besides, you need to practice under the supervision of a specialist so as not to accidentally harm yourself.
There are also restrictions on yoga exercises for scoliosis