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8 Scoliosis Questions I Get Asked Every Single Day (Finally Answered) · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: There are eight questions that I get asked from patients just about every single week.
• 0:05
  SPEAKER_00: Now these may be adults who've been managing scoliosis for years, or they may be people that have seen many different providers.
• 0:11
  SPEAKER_00: A lot of times they're bringing in stacks of medical records and notes, and often they have more questions and more confusion than before when they even saw any type of provider.
• 0:22
  SPEAKER_00: And it's these exact same questions that keep coming up over and over again.
• 0:26
  SPEAKER_00: So if you've been told something about your scoliosis or your child's scoliosis and it didn't just quite sit right with you, this video is for you.
• 0:35
  SPEAKER_00: I'm Dr.
• 0:36
  SPEAKER_00: Chris Scobles and I spent the last 18 years treating scoliosis and hyperkyphosis patients without surgery.
• 0:42
  SPEAKER_00: And that's about 6,500 patients today.
• 0:44
  SPEAKER_00: And these same eight questions keep coming up on almost every single consultation.
• 0:50
  SPEAKER_00: What I want to show you isn't just the right answers, it's what's been costing you if you don't have the right answers.
• 0:56
  SPEAKER_00: In almost every single case, it's the incomplete answer that almost always leads to confusion, waiting too long, choosing the wrong treatment, or walking away for something that could have changed the entire trajectory of the condition itself.
• 1:10
  SPEAKER_00: So we're going to walk through all eight one by one, what the patients are typically told, what the evidence actually shows, and what you should do differently starting out.
• 1:19
  SPEAKER_00: So let's dive in.
• 1:20
  SPEAKER_00: Question one, what actually causes scoliosis?
• 1:24
  SPEAKER_00: The wrong answer that patients often hear from friends or family or untrained healthcare professionals is that scoliosis is caused by bad posture or heavy backpacks or just sitting wrong.
• 1:36
  SPEAKER_00: Now, the largest percent of scoliosis, about 80% of all scoliosis, is known as idiopathic scoliosis, which is just a big fancy word that means we don't know exactly what causes or triggers it, but we really understand how it grows and develops once it begins.
• 1:53
  SPEAKER_00: See, idiopathic scoliosis is a three-dimensional growth deformity.
• 1:58
  SPEAKER_00: Now, to understand how this develops, there are multiple different growth plates that make up each individual vertebrae or bone.
• 2:05
  SPEAKER_00: And these growth plates are controlled by different vertebrae.
• 2:09
  SPEAKER_00: And something happens that activates or triggers the genes to cause part of the bone to grow slower and part of the bone to grow faster.
• 2:18
  SPEAKER_00: And when that happens, the vertebrae starts to twist or rotate.
• 2:22
  SPEAKER_00: And that's what leads to scoliosis being a three-dimensional rotational deformity.
• 2:29
  SPEAKER_00: You see, this is a structural problem, it's a spine deformity problem, not a postural problem.
• 2:35
  SPEAKER_00: So, what about the other 20% of cases?
• 2:37
  SPEAKER_00: Well, there are neuromuscular scoliosis, which shows up secondary to neurological conditions like cerebral palsy or muscular dystrophy.
• 2:47
  SPEAKER_00: And there's also what's known as secondary scoliosis or syndromic scoliosis, which are scoliosis that are secondary to conditions like Marfan syndrome or either downlow syndrome.
• 2:57
  SPEAKER_00: And then we have scoliosis that actually starts in adults, which is known as adult degenerative de novoscoliosis, which means a new scoliosis that develops in adulthood.
• 3:07
  SPEAKER_00: And de novoscoliosis typically develops with the onset of menopause in women around 50 and typically later on in the 70s in men.
• 3:16
  SPEAKER_00: Now with idiopathic scoliosis and even some of the other scoliosis, a lot of times there's a family history of scoliosis.
• 3:24
  SPEAKER_00: But if you believe scoliosis is a postural problem, you're gonna spend months on postural exercises and postural treatments that can't change the underlying structural deformity.
• 3:34
  SPEAKER_00: And that's time not spent on treatments that actually work.
• 3:38
  SPEAKER_00: And getting the right treatment at the right time is the single most important variable for the best possible outcomes with any treatments.
• 3:46
  SPEAKER_00: Now, question number two: can we reduce the curve?
• 3:50
  SPEAKER_00: Now, the answer that's almost always given by orthopedic centers and hospitals is no, you can't reduce the curve.
• 3:57
  SPEAKER_00: You can only hope to slow it down and potentially stop it from becoming surgical.
• 4:01
  SPEAKER_00: In fact, children's hospital actually says in their own promotional materials that you cannot reduce the size of the curve.
• 4:08
  SPEAKER_00: And oftentimes families just accept that information from fact because it comes from the so-called authorities.
• 4:13
  SPEAKER_00: They go home thinking the goal is simply to hope to prevent surgery.
• 4:17
  SPEAKER_00: Now, the reality is, I do partially agree with them.
• 4:20
  SPEAKER_00: I believe with the treatments that they use, you likely can't reduce scoliosis curves.
• 4:25
  SPEAKER_00: You can only potentially reduce it or slow it down.
• 4:28
  SPEAKER_00: But it's not that curves can't be reduced, it's about which treatments can and can't reduce scoliosis curves.
• 4:35
  SPEAKER_00: Here's what's interesting.
• 4:36
  SPEAKER_00: One of the single biggest or most fluential landmark studies done showing the effectiveness of scoliosis bracing in preventing surgery was done at hospitals where they only looked at can we prevent the likelihood of someone becoming surgical.
• 4:52
  SPEAKER_00: They didn't even look to see if they could potentially reduce the size of the curve.
• 4:57
  SPEAKER_00: All they looked at is if we give someone a brace, do their curves reach the threshold of 50 degrees?
• 5:02
  SPEAKER_00: And in that study, 72% of the patients did not become surgical compared to only about 40% when they weren't braced.
• 5:11
  SPEAKER_00: But they didn't even look or measure if the curves could potentially be reduced.
• 5:15
  SPEAKER_00: Now, here's what I've personally learned over the year in almost all professions, whether it's healthcare or some other profession, when someone doesn't know how to do something, they typically tell people that it can't be done.
• 5:28
  SPEAKER_00: I'll give you an example of something that I learned through my own personal experience.
• 5:32
  SPEAKER_00: We look at accounts, there's all kinds of accountants, but with the majority of accountants, all they really do is they help you file your taxes at the end of the year.
• 5:40
  SPEAKER_00: And then they either tell you how much you owe or maybe you're gonna get a refund.
• 5:44
  SPEAKER_00: They don't actually do tax planning or tax strategy, they don't actually help you mitigate the amount of taxes you have to pay, they don't help you plan for that.
• 5:53
  SPEAKER_00: Now I have a couple different practices, and I remember at one point I started asking my accountant different tax strategies I would see online or things I may hear at a seminar.
• 6:01
  SPEAKER_00: And a lot of times my accountant told me, no, you can't do that.
• 6:04
  SPEAKER_00: And then one day she said, You know what?
• 6:06
  SPEAKER_00: I think you need to get a different type of accountant.
• 6:09
  SPEAKER_00: That's not what I do.
• 6:10
  SPEAKER_00: She's like, I think you need to get someone, in her words, that was more aggressive.
• 6:15
  SPEAKER_00: Well, and then one day at a seminar, I heard an accountant presenting on tax strategy or tax planning.
• 6:22
  SPEAKER_00: And they explained that the majority of accountants do not have actual training and knowledge on how to strategize or minimize proactively how much taxes you pay.
• 6:32
  SPEAKER_00: They only help you reactively figure out what taxes you owe.
• 6:37
  SPEAKER_00: And this is what he said that always stuck with me.
• 6:40
  SPEAKER_00: He said, whenever you hear someone say you can't do that, what they're really saying is, I don't know how to do that, or I don't know how to help you with that.
• 6:48
  SPEAKER_00: And it doesn't really mean that it can't be done.
• 6:51
  SPEAKER_00: It means they don't know how to do it.
• 6:53
  SPEAKER_00: And the same thing is true with scoliosis treatment.
• 6:57
  SPEAKER_00: So when you hear someone say that you can't do something, what you're actually probably hearing is them say, We don't know how to do that, or I don't know how to help you do that.
• 7:07
  SPEAKER_00: And that's a hundred percent true when it comes to reducing scoliosis curves.
• 7:12
  SPEAKER_00: So when providers tell you that it can't be done, they're really just telling you that they're unaware or they have not been trained or simply don't know how to do it.
• 7:21
  SPEAKER_00: You see, in most adolescent and child cases, curve reduction is absolutely achievable with the right tools.
• 7:29
  SPEAKER_00: With a properly designed, custom three-dimensional corrective or overcorrective brace and scolial-specific exercises, we usually see a reduction of the curve.
• 7:40
  SPEAKER_00: We actually expect to see curve reduction in most cases.
• 7:44
  SPEAKER_00: In fact, Scully Care recently did a study that was done in a hospital in Singapore.
• 7:48
  SPEAKER_00: First of all, in our study, the scolial brace was 100% successful in preventing curves from progressing to surgical levels of 50 degrees in all of the cases.
• 7:59
  SPEAKER_00: Compared to the study I mentioned earlier, where only 72% of the cases ended up not becoming surgical.
• 8:04
  SPEAKER_00: In our study, 100% of the patients did not reach surgical thresholds.
• 8:09
  SPEAKER_00: But even more impressively, the majority of the patients actually had a reduction in the size of the curve.
• 8:16
  SPEAKER_00: Not only did the curves not get worse, the majority reduced the curve.
• 8:21
  SPEAKER_00: And when we took a bigger deep dive into the data from the study, what we also found is the patients that wore the braces more got better curve correction.
• 8:31
  SPEAKER_00: In fact, for every extra hour that they wore the brace, they got an additional 0.8 degrees of correction.
• 8:37
  SPEAKER_00: Now, what about adults?
• 8:38
  SPEAKER_00: Now, many times in adults that are younger, more flexible, it's still possible to reduce the size of the curves.
• 8:44
  SPEAKER_00: In fact, the first case I ever personally presented at an international research conference, and the first case study that I had published was on an adult with a severe scoliosis and a hyperkyphosis.
• 8:56
  SPEAKER_00: And the reason it got accepted to present at the research conference is because it had been thought that you cannot change curves in adults.
• 9:04
  SPEAKER_00: Now, to be clear, we were not changing the actual spine deformity, but with the spine deformity, there is also a big postural collapse that makes the scoliosis worse.
• 9:14
  SPEAKER_00: And in younger, more flexible people, you can reduce the postural collapse.
• 9:18
  SPEAKER_00: And in this patient, we had a significant reduction in both the scoliosis and the hyperkyphosis.
• 9:24
  SPEAKER_00: In fact, most of our younger adults that still have more flexible curves, we get a reduction in the scoliosis.
• 9:30
  SPEAKER_00: Now, older adults where their spines are more stiff, we may improve their overall balance, but generally those we don't reduce the curves.
• 9:36
  SPEAKER_00: They're we're working to reduce pain and improve quality of life and stop or slow progression.
• 9:41
  SPEAKER_00: What we have found over the years is that most families are simply not okay with just trying to keep the curve from getting worse.
• 9:47
  SPEAKER_00: Most families actually want to know if it's possible to reduce the size of the scoliosis curves.
• 9:53
  SPEAKER_00: And with that understanding and that hope of curve reduction, that actually changes every single decision that follows.
• 10:00
  SPEAKER_00: Now, question three, how many hours will I have to wear the brace?
• 10:04
  SPEAKER_00: Now, most patients ask this, hoping the answer is fewer than they actually end up getting.
• 10:10
  SPEAKER_00: When they find out the actual answer is sometimes they can disengage.
• 10:13
  SPEAKER_00: And that disengagement often determines whether the treatment is successful.
• 10:18
  SPEAKER_00: So for children and teenagers, the standard protocol is about 20 to 23 hours a day until someone reaches skeletal maturity.
• 10:26
  SPEAKER_00: Now, for smaller curves, let's say under 20 degrees, they may qualify for part-time or nighttime only bracing.
• 10:32
  SPEAKER_00: But what's also interesting, at one point we thought that you only got results with full-time brace wear.
• 10:39
  SPEAKER_00: What's interesting, it was once thought that only full-time brace wear could potentially reduce curves.
• 10:45
  SPEAKER_00: But more recent information actually shows that when we use over-corrected or hypercorrected braces, like the scoli brace, many times we can still get curve reduction when patients are wearing the brace less than 20 to 23 hours a day.
• 10:59
  SPEAKER_00: What the research also shows is there is a typically a minimal threshold for someone to have a chance for the brace to be effective.
• 11:07
  SPEAKER_00: And that minimal threshold for the brace to be effective is typically considered to be about 12 to 13 hours, which makes sense because we're trying to guide growth in adolescence.
• 11:16
  SPEAKER_00: And so you have to be in the brace more than you're out of brace generally for a brace to be successful.
• 11:22
  SPEAKER_00: And what we also know from that recent study I talked about, the Scholia brace study that we did in the hospital, we know that the more hours we wear the brace, we get more correction.
• 11:32
  SPEAKER_00: Doesn't mean that we can't still get correction with less than 20 hours.
• 11:36
  SPEAKER_00: Sometimes we do get curve correction with less than 20 hours of wear.
• 11:39
  SPEAKER_00: But overall we know the more someone wears the brace, generally speaking, the more correction they're gonna get.
• 11:45
  SPEAKER_00: And for every additional hour they wear the brace, on average, we get an additional 0.8 degrees of curve reduction.
• 11:52
  SPEAKER_00: So overall, we know that bracing results are dose dependent.
• 11:56
  SPEAKER_00: The more we wear the brace, the better results we get.
• 11:59
  SPEAKER_00: Now, for adults, the protocol is different.
• 12:01
  SPEAKER_00: For adults, we typically wear a brace minimum four hours, ideally, six to eight hours a day.
• 12:07
  SPEAKER_00: And the reason we wear it less is because what makes scoliosis worse in adults is different than what makes scoliosis worse in adolescents.
• 12:13
  SPEAKER_00: In adults, it's a degenerative process.
• 12:16
  SPEAKER_00: In adolescence, it's a growth problem.
• 12:18
  SPEAKER_00: So four hours is generally the minimal amount for success.
• 12:21
  SPEAKER_00: And ideally, when we get up to six to eight hours, we get even better results.
• 12:25
  SPEAKER_00: And for those young adults that have more flexible curves, where we are trying to reduce the curves, for the first six months or so, we encourage them to wear the brace as much as possible to reduce the curves.
• 12:36
  SPEAKER_00: And we don't know exactly how much someone needs to wear a brace as an adult to potentially reduce the curves, but we know whatever curve reduction is going to happen typically does happen in the first six months.
• 12:47
  SPEAKER_00: Now, one of the biggest predictors of curve reduction or of a brace being effective is the amount of inbrace correction, meaning how much does the scoliosis reduce while someone's wearing a brace?
• 12:59
  SPEAKER_00: And so when someone's been wearing a brace for a month, we do what's called an inbrace x-ray.
• 13:04
  SPEAKER_00: And the minimal goal is to have a 30 to 50% reduction of the scoliosis with the brace on.
• 13:10
  SPEAKER_00: And what the research is really clear on, if you do not reduce the curve with the brace on, then either that's a scoliosis that cannot be corrected with bracing or treated with brace, or that brace was designed and manufactured incorrectly.
• 13:24
  SPEAKER_00: And the majority of the time it's the latter.
• 13:26
  SPEAKER_00: We get patients that come in with other braces all the time, frequently like a Boston brace from a hospital.
• 13:32
  SPEAKER_00: And this is typically when the bracing has not been successful.
• 13:35
  SPEAKER_00: And we'll take a patient and we'll do an x-ray with their brace from the hospital, and then we'll do an x-ray with the scoli brace on.
• 13:41
  SPEAKER_00: And most of the time we get a dramatically different result.
• 13:44
  SPEAKER_00: We'll get much better correction with the Scula brace compared to a standard orthopedic brace or a Boston brace.
• 13:51
  SPEAKER_00: So if we cannot get reduction with the brace on, that's a curve that can't be reduced.
• 13:56
  SPEAKER_00: But more likely it's a brace that has not been designed properly.
• 14:00
  SPEAKER_00: So a better question to ask than how long do I have to wear the brace is what does each stage look like and how will I know if it's working?
• 14:09
  SPEAKER_00: That reframing keeps patients engaged.
• 14:12
  SPEAKER_00: And the key is keeping patients focused on the benefits of the best outcome and not every single thing that's involved in the process along the way.
• 14:20
  SPEAKER_00: Now, question four, how long is the treatment?
• 14:24
  SPEAKER_00: And the honest answer is it depends.
• 14:26
  SPEAKER_00: It depends on the severity of the curve, it depends on their goals, and it also depends on how much growth they have remaining.
• 14:33
  SPEAKER_00: If they're an adult, it also depends on their age and how likely the curve is to keep progressing if they discontinue wearing the phrase.
• 14:41
  SPEAKER_00: You see, treatment for scoliosis is not a fixed course, it's a protocol that adapts to the patient's response and growth status.
• 14:49
  SPEAKER_00: For scoliosis-specific exercises, early on, it's more intensive.
• 14:53
  SPEAKER_00: It's typically anywhere from one to three times a week in the beginning for the first two or three months, along with daily exercises at home.
• 15:01
  SPEAKER_00: Now, frequency tends to reduce as the spine and scoliosis responds over time.
• 15:07
  SPEAKER_00: For people that are traveling long distances, we'll do intensive scoliosis rehab exercises one to two times a day for one to two weeks.
• 15:14
  SPEAKER_00: And then we send them home with a home protocol.
• 15:17
  SPEAKER_00: And then when they travel again for another checkup, we may do anywhere from four to six sessions and then give them another home protocol.
• 15:24
  SPEAKER_00: And over time, we reduce the frequency of those in-office checkups.
• 15:27
  SPEAKER_00: For growing children and adolescents, monitoring continues until they reach skeletal maturity.
• 15:32
  SPEAKER_00: And for adults, over time the focus changes to pain minimization and stabilization.
• 15:38
  SPEAKER_00: Now, before we get into the second half, if you've been finding this channel useful, please subscribe.
• 15:43
  SPEAKER_00: I post information and content every single week.
• 15:46
  SPEAKER_00: And every video is built on specific clinical information that patients are not getting in the standard orthopedic appointments.
• 15:54
  SPEAKER_00: So be sure to subscribe and hit that bell icon so you're notified every time I release new content.
• 16:00
  SPEAKER_00: Now, question five, can we prevent surgery?
• 16:04
  SPEAKER_00: The wrong belief is that once the curve reaches surgical thresholds, scoliosis is the only option.
• 16:09
  SPEAKER_00: Now, in children and adolescents, that surgical threshold is typically around 50 degrees for curves in the thoracic spine and between 40 and 45 degrees for curves in the lumbar spine.
• 16:18
  SPEAKER_00: Now, just because someone's curve reaches surgical threshold and means they are a candidate for surgery, it doesn't mean they have to get surgery.
• 16:28
  SPEAKER_00: But unfortunately, most orthopedic surgeons believe that once your curve reaches a surgical threshold, there's nothing that can be done for the scoliosis outside of surgery.
• 16:37
  SPEAKER_00: That's because most orthopedic doctors are unaware of the most recent research on non-surgical treatment options.
• 16:43
  SPEAKER_00: In fact, in one recent case series published by Scully Care, there was a series of patients that had all reached surgical thresholds.
• 16:50
  SPEAKER_00: The curves were anywhere from 45 up to 60 degrees.
• 16:54
  SPEAKER_00: They were all recommended surgery and all told that surgery was the only option.
• 16:58
  SPEAKER_00: These patients were treated with a non-surgical multimodal rehabilitation program, including Sculabras custom bracing, scoli balance rehabilitation, and traction.
• 17:09
  SPEAKER_00: And all the cases had anywhere from a 41 to a 50% reduction in the curves.
• 17:14
  SPEAKER_00: And in fact, after the treatment, none of the patients that were recommended surgery were even candidates for surgery based on the amount of reduction of their scoliosis curves.
• 17:25
  SPEAKER_00: You see, in most cases, the most expensive treatment is the one that's the most invasive that could have been prevented.
• 17:32
  SPEAKER_00: Now, question number six: what are my treatment options?
• 17:36
  SPEAKER_00: Now, most patients are told their options are watch and wait, maybe a brace, or surgery.
• 17:42
  SPEAKER_00: Sometimes general physical therapies also recommend that are added.
• 17:46
  SPEAKER_00: And what that list leaves out is the distinction between generic version of those options and the specific evidence-based versions.
• 17:54
  SPEAKER_00: That distinction is everything.
• 17:56
  SPEAKER_00: You see, the full non-surgical treatment toolbox looks like this.
• 18:00
  SPEAKER_00: First, we have custom 3D corrective braces.
• 18:04
  SPEAKER_00: For scoliosis, we use the scoli brace.
• 18:06
  SPEAKER_00: It's a fully custom hypercorrective or opracorrective brace built using 3D scans of the patient's body and their full spine x-rays.
• 18:16
  SPEAKER_00: For hyperkyphosis braces, we use a kyphobrace.
• 18:20
  SPEAKER_00: The second part is scoliosis-specific exercises.
• 18:23
  SPEAKER_00: Now we use scoli balance, which integrates Schroth C's, or scientific exercise approach for scoliosis and chiropractic biophysics into its protocols.
• 18:34
  SPEAKER_00: We use this because it's more accessible and easier to maintain independently than the more complicated, complex Schroth method alone.
• 18:41
  SPEAKER_00: For adults with degenerative scoliosis, we may add spinal decompression to decrease pain in the early stages of treatment.
• 18:49
  SPEAKER_00: Now, what doesn't work?
• 18:51
  SPEAKER_00: General physical therapy for slowing or stopping scoliosis.
• 18:55
  SPEAKER_00: There's no clinical evidence to support that general physical therapy has any evidence to support it can change the trajectory of scoliosis or reduce scoliosis curves.
• 19:05
  SPEAKER_00: It's completely different than scoliosis-specific exercise or physical therapy like scolibounce.
• 19:11
  SPEAKER_00: And the biggest difference is if you go to a general physical therapist, they'll probably give you exercises to strengthen or stabilize or increase mobility.
• 19:18
  SPEAKER_00: What we do with scoliosis-specific exercises is we first teach the patient how to put their body in a true three-dimensional correct position.
• 19:26
  SPEAKER_00: And then we work to strengthen and stabilize the spine, but in correction.
• 19:31
  SPEAKER_00: And then we take it a step further and we teach the patient how to hold their body in three-dimensional correction while they do their normal activities or daily living.
• 19:40
  SPEAKER_00: Or simply put, they hold their body in correct alignment while they do things they already do in their everyday life.
• 19:47
  SPEAKER_00: Question seven, does lifting or exercise make my curve worse?
• 19:51
  SPEAKER_00: Now patients come in all the time having stop workouts, stop lifting, stop being almost everything that actually keeps them strong.
• 19:58
  SPEAKER_00: Because someone might have told them, or maybe they assume, that loading their spine or doing exercises could make their scoliosis worse.
• 20:06
  SPEAKER_00: Here's the thing general exercises or physical activity do not make your scoliosis worse.
• 20:11
  SPEAKER_00: In fact, muscle strength and fitness actually support the structures around the spine.
• 20:17
  SPEAKER_00: Research even shows that physical activity in sports may be a preventative measure for developing scoliosis.
• 20:26
  SPEAKER_00: And patients that are involved in sports and that are physically active tend to do better with scoliosis treatments.
• 20:34
  SPEAKER_00: The one caveat to that is treatments or activities that increase spinal mobility, like traction, that don't also work to stabilize the spine may show temporary improvements in scoliosis, but actually cause the scoliosis to progress faster over time.
• 20:51
  SPEAKER_00: Because whenever you put mobility into the spine, if you don't also stabilize it, you could destabilize the curve and make it progress faster.
• 21:00
  SPEAKER_00: That's a very specific clinical concern, not really a general concern.
• 21:04
  SPEAKER_00: And when a patient stops exercising out of fear, they're not protecting their spine.
• 21:09
  SPEAKER_00: They're removing the muscular support that holds it in place.
• 21:12
  SPEAKER_00: Additionally, for older adults, specifically adults beyond the age of 60, you tend to lose muscle mass at the rate of about 3 to 5% per year.
• 21:21
  SPEAKER_00: Muscle atrophy can be a contributing factor to the progression of degenerative scoliosis.
• 21:27
  SPEAKER_00: So generally speaking, we want to increase and not decrease physical activity.
• 21:32
  SPEAKER_00: Now there are a few exceptions to this.
• 21:34
  SPEAKER_00: There may be some specific exercises or movements that you may want to avoid if you have a larger progressive scoliosis.
• 21:42
  SPEAKER_00: For example, you may want to avoid doing things like heavy lifting, heavy squats, heavy deadlifting, or you may want to do things that minimize repetitive pounding type motions.
• 21:53
  SPEAKER_00: If you have a severe scoliosis or degenerative scoliosis, doing things like rowing or biking or Swimming, there's likely better for you than doing things like box jumps or running or jogging for long periods of time.
• 22:07
  SPEAKER_00: But if someone told you point blank to stop exercising because of your scoliosis, get a second opinion on those recommendations.
• 22:14
  SPEAKER_00: And question eight: Do sports make my child's curve worse?
• 22:18
  SPEAKER_00: Parents of dancers, gymnasts, and athletes ask this all the time.
• 22:22
  SPEAKER_00: The fear is that the high impactivity or the asymmetrical movements may actually accelerate the curve.
• 22:28
  SPEAKER_00: I've actually had parents that actually pull their children out of competitive sports because of this fear.
• 22:34
  SPEAKER_00: Now, first, there is evidence that shows that certain activities or sports are associated with higher incidence of scoliosis.
• 22:41
  SPEAKER_00: For example, in the general population, we're talking about adolescents, about 3% of adolescents get diagnosed with scoliosis.
• 22:48
  SPEAKER_00: However, if you look at people that are involved in arrhythmic gymnastics, ballet, or competitive swimming, they actually tend to have scoliosis at much higher incidence.
• 22:58
  SPEAKER_00: About 30% of all adolescents that are involved in competitive gymnastics, ballet, or swimming tend to get diagnosed with scoliosis.
• 23:08
  SPEAKER_00: When I say competitive, I don't mean they do it once in a while.
• 23:11
  SPEAKER_00: They're doing it many hours a week.
• 23:13
  SPEAKER_00: Now we can't say for sure that those actually cause scoliosis, but we know that there's an association.
• 23:18
  SPEAKER_00: People that do those tend to have higher incidence of scoliosis.
• 23:22
  SPEAKER_00: Now, does this mean if you have a child with scoliosis, you shouldn't let them do gymnastics or ballet or cheer or swimming?
• 23:29
  SPEAKER_00: Absolutely not.
• 23:30
  SPEAKER_00: I myself was a competitive athlete.
• 23:32
  SPEAKER_00: I wrestled from when I was young, about three years old, all the way through college.
• 23:36
  SPEAKER_00: It was one of the most important things in my life for many years.
• 23:40
  SPEAKER_00: And if I went to a doctor that told me that I couldn't wrestle, I simply would not listen to them and I definitely wouldn't go back.
• 23:46
  SPEAKER_00: So instead of telling someone that they can't do something like ballet or gymnastics that we know likely doesn't help them, instead, we use that as a reward for being compliant with treatment.
• 23:58
  SPEAKER_00: So I would just simply tell the child, look, these things likely don't help you, but I know this is really important to you.
• 24:04
  SPEAKER_00: And so I'm not gonna tell you or ask you to discontinue it as long as we are compliant with the treatment.
• 24:10
  SPEAKER_00: So the goal is to be compliant with treatment so you still get to do the thing that you love without real concerns about it being in problem.
• 24:17
  SPEAKER_00: In fact, Scully Care recently had a patient who was an Olympian, had a Scully brace, and competed in the Olympics and gymnastics.
• 24:26
  SPEAKER_00: So we know all those things may help you.
• 24:28
  SPEAKER_00: It doesn't mean you have to stop doing them or you can't do them.
• 24:31
  SPEAKER_00: Just be compliant with your treatment.
• 24:33
  SPEAKER_00: Now, as far as other impact sports like football or wrestling or hockey, there's no real evidence to support that those can cause scoliosis or make scoliosis worse.
• 24:42
  SPEAKER_00: The one new dance worth naming though, if your child has a particularly large curve, let's say over 50 degrees, certain high impact activities might want to be avoided.
• 24:51
  SPEAKER_00: Heavy lifting, heavy squats, box jumps, just like I mentioned before.
• 24:56
  SPEAKER_00: But overall, being involved in sports and being physically active is a benefit for patients with scoliosis.
• 25:03
  SPEAKER_00: It may even have a preventative function.
• 25:06
  SPEAKER_00: So here's what I want you to take away.
• 25:07
  SPEAKER_00: These are the eight questions that I get tend to ask over and over.
• 25:11
  SPEAKER_00: They're also the ones that people generally get incorrect or they get no answers to.
• 25:16
  SPEAKER_00: That leaves patients confused, misinformed, and unfortunately often prevents them from getting the best possible treatments.
• 25:23
  SPEAKER_00: My personal model is to tell patients to stay ahead of the curve.
• 25:27
  SPEAKER_00: And the most important part of staying ahead of the curve is ensuring you're getting the right treatment at the right time.
• 25:33
  SPEAKER_00: To be able to make the best decisions that leads to the right treatment, you also have to have the right information.
• 25:38
  SPEAKER_00: Now, the next video I recommend you watch is called Why Your Scoliosis Pain Keeps Getting Worse and What Actually Helps.
• 25:46
  SPEAKER_00: It goes deep on the specific mechanics behind scoliosis pain.
• 25:50
  SPEAKER_00: Why it doesn't behave like typical back pain, and what standard pain management approaches fail, and what actually creates lasting relief.
• 25:59
  SPEAKER_00: The link is on the end screen and in the description below.
• 26:02
  SPEAKER_00: Go ahead and watch it now.