Dr. Brian T Dovorany provides scoliosis rehabilitation in Wisconsin and offers a 2 week scoliosis boot camp which can significantly reduce a scoliosis curvature when measured on x-ray using the Cobb’s method. The program aids as a jump start to successfully reducing and stabilizing scoliosis long term in both children and adults. The boot camp program is not painful or exhausting and most patients find it much less physically demanding than they had thought it would be. Unlike traditional exercises for scoliosis treatments, like Schroth, this program doesn’t require the tremendous effort from the patient nor the precision of getting every movement or position perfect. This innovative approach recruits muscle memory through challenging the body’s postural righting reflexes which control spinal alignment. Since we cannot consciously create scoliosis through movement or positioning it is highly unlikely that you can permanently correct scoliosis using this principle.

Through tremendous amounts of trial and error Dr Dovorany has developed a mechanism in which we can cause scoliosis in a person that doesn’t have the condition and therefore using this principle we can apply this mechanism to correct scoliosis. Since the body responds in time and in need to its environment by challenging the postural reflexes correctly we can cause the body to adapt to this increased demand and significantly reduce an existing spinal curvature and in some instances eliminate the scoliosis all together.

Scoliosis Rehabilitation in Wisconsin has helped hundreds of children and adults successfully reduce and stabilize their scoliosis without labor intensive home care which often takes hours out of your day for a few degrees of change but rather significantly reducing scoliosis by as much as 80% in as little as 20 minutes twice a day.

If this sounds too good to be true than just take a look at our results page or ask to contact other patients who have received Scoliosis Rehabilitation in Wisconsin by Dr Dovorany to find out how they were able to succeed at beating their scoliosis condition. Better than braces, safer than surgery and certainly less work with greater rewards than the Schroth program right here in Wisconsin.

The story is the same regardless of who you talk to, They all say the same thing..

 “You’re an adult and there is nothing that can change my scoliosis at this point.”

Well… I am here to assure you they are wrong. Adult scoliosis does have more soft and hard tissue adaptation that is fact. So how does a clinician deal with all of that change, years of soft tissue changes and potentially even bony malformation. The answer is simple proper measurements need to be analyzed to determine if the bone malformation is creating permanency to the scoliosis and to what degree. Generally speaking the bony malformation typically appears in the later stages of aging around 50 years or older depending on the location of the curve and the percentage of bone wedging is fairly minimal in most cases. The majority of the structural problem in adult scoliosis is soft tissue adaptation.

The soft tissue adaptation occurs in the muscle, ligaments, and discs and is secondary to the scoliosis not the cause of it. The more soft tissue adaptation that takes place over time the more rigid the spinal column becomes and therefore  there exists less potential for changing it. Fortunately we know a lot about the physiological properties of muscle, ligament, and disc. As with many discoveries in healthcare and other fields certain pieces of technology trickle into other areas in which they were not originally intended for. The concept of continuous passive motion was originally intended for post operative joint replacement patients in order to prevent the new joint from stiffness during the repair phase.

This concept of placing soft tissue under load in a cyclical fashion has been incorporated into the treatment of scoliosis. Since the tissue surrounding the spine is very dense and loaded with collagen it was a natural transition to utilize cyclical motion and pressure, to induce a change in the physical properties of this tissue that surrounds the spine. By applying continuous passive motion in combination with belts that are positioned to reduce the scoliosis we have been able to significantly alter the flexibility of the scoliotic spine allowing the neuromuscular rehabilitation and scoliosis exercise to the stabilize the spine in a straighter position.

Scoliosis Continuous Passive Motion Table –

The use of continuous passive motion (CPM) to assist in removing adhesive qualities contributing to joint stiffness following the repair phase in post operative joint replacement has been well documented. The results of these published studies suggest as well  a potential therapeutic effect of short bouts of cyclical, passive manipulation on otherwise inactive skeletal muscles.

Scoliosis exercise can often produce limited results due to the spinal rigidity inherent to apical regions as demonstrated on scoliosis motion studies. In order to effectively rehabilitate muscle proper range of motion is needed to activate muscle firing in order to rebuild the proper contractile properties needed for spinal stability to be achieved. The use of continuous passive motion on the apical regions of scoliosis patient is applied in order to unlock the spinal rigidity and allow for substantial gains in range of motion. This gain then allows for muscle activation to occur through proper application of scoliosis neuromuscular training.

The scoliosis CPM table uses motorized flexion distraction in combination with de-rotation brackets which influence where the forces are applied during motion. By challenging the inside of the spinal curvature during continuous motion biochemical changes occur within the collagenous regions allowing for expansion of wedged discs and shortened ligamentous bands specific to apical regions of the scoliosis. Patients utilize the scoliosis CPM table on average for 20 minutes depending on the severity of spinal rigidity.

Clin Orthop Relat Res. 1989 May;(242):12-25.

The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application. Salter RB.

Continuous passive motion (CPM): Theory and principles of clinical application

Shawn W. O'Driscoll, MD, PhD and Nicholas J. Giori, MD, PhD

Mayo Clinic, Rochester MN 55905

            It is agreed that very little is known about the cause and cure of the scoliosis patient.  Obviously, there is no cure for the disease, or no one would have it.  However, an effective system of treatment for the reduction and stabilization of scoliosis has emerged on the scene.  The fight against scoliosis is being lead by the doctors of the CLEAR(Chiropractic Leadership Educational Advancement & Research)  Institute, who have developed a system of neuro-muscular rehabilitation, chiropractic adjustments, and vibration therapies that essentially “reverse engineer” the condition. This treatment provides a viable alternative to the traditional bracing and surgical treatment choices.

Clear-Institutes highly advanced protocol consists of three primary functions in its ability to reverse engineer scoliotic spines; the first being what’s referred to as the MIX component, the second component termed FIX, and lastly a SET component designed to secure the changes taking place. The MIX component is designed specifically to cause a relaxation of the scoliotic spine by using bio-mechanical and bio-chemical reactions created from cyclical motion, heat, pressure, and specific vibrational frequencies. The MIX component is critical because the amount of reduction of a spinal curvature is in most cases directly proportional to the curves flexibility. The MIX component is designed to enhance the flexibility of the spinal curvature.

The FIX component involves a very sophisticated analysis of the patients spinal biomechanics using both static and dynamic x-rays. The global spine is then broken down into 6 primary functional units using vector analysis which is commonly used in the engineering field. CLEAR doctors are trained extensively in this process and are able to consistently create a spinal adjusting sequence to match the patient’s biomechanical needs. Spinal adjusting is a combination of techniques using instrumentation, drop mechanisms, and hand contact force. A critical part of adjusting protocols which differs from the general chiropractic profession is that P-A thoracic spine adjusting is contraindicated in the scoliotic patient and is never performed by CLEAR doctors.

The SET component is a combination of fixing and setting the spine. It involves traction coupled with de-rotation and vibration. The primary weapon utilized to accomplish this unique combination of therapies is the scoliosis traction chair or “STC”. The STC provides the scoliotic patient an opportunity to workout in a decompression environment. The STC has the ability to create global spine traction, de-rotation using a specific ratchet system with strapping, and vibration based muscle reeducation similar to the very publicized whole body vibration fitness craze. The SET component continues with specific spinal isometric exercises in addition to gait and proprioception re-training.

            Due to the coupled motion (lateral bending and rotation) of spinal movement patterns, scoliosis creates a twisting of the spine around its own axis.  Much like twisting a rubber band from the top and bottom, the middle of the rubber band is susceptible to buckling into a curved and rotated position which is the beginning appearance of the spinal curvature.

            The twisted and bent position of the spine creates a tremendous amount of torque which then further drives the existing spinal curvature into more twisting and bending and results in further buckling (increase in the spinal curvature).  This becomes a self feeding loop which is often referred to as the “crankshaft phenomenon”.  Often at this point the spinal deformity starts becoming outwardly apparent in the form of a torso translation or a rib hump.

            A large scale, medically peer reviewed study clearly shows that curvatures under 30 degrees (measured with the Cobb angle method) in early spinal development (Risser’s sign of 0-1) will see their spinal curvature progress 68% of the time. (1)  Since the majority of spinal curvatures under 30 degrees are diagnosed in pre-adolescents, a progression of the spinal curvature can be expected over 2/3 of the time!

            The current medical standard for the treatment of scoliosis does not recommend any treatment for spinal curvatures until they progress to a lofty 25 degrees Cobb’s angle.  At that point, spinal bracing is recommended which has not been showed to effect the progression of the curvature until it reaches a measurement above 30 degrees Cobb’s angle. (2)  While there have been no research attempts to introduce the concept of highly invasive surgery into the early intervention of scoliosis, one study shows a worse outcome for patients whom had the surgery at a younger age than patients whom were older at the time of the surgery. (3)  Spine Cor has attempted to introduce bracing into the realm of early scoliosis intervention with little to no success. (4)  Despite early scoliosis intervention in terms of patient age and size of curvature, both bracing and surgery have shown poor results.It is apparent that a non-surgical, non-bracing early scoliosis intervention for the treatment of spinal curvatures and idiopathic adolescent scoliosis is long over-due. 

            What CLEAR trained doctors are finding out is that curvatures under 30 degrees when treated using their protocols respond even better than curves over 30 degrees. In most cases of curvatures under the 30 degree mark, full correction to under 10 degrees is not only obtainable, but fairly common. Spinal curvatures reduced to below 10 degrees are no longer considered a scoliosis by most authorities meaning it would be defined as a cure. The bio-mechanical reasoning for this response is most likely due to a lack of “coildown phenomenon” being present in curves at this smaller level. Radiographic review of smaller curves, under 30 degrees, demonstrate much less visible spinous process rotation at this level indicating less torque, and therefore more flexibility.The higher the degree of flexibility of the curve the greater amount of correction is possible.

CLEAR recommends that chiropractors refer any curvatures detected to a properly trained doctor that can apply these protocols in either an expanded treatment schedule over the course of several months or if a certified doctor is not within driving distance for the patient an “Intensive Care” program can be administered which generally is done in one week with smaller curves under 30 degrees. CLEAR doctors will then work with the referring chiropractor and coordinate treatment plans together to better serve the patient.

There are several ways to identify smaller curvatures including visual posture analysis demonstrating a tipped shoulder, high hip, or even translation of the skull or pelvis,

 scoliometers can detect even relatively small curvatures.  The most reliable and definitive test would be to take a full spine standing x-ray. Other factors to consider when suspecting a possible curvature are forward head posture or sway back type postures.

1.  Lonstein & Carlson, The prediction of curve progression in untreated scoliosis during growth, J Bone Surg Am 1984 Sep;66(7):1061-71

2.   The etiology of Adolescent Idiopathic Scoliosis

           Am J Orthop 2002 Jul;31 (7) :387-95

Ahn et al, New Hampshire Spine Institute

3.    Brace treatment during pubertal growth spurt in girls
with idiopathic scoliosis (IS): A prospective trial
                                                                    comparing two different concepts                                                                    

Pediatr Rehabil 2005 Jul-Sep;8(3):199-206 (ISSN: 363-8491)
Weiss HR; Weiss GM

4.   Hawes M., University of Arizona, Tucson, AZ 85721, USA. Pediatr Rehabil. 2006   

1.      Torso Extension

Scoliosis is a 3 dimensional spinal deformity that often involves a reduction of the spine curves of the side view, lateral bending with translation of the front view, and rotation of apical vertebrae from a top down view. Since biomechanics or body mechanics can influence these changes it is important to recognize some simple concepts when doing repetitive activities. Repetitive extension of the thoracicscoliosis spine should be avoided if you have scoliosis, primarily a curvature in the thoracic spine will be negatively impacted by extension of this region. Biomechanically extension will cause a anterior shear force to occur which will cause the thoracic vertebrae to rotate further into the concavity of your scoliosis curve. Avoid doing backbends, gymnastics, certain yoga positions, and dance maneuvers that arch your body backwards.

2.   Sleeping With A light On

Melatonin is a hormone secreted by a tiny gland deep in your brain called the pineal gland.

This hormone is responsible for many things including the regulation of puberty in females.

Many studies have confirmed a decrease in melatonin levels in patients with scoliosis. Melatonin is secreted primarily when you sleep but even the smallest hint of light can slow or stop its release and create deficiency. So sleeping with the lights on, the television on, a night light, a street light shining through the window etc are a definite no no if you have scoliosis spine . A melatonin deficiency can cause early onset pubertal growth and increase the progressive behavior of scoliosis. Quite often children that enter puberty early have increased risk of scoliosis progression due to neurological posture immaturity which simply means the brain and body aren’t quite in sync yet. So stay away from scary movies and haunted houses so you can ditch the night-lite.

3.   Long Distance Running

This is a no brainer for patients with scoliosis. Avoiding prolonged running or jogging can reduce your risk of scoliosis spine  progression. It is simple biomechanics or physics for that matter. If you pound a bent nail with a hammer it becomes more bent. Increasing axial forces into your spine will cause stress on the apical zones of your scoliosis curves these are the peaks of the hills and the areas that are most susceptible to bending and rotating when compressed. Compression occurs every time you take a step, jump up and down, or run. When a person runs there is a physics term called ground reaction force, this force occurs every time we take a step during our gait cycle and is measured by a force plate. According to Jacqueline Perry MD, chief pathokinesiologist and author of the highly referenced book entitled Gait Analysis , ground reaction forces from normal walking peak at 120% of body weight twice during a person’s gait cycle and reach an astounding 225% body weight at the heel strike during running. If we do the math on this that means a typical 12 year old with adolescent idiopathic scoliosis weighing 80 pounds would create a ground reaction force of 180 pounds into her spine every time her heel hits the ground when running. I generally recommend limiting running to one lap at a high school track or 400 meters.

The vast majority of scoliosis doctors are pediatricians and orthopedic surgeons. The communication pipeline between these practitioners and parents is scripted. The current medical model addresses scoliosis with blinders on using only three primary treatment options, observation with mild curves, bracing for moderate range curves, and surgical fusion for curves greater than 40 degrees. So naturally what most doctors are failing to communicate is that observation is not a form of treatment yet scoliosis is a progressive condition, meaning it gets worse with time. What doctors are telling you that it is ok to wait and watch with periodic x-rays because most of these don’t get worse is false; most scoliosis cases do get worse. The majority of mild scoliosis  curves may not reach levels where surgery is recommended but often your child’s scoliosis will get large enough to produce noticeable postural deformity. Doctors won’t tell you that 1 out of every 4 cases will reach a severe level.  If you knew that there was a 25% chance that your child would develop a severe spinal deformity would you still wait around while 6 months of growth passes by?

Scoliosis doctors won’t tell you that rigid bracing is controversial and there are just as many research studies proving bracing doesn’t work as there are proving it does. The most common brace utilized in the US is the Boston Brace or TLSO which is one of the main brace types that has been under scrutiny for years with ample investigation demonstrating its short comings and failure as a progression stopper. Doctors won’t tell you that scoliosis is primarily a neurological condition and that the biomechanics of rigid scoliosis brace treatment like the Boston brace are not addressing this neurological component and therefore are treating the scoliosis with a band-aid approach pushing around curvature with external passive force rather than treating the condition using neurology based rehabilitation which is becoming more readily available. Doctors won’t tell you that moderate to high risk genetically stratified children with scoliosis who wore the rigid brace had no different of an outcome as the control group who did nothing, meaning the brace had no effect whatsoever on this group. They won’t tell you that rigid braces significantly decrease breathing capacity and can cause permanent psychological scars.

Scoliosis doctors won’t tell you that breathing capacity is the same in children with scoliosis as children without scoliosis all the way up to 60 degree curvature in the thoracic spine. In addition scoliosis doesn’t impact the cardiac or other organs function until thoracic curvatures reach upwards of 100 degrees. Surgeries performed on scoliosis curvature prior to 60 degrees are performed for cosmetic improvement only. Rib hump deformity is not corrected by scoliosis fusion surgery and often gets worse afterwards. The only way to permanently reduce the rib malformation is to perform a second surgery called a rib resection surgery which causes permanent breathing capacity loss, and a much longer recovery time. Doctors won’t mention that lumbar scoliosis doesn’t affect breathing capacity at all and that fusion of the lumbar spine below L4 will significantly reduce spinal range of motion potentially creating a 60% decrease in side bending capability. In the majority of cases scoliosis fusion surgery is worse than the condition itself and trading deformity for dysfunction, disability and pain is not a smart tradeoff.

1.       Is there another option for my child’s scoliosis other than watching and waiting?

The most dangerous game a patient of any progressive condition is to sit around and do nothing. This gabling approach has been the standard operating procedure for decades with a very small rate of success and even that small percentage of kids that don’t get worse watching and waiting certainly didn’t improve their scoliosis. Although your doctor will tell you most cases don’t progress and maybe even throw out a percentage like 60 or 70%, keep in mind that a 20-30 degree thoracic or lumbar scoliosis can produce visible postural deformity, and influence functional biomechanics enough to alter degenerative changes of discs and produce pain in the future. The answer to the question when asked should be a resounding YES! There is absolutely something you can do proactively to help minimize the risk of progression and potentially even eliminate a smaller curve. The problem with the orthopedics is that they are limited to medical procedure and exposed most often to surgical research in their journals so they might not even be aware that new innovations in the area of early stage scoliosis treatment are available through highly trained rehabilitation specialists like myself and Dr Stitzel who have created the “Early Stage Scoliosis Intervention” program for this purpose.

2.       Is there a genetic test that can help assess risk of progression?

Most competent pediatricians and orthopedic surgeons are aware of the scoliscore test and its purpose. All Caucasian children diagnosed with mild scoliosis that are and between 9-13 years of age should have this simple insurance approved saliva test performed which indentifies their risk of progression to surgical levels with an impressive 99% accuracy rating. This allows the doctor to create a much more customized plan of action depending on their score.

3.       Are there any potential side effects from wearing a scoliosis brace?

The most commonly used treatment for scoliosis curvatures between 20-40 degrees is the rigid scoliosis brace. It is prescribed like an aspirin for a headache. The absolute lack of knowledge and conversation that takes place regarding rigid orthosis for scoliosis is appalling. This is one of the most controversial topics in the world of scoliosis treatment and there are just as many studies proving its ineffectiveness as there are proving its effectiveness but yet it is still the go to option for medical providers nationwide. Rigid bracing is also utilized on all curve types and has been statistically proven to be completely useless for certain types of scoliosis especially upper thoracic curvature. In addition scoliosis braces produce significant decreases in breathing capacity while in the brace and have been shown to cause psychological trauma in adolescents.

4.       Should I get an MRI performed?

According to recent literature as many as 20% of thoracic curvatures have positive MRI’s for chiari malformation or cord tethering and are no longer classified as idiopathic. If your child has a high thoracic curve get an MRI done to rule out pathology. In the case where the thoracic curve is to the left always get an MRI to rule out syrinx formation or possible space occupying lesions.

5.       Are there any activities that can harm my child’s scoliosis?

Scoliosis is a multi-factorial condition which also involves environmental influences which can play a significant role in accelerating curve progression. Activities that involve extension of the thoracic spine like ballet, gymnastics, and yoga can increase shear forces on the thoracic spine which accelerates rotation. Prolonged neck flexion like texting, schoolwork, and computers can alter the normal sagital spine profile and create tension on the spinal neurological system which may increase instability and progressive behavior of scoliosis. A doctor should have common knowledge of these biomechanical principles and they should be explained to you and your child to avoid potentially throwing gasoline on a preexisting fire.

Please click here to receive a FREE SCOLIOSIS TREATMENT INFORMATION KIT.

The current statistical data regarding AIS adolescent Idiopathic Scoliosis suggests that there is an 8 to 1 occurrence rate of scoliosis in females versus males. There have been several theories suggesting the root cause of this huge gap between the much higher occurrences of scoliosis in adolescent females versus the males. This detailed paper published in 2009 in Scoliosis is one of the best and most comprehensive papers discussing the different theoretical models of scoliosis etiology I have seen.

In this paper the definition of postural maturity (Figure 15 page 22)Scoliosis_Eitiology.pdf

 really gains some traction and can nicely explain why scoliosis is more prevalent in female adolescents. The idea that the nervous system has an actual timeline in which the posture control mechanism matures is brilliant and very provable. The righting reflexes consisting of the eyes, ears and body joint receptors can easily be tested. The shear fact that the strength of this system improves and stabilizes at a certain age approximately 12 years old allows us to see why scoliosis, a neurological problem, can hit the female population more frequently.

Since females enter pubertal growth spurt at an earlier age and usually before postural maturity this would mean female rapid growth occurs primarily while the spines stability control is underdeveloped leading to brain-body confusion and an increased prevalence of spinal imbalance and curvature development. Males enter their growth spurt while this central spine stabilizing system is strong allowing a much better control of imbalance and better compensation for imbalances as the body rapidly changes form.

The importance of a child entering a neurological based rehabilitation program to strengthen the postural control system prior to rapid growth becomes apparent when looking into this theoretical model of prevalence differentials.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781798/

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Many theories exist as to the potential etiology of scoliosis. The recent genetic testing and research from axial biotech has isolated DNA that contributes to scoliosis and most likely cause and progressive nature of the disease. The majority of theory that describes possible mechanisms of producing scoliosis in children often include a brain- body scheme dysfunction where input (information from the environment) via the spinal cord and output (motor control of spinal muscle balance) also via the spinal cord are confused causing a lack of balance between the two communicating systems.

The research study attached describes the involvement of both systems in the production of scoliosis in rabbits. Granted the translation of animal studies to humans is always a source of probable validity issues I feel in this case the information is most likely applicable to humans. The study discusses how when the afferent system, the sensory mechanism of our body is damaged by itself will not produce scoliosis. This is important because it allows important information regarding probable spinal cord or central nervous system pathology must include both input and output control in order to produce scoliosis. Deafferentation, the removal of just input, is not sufficient enough to cause the scoliosis deformity. The deformity involves both sensory and motor control pathways.

This information can then be utilized to design a system of rehabilitation (scoliosis exercises) that involves both the afferent and efferent system to stimulate a reconnection and strengthening of this communication mechanism. The continual advancement of the neuromuscular retraining techniques where spinal cantilever weighting systems create changes to input and sensory afferent input causing a direct response of the body’s righting reflexes to adjust its motor control to achieve balance will inevitably become the standard of care for children and adults with scoliosis. The fact that we can alter spinal alignment utilizing sensory and motor control at a subconscious level is a major breakthrough in how we approach scoliosis exercise.nmrdeafferentation_and_scoliosis.pdf