Tri Bars Modified Walker[/caption] [fusion_text] I usually write about complex scoliosis deformity patterns but this time I’m writing about a case I saw today, involving the much more typical stooping over deformity that affects up to 60% of the ageing (that means you, maybe in a few years… but it means you…..!!) population.  This stooping over posture is associated with increased pain, reduced independence and reduced quality of life. My case involves a semi-retired businessman (we’ll call him Bruce) who happens to be one of my triathlon training partners.  He has had his fair share of back pain… and I have treated and rehabilitated him through spinal injections, laminectomies and discectomies. He has taken his time to recover and now prefers to spend his training time on the bike and in the pool. My research over the last few years has involved quantifying spinal posture and evaluating the complex equations and models used by spine surgeons. I think that we can use some of these models to predict and monitor this stooping over spine posture.  I evaluated Bruce’s spinal alignment a few months ago and calculated that he is at risk (and partly displaying) this type of postural deformity.  I took some baseline measurements and prescribed a series of home based stretches. [caption id="attachment_11693" align="alignright" width="397"]Spine deformity progression Deformity prediction models[/caption] Bruce experienced a minor flare up of his pain and returned for review today. He reported he had stopped doing his stretching exercises a few months prior as he had been feeling better.  His repeat measurements today show slight improvement but he is still well within the “at risk” range. I stressed the importance of resuming his stretching exercises and took the opportunity to demonstrate the “modified for triathletes” walking frame I recently created.  My wife and colleagues in the clinic think I am mad but I need to create a tangible link to the importance of spine posture deterioration. Hopefully Bruce’s expletive laden response was his realisation that we are taking his long term spine health seriously and he will resume his stretching program. Postural deformity correction is complicated but logical. If there are pre-existing pain generating pathologies these need to be addressed first or in conjunction with deformity prevention / correction. However some general guidelines are:

  • Maintaining a flexible spine, especially lumbar spine and thoracic spine into extension
  • Keep your hips joints and hip flexors muscles flexible, especially into extension
  • Keep your back and core musculature strong
  • Work on balance and stabilisation and falls prevention
  • Recognise whether you have potential for future spine deformity. If so, you can’t do nothing!
An example of a yoga block under your pelvis to stretch your hip flexors and extend your lumbar spine.
Stay Straight! Larry Cohen, Founder of Upright Care – A world leading Physiotherapy practice specialising in Spinal deformity and back pain.[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]]]>

+ posts

Larry is a highly skilled physiotherapist who specialises in treating back and neck pain, postural issues and scoliosis. He is certified in Schroth and SEAS methods and through the Egoscue University. Larry has a background in elite gymnastics and springboard diving and also has many years experience in endurance running and triathlons. His specialist knowledge and techniques have seen him appointed as a gymnastics coach and physiotherapist at both the Olympics Games and Special Olympics.

His passion and driving philosophy is about achieving the best outcomes for his patients utilising an amalgam of the latest techniques and theories while recognising there may sometimes be a need for invasive procedures. Where deemed appropriate Larry will then refer to a specialist. To further his holistic understanding and approach, Larry is currently undertaking a Ph.D. in Spinal Deformity and regularly attends and speaks at international conferences and courses and clinics.

Fun fact: Larry is learning how to surf - so be careful next time you go to the beach! Qualifications: B.Sc (Physiotherapy); M.Sc. (Exercise Physiology); Advanced Certificates in Schroth (BSPTS) and Egoscue (PAS) and SEAS Larry is Level II certified (advanced) in the conservative treatment of Scoliosis based on the Schroth method. The training was conducted by Dr Manuel Rigo of the Barcelona School at Scoliosis Rehab Inc in Wisconsin. He has completed his SEAS scoliosis treatment training at ISICO in Milan. Larry has also spent time working with Dr Rigo in the Barcelona clinic. Larry also has advanced certificates in shoulder treatment, posture alignment therapy and acupuncture.