Latest / Scoliosis with Dr. Chris Gubbels / Why Hunching Over Can Shorten Your Life

Transcript

Why Hunching Over Can Shorten Your Life · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: So let's look at one of the most famous heart studies out there.
• 0:02
  SPEAKER_00: It's called the Framingham study.
• 0:05
  SPEAKER_00: It's the longest-running cardiovascular study ever done.
• 0:08
  SPEAKER_00: And what they found is people that had severe hyperkyphosis or they're hunched over, it actually reduces their lung function by an amount compared to someone that's smoking up to 15 cigarettes a day.
• 0:19
  SPEAKER_00: Let me say that again.
• 0:20
  SPEAKER_00: If you're severely hyperkyphotic, that will reduce your lung function at the same amount as someone that smokes 15 cigarettes a day.
• 0:29
  SPEAKER_00: And not from smoking, that's just from the shape of your spine.
• 0:32
  SPEAKER_00: So if you've never smoked a single cigarette in your life, you have to ask yourself, is my posture doing to my lungs what cigarettes would?
• 0:39
  SPEAKER_00: And that's exactly why fixing your posture isn't just about looks.
• 0:43
  SPEAKER_00: It can transform the quality of your life.
• 0:46
  SPEAKER_00: But in order to fix your posture, you have to know exactly what's causing the problem in the first place.
• 0:51
  SPEAKER_00: I'm Dr.
• 0:51
  SPEAKER_00: Chris Google's leading expert in the non-specifical treatment of hyperkyphosis and scoliosis.
• 0:56
  SPEAKER_00: In this video, I'm going to break down exactly what hyperkyphosis is, what causes it, what kinds there are, and more importantly, what you can do about it.
• 1:06
  SPEAKER_00: Here's what most people don't realize not all hunching over is the same condition.
• 1:10
  SPEAKER_00: And that means the treatment may not be the same either.
• 1:12
  SPEAKER_00: Here's the simplest way to look and think about it.
• 1:14
  SPEAKER_00: The first type, if someone reminds you to sit up straight and you can easily just stand and put yourself in a correct position, that's a very different situation than someone who's physically not able to straighten up anymore.
• 1:26
  SPEAKER_00: The first one is a mere postural hyperkyphosis.
• 1:29
  SPEAKER_00: This comes from years of just hunching over your muscles that used to hold you upright are getting weak.
• 1:33
  SPEAKER_00: This becomes the new normal.
• 1:34
  SPEAKER_00: This a lot of times is caused by people hunching over computers, kids looking down at phones, being on devices all the time.
• 1:41
  SPEAKER_00: It's simply bad posture, and a lot of that is related to a modern lifestyle being sedentary.
• 1:46
  SPEAKER_00: We see it in our youth all the time, and it's becoming more and more common.
• 1:52
  SPEAKER_00: We are not designed to sit and hunch over devices.
• 1:55
  SPEAKER_00: But because we do, our bodies start to adapt to that.
• 1:58
  SPEAKER_00: And because of that, a lot of people start to hunch over with bad posture.
• 2:02
  SPEAKER_00: But the first type is still pretty flexible, which is why you can actually put yourself in the correct position just by thinking about it and focusing on holding yourself in an upright position.
• 2:11
  SPEAKER_00: The second type is when you start to get true structural problems going on.
• 2:15
  SPEAKER_00: The vertebrae and discs themselves can actually start to change shape.
• 2:19
  SPEAKER_00: In fact, just last week I had a teenager flying from Indiana.
• 2:22
  SPEAKER_00: He went to see his chiropractor who actually noticed he had something called Sherman's hyperkyphosis.
• 2:28
  SPEAKER_00: This is a genetic condition where the vertebrae actually grow extremely wet shape and he became very severely honched over.
• 2:36
  SPEAKER_00: So someone like that, even if we told him this setup, he could to some degree, but he can't fully change that hyperkyphosis because his vertebrae have actually changed shaped over time.
• 2:47
  SPEAKER_00: It's a true structural deformity.
• 2:49
  SPEAKER_00: And then there's the third type, which is more age-related, but it still becomes structural over time.
• 2:55
  SPEAKER_00: This one comes from the disc and the vertebrae breaking down.
• 2:59
  SPEAKER_00: The discs are like the shock absorbers that actually hold the space between your vertebrae.
• 3:03
  SPEAKER_00: And what happens in this type is the discs start to break down the front, and the bones start to break down and decay in the front.
• 3:10
  SPEAKER_00: It's a degenerative process.
• 3:12
  SPEAKER_00: And when you're hunched over for a long period of time, we're talking years upon years upon years, that becomes very stiff because the connective tissues change, the ligaments in the front start to shorten tight, and the bones and the disc themselves change shape over time due to degeneration from being hunched over and putting more pressure on the front of the disc and the joints.
• 3:35
  SPEAKER_00: In that third type, we have three things going on.
• 3:37
  SPEAKER_00: One, that's become normal, and the muscles that hold your body in the right position have likely become weak over time.
• 3:42
  SPEAKER_00: Two, you have structural changes where the disc and joints have changed.
• 3:46
  SPEAKER_00: And three, the spine has gotten very stiff because all the connections in the front have also shortened and tightened from years of being crunched over and hunched over.
• 3:56
  SPEAKER_00: Now, these all may look the same from the outside, but they're different on the inside.
• 4:01
  SPEAKER_00: And almost nobody that ever comes to me has actually been explained exactly which type they have and why it keeps getting worse.
• 4:08
  SPEAKER_00: When different providers just assume every curve is the same, they tend to get each patient the same advice.
• 4:13
  SPEAKER_00: They'll say things like work on your posture, do some stretching, try general physical therapy, get adjusted.
• 4:19
  SPEAKER_00: Let's keep an eye on it and see if it gets worse.
• 4:21
  SPEAKER_00: You see, with a lot of providers, it doesn't matter if the bones have changed shape, whether the curve is still flexible or not, whether it's actively progressing, everyone gets the same advice.
• 4:30
  SPEAKER_00: And that's the part that drives me absolutely crazy.
• 4:33
  SPEAKER_00: People will come in, they tell me about their problem, then they give me this big laundry list of everything they tried, and maybe they felt better temporarily, but hasn't fixed anything.
• 4:41
  SPEAKER_00: They went to their regular doctor, their primary care physician.
• 4:44
  SPEAKER_00: They were told to work on their posture, maybe see a physical therapist.
• 4:47
  SPEAKER_00: So they did that, maybe for a year or even two.
• 4:50
  SPEAKER_00: Nothing changed because nothing actually changed.
• 4:52
  SPEAKER_00: They just thought, well, I guess this is how I am right now.
• 4:55
  SPEAKER_00: Maybe they went to their chiropractor, they got adjustments, they felt better, they moved better.
• 4:59
  SPEAKER_00: After they get adjusted, they probably feel like they're standing up better.
• 5:02
  SPEAKER_00: But over time, they notice they're starting to hunch over more and more and more.
• 5:06
  SPEAKER_00: And then eventually, someone tells them this is not normal and they need specialty help, or they just seek out specialty help on their own through their own intuition.
• 5:14
  SPEAKER_00: But by the time they get to meet, many times the curves have gotten very, very rigid.
• 5:18
  SPEAKER_00: The flexibility that would have allowed us to make progress in a very simple and short amount of time, that window is actually gone.
• 5:26
  SPEAKER_00: Now, we can still help these people most of the time, but what's possible has changed, and what it's gonna take, the amount of work it's gonna take to actually get that change has also changed.
• 5:36
  SPEAKER_00: Now, to be clear, I'm always glad people have tried something.
• 5:39
  SPEAKER_00: But doing something isn't always the same as doing the right thing or the best thing.
• 5:45
  SPEAKER_00: You see, general back pain or general back care is built for general back problems.
• 5:49
  SPEAKER_00: Something like those elastic postural straps and do exactly one thing.
• 5:52
  SPEAKER_00: They're designed to hold your shoulders back temporarily.
• 5:56
  SPEAKER_00: The other problem is they're elastic.
• 5:57
  SPEAKER_00: Whenever something's elastic, it has the potential to compress your spine, which is exactly what we don't want to do if someone is hunched over.
• 6:04
  SPEAKER_00: We want to elongate the spine and not compress.
• 6:08
  SPEAKER_00: The other thing with those elastic braces is they don't generally change anything internally.
• 6:12
  SPEAKER_00: And as soon as you take them off, your body goes right back to where it used to be.
• 6:16
  SPEAKER_00: Because nothing underneath has actually been addressed.
• 6:18
  SPEAKER_00: You're still in with the same spine that you were before.
• 6:21
  SPEAKER_00: You see, every progressive condition has a window.
• 6:24
  SPEAKER_00: For hyperkyphosis, that window is tied directly to how much flexibility is actually left in the curve.
• 6:30
  SPEAKER_00: A flexible spine can respond to corrective forces much more easily.
• 6:35
  SPEAKER_00: A rigid one can't respond the same way and takes a lot more work.
• 6:39
  SPEAKER_00: And so the longer the right intervention is delayed, the more the body actually locks into that position of being hunched over and it becomes more and more permanent over time.
• 6:49
  SPEAKER_00: But not everyone falls into that camp.
• 6:52
  SPEAKER_00: I do see people that come in early on.
• 6:54
  SPEAKER_00: Their curves are still very flexible, they're very movable, and what we can do to that person is generally dramatically different.
• 7:00
  SPEAKER_00: If someone has a pretty flexible spine and there's not significant or severe structural change, that person may be able to go back to 100% normal.
• 7:07
  SPEAKER_00: But here's what gets me neither of those people were ever told that their condition was time sensitive.
• 7:12
  SPEAKER_00: Because most of the time, nobody told them that it was really that serious at all.
• 7:16
  SPEAKER_00: They just thought it was posture.
• 7:18
  SPEAKER_00: Most people don't understand how the shape of your spine directly impacts what's called your health-related quality of life.
• 7:24
  SPEAKER_00: Meaning it's not just about your posture and how you look, or maybe having some back pain.
• 7:28
  SPEAKER_00: We know being hunched over directly impacts the quality and longevity of life.
• 7:34
  SPEAKER_00: So if you're watching this and you're like, that's me, I have bad posture, I'm hunched over, no one's ever told me this before.
• 7:40
  SPEAKER_00: Be sure to hit that subscribe button and hit that bell icon because I release new content on non-surgical treatments for scoliosis and hyperkyphosis every week.
• 7:49
  SPEAKER_00: And you don't want to miss out.
• 7:51
  SPEAKER_00: Now, here's the thing you have to understand the right approach or the right treatment depends entirely on which type of hyperkyphosis you have.
• 7:58
  SPEAKER_00: For someone that has a flexible postural curve, hyperkyphosis-specific exercise may make major progress.
• 8:05
  SPEAKER_00: That may be enough to actually correct it.
• 8:07
  SPEAKER_00: Not general exercises, exercises that are actually designed to put your spine in the exact correct position to strengthen muscles that are weaker and to stretch and elongate muscles that have gotten short and tight over time.
• 8:20
  SPEAKER_00: This is called neuromuscular re-education.
• 8:23
  SPEAKER_00: You actually have to train your body to hold itself in the right position, and you have to strengthen and stabilize the body in the correct position while you're doing things you already do in your everyday life.
• 8:34
  SPEAKER_00: That's the only way you train your body to hold your body in the right position and make that your new normal.
• 8:40
  SPEAKER_00: Now, for the structural types, the ones that are more rigid, exercise alone generally isn't enough.
• 8:45
  SPEAKER_00: This is where we're going to start thinking about things like bracing and traction to actually move the body into a correct position.
• 8:51
  SPEAKER_00: Not a simple postural strap, but a true custom corrected brace built around the patient's specific curves that are designed to apply very specific and direct forces in the exact area of the spine that actually needs corrected, not one that's just gonna hold it where it is already.
• 9:09
  SPEAKER_00: When you combine custom bracing with kyphosis-specific exercise, you're addressing the problem in two directions at once.
• 9:17
  SPEAKER_00: And here's the part that tends to surprise patients the most.
• 9:20
  SPEAKER_00: When the curve actually starts to reduce, they get taller, not a little taller, sometimes a lot taller.
• 9:27
  SPEAKER_00: I always joke with patients and say, hey, I charge by the inch.
• 9:30
  SPEAKER_00: Because here's what's happening.
• 9:31
  SPEAKER_00: When the spine stops being compressed forward and hunched over, that height is regained when we open up and elongate the spine and put it back into its normal position.
• 9:40
  SPEAKER_00: Now, older adults generally don't regain as much height as a younger adult or a kid that's more flexible just because they probably have more deformity and they're more rigid.
• 9:49
  SPEAKER_00: But a lot of times they still see improvement.
• 9:52
  SPEAKER_00: In fact, we can actually measure height changes with someone's corrective brace on because when they're wearing a corrective brace, that actually elongates and holds their body in the right position.
• 10:00
  SPEAKER_00: So what that means is with the corrective brace on, someone is generally taller than they are with the corrective brace off.
• 10:06
  SPEAKER_00: Now, everything starts with getting information, and the information you need is what your number is.
• 10:11
  SPEAKER_00: You see, hyperkyphosis is diagnosed on X-ray.
• 10:15
  SPEAKER_00: Now, ideally, we want a full spine x-ray standing up, and we want to view your spine from the front and from the side.
• 10:22
  SPEAKER_00: When we view your spine from the side, that's how we're going to measure how much curve you have in your spine.
• 10:26
  SPEAKER_00: Now, a normal person will have anywhere from maybe 40 to 45 degrees of that curve in their mid back or the thoracic spine.
• 10:34
  SPEAKER_00: But when that gets beyond 50 degrees, that's when you're clinically diagnosed with hyperkyphosis.
• 10:40
  SPEAKER_00: Now, we can generally do conservative treatment for curves anywhere from 50 up to 80 degrees.
• 10:46
  SPEAKER_00: Beyond 80 degrees, someone may need a surgical consultation.
• 10:50
  SPEAKER_00: However, we have successfully treated hyperkyphosis over or greater than 80 degrees in the right cases.
• 10:58
  SPEAKER_00: So generally you can tell someone's getting hunched over and they're hyperkyphotic on the outside, but you generally can't tell as much without a proper x-ray.
• 11:06
  SPEAKER_00: You need the x-ray to know the exact severity of the hyperkyphosis, and you need the x-ray to tell you other vital clinical information.
• 11:14
  SPEAKER_00: For example, are there actual structural changes?
• 11:17
  SPEAKER_00: Do they have wedging in the vertebrae in the disc?
• 11:20
  SPEAKER_00: Do they have bone spurs or osteophytes connecting those discs, meaning are they getting fused?
• 11:25
  SPEAKER_00: All that information is needed to help us know the severity of the hyperkyphosis and also predict the prognosis and what results may be achievable with the right treatment.
• 11:36
  SPEAKER_00: Now, a real evaluation also looks at how much flexibility you have in your spine because the amount of flexibility helps us predict how much we can actually correct.
• 11:45
  SPEAKER_00: The way we determine how flexible someone's curve is in their midspine is we'll do an X-ray with them standing up full spine, and we can actually measure the severity or degrees of their hyperkyphosis or how much they're hunched over.
• 11:58
  SPEAKER_00: And then we can actually have them lay face down on a solid surface, and we can take an x-ray with them face down and we can determine how much of that hyperkyphosis reduces.
• 12:08
  SPEAKER_00: And that gives us a very accurate predictor of how much of that curve can actually be reduced.
• 12:14
  SPEAKER_00: Generally speaking, however much their curve reduces when they're laying face down, we can reduce 50% or more of that amount.
• 12:22
  SPEAKER_00: So if someone has an 80-degree curve in their mid back standing, and when they lie down, that goes down to 50, they're actually fairly flexible.
• 12:30
  SPEAKER_00: And we can feel pretty confident we can reduce that down to at least 65 degrees or more.
• 12:35
  SPEAKER_00: But if they lay down and they get no reduction, meaning the curve doesn't budge at all, we know they're very stiff, and it's going to be really hard to reduce the hyperkyphosis.
• 12:44
  SPEAKER_00: And at that point, we're more focused on keeping it from getting worse.
• 12:46
  SPEAKER_00: Now, a lot of patients that come to us have had some kind of x-rays in the past, but most of the time it's actually done in sectionals.
• 12:52
  SPEAKER_00: Maybe they have their mid back, their low back, maybe their neck.
• 12:55
  SPEAKER_00: And you can stitch those together, but it's not as good as having a full spine image done at one shot.
• 13:01
  SPEAKER_00: Because between images you can move and stitching software does have some errors.
• 13:06
  SPEAKER_00: So ideally, you have a standing upright, full standing x-ray of your spine.
• 13:10
  SPEAKER_00: The other thing we will be looking at with those is your overall sat, what's called your sagittal balance, meaning is your body starting to lean forward or backward?
• 13:18
  SPEAKER_00: Not just the curve in your mid-back.
• 13:20
  SPEAKER_00: We want to have all the critical information needed.
• 13:23
  SPEAKER_00: And once we have a thorough physical exam and proper x-rays, and we can use that to determine the severity of hyperkyphosis, what's possible for improvement, and what the best treatment recommendations are for each and every individual.
• 13:36
  SPEAKER_00: Not just random, one size fits all, but what's best for that exact person and their spine.
• 13:42
  SPEAKER_00: So that's where all that starts, not what the strap, not what simple stretches, but actual number, knowing exactly what you're dealing with.
• 13:49
  SPEAKER_00: So if you're out there and you're dealing with hyperkyphosis and you're hunched over and nothing that you have done in the past has worked, reach out to our office and set up an initial evaluation so we can see exactly what you're dealing with and what can be done for it.
• 14:03
  SPEAKER_00: And if you've ever been told you have scoliosis, you may have hyperkyphosis and scoliosis.
• 14:08
  SPEAKER_00: Be sure to watch this video about why that pain keeps getting worse.
• 14:12
  SPEAKER_00: It'll appear in the notes below and on your end screen.
• 14:16
  SPEAKER_00: I'll see you there.