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Transcript

Denver Scoliosis Treatment: Why Nothing Has Worked (And Where to Go Next) · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: If you live in Denver and you've already tried physical therapy, general chiropractic, or maybe some other kind of scoliosis brace, and none of those has stopped your scoliosis from progressing, there is a reason.
• 0:10
  SPEAKER_00: And it's not what everyone has told you.
• 0:12
  SPEAKER_00: Now, if you've been through the typical hospital system, whether in Denver or some other city, and you came out the other side more frustrated than when you started, stay with me.
• 0:21
  SPEAKER_00: By the end of this video, you'll understand exactly why each thing you did didn't work and what a correct treatment path actually looks like.
• 0:28
  SPEAKER_00: Now, we're gonna cover four different things.
• 0:31
  SPEAKER_00: Why scoliosis is a three-dimensional problem and almost every standard treatment is a one-dimensional solution, why watch and wait is not a neutral choice, why the brace you may have been given may not have worked, and what the correct path forward actually looks like, including what to ask and what to expect.
• 0:50
  SPEAKER_00: And at the end, I'll give you three steps that you can take if you're ready to stop guessing and start taking action on a solution that actually works.
• 0:57
  SPEAKER_00: So, point one, scoliosis is a three-dimensional spine problem.
• 1:02
  SPEAKER_00: Here's the mechanical reality that almost no one explains clearly.
• 1:05
  SPEAKER_00: When you have scoliosis, your spine isn't just bending to the side, it's simultaneously curving or bending while it's rotating on its own axis.
• 1:15
  SPEAKER_00: Both things are happening at the exact same time in three-dimensional space.
• 1:19
  SPEAKER_00: That's what makes it structurally distinct from nearly every other spinal condition a provider sees on a weekly basis.
• 1:25
  SPEAKER_00: General physical therapy is built for general posture and basic alignment problems, muscle weaknesses, and restricted joints.
• 1:33
  SPEAKER_00: But idiopathic scoliosis is not an alignment problem, it's a growth deformity.
• 1:38
  SPEAKER_00: And in adults, a degenerated structural deformity.
• 1:41
  SPEAKER_00: Here's the thing: there's actually no peer-reviewed evidence that general physical therapy can do anything to slow or stop the progression of scoliosis because it was never really designed to do that.
• 1:51
  SPEAKER_00: And general chiropractic works on a similar premises.
• 1:54
  SPEAKER_00: The logic behind chiropractic adjustments is to restore motion and realignment in individual joints.
• 2:01
  SPEAKER_00: Scoliosis is not a misalignment condition.
• 2:04
  SPEAKER_00: This is why people feel really good temporarily after an adjustment, but their x-rays actually don't change when you're looking at scoliosis curves.
• 2:11
  SPEAKER_00: The adjustments reached the symptom but left the structure untouched.
• 2:15
  SPEAKER_00: When you look at injections and pain medications, they operate the exact same way.
• 2:20
  SPEAKER_00: They address the pain that a rotating spine produces, but they don't actually touch the structural curve itself.
• 2:26
  SPEAKER_00: And the moment that you understand that scoliosis lives in three dimensions and that most standard treatments work in two or one dimension, you realize why most of the treatments don't work for scoliosis.
• 2:37
  SPEAKER_00: See, they weren't actually failed attempts to treat scoliosis.
• 2:40
  SPEAKER_00: They were just the wrong tools applied to treat scoliosis.
• 2:43
  SPEAKER_00: Point two, watch and wait can be dangerous advice.
• 2:46
  SPEAKER_00: Let's say you get a diagnosis and the curve is 20 degrees, maybe 25.
• 2:50
  SPEAKER_00: The provider says the threshold for concern is typically around 45 degrees and you're below it.
• 2:55
  SPEAKER_00: So the plan is just to monitor and see if it gets worse.
• 2:58
  SPEAKER_00: Come back in six months and we'll check.
• 3:01
  SPEAKER_00: That sounds careful, but it's actually not.
• 3:03
  SPEAKER_00: See, watch and wait was established before modern day corrective tools existed.
• 3:08
  SPEAKER_00: 45 degree surgical threshold, six-month interval checks, and all of it was set when the main goal of treatment was just to try and avoid surgery, not to actually try and correct curves.
• 3:18
  SPEAKER_00: You see, the monitoring period existed to decide when someone was bad enough to actually warrant operation.
• 3:25
  SPEAKER_00: In hospitals today, bracing is only recommended for curves between 25 and 40 degrees because the goal is only to try and prevent surgery, not to correct the curve.
• 3:35
  SPEAKER_00: Meanwhile, two things are happening simultaneously in the spine.
• 3:39
  SPEAKER_00: One, the curve is progressing, and two, the spine is starting to stiffen.
• 3:43
  SPEAKER_00: Those two processes interact in a way that matters enormously.
• 3:46
  SPEAKER_00: You see, a more flexible spine is correctable in a way that a stiffer one is not.
• 3:51
  SPEAKER_00: Every month of delay narrows the correction window.
• 3:53
  SPEAKER_00: Not just because the curve is getting larger, but because the tissues are getting stiffer and less capable of responding to corrective treatments.
• 4:01
  SPEAKER_00: We treated one patient whose curves were actually 52 degrees, and she was a young adult.
• 4:05
  SPEAKER_00: She was told surgery was the only option, but she still had a pretty flexible spine.
• 4:10
  SPEAKER_00: So three months after treatment, we got her curve from 52 degrees down to 34.
• 4:14
  SPEAKER_00: And she went from being unable to lift even five pounds to being able to work out and train with a personal trainer.
• 4:20
  SPEAKER_00: But an outcome like that required her spine to be flexible.
• 4:23
  SPEAKER_00: Wait long enough, and that window closes.
• 4:26
  SPEAKER_00: Just remember, watch and wait can be dangerous advice.
• 4:30
  SPEAKER_00: Now, if what I'm talking about makes sense to you and you're looking for a more proactive approach to scoliosis, be sure to subscribe.
• 4:36
  SPEAKER_00: We put out evidence-based scoliosis content every single week for people that know that something is missing from our standard system.
• 4:43
  SPEAKER_00: So be sure to subscribe and hit that bell icon so you're notified when we release new content.
• 4:48
  SPEAKER_00: The brace you may have been given was not billed to correct your curve.
• 4:52
  SPEAKER_00: See, the most commonly prescribed brace in the United States is the Boston brace or some type of variant.
• 4:57
  SPEAKER_00: It's a rigid compression type brace.
• 5:00
  SPEAKER_00: It works using what's called three points of pressure.
• 5:02
  SPEAKER_00: And in principle, it applies pressure by pushing on the curves from the side.
• 5:07
  SPEAKER_00: And the goal is just to try and hold the spine in place and keep it from progressing.
• 5:12
  SPEAKER_00: Now, for specific curve patterns in young patients, it does have some track record.
• 5:17
  SPEAKER_00: But compression is one-dimensional, but Scoius is a three-dimensional rotation problem.
• 5:22
  SPEAKER_00: A brace that only corrects it in one plane can't correct the rotation.
• 5:26
  SPEAKER_00: Then there are soft braces which are even more limited, and they have no meaningful evidence to support them for moderate and larger curves.
• 5:33
  SPEAKER_00: You see, the current standard is a custom three-dimensional corrective or over-corrective brace built from 3D body scanning and full spine x-rays, designed to reduce the curve rather than just holding.
• 5:46
  SPEAKER_00: The brace we use is Scully Brace.
• 5:48
  SPEAKER_00: It uses computer-aided design and computer-aided manufacturing to custom fabricate each brace from 3D scans of the patient's bodies and their X-rays.
• 5:58
  SPEAKER_00: And it allows spinal movement in the brace, so trunk muscles stay active.
• 6:03
  SPEAKER_00: In fact, in one study done using the Scully brace, along with scoliospecific exercises, 100% of the patients had an increase in trunk muscle strength and endurance, which completely debunks the myth that scoliosis braces cause muscle atrophy.
• 6:19
  SPEAKER_00: Now, adults also respond to corrective bracing, just four to eight hours a day paired with the right exercises.
• 6:27
  SPEAKER_00: So if you got a brace and it didn't work, there's a strong possibility it was the wrong type.
• 6:32
  SPEAKER_00: The good news is that's a solvable problem.
• 6:34
  SPEAKER_00: And part four, what the correct path forward actually looks like.
• 6:38
  SPEAKER_00: Now the correct treatment for scoliosis requires two components working together for most cases: scolio-specific exercises and custom three-dimensional corrective bracing.
• 6:49
  SPEAKER_00: Now, although exercises or bracing alone may be appropriate for some cases, the best results for improved posture, curve reduction, and pain relief are achieved when we use them simultaneously.
• 7:02
  SPEAKER_00: You see, scolio-specific exercise is not yoga, it's not PLOTIS or general strengthening.
• 7:08
  SPEAKER_00: It is actually four-part component to scoliospecific exercises.
• 7:12
  SPEAKER_00: The patient actually learns how to put themselves in a three-dimensional correct posture.
• 7:17
  SPEAKER_00: Then we strengthen and stabilize them in that cryptic position, and then they carry that cryptic position into everyday activities so it's reinforced all day, not just during the individual scoliosis rehab sessions.
• 7:29
  SPEAKER_00: And they develop an understanding of their conditions so they can actively participate in their own care.
• 7:35
  SPEAKER_00: This requires a highly trained scoliosis therapist.
• 7:38
  SPEAKER_00: A general physical therapist can teach a protocol they were never trained in.
• 7:42
  SPEAKER_00: The protocol we use is called Scolibalance.
• 7:44
  SPEAKER_00: It draws from Schroth, Cs, and chiropractic biophysics.
• 7:48
  SPEAKER_00: So when you're looking for a provider in the Denver area, ask whether they specialize exclusively in scoliosis.
• 7:55
  SPEAKER_00: Ask whether they use scoliospecific exercises that are done one-on-one, not in a group session, or do they do general physical therapy?
• 8:02
  SPEAKER_00: Ask whether their bracing is built from three-dimensional scans and full spine X-rays custom to each individual patient and ask to see their outcome data.
• 8:13
  SPEAKER_00: Ask for their results, their research, their case studies.
• 8:16
  SPEAKER_00: You see, a specialist using evidence-based tools will not hesitate to give you any of those or to answer any of your questions.
• 8:23
  SPEAKER_00: You've already invested time, money, and trust in the treatment that didn't work.
• 8:27
  SPEAKER_00: What you find going forward should match what this condition actually requires.
• 8:32
  SPEAKER_00: Scoliosis is not a condition that defines treatment.
• 8:35
  SPEAKER_00: It's a condition that has historically been treated with tools designed for something else.
• 8:39
  SPEAKER_00: Patients that don't progress, who reduce their curves, who end up avoiding surgery, they don't have easier cases.
• 8:46
  SPEAKER_00: They just have the right care.
• 8:48
  SPEAKER_00: And if what you tried so far isn't working, that's information.
• 8:51
  SPEAKER_00: Now use it.
• 8:52
  SPEAKER_00: So today, do these three things.
• 8:54
  SPEAKER_00: First, pull your most recent imaging and find the data your last full spline x-rays.
• 8:59
  SPEAKER_00: If it's been more than six months or you've never had them, then that's a gap.
• 9:02
  SPEAKER_00: No scoliosis specialists can accurately assess your situation without current and updated imaging.
• 9:08
  SPEAKER_00: Second, search specifically for scoliosis specialists in your area or in Denver.
• 9:13
  SPEAKER_00: Enter the term scoli care and you will get to the right category.
• 9:17
  SPEAKER_00: And third, write down your treatment history before any new appointment, what you tried, how long you did it, and what happened.
• 9:23
  SPEAKER_00: What were the results?
• 9:24
  SPEAKER_00: A provider doesn't ask for that history, is not doing a complete evaluation.
• 9:28
  SPEAKER_00: Now, the next video in this series is called Watch This If You Are Told to Watch and Wait on Scoliosis.
• 9:34
  SPEAKER_00: If any part of today's video resonated with you, that one was made for exactly where you are right now.
• 9:40
  SPEAKER_00: It goes deeper into what watch and wait actually costs over time and what you can do if you're already years into monitoring protocol with no actual interventions or recommendations.
• 9:51
  SPEAKER_00: The link is at the end screen and in the description below.
• 9:54
  SPEAKER_00: Watch that one next.