Latest / Scoliosis with Dr. Chris Gubbels / If Your Child’s Posture Keeps Getting Worse, Watch This

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If Your Child’s Posture Keeps Getting Worse, Watch This · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: If you keep telling your child to sit up straight and they either don't or they're unable to, this video is for you.
• 0:06
  SPEAKER_00: I'm Dr.
• 0:07
  SPEAKER_00: Chris Skubel's leading expert in the non-surgical treatment of scoliosis and hyperkyphosis.
• 0:12
  SPEAKER_00: And sometimes what's happening is more than just your child ignoring you.
• 0:17
  SPEAKER_00: You see, sometimes they want to stand up straight, but they simply can't.
• 0:21
  SPEAKER_00: And when that happens, there's a window of opportunity to fix it more easily.
• 0:25
  SPEAKER_00: But when that window closes, the spine change becomes much more difficult to reverse or possibly becomes permanent.
• 0:33
  SPEAKER_00: In this video, I'm going to walk you through what I look for, what you can check at home, where the exact point is where I stop calling a lazy slouching problem and I start asking whether something else might be going on that we need to address.
• 0:47
  SPEAKER_00: You see, kids slouch all the time, especially when we're looking at teenagers.
• 0:52
  SPEAKER_00: They hunch over looking down at their phones, they flop down in the chairs, and some of them can just sit on the couch completely hunched over hours on hours.
• 1:00
  SPEAKER_00: Now, most of the time that's just being a kid slouching.
• 1:04
  SPEAKER_00: But when it gets my attention is when that slouching posture stops looking like something they're just randomly doing.
• 1:10
  SPEAKER_00: Maybe you start noticing one shoulder looks higher than the other.
• 1:13
  SPEAKER_00: Or every time you see them standing in their natural neutral position, their body starts to shift over to one side.
• 1:19
  SPEAKER_00: And then you pull up a picture from, you know, a six years ago or a year ago, and you say, wait a second, I noticed that same posture or them standing in that same offward position now that I noticed it.
• 1:31
  SPEAKER_00: Possibly even worse now.
• 1:32
  SPEAKER_00: And that's completely different than simply catching your kids slouching over, looking down at their phone or device.
• 1:38
  SPEAKER_00: When we see this, we have a pattern that's been established.
• 1:41
  SPEAKER_00: And once I see a pattern, the next thing I want to know is whether your child or teenager actually has structural change and if they're able to change that pattern on their own.
• 1:51
  SPEAKER_00: Basically, can they stand up straight on their own when they try?
• 1:55
  SPEAKER_00: So have your child stand naturally and then ask them to stand up as straight as they comfortably can.
• 2:00
  SPEAKER_00: Now don't position themselves, just let them try to correct their posture on their own.
• 2:04
  SPEAKER_00: Now take another look.
• 2:05
  SPEAKER_00: If they straighten up and suddenly everything looks completely normal, that's reassuring.
• 2:10
  SPEAKER_00: But sometimes a parent tells the child to stand straight and something still looks a little bit off, something doesn't look quite just right.
• 2:17
  SPEAKER_00: Maybe they improve a little bit, but they can't quite get themselves centered or symmetrical on both sides.
• 2:24
  SPEAKER_00: And that's when I become less interested in how many times you're reminding them to sit up straight and more interested in why their body keeps wanting to sit in that awkward or asymmetrical position.
• 2:35
  SPEAKER_00: You see, parents tell me all the time, I thought they were just slouching, or I thought maybe it's because they always carry their backpack on their same side, or I thought they just stood weird.
• 2:44
  SPEAKER_00: And those are all reasonable and rational assumptions, but there comes a point when you have to stop asking why your child doesn't just fix their posture and start asking whether they can actually do that.
• 2:56
  SPEAKER_00: So, how do you tell if maybe there's more going on underneath?
• 2:59
  SPEAKER_00: Well, you have to actually look at their spine or look at their back.
• 3:03
  SPEAKER_00: Now, there are some things you may not notice from the front that you will pick up when you look at them from behind.
• 3:09
  SPEAKER_00: And a lot of parents first notice their child's posture looks odd when they look at them from the front.
• 3:14
  SPEAKER_00: The shoulders look uneven or the child seems to lean to one side.
• 3:18
  SPEAKER_00: But sometimes the more useful clues actually come when you look at them from behind.
• 3:23
  SPEAKER_00: So do this.
• 3:24
  SPEAKER_00: Look at your child's back while they're standing naturally.
• 3:27
  SPEAKER_00: You may notice that one of their shoulder blades is more prominently sticking out on one side compared to the other, or you may notice that one side of the torso is flat and the other seems to have a bigger intention.
• 3:37
  SPEAKER_00: It looks asymmetrical.
• 3:39
  SPEAKER_00: And when we see these things, we're likely seeing more than a child that simply likes to slouch or just always puts themselves in an awkward position.
• 3:46
  SPEAKER_00: You see, a scoliosis curve doesn't just bend the spine, it actually twists and rotates the spine at the same time.
• 3:53
  SPEAKER_00: And that rotation creates something you cannot necessarily correct just by pulling the shoulders back and telling them to stand up straight.
• 4:00
  SPEAKER_00: There's a very simple way to assess them and look for this.
• 4:03
  SPEAKER_00: It's called the forward atoms bending test.
• 4:05
  SPEAKER_00: Now, here's how you do this.
• 4:07
  SPEAKER_00: Have your child stand with their shirt off and you're gonna be standing behind them.
• 4:10
  SPEAKER_00: You're gonna have their feet shoulder width apart, you're gonna have them bend over at the waist with their arms or hands together extending straight, like they're praying, leaning forward.
• 4:21
  SPEAKER_00: And then you're gonna squat down and you're gonna look at their back and you're gonna see does one side appear higher than the other side?
• 4:28
  SPEAKER_00: Do you see a humping or the ribs humping?
• 4:31
  SPEAKER_00: You also want to look at their low back.
• 4:33
  SPEAKER_00: Do one side of the muscles appear higher or humped on one side compared to the other side?
• 4:38
  SPEAKER_00: We call that actually rotation.
• 4:41
  SPEAKER_00: And the reason one side may be high when someone has scoliosis, as the spine twists and rotates, that causes the other side to be elevated in the rib cage or in the musculature in the lower back, looking at the lumbar spine.
• 4:54
  SPEAKER_00: Now, the screening isn't necessarily a diagnosis, but it's used as a screen tool and tells us that we're seeing signs of scoliosis.
• 5:03
  SPEAKER_00: And once we see signs of scoliosis, then we actually want to look under the hood and see what's going on on the inside.
• 5:09
  SPEAKER_00: And we do that with full spine standing x-rays, because x-rays are this gold standard for diagnosing scoliosis.
• 5:17
  SPEAKER_00: So when we see these signs and we see that humping, then we would actually take x-rays to either rule in or rule out actual scoliosis.
• 5:26
  SPEAKER_00: If you've been noticing something about your child's posture that doesn't just look right, you can actually set up a free discovery call that's at Scholar Care Denver.
• 5:33
  SPEAKER_00: All you have to do is click on the link below in the description.
• 5:36
  SPEAKER_00: And then our staff will reach out to you and we'll set up a time when we can discuss your child's spine.
• 5:41
  SPEAKER_00: We can tell you what we think may be going on.
• 5:43
  SPEAKER_00: If you have any x-rays, we can evaluate this x-rays, and then we'll tell you what we think the best next step is for you andor your child.
• 5:49
  SPEAKER_00: And now I want to show you where parents can frequently get confused with this whole process.
• 5:53
  SPEAKER_00: And that's because they may see some concerning signs or asymptoms on the outside, but their child doesn't report any pain or discomfort.
• 6:00
  SPEAKER_00: The child might simply say, Well, nothing really hurts.
• 6:03
  SPEAKER_00: And one of the biggest mistakes parents can make is waiting to do something until they actually start having pain, or assuming just because they have no pain, there's no real concerning problem.
• 6:12
  SPEAKER_00: You see, your child may have scoliosis and feel nothing absolutely wrong.
• 6:17
  SPEAKER_00: They can play sports, they can run around with their friends, they can go to school, all those things without physically experiencing any pains or discomforts.
• 6:25
  SPEAKER_00: And your logical thought may be, well, their back doesn't hurt, so it's probably isn't anything serious.
• 6:30
  SPEAKER_00: But I'd be careful with that assumption.
• 6:32
  SPEAKER_00: You see, pain doesn't always decide whether a growing child actually needs to have their spine evaluated.
• 6:37
  SPEAKER_00: In fact, most children and adolescents with sclesis don't have any pain or symptoms.
• 6:42
  SPEAKER_00: The bigger question is, how much more growth do they have and how big is the curve currently?
• 6:47
  SPEAKER_00: Because growth does win a scores curve can change dramatically.
• 6:51
  SPEAKER_00: And a small curve in a 17-year-old who's almost finished growing is one situation.
• 6:57
  SPEAKER_00: But that same small curve in 11 or 12-year-old that's just heading into a period of rapid growth spur, that's a completely different situation.
• 7:06
  SPEAKER_00: So once I suspect there may actually be a scholiotic curve, then I want to know something you cannot really figure out just by looking at someone's posture.
• 7:14
  SPEAKER_00: I want to know, first of all, how much time do we have?
• 7:16
  SPEAKER_00: And two, how big is the current curve?
• 7:19
  SPEAKER_00: Now there's a critical window that parents absolutely don't want to miss.
• 7:23
  SPEAKER_00: Because if your child does have scoliosis, it's one of the biggest factors in what happens next is how much growth they have remaining.
• 7:30
  SPEAKER_00: And that's why you have to take timing so seriously.
• 7:33
  SPEAKER_00: Parents will frequently tell me, we first noticed this last year, but we were just told to watch and wait.
• 7:38
  SPEAKER_00: And sometimes watching or active observation is completely appropriate.
• 7:42
  SPEAKER_00: But I want to know how are we watching that?
• 7:44
  SPEAKER_00: What are we actually watching?
• 7:46
  SPEAKER_00: And how much risk that curve will actually change while we're waiting.
• 7:50
  SPEAKER_00: Because the year in an adult may not change a lot of their curve, maybe only one or two or three degrees or nothing at all.
• 7:55
  SPEAKER_00: But a year in an adolescent going through a rapid growth spurt can cause their spine to change dramatically in a very short window of time.
• 8:03
  SPEAKER_00: So when do we stop just checking posture at home and actually get a professional evaluation and some x-rays of the spine?
• 8:10
  SPEAKER_00: Whenever I see any consistent asymmetries or obvious signs of scoliosis in a growing adolescent, typically a girl between the ages of 10 and 12 and a boy between the ages of 13 and 14, then I absolutely want to get a full spine x-ray from both the front and the side to see exactly what's happening.
• 8:29
  SPEAKER_00: This will tell us if they actually have a scoliotic curve.
• 8:32
  SPEAKER_00: If so, how big it is, and most importantly, how much growth do they have remaining.
• 8:37
  SPEAKER_00: You see, when we look at their x-rays, we can actually determine where a child is in their growth phases and how much growth they have remaining by evaluating their growth plates on things like their pelvis, their hand, and in their shoulder bones.
• 8:50
  SPEAKER_00: Because when we match how big the curve is and how much growth they have remaining, those combined are the biggest predictors of how likely a curve is to progress and become more severe.
• 9:01
  SPEAKER_00: And based on that information, we can also let someone know what the best and most appropriate treatment options are.
• 9:08
  SPEAKER_00: So, what happens if we do catch a scoliosis early when the curves are still relatively small?
• 9:13
  SPEAKER_00: You see, I'd always rather have a patient come in when the curves are still small and they're not really sure if it's even something that needs to be addressed, versus waiting until something's got a lot bigger.
• 9:22
  SPEAKER_00: Because finding a small curve doesn't automatically mean that someone needs treatment or even aggressive treatment.
• 9:28
  SPEAKER_00: Sometimes we do do actively monitoring, as several patients right now we're not doing any treatment, but we're checking them every three to six months to see if their curves stay stable or if it starts to progress.
• 9:39
  SPEAKER_00: Sometimes scolar-specific exercise alone is appropriate, and sometimes bracing is appropriate, and many times both of those.
• 9:46
  SPEAKER_00: And one of the biggest mistakes I see also from the healthcare professionals have doctors all the time that try to treat it with treatments that are not really proven to treat scoliosis.
• 9:56
  SPEAKER_00: And then once the curve has taken off and gotten bigger, they kind of go, oh crap.
• 10:00
  SPEAKER_00: And then they refer it to us to address.
• 10:03
  SPEAKER_00: But the reality is we'd be much better off addressing those curves when they were smaller instead of waiting until they got larger and more severe.
• 10:09
  SPEAKER_00: You see, all big curves start as small curves.
• 10:12
  SPEAKER_00: And we do earlier, more appropriate interventions and curves are small, we tend to have much better outcomes long term.
• 10:18
  SPEAKER_00: So it really all depends on the size of the curve, the child's age, and how much growth they have remaining.
• 10:24
  SPEAKER_00: We take all that information together, then we can accurately assess their scoliosis and give the best recommendations.
• 10:31
  SPEAKER_00: And having conversations with parents and patients when their curves are small and much more easily managed is always better off when we're in a crisis and we're just doing things to try to stave off more serious things like surgery.
• 10:45
  SPEAKER_00: Because I hate it when parents come in and they say, I can't believe how bad this got in a short period of time.
• 10:52
  SPEAKER_00: This seemed to come out of nowhere.
• 10:53
  SPEAKER_00: It was really small, and before we knew it, we have a really big curve and we're being told they need surgery.
• 10:58
  SPEAKER_00: So, like many conditions, the goal is always to identify and when appropriate treat when the problem is small as possible.
• 11:05
  SPEAKER_00: So, what would I do if it's my child and I notice some of these asymmetries?
• 11:08
  SPEAKER_00: In fact, I'll tell you right now, I have a 14-month adult and I noticed one of his shoulders is higher than the other.
• 11:14
  SPEAKER_00: And I immediately started wondering is this the same apostural issue?
• 11:18
  SPEAKER_00: Is that because he's always raising one arm and like, you know, having someone hold his hand with the same side?
• 11:23
  SPEAKER_00: Or do we have something structured?
• 11:25
  SPEAKER_00: So the first thing I did is I actually just really started paying attention to him.
• 11:29
  SPEAKER_00: I started making sure we weren't putting him in an awkward position over and over, but I also checked the spine.
• 11:34
  SPEAKER_00: Now it's probably easier for me because this is what I do as a profession, but it's the same thing I would recommend for you.
• 11:40
  SPEAKER_00: I would watch them, I would see if you're noticing the same thing day after day.
• 11:43
  SPEAKER_00: And if you are, I bring him to a professional and have it checked.
• 11:47
  SPEAKER_00: Instead of waiting to see if it got worse, I would find out if there's anything going on, and if there is, what could be done about it while the curve is still potentially small?
• 11:55
  SPEAKER_00: So simple things you can do for child's a little older.
• 11:57
  SPEAKER_00: One, ask them to stand up straight, see if you're noticing the asymmetries disappear, or do they stay there when you ask them to stand up straight with better posture?
• 12:06
  SPEAKER_00: And I wouldn't let just one good looking moment fool me because kids can be pretty good about putting themselves in a better position and holding there for a few seconds.
• 12:14
  SPEAKER_00: But if they go back to the irregular position over and over, or you tend to notice that pattern day after day, that would get my attention.
• 12:20
  SPEAKER_00: Because what you really want to know is how does their posture look when they're not thinking about it?
• 12:24
  SPEAKER_00: Do they drift right back to that same awkward or asymmetrical position?
• 12:28
  SPEAKER_00: Does one shoulder creep up compared to the other side?
• 12:30
  SPEAKER_00: Do they tend to shift or lean towards one side?
• 12:33
  SPEAKER_00: And then now I do that Ford Adams binning test where I have them bend over with their hands together, arms straight, and I would look to see if I see any humping on either the lumbar spine or the rib cage on the other side.
• 12:45
  SPEAKER_00: And I absolutely wouldn't wait till they express there's pain.
• 12:48
  SPEAKER_00: And if I notice any of those asymmetries coming up over and over again, I absolutely wouldn't wait for several more months or a year.
• 12:56
  SPEAKER_00: I would get them in and get them assessed.
• 12:58
  SPEAKER_00: Because if it's just posture, that's pretty easy.
• 13:00
  SPEAKER_00: But if there's something truly structural going on underneath, like scoliosis, it's much better to treat it when it's small versus waiting until it becomes more severe.
• 13:08
  SPEAKER_00: Now, if you or your child have scoliosis and you want us to take a look at their case where you have x rays, book that free discovery call.
• 13:16
  SPEAKER_00: My team will reach out to you, and we can go over their individual case, how severe it may be, and what the best treatment options are.
• 13:22
  SPEAKER_00: And if you want me to walk you through exactly how to check your child for scoliosis at home, watch this next video and I'll show you the full screening process step by step.
• 13:32
  SPEAKER_00: I'll see you there.