Often doctors send you for an MRI because they want to stop you complaining. They should send you off to answer specific questions or validate , in invalidate, clinical assumptions. Either way, its as well to know, in advance, what the process feels like. Here is a great personal reflection from the blog “In love with lower back pain”.
I have a belief that handstands have a role is developing the Core and aiding spinal mechanics. However, Im sure this has not been studied in any depth. The aim of this review is simply to collect enough evidence from easily accessible sources to justify experimenting with my clients.
Whilst Im not sure about many of her recommendations, it was interesting to note that Sarah Key recommends the handstand for her scoliosis patients.
“the best specific strengthening exercise is handstands….. being upside down it literally tricks both sides of the para-spinal muscles into working equally hard in keeping you upright and balanced”
According to site that sells inversion tables, “In mild cases of Scoliosis, research and clinical studies have shown that inversion tables and regular exercise can have a positive effect on treating the physical defect. Unfortunately, inversion therapy has not been shown to effectively treat Scoliosis in severe cases”
BTW, I’m not validating passively hanging upside down. The benefit of a handstand is that your body needs to be the tightest its ever been.
The “Mindbodygreen” blog by Heidi Kristoffer discusses that handstands can heal, but to avoid headstands! I must admit, I’ve never been a headstand fan!
Whilst this is far from anything resembling science, hanging people upside down , making them handstand, seems not to kill people, so it may be worth experimenting with, as long as a proper posture ( neutral spine) is maintained. .
I’m assuming that I’ll develop the handstand from a good plank position, then walk it slowly up the wall!
I should say, I think that handstands will help IF people have adequate shoulder flexibility: hanging in an awful arch could do harm
Regular readers will know that is was my intention to conduct a lot of research on scoliosis and then publish some results. I am however, getting quite a lot of interest, so rather than sit on research , Ill publish thoughts and theories as i come across reports and Journals; There is a risk that i can publish something that could be wrong and need to correct it later However, the value in people feeding back, digging out reports or treatments, is worth a possible public U turn!
Andrew Stemler ( email@example.com)
Is physical activity contraindicated for individuals with scoliosis? A systematic literature review
[Sports capacity of patients with scoliosis].
von Strempel A, Scholz M, Daentzer M
Sportverletz Sportschaden. 1993 Jun; 7(2):58-62.
Cobb angle less than 20. No restrictions
For curves of 20° to 30°, they recommended restriction from what they call performance sport; but school sports and competitive sports were allowed.
For curves of 30° to 50° or 20° to 30° with progression of 5° in 6 months, they allowed school sports with patients wearing a brace
Recommended these sports,:horseback riding, tennis, table tennis but not “performance sport or competitive sports at club level”. competitive sports allowed at school under the watchful eye of a teacher. For curves of 50° or more, they recommended endurance sports (eg, cycling, swimming, hiking, jogging)”
Idiopathic scoliosis and spondylolysis in the female athlete. Tips for treatment.
Omey ML, Micheli LJ, Gerbino PG 2nd
Clin Orthop Relat Res. 2000 Mar; (372):74-84.
Scoliosis is not a contraindication to participation in sports and asserted that, unless a scoliosis was severe, it would not reduce physical function..
“Scoliosis is not a contraindication to participation in sports by the young athlete”; and they suggested examination for underlying pathology (eg, syringomyelia, disk herniation, degenerative spinal disease) if pain accompanied scoliosis.
They also encouraged active strengthening and flexibility exercises for the spine during brace wearing and maintained that sports may be played while the athlete was not wearing a brace. Specifically asserted that swimming and water activity may be helpful to maintain flexibility, strength, and endurance.
Professional volleyball should be avoided, but recreational/amateur volleyball is acceptable.
Spinal deformity in the adolescent athlete.
Clin Sports Med. 2002 Jan; 21(1):77-92.
“There is no objective evidence in the literature to suggest that active participation in any sport is directly associated with worsening of scoliotic curvatures beyond that of the natural history of the disorder.”
Recommended active exercise for brace wearers and encouraged brace wearing during exercise. No study exists showing negative effects of contact sports on the curve of a braced individual. He encouraged all athletics out of a brace, not only for physical benefit, but for psychologic and social well-being!
Spinal deformity and athletics.
Schiller JR, Eberson CP
Sports Med Arthrosc. 2008 Mar; 16(1):26-31.
Recommends flexibility training and indicated that patients with scoliosis treated non-operatively can participate in all sporting activities.
Sport participation while wearing a brace was allowed and that sport participation out of a brace was also possible.
Conditioning should focus on flexibility of the spine and core strengthening and felt that the addition of plyometrics and power lifting after appropriate conditioning was acceptable. Athletes with scoliosis should be encouraged to participate in sport.
For postoperative patients, they maintained that sports participation should be at the discretion of the surgeon.
They did not recommend against torque sports for postoperative patients (eg, gymnastics, ballet, swimming, wrestling, javelin), as had previous authors.
Should a client with Scoliosis perform the side Plank? I think so, as a strong side plank, when matched with a strong plank and a good “brace” means the torso is “nice and locked down” ( highly scientific stuff)
The paper, “Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis” came to my attention as it was reported In the Wall street Journal. I chased the actual study down to an obscure Journal
So, it got some people to perform the side plank
“Results: The mean self-reported practice of the side plank was 1.5 minutes per day, 6.1 days per week, for a mean follow-up period of 6.8 months. Among all patients, a significant improvement in the Cobb angle of the primary scoliotic curve of 32.0% was found. Among 19 compliant patients, the mean improvement rose to 40.9%. Improvements did not differ significantly among adolescent idiopathic and degenerative subtypes (49.6% and 38.4%, respectively).
Conclusions: Asymmetrically strengthening the convex side of the primary curve with daily practice of the side plank pose held for as long as possible for an average of 6.8 months significantly reduced the angle of primary scoliotic curves. These results warrant further testing”
My own take on this is that no harm resulted from this experiment, and it makes sense to test strengthening both sides. The core and torso needs to be braced: lets do it all! I should say the self reporting , does not make this the best evidence ever, but , interesting . The side plank is used by Stuart McGill in the treatment of back pain. It seems safe, if monitored, to use and test.
We will see how my client responds
Much of the development of human movement comes from coaches comparing techinques. Better coaches hang out with other coaches, go on their courses, read their blogs, learn, analyse, video, and humbly put stuff up for criticism. Many sport science papers purport to do the same thing. However, the only value of a report of an experiment is, if you can reproduce the experiment yourself.
Do you remember those basic physics and chemistry experiments we did at school? We followed the exact doses, mixed , shook, heated and retreated to a safe distance. The instructions told us, how much, in what container , in what proportion. to what temperature.
This often isn’t the case in sport science journals. Sport scientists casually say they are testing the efficacy of , say, the deadlift and squat but often fail to explain what they mean. This frequently means back specialists often prescribe or ban movements where there is no correct understanding about what the movement is and how to perform it. I often see clients who have been banned from performing movements they do well and perfectly, and being set drills and movements, which, clearly, the instructor had not the faintest idea of the correct form or the correct mechanics .
The picture here is from a leading book on back issues and is supposed to be the correct form of the deadlift. It is, unfortunately not brilliant, (probably for all the best reasons), but, if you deadlifted in this way, you would , eventually, overload your back ( as always, poor form needs to be mixed with repetition and escalating load weight to be truly nasty).
This is not an attack on sport scientists ( I do that elsewhere). After all, all research is useful , it is a plea to look for the instructions or method in the report you are reading. Can you reproduce what they did? If not, treat the information with caution.
inspired by a re-reading this report:
Effectiveness of Transcutaneous Electrical Nerve Stimulation for Treatment of Hyperalgesia and Pain
and talking to a former (100% cured,) Backaholic, i was encouraged to drag out from the bottom of the wardrobe, my old “Bodi-tek” machine.
I bought a “Bodi tek” years ago (seriously, 2001, 2002) when I thought it would improve my Martial arts.
In my favour i only used it once. I sat there covered in those patches. Twitching.
However, there is, at certain levels, a validity to the electro stimulation of muscles and, well, according to the report above, some use in the therapeutic relief of pain.
To be honest, as I write, I am reminded that , about 2 years ago, when a sales rep from “firefly” came a calling, I got this machine out again, slapped it on various leg lower leg muscles and it seemed to help my achilles tendonopathy ( along with massage, trigger point therapy and some taping) So, if we, in the future, ask you to lie on the massage couch for a short while, hook you up, and make you twitch, you’ll know the reason why.
Interesting to see if we can effect the piriformis thinking about it.
Im deep in the throws of evaluating the role of Medical dry needling in helping back pain. We ( kate and I) are conducting some very interesting practical experiments
This M.E.T ( muscle energy technique) gets your glutes working again.
It isn’t the whole story but a useful drill if your piriformis is giving you “jip”
So, you have tweaked you back again! Now your whole day consist’s of finding positions of comfort and seeing what moves hurt.
Don’t think of this as suffering, Think of this an an experiment. Of course you are the only participant so no drug company can use your results, ( without re validating them) but, its interesting science nevertheless.
if you have been reading this blog you will have had several bracing strategies discussed. You probably ignored them or just skim read them.
Now its time to experiment. Does bracing your abs stop the pain: is sucking you abs in or pushing them out pain relieving. If so, how much in and how much out. Is it mild engagement or hard engagement ? Experiment with the anti shrug. Does pulling your shoulders down help?
Now, if possible get up and walk, swing your arms.
Does that help?
Do you find that if you lie down or lean against something it helps, but its a bit of a pig to get moving again?
What back movements hurt or help: does moving into flexion hurt, or extension? Can you find a neutral spine? does it help.
Now pay attention to your bum. Does one cheek hurt more than the other. Does it feel dull? Is one leg sore compared with the other
What movements create pain. if theses are limb movements can you reduce the pain by bracing your abs more, because, if you can, you could well have discovered, that for example, every time you move your leg, you actually move your back too! Thats a lot of work for your poor back.
Observe, experiment, record.Learn.
Unless your doctor has diagnosed “cancer of the back”, the chances are that the LBP you suffer from is what 98% of others suffer from. You can fix it!
As always if you cannot find a position of ease check out RED FLAGS , so see your doctor who may want to screen you for other possibilities. but if you simply have LBP, start to sort the issues.