Scoliosis Support  

Go Back   Scoliosis Support > Scoliosis > Non Surgical Room

Notices

Reply
 
Thread Tools Display Modes
  #1  
Old 8th June 2013, 03:50 AM
hduggan hduggan is offline
Blue
 
Join Date: Aug 2009
Location: Portland, OR
Posts: 121
Default Is side-shift still used in the UK

A bit of a re-introduction. I have an adult son in his 20s with a curve that got big right at the end of growth. By the time they realized it was in surgical territory, he had stopped growing. He has both kyphosis and scoliosis in the 50/60 degree range - both are stable (so far) and he's in no pain - managing with massage, stretching, and weight training. We assume he'll need surgery some time in his adult life, but no one is recommending it now.

So, he's good for the moment and heading off to graduate school in the fall, so I have some time on my hands and wanted to put it to good use

I've been looking into methods used to keep small curves small. The kinds of things you could reasonably ask a child with a 15 or 20 degree curve to do which would keep that curve at 15 or 20 degrees. The simplest thing I've seen is side-shift exercises - basically, you shift your torso in the direction of the concave side of the curve, hold it for 10 seconds and then relax. And then do that 30 or so times a day.

But, the literature just totally peters out on the topic. I see the original paper from Min Mehta in the 80's when it was a regular part of her practice, then a follow up in 2003. And then, nothing. I've never heard of any patient in the US being recommended these exercises by their doctor, or even having them incorporated as part of prescribed physical therapy.

Are they still being prescribed in the UK? Or, did anyone here have them prescribed when they were younger? It seemed like a promising idea - I can't figure out if they decided it didn't work, or if it just never caught on with anyone other than Dr. Mehta.
Reply With Quote
  #2  
Old 8th June 2013, 11:09 PM
tonibunny's Avatar
tonibunny tonibunny is offline
T Sr: Admin, Big Sister and Da Police!
 
Join Date: Jan 1970
Posts: 15,340
Default Re: Is side-shift still used in the UK

As far as I'm aware, it isn't used much if at all. I never hear of it being used apart from by a handful of parents who have come across her old article on the subject. I'm actually meeting with Min Mehta within the next couple of months so I will ask her about whatever happened to her Side Shifting theory stuff then. She was one of the most senior scoliosis consultants in the UK and was based at the largest scoliosis centre here so you would think that if it had proved effective, it would have been used more.
__________________
37 years old, diagnosed with infantile idiopathic scoliosis at 6 months old with curves of 62(T) and 40(L) degrees. Casting and Milwaukee braces until surgery at 10 - ant release/pos fusion T1-T12, halo traction. Post op cast and then TLSO. Further surgery at 18 (ant release/pos fusion extended to L3 to include lumbar curve, costoplasty) and 25 (another costoplasty). Fusion extended to L4 at 33 (XLIF with 4 pedicle screws and two short rods). Pre-op curves: 76(T) and 70(L). Post-op curves: 45(T) and 35(L). Diagnosed with Ehlers-Danlos Syndrome aged 34; scoliosis almost certainly due to this rather than being idiopathic.
Reply With Quote
  #3  
Old 9th June 2013, 03:57 PM
hduggan hduggan is offline
Blue
 
Join Date: Aug 2009
Location: Portland, OR
Posts: 121
Default Re: Is side-shift still used in the UK

Thanks, Toni. I'd love to hear her take on it.
Reply With Quote
  #4  
Old 14th June 2013, 04:54 AM
CamelHumpHipChick's Avatar
CamelHumpHipChick CamelHumpHipChick is offline
Senior Member
 
Join Date: Jun 2013
Location: Utah, US
Posts: 167
Default Re: Is side-shift still used in the UK

My therapist has me do something that sounds similar. I sit with a towel under my left cheek (for my bottom compensatory curve) and push my ribs into the concave side of my big lumbar curve.
Reply With Quote
  #5  
Old 20th June 2013, 04:58 AM
hduggan hduggan is offline
Blue
 
Join Date: Aug 2009
Location: Portland, OR
Posts: 121
Default Re: Is side-shift still used in the UK

I've seen something similar to that in the side-shift literature for double curves - they had the patient sort of stand on tiptoe on one side for the lower curve, and then do the side shift for the upper curve.

My sense is that side shift has been integrated into some of the scoliosis PT therapies - I know it's part of the SEAS treatment. But the idea behind it is that is isn't physical therapy - it's just an auto-correct that you incorporate into your life. And that's where I don't see it any more.
Reply With Quote
  #6  
Old 14th August 2013, 01:50 AM
hduggan hduggan is offline
Blue
 
Join Date: Aug 2009
Location: Portland, OR
Posts: 121
Default Re: Is side-shift still used in the UK

I heard back from a physical therapist at RNOHT, who worked with Dr. Mehta and he was tremendously helpful. He said he still uses side-shift (along with other exercises, such as breathing exercise, balance, and core strengthening). He's been writing papers about it recently, which is how I found him.

His sense is that the cluster of exercises is most helpful for adults and teens hitting the end of their growth spurt, and is good for pain and posture.

Like other exercise practitioners, he doesn't feel that it can be used alone at the height of the growth spurt to hold a curve. I forgot to ask him about small curve - hopefully the paper he's working on will address that.

I'm still puzzled why it hasn't gotten more traction. My son has had a few basic recommendations for physical therapy, but we were never recommended anyone who had any special knowledge about scoliosis. We've sort of stumbled onto things on our own that helped his pain and posture, but there just doesn't seem to be any experts that doctors send their patients to.
Reply With Quote
  #7  
Old 14th August 2013, 02:12 AM
tonibunny's Avatar
tonibunny tonibunny is offline
T Sr: Admin, Big Sister and Da Police!
 
Join Date: Jan 1970
Posts: 15,340
Default Re: Is side-shift still used in the UK

I met Dr Mehta a couple of weeks ago, and specifically asked her about Side-Shift Therapy. She agrees that it cannot permanently straighten a curved spine, but is most useful in helping to prevent the premature degeneration of the discs that can accompany unbalanced vertebrae. Dr Mehta has a very severe scoliosis herself (treatment was not available in India when she was a child, so she resolved to become a doctor and do something about that!) - I would guess her main thoracic curve is at least 150 degrees. Despite this, she is not too much pain from disc problems because she has constantly used her Side-Shift technique to keep pressure off her lumbar discs.
Sadly, she does get a lot of pain from muscle spasms instead.

Dr Mehta is a fan of the Italian SEAS people and has visited them several times
__________________
37 years old, diagnosed with infantile idiopathic scoliosis at 6 months old with curves of 62(T) and 40(L) degrees. Casting and Milwaukee braces until surgery at 10 - ant release/pos fusion T1-T12, halo traction. Post op cast and then TLSO. Further surgery at 18 (ant release/pos fusion extended to L3 to include lumbar curve, costoplasty) and 25 (another costoplasty). Fusion extended to L4 at 33 (XLIF with 4 pedicle screws and two short rods). Pre-op curves: 76(T) and 70(L). Post-op curves: 45(T) and 35(L). Diagnosed with Ehlers-Danlos Syndrome aged 34; scoliosis almost certainly due to this rather than being idiopathic.
Reply With Quote
  #8  
Old 14th August 2013, 05:01 AM
hduggan hduggan is offline
Blue
 
Join Date: Aug 2009
Location: Portland, OR
Posts: 121
Default Re: Is side-shift still used in the UK

Thanks for asking about it Toni. It's funny that there's so little interest in curve progression in adults. It's as if, if you make it through your teen years, you're just magically OK. If you could keep small curves in grown teens from advancing to surgery through adulthood, you could do a world of good. Or if you keep keep a thoracic curve in a grown teen from going down to the lumbar curve.

The SEAS people have been really helpful and straightforward whenever I've talked to them. They told me straight up that they just didn't have much experience with a curve as high as my son's, that there wasn't really much chance that they could reduce the curve, but that they'd be willing to see if they could slow or halt progression.

That Dr. Mehta likes them is the golden stamp of approval
Reply With Quote
  #9  
Old 30th October 2013, 04:45 PM
lindsay roberts lindsay roberts is offline
Junior Member
 
Join Date: Jan 2013
Posts: 5
Default Re: Is side-shift still used in the UK

Hi my 19year old who had amid thoracic curve at 15years ( with compensatory curve above and below, so appears straight)was discharged from followup by Bristol orthopaedics last year when they said the curve was unlikely to progress. He narrowly escaped bracing.
He was started on Schroth and some Pilates exercises by my husband who is an osteopath and Schroth and Pilates trained. He is now at University and does lots of sports( Polo, lacrosse and is training for a Tough Mudder challenge.) Whenever he becomes stiff or has areas of pain, he restarts the exercises or ups the amount that he does to maintain flexibility and strength( including some like the side shift)
We have seen people in their 60's who are struggling due to added degenerative disease who also have reduced symptoms and improved their movement range with similar targeted specialised exercises.
Birmingham National Orthopaedic hospital just stated in their Scoliosis association U.K. (SAUK) meeting last week that they are trialling more specific exercise programmes and will publish on it in the near future.
Too little is said about how to maintain the back and improve symptoms in adults; the focus is all on genetic factors and possible prevention in the future ( important, I know as the less people who initially get the problem the better)
Reply With Quote
  #10  
Old 30th October 2013, 05:52 PM
hduggan hduggan is offline
Blue
 
Join Date: Aug 2009
Location: Portland, OR
Posts: 121
Default Re: Is side-shift still used in the UK

That's great that your son managed to avoid treatment. Mine avoided it, but his curve is largish and he's likely to need some treatment as an adult. Likely surgery, hopefully something less.

I agree about the complete lack of interest in keeping adults with scoliosis as painfree as possible. This is just an area where research money doesn't seem to flow at all. Which is odd, since the surgery is so expensive - you'd think it would be worth quite a bit to reduce the number of surgeries in adults, or to decrease the number of lost work days due to pain and other problems.

My son is also using exercise and stretching to keep himself in shape. So far, he's managed to greatly improve his appearance and how he feels with just exercise and massage. Hopefully that will hold him a good long time.

The Scoliosis Association looks great. I wish it looked as active in the US as it looks in the UK.
Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT +1. The time now is 09:33 AM.


Powered by vBulletin® Version 3.7.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
(c) Scoliosis Support