Adolescent idiopathic scoliosis is a multi-factorial condition involving both genetic and environmental risk factors. Neither seems to be enough to cause the condition on their own, but it can be positively devastating when they do combine to form progressive scoliosis. Two separate questions keep popping up in regards to scoliosis; 1. Why does it occur in some child and not in others? 2. Why do some spinal curves progress and others do not?

Genetic factors + Environmental factors = Progressive Scoliosis

1. Initiating/inducing factors…..which is thought to involve a genetic pre-disposition….undetected neurological development/dysfunction which affects control of posture and coordinated movements in relation to the central nervous system body schema…. (‘Body scheme’ or ‘body set’ is the neural representation in our brainstem of our body. It is a sort of reference frame for our brain.
fMRI studies can show us the we can increase activity there by doing certain activities.)

These include multiple theories, which I’ll elaborate more on individually later in this article.

- Rotational preconstraint theory
- Uncoupled spinal neuro-osseous growth (The String and Spring Theory)
- Brain, nervous system, and skull concepts
- Neuro-Osseous timing of maturation theory (NOTOM)
- Transverse plane pelvic rotation, skeletal asymmetric, and the “developmental theory: timing of maturation from the top-down to bottom-up organization of postural control.

2. Curve progression factors (which is generally thought to involve a mechanical process (torsion, vicious cycle, dorsal shear forces, etc) with eccentric loading (having axis away from the center) and vertebral growth modulation….AKA:Hueter-Volkmann principle. These are generally accepted to have both neural and osseous components.

These include theories on curve progression that appear after the initial onset of AIS.

- Relative Anterior Spinal Overgrowth (RASO) (although this could possibly be controlled via genetic factors in some AIS cases)
- Thoracospinal concept – girls with right thoracic adolescent AIS only
- Origin in contracture at the hips
- Osteopenia – a risk factor for curve progression?
- Melatonin deficiency
- Platelet calmodulin dysfunction
- Biomechanical spinal growth modulation

1. Rotational preconstraint theory

This theory is pretty straight forward and not too complex…on the surface. It basically states that paravertebral muscle imbalance with interference of the postural reflexes and body weighted related vertical loading lead the formation of scoliosis. The lingering question is… what causes the interference of the postural reflexes?

2. Uncoupled spinal neuro-osseous growth (The String and Spring Theory)

Biomechanically speaking, the continuous axial tissue tract of the pons, medulla oblongata (the CNS postural control centers) and spinal cord are all functionally linked together and anchored vertically from the skull to the caude equina at the base of the spine. It is also anchored laterally through out the spine by dentiulate ligaments, nerve roots and nerve sleeves. Take home message: The spine is tied down in the spine pretty tightly.

Alf Breig’s 1978 work shows changes in relative lengths of spinal canal and cord CAN lead to pathologic axial tension. JD Reid’s research confirms this when his research found physiological lengthening of the cord chiefly between C2-T1 up to a maximum of 17.6% in flexion (AKA: reversal of the normal cervical curve). Essentially, an acquired spinal cord tethering is the result from a loss of the normal side view cervical curvature.

Roth built off this information in 1981 when he speculated that AIS is a disproportion of vertebro-neuro growth due to either a short spinal cord or a too rapid growth spurt of the spine. In this spring/string model, he found that shortening of a string running though a spring model (think of a slinky with a string running though it) hindered elongation of the spring resulting in a scoliotic deformity.

Porter supported the uncoupled neuro-osseous growth concept of AIS being a physical manifestation of the mal-adaption of the growing immature spine to the tether created by the short spinal cord. This evidence for this was the finding that the conus medullaris (the end of the spinal cord) position is NOT significantly different from that of a normal spine.

Dr. Chu re-examined the Roth-Porter theory via an MRI study (comparing AIS patients with severe curvatures vs normal subjects) in 2007. They found the vertebral column in the AIS population was significantly longer, yet the there was no detectable change in spinal cord length. The speculated that the initiation and progression of AIS result from vert. column overgrowth through a mal-adapation of the spine to the subclinical tether of a relatively short spinal cord.

3. Brain, nervous system, and skull concepts

Dr. Chu (the same researcher who re-investigated the uncoupled neuro-osseous growth concept) developed a concept of AIS progression with 6 linked and overlapping processes a follow…

1. Longer latency somato-sensory evoked potentials (SSEPs) via a higher CNS disturbance producing visuo-spatial perceptional impairment, motor adaptation, and learning deficits which lead to faulty recalibration of the proprioceptive (bodily awareness in space) from axial musculature.
2. leading to impaired balance control, with…
3. Low lying cerebellar tonsils due to acquired spinal cord tethering, together with…
4. Other intracerabral structural abnormalities (Ex: abnormal skull base and vault) that could contribute to…
5. Inappropriate postural adjustment during…
6. The adolescent growth spurt that leads to…
7. Progressive AIS.

4. Neuro-Osseous timing of maturation theory (NOTOM)

This theory was introduced in 2002 by Burwell and Dangerfield and it suggests that the maturation of postural mechanisms in the CNS may be complete about the same time in boy and girls and the higher prevalence of progressive AIS in girls may be the result of entering there adolescent growth spurt in postural immaturity vs boys whose later adolescent growth spurt occurs post postural maturity.

Essentially, they are viewing the problem as a dis-coordination between the Osseous (bone) escalator (increasing skeletal size, changing skeletal shape, and relative mass of the different body segments) and the neural escalators (postural maturation with the CNS body schema being recalibrated as it continually adjusts to skeletal enlargement, shape, and relative mass changes to enable it to coordinate motor actions.

5. Transverse plane pelvic rotation, skeletal asymmetrics, and the “developmental theory: timing of maturation from the top-down to bottom-up organization of postural control.

This theory demonstrates correlation between thoracic curvatures and pelvic rotation in the same transverse plane. They speculate that the feet, pelvis, and “bottom-up” organization of postural control emerges prior to postural control and the “top-down” postural control re-organizes around age 7. It is possible that a dis-coordination of timing between the top-down (visual and vestibular) from the “bottom-up” (feet) organization of postural control could serve as the initiation and progression of AIS.

6. Relative Anterior Spinal Overgrowth (RASO)

Relative Anterior Spinal Overgrowth (RASO) essentially states that in many AIS cases the anterior elements (vertebral body) are longer than the posterior elements (the posterior joint complex) resulting in a structural hypo (decreased) thoracic kyphosis (the normal reversed side view curve seen in the mid back area).

It is not clear if this phenomenon is the result of an intrinsic abnormality of skeletal growth in patients with AIS which may genetic or an adaptation to biomechanical bone stress….which is the more accepted premise thus far… via the Hueter-Volkmann principle(bone under stress grows slower then bone not under stress) which would mean AIS has primarily a mechanical basis (aka: Dorsal shear forces theory).

The dorsal shear forces theory states the initial event is a lordotic segment in the thoracic spine with the spinal rotation and cobb angle being created by secondary torque forces from the posterior musculo-ligamentous structures.

Castelein has outlined 6 link/overlapping processes of the dorsal shear forces leading to AIS.

1. Upright human posture
2. Backward inclination of the vertebra in the sagittal plane (lordotic segment in the thoracic spine) creates…
3. Dorsal shear forces that render the facet joints inoperative and introduce…
4. Axial rotational stability enhancing slight asymmetries in the transverse plane with already exist.
5. Asymmetric loading of the posterior part of the vert. lead to asymmetric growth in 3-D of the pedicles, vert bodies, arches in accordance with the Hueter-Volkmann effect.
6. Progressive AIS

7. Thoracospinal concept – girls with right thoracic adolescent AIS only

Dr Sevastik developed a “thoracospinal concept” based on experimental, clinical, and anatomical data and it only applies to females with right thoracic curves.

His 6 steps has a linear causality mechanism…

1. Dysfunction of the autonomic nervous system (which is responsible for involuntary neurological postural control)
2. Increase vasularity of the left anterior hemithorax
3. Overgrowth of the left peri-apical ribs which…
4. disturbs the equilibrium of the forces that determine normal alignment of the thoracic spine, in a putative growth conflict, that…
5. triggers the thoracospinal deformity simultaneously in the three planes.
6. Biomechanical spinal growth modulation.

Basically, he is staying that asymmetrical blood flow between the left (increased) and right (decreased) to the anterior chest wall which causes and elongation of the left ribs.

8. Origin in contracture at the hips

Dr. Karski developed this concept of AIS orgin/progression based on 3 step linear process.

1. Hip abduction (external rotation)…which equates to a limitation of internal hip rotation…mostly of the right hip.
2. Disturbance of growth of the pelvi-sacral lumbar region with development of a left lumbar curvature.
3. Development of a compensatory right thoracic curvature.

Based off this theory he developed 3 groups with varying degrees of hip contractor to explain the “S” and “C” curve patterns.

9. Osteopenia- a risk factor for curve progression?

Low bone calcium has been found and noted in approximately 50% of AIS females in which their curve progressed 6 degrees or more and especially in the femoral neck of the hip on the side of the curve convexity (the outside of the curve) due to more weight bearing loading on the side of curve concavity (the inside of the curve). The researchers feel some of these findings could be explained via low calcium in-take, but felt that a lack of weight bearing activity and programmed exercise due to spinal brace treatment may be a primary contributor to the osteopenia in AIS.

10. Melatonin Deficiency

Virtually all of the work done in area of Melatonin deficiency and AIS has concluded that it may be factor in curve progression, but probably not related to initial onset of the condition. Machinda and colleagues postulated that in the development of progressive AIS, melatonin acts through the nervous system.

1. An inherent disorder of neurotranmitters from neuro-hormonal origin affect in melatonin,
2. associated with the bipedal condition, and……
3. a horizontal localized neuromuscular imbalance with torsion produces…..
4. a scoliotic deformity of the fibro-elastic and body structures of the spine.

Dr. Alan Moreau reported a melatonin-signaling transduction to be impaired in osteoblasts (bone builders) caused by the inactivation of Gi proteins. Which could serve as a biological marker with potential for curve progression prognosis via a blood test using lymphocytes.

11. Platelet Calmodulin Dysfunction

This curve progression theory also incorporates melatonin and the RASO concepts. Calmodulin is a protein that helps regulate skeletal muscle contraction via regulation of calcium within the muscle. Melatonin functions may include modulating calcium-activated calmodulin.

It is suggested that altered para-spinal muscle activity explained the relationship between calmodulin level changes and cobb angle in AIS.

Lowe offered an alternative calmodulin concept in 5 linear steps which ends in with development of RASO (relative anterior spinal over growth in the thoracic spine).

1. A small scoliotic curve.
2. Increased axial loads (growth spurt) create micro-damage to the vert. body growth plates…
3. causing vertebrae vascular damage…
4. combined with genetic pre-disposition calmodulin changes occurs with dilated blood vessels of deforming vert. bodies
5. which releases growth factors, which in a mechanically compromised vertebral endplate promotes RASO

12. Mechanical spinal growth modulation (AKA: The vicious cycle)

This theory is the most supported and generally accepted theory. Purposed by Dr. Ian Stokes (one of my personal favorites) as early as 1996, the biomechanical spinal growth modulation suggests spinal imbalance through gravity and continuous muscle action leads to asymmetric loading of the vert. growth plates and hence asymmetric growth via the Heuter-Volkmann principle.

Perdriolle reports that the onset of AIS occurs as a result of a mechanical process termed “geometic torsion of the vertebral bodies” but worsening was caused by deformation of the vert. bodies.

Stokes developed a 2-D mathematical simulation of the lumbar vertebra (not the discs) and tested whether the calculated loading asymmetry created by muscles in a spine with scoliosis could explain the observed rate of scoliosis. The results were consistent with the clinical observations.

Stokes’ “Vicious Cycle”
1. Pre-existing scoliosis curve of unknown etiology (probably genetic underdevelopment of the neurological postural control centers in the CNS from the current knowledge provided by Axial bio-tech (developers of Scoliscore).
2. Putative neuromuscular dysfunction with the most physiological strategy causing loads more the concavity at the apex of the curve.
3. Neuro-muscular determined left-right asymmetric loading of vertebral bodies sustained over a substantial portion of the day.
4. Vertebral body growth plates (sensitive to altered asymmetric compression) with mechanically modulated alteration of growth leads to AIS curve progression

*** Different individuals adopt different neuromuscular strategies which explains curve patterns and varied progression rates.

What does it all mean? Well, there are a few conclusions that can be out of this massive amount of data and theory.

1. The origins of AIS is most likely linked to a genetic defect of the central control or processing by the central nervous system (Pons and hind brain) that affects the growing spine.
2. It appears that factors that pre-dispose/initiate AIS are separate from the factors that drive curve progression.
3. The consensus is that RASO results largely from biomechanical spinal growth modulation.
4. The NOTOM concept was formulated to explain why adolescent girls are more susceptible than boys to curve progression. Based on the timing of adolescent growth spurts (earlier in females) in relation to the timing of postural maturity (similar in boys and girls).

So how will all of this new information change the future of scoliosis treatment? No one really knows for sure, but it obviously will and has even spun an new concept in scoliosis treatment called Bernstein’s Problem.

The Bernstein’s problem: The brain is responsible for coordinating an amazing number of mechanical linkages, so Bernstein theorized the nervous system organized movement in a hierarchical manner which places the “body schema” at the top.

During the development of the body Schema the overwhelming evidence suggests it is tied to growth of the muscular-skeletal system and brain.

The key theoretical issue centers around how the brain adapts circuitry controlling muscles/joints and matches them to the developmental biomechanical changes during growth spurts.

The body schema is developed long-term from both somatotrophic body maps and immediate sensory input. (AKA: it is partly genetic and partly acquired through adaptation to the environment)

The first part of the body to develop postural organization is the head via visual and vestibular sensors (Top-Down mode by postural organization by age 7)

The NOTOM escalators may influence the CNS body schema during growth via proprioceptive inputs and brain plasticity. Particularly the decoupling that occurs between the head and torso past the age of 7 years old.

The evidence is continuing to support the notion that early stage scoliosis intervention using a neuro-muscular system of involuntary postural control may be the only way to alter the natural course of adolescent idiopathic scoliosis.

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There are a few exercises you can do at home that will keep you tone. They target arms(biceps/triceps), shoulders, lats, legs(quads) and abs. Theses exercises can be done while sitting in your wheelchair or lying in bed using inexpensive items such as dumbells, exercises bands, and ankle/wrist weights.

BICEPS.
The most basic movement for arms is the bicep curl. There are many variations, but for our population, the seated dumbell curl is what we will do. Depending on your hand function, you can perform this with either dumbells or wrist(ankle) weights that wrap and velcro around your wrists. There are 2 ways to do these, 1st…. with your arm(s) hanging down at your side, palms facing in towards your body, curl your arm up, be sure to keep your upper arm from shoulder to elbow in a fixed position As you bring the weight up,(if possible) rotate your wrist so it ends palm up. This rotation has an affect on the bicep muscle. The 2nd way i like, if your wheelchair has armrests, simply use it as a base of support under your elbow. This will prevent any upper arm/ shoulder movement and really isolate the bicep muscle. 10 reps, 3-5 sets

TRICEPS.
The tricep is the muscle in the back of the arm. This muscle is often affected by Spinal Cord Injury. If you have function of tricep, there are a few ways we can train this muscle from a wheelchair and lying down. A few require should function, one does not. Lets look at ways from a seated position which also require shoulder movement..

1- With a dumbell or wrist wrap weights, raise your arm(s)straight overhead. Bending at the elbow, lower the weight to behind your head, then raise to full extension again. This can be done each arm individually, or both hands holding one dumbell.
2- Lying down flat on your back, raise one arm straight up towards the ceiling, lower the weight to the side of your head. Keep your elbow pointed upwards. It is basically the same as movement #1, but lying down.

The 3rd movement requires NO shoulder involvement. For this exercise you will need an exercise band. Place an exercise band either over the top of a a door or even over the back of your neck, as if u had a rolled up towel over you. With your elbow either at your side or planted on your armrest, press downwards towards the floor. Pause at full extension, then slowly release back to start. 10 reps, 3-5 sets

FOREARMS.
To perform this movement, you need to have some hand function to grip and hold a dumbell, as well as wrist control.

Place your arm(s) on your thighs with your hand extended slightly further than your knees.

With your palms facing up, roll your wrist down, then up. If you have good finger control, you can open your hand on the downside of movement and roll the dumbell so only your fingers are griping. Then roll your hand closed and then your wrist up.

This can also be done with your palms facing down. This will work the topside of the forearm. 10 reps 3-5 sets

SHOULDERS.
SIDE RAISES- This movement will work the shoulder muscle. Again, depending on your hand function, you can use dumbells or wrist (ankle) weights.

Hold the dumbbells with your palms facing in and your arms straight down at your side. This will be your starting position. Raise your arms out to the side, with just a slight bend, to just past shoulder level. Slowly return to starting position. 10 reps 3-5 sets

PRESSES- The seated dumbbell shoulder press is one of the best shoulder exercises for developing all heads of the shoulder.

Hold one dumbbell, or wrist weight, in each hand at shoulder height using a pronated grip. With the elbows pointed downward and to the sides. Press upwards towards the ceiling. Stop just short of full extension, then slowly lower to starting position. 10 reps 3-5 sets

ABDOMINALS…
CRUNCHES- Core strength is extremely important to people with spinal cord injury. Having a good strong core with not only allow us to feel good, it will aid in getting in and out of bed, sitting up, reaching, bending over to pick something off of the floor, dressing, etc. Depending on your level of injury, theses should be done daily. Start your day off with crunches before you even get out of bed.

Lying on your back, bend your knees up to approximately a 45 degree angle. You can place a bolster, exercise ball, chair, or even a pile of pillows under your legs for support.

The movement begins by curling the shoulders towards the pelvis, then back down to flat. Do this movement nice and slow. he hands can be behind or beside the neck or crossed over the chest.

DO NOT pull on your neck, simply place your hands back there.
When performing a crunch the lower back should not leave the floor.
Start with 2 sets of 25 reps..That should give you a good burn.

SEATED SIDE BENDS- This exercise I found to be very beneficial. Being in a wheelchair, we cannot always reach things and need to stretch to get to them. Without core strength, we would fall over. This movement requires you to be in your wheelchair, at a table, and you will need a towel. Depending on your ability, you may need the aid of someone in case you go to far and cannot get back to center.

Place the towel on the table. Pull your chair sideways to the table and place your closest arm on the towel.
Lean as far as you can, as if you were reaching for something across the table, then come back to center.
This can be a tough movement, so find your range to where you wont get stuck.
Spin around and work the other side as well.

This can also be done facing the table. Place both hands on towel, arms extended forward. Lean forwards, then back to sitting up. Find your range and build on it.

BACK…
LATS- The lat (Latissimus Dorsi) is a muscle of the back. Pulldowns are the most basic exercise for this muscle. To perform this exercise, you will need either an over the door pulley, or an exercise band. If a pully is used, some sort of resistance will need to be on the opposite handle. You can wrap ankle weights to the handle.

Start with your arm extended upward, palm forward. Slowly pull downward. Be sure to keep your elbows pointed out to the side. Stop when your arm is just past 90′. Slowly control the movement back up.

The further outside of the shoulder your hand is to start, the more the lat muscle is focused on. When your hand is above the shoulder, you will use more bicep muscle to pull down.

This exercise also incorporates shoulder and bicep muscles. 10 reps 3-5 sets

LOW BACK/HIPS…
BRIDGING- Bridging is great for maintaining strength in the low back. Pelvic bridging is also a great exercise that strengthens the paraspinal muscles, the quadricep muscles at the top of your thighs, the hamstring muscles in the back of the thighs, the abdominals and the gluteal muscles. This is an exercise that not many with an spinal cord injury can do. If you can, it is a great movement. If you have any movement or strength in your hip and low back areas, you should give this a try. Even the slightest movement can be built upon. You will need the aid of someone to sit on your feet and support your knees in place.

Lie flat, knees bent and feet flat on the floor about 6 inches apart.

Push your hips towards the ceiling, hold at the top for a few seconds, then slowly lower back to start.

3 sets 10-15 reps

LEGS…
Quadriceps- This exercise will strengthen the quads. The quadriceps is a large muscle group, stretching from hip to knee, which makes up the front of the thigh. You can perform this movement with nothing, or if you have strength, you can add ankle weights for resistance.

From your sitting position, extended your leg out as straight as you can, hold for 3 seconds, then slowly back to start.

10reps 3-5 sets

Having a Spinal Cord Injury wreaks havoc on our body. Able bodied people can get away with not exercising more so because at least they are moving, walking, bending, etc. We pretty much are stationary and muscle will quickly atrophy with non use. We NEED to exercise whatever functional muscles we have. If you have the hope of recovery when a cure comes along, you need to have as much muscle tone as possible.

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Ordering imaging scans on patients with back pain had become a common practice for many doctors. Unfortunately, this practice may only serve to drive up the cost of healthcare and lead to misdiagnoses. In fact, the American College of Physicians recently released guidelines which suggest that unnecessary imaging scans may do more harm than good.

X-rays, MRI’s, and CT scans raise the overall cost of healthcare. In addition, these scans may show abnormalities which are totally unrelated to the patient’s pain, but which doctors address anyway. Additionally, excess or repeated exposure to radiation has the probability of causing cancer and other health problems in patients.

Dr. Amir Qaseem, director of clinical policy in medical education at the American College of Physicians, states that back pain is usually caused by muscle strain and that other scans “should be reserved for selective high-risk patients who have serious symptoms” only.

Back pain is a problem which affects millions of Americans every day, sometimes making it difficult for people to even get out of bed or around the house. Fortunately, instead of going to a doctor for unnecessary scans and allopathic medicine, there are simple natural treatments available to you.

The first, and most common relief from back pain is chiropractic treatment. While chiropractors may recommend supplements, they usually focus more on the muscle tension causing back pain, and offer stretches and other treatments to relieve the pressure on the back. If your chiropractor does recommend supplements, they are usually natural or “alternative” medication, including herbs or vitamin and mineral supplements.

Another common pain relief treatment is acupuncture, a medical art which was conceived in China thousands of years ago. While it may seem scary, many patients who have had acupuncture treatments report that the treatment itself was actually painless. Additionally, back pain is relieved long-term, even once acupuncture treatments have no longer been used.

Supplements help to relieve pain by either numbing pain-sensitive nerves or by giving your body enough nutrition to prevent pain. For example, topical Magnesium has been touted as having benefits such as muscle pain relief. Other patients have noted that topical Magnesium relieves cramps within minutes of use. Studies show that Magnesium is used by every cell in the body, and that muscles need Magnesium to function properly, and that means no cramping or tightening.

A relatively new treatment for pain is music therapy, which uses -you guessed it, music – to help relieve pain. Many doctors have used music therapy in hospitals for treating chronic pain problems, and have had favorable results. The best thing is music therapy is cheap, easily accessible, and actually works.

Yoga has been used and promoted for its health benefits for hundreds of years, and it definitely makes sense that using stretching and other exercises would help to relieve pain, especially back pain. Most yoga poses are relatively easy to master, and joining a yoga class is a great way to share that time with others. Some poses, such as the cobra, are really great for stretching the lower back.

These five methods are natural alternatives to medication and unnecessary radiation. Take your health into your own hands today and treat your back pain naturally, easily, and significantly more cheaply than visiting a doctor.

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There are many great foods and other substances in history, but every now and then one comes along that actually proves to be directly beneficial to someone who is suffering as regards a medical condition. Often this ‘wonder food’ is picked up by the media and converted into something that will save thousands of lives. When it comes to a condition like Scoliosis, where sufferers have the discomfort and embarrassment of a spinal curvature to cope with, any food substance that can help with the general problem is welcome.

Food full of bacteria is now being recognised as one of the most effective measures one can take when dealing with much of what makes modern man sick. Bacteria can work hard to clean up the intestinal system and generally protect it from the harmful bacteria that can take over and damage the git on a permanent basis. Generally speaking, fermented foods contain enough bacteria as well as vitamins and minerals to boost our immune system, but also a lot more.

Minerals and vitamins such as calcium are contained in many fermented foods. It is for this reason that they are excellent sources of support and growth for skeletons, especially younger skeletons, which need all the growth help they can get.

Back when Early Man was trying his best to eat well and essentially survive, he maintained a diet that was rich in fermented elements. Early Man was basically a nutritional powerhouse. Without the means to sterilise or make food into what we have today, without the ability to process food in other words, he was getting the very best that Nature could offer. If you want any further evidence on the qualities of fermented foods, you should bear in mind that the World Health Organisation published s study a little while ago that pointed out that people in countries like Japan, who have a diet rich in such nutrients, have the longest life spans in the world. This is no surprise, and it is encouraging to see so many people in the Western world adopting such foods.

Kefir, which means ‘feel good’ in the Turkish speaking world, is a blend of cultures and fermented agents, one which is becoming particularly popular in the East. When made as highly tart tasting yoghurt, it can b easily enjoyed as one part of a main meal. The many micro organisms that are found in kefir can work hard to help balance the inside of your stomach, creating a harmonious environment that promotes good, balanced health.

People in the Caucasus Mountains enjoyed kefir many years ago. They also enjoyed long life. What this means for people with scoliosis though is that anyone who suffers from this condition have a readily available substance that they can include into their diet, one that can taste great if prepared well, and also help to ease the discomfort and the anxiety caused by scoliosis.

There is a lot of serotonin in kefir, and this helps to boost the structure of bones much more than any chemical will. Alongside these benefits, kefir also offers lots of calcium and magnesium, both of which bring real advantages to those who are suffering from scoliosis.

Dr Kevin Lau D.C. is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition from Clayton College of Natural Health in USA.

He has completed 3 thesis on “Scoliosis and Exercise”, “Scoliosis and Nutrition” and “The role of calcium and vitamin D in the prevention of low bone density and Adolescent Idiopathic Scoliosis (AIS) in prepubertal women.” With his research into spinal conditions he is the published author of “Health in Your Hands – Your Plan for Natural Scoliosis Prevention and Treatment”.

In 2006 I was awarded the “Best Health-care Provider Awards” by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to: http://www.scoliosis.com.sg/.

Article Source: http://EzineArticles.com/?expert=Dr_Kevin_Lau_D.C.

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Using this simple 7-step video guide, your child need not be stressed by major changes to his or her lifestyle. There is no strict diet involved, no expensive gym membership, no equipment to buy and no need to deprive the child of many foods they enjoy.

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A healthy back has natural curvature. A straight lumbar spine is often an indicator of pain in the L4, L5, S1 region. People lacking lumbar curvature will commonly indicate pain on or near their sacrum. A straight spine involves numerous muscles in the lower body being overly tight. Gaining curvature of the lumbar spine requires lengthening numerous lower body muscles. The psoas muscle, in particular, must be lengthened to bring curvature to the lumbar spine. Active Isolated Stretching (AIS) restores curvature to the lower spine. And more importantly, AIS helps people recover from chronic back pain.

When a person is tight in the lower body, the lumbar region loses its natural curve. The psoas, gluteal (buttocks), and hamstring muscles are almost always involved in a lumbar region that lacks curvature. Many more muscles are involved, but these three are almost always a contributing factor. All three muscles can become tight from numerous hours of sitting. Unfortunately, modern society requires many of us to sit eight to ten hours a day. And this is a major reason why one third of the world population suffers from back pain.

A tightened psoas muscle cannot be massaged to normal length because there are too many points of attachment to be released manually. Chiropractic adjustments would be more effective after AIS treatment because chiropractic does not address psoas tightness in their procedure. PNF stretching uses the wrong position for psoas stretching, which can cause herniation to the discs around the L4, L5, S1 region. Active Isolated Stretching is most effective at opening the psoas muscle, which is essential for restoring the natural lumbar curve. Some therapists incorrectly advise laying and rolling on a foam roller to gain curvature in the lumbar region. This exercise does not bring long term curvature to the lumbar spine because the psoas does not get stretched while using the foam roller.

Muscles attach to bones. Tightness in the psoas, hamstrings, and gluteal muscles will put excessive strain on the pelvis and spine. This tightness will cause the lower spine to lose its natural curve and the discs around L4, L5, S1 will often become strained to the point in which they herniate, bulge, or degenerate. This abnormality in the low back discs can also be restored with AIS therapy because the cause is excessive muscle inflexibility. A herniated, slipped, or bulging disc can return inside the vertebral column when muscular pressure is discontinued. Similarly, a degenerative/herniated disc will stop pinching on the spinal nerves because removing muscular tension will remove nerve pain.

Weakness in the lower body muscles also contributes to a straight spine. Complete rehabilitation from flat back syndrome entails doing lower body strengthening exercises to maintain the natural curve in the low back. After the psoas muscle is lengthened, it needs to be strengthened. Abdominal exercises are an important part of rehabilitation, but it is important to do correct abdominal exercises. Many people perform full sit-ups as abdominal exercises. Full sit-ups are when the hands are interlocked behind the head and the person performs a full ab crunch to the point in which their elbows touch their knees. This is the wrong way to practice abdominal exercises! Full sit-ups will tighten the psoas muscle, which will decrease curvature of the lumbar spine.

A flat back is more of an indicator than a cause of lumbar back pain. Active Isolated Stretching can restore curvature to a straightened spine because one of the primary causes is inflexibility. Conventional stretching, PNF stretching, yoga, Thai massage, or any other type of stretching has failed to grasp key mistakes they are making in their procedure; which is why AIS therapy can restore lumbar curvature while other forms of stretching cannot. One-to-one AIS treatment is the kick start to gaining curvature in the lumbar region. At-home exercises are what maintain correct posture.

Anthony Ohm is an advanced practitioner of Active Isolated Stretching therapy. Active Isolated Stretching (AIS) is a form of assisted therapeutic stretching. AIS is an alternative to chiropractic, physical therapy, and surgery. It is used for chronic pain, healthy aging, neuromuscular diseases, and athletic performance. Anthony Ohm came to AIS therapy through a twenty-five year search to resolve his own chronic back pain, which involved seeing over forty specialists.

Active Isolated Stretching is highly beneficial for numerous conditions, including: herniated/bulging/degenerative disc, sciatica, neuropathy, scoliosis, spinal stenosis, spondylolisthesis, kyphosis (dowager’s hump), arthritis, bursitis, chronic neck pain, frozen shoulder or shoulder pain, headaches, sports injuries, Parkinson’s, Alzheimer’s, stroke, Multiple Sclerosis, and many other physical issues.

Anthony Ohm is a massage therapist and personal trainer. He practices in Los Angeles, California and Honolulu, Hawaii.
For more information visit:
http://www.ResolveYourPain.com/

Article Source: http://EzineArticles.com/?expert=Anthony_Ohm

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Back massagers are an excellent way to help relax the body after a hard days work. First of all, if you have one available, you will not need a friend or masseuse to massage your back. Not only that, back massagers can be used practically whenever and wherever you need it. No need to wait for someone else’s convenience. Apart from convenience, it is much less costly in the long run to use a back massager. We all know that professional massagers can cost a fortune.

So the next obvious question is ‘How does a back massager work”? The concept is quite simple. It is an electronic device designed to vibrate while pressed against the back. The high vibration force will instantly relax the body and muscles. It is capable of giving a full massage for the back. In fact it has shown to be an effective substitute for a real massage, done by a masseuse.

Back massagers also come in the form of chairs. These chairs will have back rollers as well as a vibrating seat. It is designed to simulate a shiatsu massage. These massaging chairs are a great way to sit back and relax, get a massage, while watching your favorite television program. These chairs come with other features such as heat producing elements. This added heat can be very comforting while getting the massage.

Portable massagers will come with extra units, such as spot massagers, which are capable of targeting specific areas of the body, which may require more attention. Prices of portable massagers can vary greatly, from as little as 50 dollars to as high as 300 dollars, depending on the features it comes with. All portable massagers are capable of attaching to a chair for using. These portable units are made either to use strictly on the upper and lower back or for the neck, shoulders and lumbar area.

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