Overlooked Alternatives to Invasive Scoliosis Surgery: Exercises & Tips for Teens
Many teenagers face scoliosis, which can lead to concerns about treatment options, especially surgery. In this article, we'll explore the challenges of scoliosis, the limitations of traditional treatment methods, and various non-invasive alternatives that teens can use at home. By understanding these alternatives, teens can make informed decisions that may help them avoid invasive surgical procedures.

Avoiding Scoliosis Surgery

For many teens diagnosed with scoliosis, the immediate worry is the possibility of surgery. However, there are many alternatives to explore before considering such a drastic step. While surgery might be necessary in severe cases, effective non-invasive treatments can help many manage their condition successfully.

Understanding Scoliosis & Its Challenges

When scoliosis is first diagnosed, it can be a shocking experience, especially for teenagers. The condition often seems to appear suddenly, which can be alarming for both the teen and their family. However, scoliosis typically develops over time, and it's essential to recognize the signs early. Scoliosis causes the spine to curve sideways and can affect any part of the spine, but it most commonly impacts the thoracic (chest) and lumbar (lower back) regions. Idiopathic scoliosis, the most common form, has no known cause, leaving many teens wondering why it happens to them. Accepting this condition can be tough, as it often leads to self-esteem issues due to changes in appearance, such as uneven shoulders, rib humps, and a shifted waist.  Girls are more affected than boys, and the most common curve is the Reverse S shape when looking at someone from behind. It is also called a Dextro Thoracic, Levo Lumbar curve.  While mild scoliosis may not cause significant health problems, severe cases can compress vital organs like the lungs and heart, leading to serious health risks. The degree of the curve will be above 80, measured using the Cobb Method. As teens grow older, they may experience pain, stiffness, and fatigue, which can impact their daily activities and quality of life.

Traditional Treatments: Are They Enough?

When teens first see a doctor for scoliosis, they often encounter a limited set of options: watchful waiting, bracing, or surgery. This traditional approach only sometimes considers the variety of non-invasive therapies that teens can use immediately. The wait-and-see approach involves regular monitoring through X-rays to see if the curve worsens. If it does, bracing might be recommended, and surgery becomes a possibility if the curve reaches a specific angle. Traditional surgery often involves fusing the spine with rods, which can lead to complications and a lifetime of limited mobility. While modern techniques have improved, they still carry risks and don't guarantee success. An emerging technique called vertebral tethering shows promise, but at the moment (2024) it's not widely available. Many teens undergo unnecessary surgeries that may lead to further pain and complications, which can be incredibly frustrating.

What YOU Can Be Doing at Home

Fortunately, teens can use several non-invasive methods at home to manage scoliosis effectively. One of the most beneficial approaches is exercise. Research shows that specific exercises can help slow down, stop, or even reverse the progression of scoliosis. For example, this study found that patients with curvatures between 20° and 40° who wore a brace for at least 18 hours a day saw significant reductions in curve progression. However, sticking to a bracing schedule can be challenging, especially for teenagers. Incorporating scoliosis-specific exercises can be incredibly effective. Take Fabi, who reduced her upper back curve by 18% and her lower back curve by 31% in the same timeframe by following the Scoliosis Protocol online. The remarkable thing is that the course we offer is in English, and Fabi had to get a translation to help her with the videos and Zoom meetings!

Dietary Changes and Supplements

Another crucial aspect to consider is diet. Research indicates that teens with scoliosis may have imbalances in neurotransmitters like serotonin. Eating tryptophan-rich foods like salmon, chicken, eggs, and spinach can help support serotonin levels. In addition to exercise and dietary changes, passive therapies like physiotherapy, chiropractic care, massage, and acupuncture can help manage symptoms like pain and stiffness. However, these treatments alone haven't been shown to reduce spinal curvature.

What's the Takeaway?

In conclusion, teens diagnosed with scoliosis should know that their treatment options extend beyond bracing and surgery. Non-invasive methods, including specific exercises and dietary changes, can significantly impact the management of scoliosis and may even reverse its progression. Teens need to explore holistic approaches that benefit their overall health, including bone and muscle strength and mental well-being, whether or not they choose surgery. If you're a teen looking to explore these techniques further, consider contacting a professional specializing in scoliosis management. By taking control of your treatment plan, you can improve your quality of life while avoiding invasive surgical options. Stay informed about your condition and share this knowledge with others who may benefit. Together, we can create a supportive community for teens navigating scoliosis. If you want us to have a look at your case and help map out your next steps then email me: ed@edpaget.com
A Day With Orthopaedic Surgeons: An Osteopath’s Perspective
As an osteopath, I approach the human body with a deep respect for its intricate balance and ability to heal. Recently, I had the unique opportunity to shadow an orthopaedic surgical department for a day, and it was an eye-opening experience that challenged my perceptions of surgical medicine. Going in, I expected the environment to be extremely clinical and high-tech, but what I witnessed was a blend of learned human skill, knowledge, and hand precision. The surgeons used screws, drills, and saws—tools you might find in a carpentry workshop, and in many respects, the job of the orthopeadic surgeon is a lot like carpentry.  One of the surgeons even mentioned that the body is more forgiving than wood because it has the remarkable ability to grow back. This comment struck a chord with me and underscored the body's resilience, something I see daily in my osteopathic practice. The surgical team was incredibly professional, with a noticeable difference in how they approached routine surgeries versus trauma cases. In routine procedures, like a knee arthroscopy and a total knee replacement, the team worked seamlessly, almost like a well-rehearsed orchestra. The lead surgeon, his registrar, a team of nurses, and the anesthetist all moved in unison, efficiently operating at a specific time. However, when it came to trauma repairs, such as fixing a fractured clavicle or a shoulder with multiple fractures of the humerus, the dynamic shifted. These surgeries required more time, careful consideration, and problem-solving. One of the highlights for me was seeing the use of real-time X-rays to guide the placement of screws over a fracture site. The precision was impressive, as the team worked meticulously to ensure that the shoulder would retain its full range of motion after the surgery. Before each surgery, the lead surgeon held a team meeting. Introductions were made, especially since the anesthetic teams rotate between surgeries and don’t always know each other. Each case was discussed in detail, ensuring everyone was on the same page before the patient went under. This level of preparation was fascinating and highlighted the importance of teamwork in such high-stakes situations. One of the most striking differences between osteopathy and surgery became evident during the total knee replacement. The patient had multiple comorbidities, including obesity, diabetes, and significant bunions, all of which likely contributed to the rapid deterioration of the knee joint. When I pointed this out to the surgeon, he acknowledged it but remarked that his job was simply to replace the parts that had worn out. This interaction illuminated the contrasting approaches of our fields. As an osteopath, I would aim to address the underlying factors that led to the surgery or could impact recovery. Surgeons, on the other hand, focus on the immediate mechanical fix.  Seeing it in action and hearing the surgeon’s perspective helped me understand that as much as they might want to help in that regard, it simply isn’t part of their job.  My day in the orthopaedic theatre was a powerful reminder of the body's strength and resilience. Watching the surgeons use mallets, saws, and screws, I couldn’t help but marvel at how well the body recovers from such interventions. It’s a lot stronger than we often give it credit for, and its power to heal is immense.  This experience deepened my appreciation for the complementary role that osteopathy can play both before and after surgery. While a surgeon's tools and training allow them to do amazing things to and with our bodies, the ultimate goal is the same: to restore function and improve the quality of life for our patients. Many thanks to consultant surgeon Mr Oliver Donaldson and his team at Yeovil Hospital, UK.
Understanding Sarcopenia: The Battle Against Age-Related Muscle Loss
As we age, maintaining our physical strength and functional abilities becomes increasingly important. One of the crucial aspects of this is understanding sarcopenia, which is the age-related loss of muscle mass and function. In this article, we will explore what sarcopenia is, its implications for longevity, and practical strategies to combat its effects. I had the pleasure of sitting down with Justin Keogh who is the Associate Dean of Research for the Faculty of Health Science and Medicine at Bond University, with a special interest in geriatric exercise prescription who helped me understand this area better and write this guide to help you maintain muscle health as you age.

What is Sarcopenia?

Sarcopenia is defined as the progressive loss of muscle mass, strength, and function associated with aging. It is not merely a consequence of getting older; rather, it significantly impacts independence and quality of life. As muscle mass decreases, older adults often find everyday activities more challenging. Tasks like standing up from a chair, walking, or climbing stairs become increasingly difficult. Contemporary definitions of sarcopenia encompass not only muscle mass but also muscle strength and physical performance. Physical performance can be gauged through assessments such as gait speed and the ability to perform sit-to-stand activities. These metrics are used because the movements offer a proxy for fundamental movements for maintaining independence and functionality in daily life.

The Importance of Muscle Health in Aging

Taking steps to maintain and enhance muscle strength as we age is important for several reasons. Loss of muscle mass can lead to:
  • Increased risk of falls
  • Reduced mobility
  • Decreased overall strength
  • Lower metabolic health

How Does Muscle Loss Affect Longevity?

One of the key questions surrounding sarcopenia is its relationship with longevity. Studies have shown that individuals who lose muscle as they age may not only experience functional decline but may also have a higher risk of premature death. For instance, walking speed has been identified as a significant biomarker of longevity. A gait speed of less than 0.8 meters per second is associated with increased negative health outcomes aka not living as long as you might.  As walking speed decreases, the risk of severe health consequences and mortality increases. Therefore, maintaining muscle strength along with function is paramount for promoting longevity.

Factors Contributing to Sarcopenia

Sarcopenia can result from various factors, including:
  • Reduced physical activity
  • Hormonal changes
  • Chronic diseases
  • Malnutrition
These factors can compound over time, leading to significant muscle loss. It is crucial to address these elements proactively to mitigate the effects of sarcopenia.  You might do this with your doctor, nutritionist, chiropractor or osteopath, but whomever you work with make sure they have skills in working with an elderly population. 

Strategies to Combat Sarcopenia

To effectively combat sarcopenia, a multifaceted approach is required. Here are some practical strategies: 1. Engage in Resistance Training Resistance training is one of the most effective ways to maintain and build muscle mass. Engaging in strength training exercises at least twice a week can help counteract muscle loss. Focus on exercises that target major muscle groups, which can start with things like getting up and down from a chair and progress to:
  • Squats
  • Lunges
  • Push-ups
  • Rowing
2. Incorporate Balance and Flexibility Exercises Improving balance and flexibility is crucial for functional mobility. Incorporate exercises such as:
  • Tai Chi
  • Yoga
  • Dynamic stretching
These activities can enhance stability and coordination which increase the brain's control of your muscles.  This can reduce the risk of falls. 3. Optimize Nutrition A well-balanced diet rich in protein is essential for muscle repair and growth.  For most people as they age their protein requirement actually goes up.  This is due to difficulty absorbing some proteins as the intestines age. So, aim to include for following foods in your diet. 
  • Lean meats
  • Dairy products
  • Legumes
  • Nuts and seeds
Consuming adequate amounts of protein can help maintain muscle mass as you age. 4. Maintain an Active Lifestyle Incorporating physical activity into your daily routine is vital. Consider activities such as:
  • Walking
  • Gardening
  • Dancing
  • Swimming
These activities can help sustain muscle health and improve overall fitness levels.  In some communities they have exercise classes specifically for an elderly population.  For example my mother, who is currently 86 regularly attended a group exercise class for the elderly in the UK.  She does this with friends and finds it a really good way to socialize as well as exercise.  5. Use Movement Snacks For those struggling to find time for formal exercise, "movement snacks" can be an effective solution. This concept involves integrating short bursts of physical activity into your day. Examples of movement snacks include:
  • Doing calf raises while cooking
  • Performing squats while watching TV
  • Taking the stairs instead of the elevator
  • Standing on tiptoe while brushing your teeth.
These small actions can accumulate significant benefits for muscle health.

Addressing Common Concerns

Many individuals may question whether they can still gain muscle mass as they age. Dr. Keogh says that while it is more challenging, it is certainly possible, especially for those who are new to resistance training. Older adults can experience significant strength gains and improvements in functional capacity. It is essential to start with a manageable routine and gradually increase the intensity. Consulting with a fitness professional can help tailor a program that meets individual needs and goals. Understanding and addressing sarcopenia is critical for promoting longevity and maintaining a high quality of life as we age. By engaging in resistance training, optimizing nutrition, and incorporating physical activity into our daily routines, we can combat the effects of muscle loss. Remember, it is never too late to start prioritizing your muscle health—every effort counts towards enhancing your health span and lifespan. For more information on muscle health and effective strategies to combat sarcopenia, reach out to me via the Contact Page and we’ll see if we can start making Your Lifestyle Your Medicine.
Navigating Scoliosis: Understanding Your Options Beyond Surgery
The shock of discovering scoliosis can be very sudden.  Adolescent Idiopathic Scoliosis can feel like it comes on overnight, one day it isn’t there then the next day it is.  Or course it doesn’t happen like this but when parents notice it for the first time it seems like it does.   If you are like most people, you’ve gone home and googled it. And what do you read? Most likely you start by reading the definition: Scoliosis is a condition that causes the spine to curve to the side. It can affect any part of the spine, but the most common regions are the chest area (thoracic scoliosis) and the lower section of the back (lumbar scoliosis). Idiopathic scoliosis has no known cause. That doesn’t tell you much, so you dig a little further and see something like this from the Mayo Clinic: “If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Problems with Appearance. — including unlevel shoulders, prominent ribs, uneven hips, and a shift of the waist and trunk to the side “Complications can involve lung and heart damage, back problems.” This doesn’t sound good…you don’t know if you or your child's spine will get worse, get better, or just stay the same. Your doctor will probably ask for some x-rays. Once they come back, they will measure the change in degrees of your spine from straight to bent, called the Cobb Angle and depending on how severe the curve is, they will give you three options:
  1. Wait and see what happens to the angle of the curve.
  2. Bracing
  3. Surgery
This is pretty typical of modern medicine. They have to draw a line in the sand somewhere, but it doesn’t take into account all the other types of therapy you could try.  Viewing scoliosis simply as an unwanted curvature in the spine means it seems logical that correction is the only solution. For example, if I’m a surgeon trained to fix physical issues through surgery, how would I want to fix a curve? Most likely, I would recommend surgery. A review of the history of surgery for scoliosis by Carol Hasler in the Journal of Children’s Orthopaedics (1) points out that when the methods used in scoliosis surgery are compared to other orthopedic surgeries such as hip and knee replacements, it is stigmatized by the medical world as ‘a rather archaic way of sacrificing function in young and otherwise healthy individuals.’ However, it’s come a long way from the way Galen and Hippocrates used to treat scoliosis. In the 1950s, a surgeon named Paul Harrington pioneered a procedure that corrected the side bending of the spine by cutting people along the length of their back and inserting metal rods. It’s been estimated that between 1960 and 1990, about one million people had this surgery. However, it’s no longer used in the original format because it came with numerous problems.  For example, the rods had a tendency to  break resulting in more operations.   Historically, surgeons didn’t consider the spine as a three-dimensional structure, meaning it moves forward and backward, side to side, and rotates both ways. This resulted in the areas on either end of the rod being overworked, wearing out, and developing arthritis.

Modern Surgical Techniques

During the 1970s and 80s, surgery was developed to work with the three-dimensional nature of the spine by using wires, hooks, screws, and rods. These procedures were refined during the 90s, but still, new surgeries were created due to the shortcomings of the wires, hooks, and rods. More recently, surgeons offer osteotomies (removal of parts of the bone), vertebral body resection (removal of the vertebra), and most recently, vertebral tethering, in which a surgeon essentially takes some cord and tacks it between two vertebrae on the the long side of the curve. As the person grows, it creates tension and straightens the spine. Some of these modern surgeries aim to preserve the ability of the spine to function or express movement in young people which is a huge leap forward from the rods. 

Before You Commit to Surgery

Don’t get me wrong, I’m not against surgery. But before we commit to a procedure from which there is no turning back at such a young age, we need to ask some pretty deep questions.
  • At what point do you need surgery, and what happens if you don’t have it?
Ask your doctor 
  • At what curve angle is surgery medically necessary due to heart or lung problems? 
You’ll be surprised by the answer.
  • Ask them what happens if you don’t have surgery?
  • Ask them what problems can be caused by the long term loss of motion in the spinal joints after surgery?
If you are not considering surgery then you should look into bracing and exercise. Bracing has been shown to be effective(2) in halting curve progression and exercise can be used in combination with bracing or by itself to slow down, stop or reduce curves. Exercise, in some but not all cases,  is also a great way to reverse the curve. For example, Charlotte, at 12 years old, had a curve of 25 degrees, and in just 3 months reduced it by 10 degrees by following the Scoliosis Protocol.   Scoliosis specific exercises can be done in water, with a kinesiologist, physiotherapist, osteopath or chiropractor.  Depending on your age you may also want to consider dietary changes or supplements and more passive therapies like massage and foam rolling.  These can help the symptoms of scoliosis which are pain and fatigue and are more common in adults than teens.  The takeaway here is that your doctor might not even mention other approaches and instead just focus on the angle of the curve and surgery, when specific exercises in adolescence and adulthood can slow down, stop or even reverse the progression of scoliosis. If you would like to receive my FREE E-book on the 7 Secrets of Scoliosis join the Public Scoliosis Correction Protocol Group here and download it once you join: https://www.facebook.com/groups/351414238781617/ Sources:
  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566253/
  2. https://www.nejm.org/doi/full/10.1056/NEJMoa1307337