Episode 40: Real Talk on Scoliosis: How to Manage Scoliosis Without the BS with Dr. Meghan Teed

Dr. Meghan Teed, a physical therapist specializing in scoliosis and a dear friend to Dr. Mary, joins the podcast with Dr. Mary this week. The conversation addresses common myths about scoliosis, such as the misconception that scoliosis can't cause pain or that it can't progress beyond adolescence. 

Dr. Meg mentions the role of hormones (especially during peri-menopause) and stress in scoliosis progression and explains how specialized physical therapy for scoliosis differs from traditional methods. The episode also covers when to consider using a brace, opting for surgery and non-surgical treatment options, the controversy around heel lifts, and the importance of finding a practitioner who makes you feel comfortable without forcing you into quick fixes. 

Dr. Meg emphasizes the need to be wary of overly simplistic or quick-fix solutions presented online. Lastly, Dr. Mary and Dr. Meg discuss the potential connection between childhood trauma, chronic stress, genetics and scoliosis and how understanding your curve can help in managing the condition effectively.

00:00 Introduction to Scoliosis

00:24 Meet Dr. Meghan Teed

02:44 Common Myths About Scoliosis

04:44 Scoliosis and Pain Misconceptions

06:34 Scoliosis Progression and Hormonal Influences

09:20 Finding the Right Help for Scoliosis

17:14 Braces and Surgery for Scoliosis

26:18 Personal Experiences and Professional Insights

29:57 Pelvic Floor Assessments and Sensitivity

30:47 Critical Thinking in Continuing Education Courses for Those Who have Scoliosis

33:29 Trauma-Informed Care in Scolisis

34:05 Finding the Right Practitioner Who Doesnt Shame you

37:18 Genetic Factors in Scoliosis

40:07 Hormonal Influences on Scoliosis

44:35 Scoliosis-Specific Exercises

49:08 Heel Lifts and Leg Length Discrepancies

51:07 Summarizing Key Points

53:56 Contact Information and Resources

You can learn more about Dr. Meghan Teed here: 

Her podcast: Ahead of the curve

Learn more about her and her services at her website https://thescoliotherapist.com/

If you have any other questions or topics you want to talk about, send me a message on Instagram. And if you loved this episode, please leave me a rating and a comment with your feedback. Please share this with your friends and loved ones, too!

I’ll see you in a week!

Transcript

Audio Only - All Participants-1: 0:00

Welcome back to TMI Talk with Dr. Mary. I'm your host, Dr. Mary, and today we're going to be talking all things scoliosis. This is a widely misunderstood Stood diagnosis, that many, many people struggle with. And there's a lot of misinformation out there, even in the physical therapy realm. And so I wanted to bring on somebody who specializes in this. And today I brought in Dr. Megan Teed she's a physical therapist who specializes in scoliosis. She also has a podcast called Ahead of the Curve, and she owns Mindful Movement, physical Therapy, and Pilates, and offers in-person and virtual services. And. In this episode, we're going to be talking about common myths around scoliosis, what can be done to help with scoliosis, how physical therapy specifically focused on scoliosis is different than traditional physical therapy, how hormones and stress can play a role, when to consider surgery, how different phases of our life. can potentially affect scoliosis such as during pregnancy or during perimenopause and a lot of people with scoliosis tend to be put within a heel lift And so sometimes that can actually worsen symptoms So when to use a heel lift or when not to and then finally Understanding how the nervous system can be involved. So Not forcing specific movements. Maybe that your spine is not necessarily ready for, and then how to discern between what's real and what's not out there with all of the information on the internet. So without further ado, we're going to jump into the episode and I hope you enjoy it as much as I did

1:45

Ready to tackle the topics that you've been curious about but never felt comfortable asking? With a straightforward, no nonsense perspective on life, blended with candid stories and a healthy dose of humor, Dr. Mary Grimberg cuts through the fluff and addresses the conversations we all need to have on TMI Talk, where no subject is too taboo. Our bodies, our minds, and everything in between. Now here's your host, Dr. Mary.

Audio Only - All Participants: 2:13

Welcome to the podcast. Megan. Happy to have you on again. Thank you. It's good to be here. What? Yeah. The last time I was on was over a year, at least I think. Probably because I took that little hiatus, like nine months or so. So I think it's been over a year, year and a half or something like that. And we talked more about pregnancy. And so today I wanted to dive in more to a lot of the common questions about scoliosis. Sounds good. So, cool. Well, jumping right in, you know, what are some, there's so many myths about, uh, scoliosis and I'm sure you're busting those every day, left and right, like karate chopping them. So explain to me, what are like the most common myths that you hear and then what's kind of reality from it? I think one of the most common myths I hear is there's nothing you can do about scoliosis. You basically have to live with your situation or get surgery. You don't really, you're not really given any other options. Um, And obviously I wouldn't have a job or business if that was true, um, every day, you know, even in my own body, I have scoliosis and I am always like seeing changes in my own body through the work that I'm doing and other people are experiencing that themselves. So that's probably the. Biggest myth, um, that I encounter and I mean, there's so many, how many do you want me to list? Just give me like your most common ones, you know, because you know, for people that are listening, you know, um, oh, I guess it would be the, if you are listening, you're the people that are listening. So anyways, in physical therapy school, we're not talking about, we didn't talk about scoliosis. And we weren't taught on pelvic floor dysfunction, so the training that Meg and I have had to do on our, you know, specializations have had to be outside of PT school. And so, what, you know, even as a physical therapist, like, you know, I know the basics about scoliosis and can guide people, but, you know, you're in it. And doing this every single day. So what are some other things? I know that I've even heard, I shadowed a physician once years and years ago who was a pediatric orthopedist and they were telling people that scoliosis can't cause pain. Yeah, that is another one. I thought I was like, wait, what? And, and, you know, I was a young little PT, so I didn't question this orthopedic surgeon, but I'm like, Oh, that's bullshit. But anyways, I just imagine the person that has scoliosis and you have a bunch of pain and you're told that over and over again, like it's insane to me. How can you even like look at a spine shape like that and think that that person wouldn't experience pain because of the asymmetries and different loading, the compression areas. I mean, obviously, they're going to cause some discomfort in your body, even if it's not like Extreme, debilitating pain. Yeah, I mean, I, I couldn't believe it. I mean, think about it in any other body part. If somebody's ankle was, like, completely rolled in, and they're walking on the inside of their foot, and you go up to them and you're like, that, that doesn't hurt. Like, you're telling them it doesn't hurt, you know? And, you know, sometimes there are cases where people, you can look at them structurally and be like, ooh, are they in pain? You know, they look like they're in pain and they're not. Yeah, that's a rarity though, but you, any of these blanket statements, I think in medicine, just like really ticked me off. Cause I'm like, then there's medicine is science. So it's constantly evolving. And so there's no absolutes, you know, there's, there's a lot of high probability. We can guess basically based on a specific data set of a specific population, but that's doesn't, you know, always translaTeed right. And there's nothing in medicine that's like a hundred percent, you know, so, yeah, uh, one, one of the unfortunate myths is that scoliosis can't progress beyond adolescence. Um, is a myth that can progress again, uh, during pregnancy and then once again and menopause. Uh, those are the two most common times that, um, it can progress again. And that's usually because of hormone changes and shifts and. In those, uh, levels during those times. So you have a period of rapid growth during adolescence. So that's why that's one time that it can progress and change a lot. And then, uh, during pregnancy, obviously you have, uh, relaxin that plays a major role in things. Um, you can use that to your advantage though, during pregnancy, that things are more mobile and able to shift. Um, but if you don't. Understand your curve or understand anything about scoliosis. You wouldn't know how to take advantage of that. And then, uh, the final time is during menopause. So, um, there's a lot more research thankfully being done about menopause and just about the genetic factors, um, that influence scoliosis. So hopefully there will be ways that we can like just take some additional supplements or Change the way that our eating habits are, that will help with, um, changing the, the progression. Well, what kind of leading into that. So I treat a lot of people in perimenopause. And so, you know, they're listening to this and what, what can they do to learn more about their curve and their curve type, because it can be. daunting to know where to go and who to talk to. Obviously they can follow your social media as well, and we'll tag you in this so they can reach out and look into your programs, but where can they start? You know, because I think more of the fear is, is a lot around pregnancy too. But I mean, if they're, Because of similar, um, hormone changes and stuff like that, or we know that what can they, how can they learn, like, say, if I know I have scoliosis, and I have no idea what type of curve I have, I have no idea that this was even an option, like, what, where could they go? Like, where could they start? Um, I would say looking locally is, is a good idea, doing a little search and seeing if you do have any physical therapists who specialize in scoliosis local to you. One thing to be wary of is just going to a PT clinic and asking if they treat scoliosis or know how to treat it. Uh, because everybody will say that they do, uh, a lot of the times that will happen. So look for specialized training in scoliosis, like the Schroth method, Pilates for scoliosis, things like that. Um, that would be the first avenue I would go if I were looking for help. And then if you're not seeing anybody local to you that is Certified or has any extra training, then I would kind of take that next step and go online and do some searches that way. So, um, I will. I would avoid going on like Google and YouTube and doing general searches about scoliosis because that can get a little bit scary. So, I mean, you can do that, but then look at, you know, who is writing that article or blog posts about. What to do about scoliosis because it's not always reputable. Yeah, it's discernment. I feel like there's a lot, there's so many people that can put stuff out there now. I've seen a lot of people that are apparently pelvic health specialists and they're not. And there's no medical degrees and some of the stuff might they be saying might be okay, but it's like, we're in an era right now where there's a lot of misinformation. I don't know if you've been seeing like some of these, uh, there's like three different documentaries. I mean, this is kind of like a deflection of it, but it was like three different documentaries on, um, people faking cancer. I don't know. Yes. I was. Looking to watch that. It was like apple cider vinegar was one. I just saw that one. And then there's another one called Scamanda or something. And she fakes, she fakes the cancer that I had. And I was like, Oh my God, didn't know you could monetize that. That's crazy. Like that you would even do that. But then they've set up these protocols and stuff, or I don't know exactly what it is, but a lot, I think a lot of people were believing them and following them and. Just because somebody has a lot of followers, like sometimes that does not translaTeed yeah. You can also buy followers. I don't know if people know that you can buy them. You can buy comments, you can buy likes. So there's a lot of, there's a lot of information, misinformation that can be out there. So looking to see if people are medically qualified. You know what their degrees are, whether it's physical therapist or chiropractor, physician, or things like that, that they have a license as well. Yeah, and I, I would say when you are reading the information, make sure That it's not just like these black and white statements, sweeping statements, like all or nothing type of things, because that's usually false. I think that, yeah, that's for most things. I feel like, yeah, variability, person to person and, um, any medical condition is not just black or whiTeed type of situation or the sweeping statements like my program will change your life and actually oh my gosh I was just at the gym this morning it was like lose 15 pounds in 30 days and I was like you guys it is 2025 like it is 2025 like the world's on fire and you're telling people to lose weight in 50 It's like, if you're doing that, it's all water, and it's just going to come back. Unfortunately. Yeah. If it sounds too good to be true, it probably is. It probably is. And Hey, there are. You know, I've seen a lot of people make drastic progress in my practice, and I'm sure you've seen the same, but it took time and it took effort and it took like a continuous, process of doing that. So any of the sweeping statements, have you seen any, like in particular, like specific ones, like, Hey, your spine will be straightened five days. If you do the, it's like, Oh yeah. And there's, there's a lot of braces out there that say that it's going to straighten your scoliosis. And if anything, I mean, it'll weaken you because. You're not using your muscular strength to support yourself. So you're relying upon that external support. And I think if anything, it worsens the situation if you're wearing it all day, every day. Um, but that, and yeah, there are people out there. Um, there's, I don't know how legit this is, but there's like some sort of machine thing that people go and they use that. There's this guy that used like a mathematical formula for their school and I'm like, I don't know enough to say yes or no about it, but. To have results happen in, um, like a week or two is pretty unbelievable. And if you do get results, I don't think that they're going to stick. Mm hmm. You're getting them that fast. You know, it's hard. I, so many people ask me about different things. They'll be like, what do you think about this gadget or that gadget? And I'm like, I, I literally, I can't keep up. Like, I can't. And I am, if something works. Like, let's see if it stands the test of time. Like I am all about it, but there's so many. gimmicky things that I've seen over the years, like even just in pelvic floor physical therapy, it's like, Hey, you know, I saw something posted the other day. This person was like, this program is better than in person PT. And I'm like, you just put down the entire profession, be careful, like, you know, and, and if somebody is putting down an entire profession and I mean, Hey, there's good and bad PTs, there's good and bad every profession. And so, but to blanket, like put your whole. That's also something to consider. And so like this is the discernment part of like deciding like who do I want to listen to? Do you resonate with their marketing? Are you, does it, is it very fear based? Is it, does it seem too good to be true? You know, I think those are, those are some big ways to kind of. Discern like, Hey, is this person right for me? And is it not? Because, you know, when you're in pain, in pain and you're scared, you're vulnerable. And when you're vulnerable, that's when you're taking advantage of. Yeah. Yeah. The amount of things I've been seeing about like, this will help strengthen your pelvic floor and do all these things. I'm like, the issue is that we're so stressed that our asses are tight. Like it is just. It's so true. And that's the case with scoliosis too. Yeah. You're having so much tension and stress in your life. And in your body, it's going to perpetuate the things that are already tight and wound up. It's going to make them worse. I never ceased to make you, uh, uh, yeah. So with. With that, I mean, you kind of jumped into the braces and stuff. So when would somebody want to use a brace and following that? When, when is it time to consider surgery? when should somebody consider a brace and or surgery? In adolescence, it's a very critical time to take action with that. Um, between the degrees of, I think they're, they're bracing a lot earlier now than they used to. So, um, meaning, It's not quite as severe of a degree. So 25 now is about the degree that they'll start bracing adolescent, um, people. And, um, there's all sorts of different braces out there. Usually a firm brace is what's going to be the most beneficial, uh, firm brace. That's three dimensional. There are some braces that kind of turn you into a pancake and, um, they just kind of flatten everything out and they don't allow for the D rotation to happen, the opening to happen, um, and the maintenance of the. Kyphosis and lordosis of the middle and lower back. So just like the side curvature, you want to maintain that as best as you can. Um, because that will create other pain problems down the line if you flatten out those areas. So wait, so some of them are only front and back, even though the scoliosis is literally side, like side to side. Oh, interesting. This is, yeah, this is why it's important when these gadgets and these things is to, to see, because I mean, how would that straighten that would only help somebody's upright posture wouldn't help the curvature, right? Yeah, it makes sense. And yeah, so that, um, that can be problematic and even not putting your brace on correctly can be problematic too. So like, if you don't have it tight enough, your curve is going to try to escape wherever those openings are. And that's a good thing if the openings are in the correct positions, but if they're not in the right spots, then it can make things a little bit more tricky. Um, and then for an adult who is looking for a brace or curious if a brace will be helpful for them, I generally recommend those. If You are a person who can't stand for prolonged periods of time, get your housework done without excruciating back pain. And it's really limiting you that way. I would use that kind of as like a little supplement, extra crutch where you put it on when you're doing stuff like that, but wearing that all day, every day that ends up again, kind of taking the route of. A little bit of a downward effect because it restricts your rib mobility and your ability to breathe and expand the ribcage. And then that just increases your anxiety, um, and increases your pain levels. I mean, that makes sense. There's, um, it's for pelvic floor dysfunction. If somebody has prolapse, I mean, it's to a lesser degree, but of the spine, like a smaller version of, of bracing, but basically a pessary will go into the vagina and hold the vaginal wall up. And it's the same thing. It's like, well, It's not a, like people wear these all day, every day. So it's a bit different, but sometimes people just need to put it in for a specific activity. And then like, so if they want to weight train or something like that, they can put it in and then take it out or whatever the activity is. So yeah, that makes, that makes sense. Where can they get a brace? Like what, where, where do you find them? Adolescents, they need to go to an orthotist and have one specially custom. They do do that for adults now. Um, Align is a good company to look for if they have them in your area. They are throughout the country. Um, and. Yeah. They do custom braces. And then for adults, you could just, you know, go on Amazon and get, you know, a supportive brace that way. And that would be sufficient for that. Like you could even just get like a lumbar support type of brace, um, for something like that. It doesn't have to be a special custom made one. Oh, good to know. When should someone consider surgery? So, definitely a delicate topic for people. Um, like you mentioned with your brothers, if This is a person, um, who's in adolescence and their curve is quickly progressing. That's a time that I would be considering surgery if, um, they are 55 degrees and beyond. That's usually the route in adolescence that, um, is recommended to stabilize the curve and make sure it doesn't continue to progress. That's because on average, if you aren't doing anything to help your scoliosis, if you're just living your life and you're a teen and your curve is at 55 or more on average, that curve is going to progress one degree per year. So it. Ends up becoming a problem later in life and then you might not be a candidate for surgery by the time, you know It's really causing you a problem Yeah, I think and I don't know if people are aware of like why like people need surgery, too It's you know in in the case of my brothers like it was their curve was so bad And again, it was a progressive disease But it's like you can do all this strengthening and they don't have the muscle capacity to do it. So there's It was like a must, but the, like the compression of like their internal organs and not able to fully expand and contract. So like in a difficulty breathing and things like that can make, make a difference. So if somebody is, say somebody's going through perimenopause right now, right? So say they're going through it and they hear this and or pregnancy, we've also had that episode in the first season if you guys, um, want to check that out, but what. What are some precautions or things that they could work on now? So we talked about going to somebody local. You can kind of see, you know, not just like a generic PT clinic or anywhere that says like somebody that specializes in scoliosis. Um, but what, what would that look like? So say if somebody wanted to come in and be preventative of that, Could you give them an idea of what that might look like? Obviously, each practitioner might be a little bit different, but I'm sure there's some common, common themes. Um, so during that first session, no matter the reason why you're there to address your scoliosis, you kind of go through a standard assessment with that person. We take look, a look at things like your rib expansion, your lung capacity. Um, just getting some baseline measurements for that, uh, the rotation that you have of the spine. So that means when you bend forward and you reach for your toes, that's the prominence that you see pushing out into the skin. So we assess that because that can actually improve, uh, with exercise specialized for your curve. And, um, we take strength and balance measurements, baseline photos. And that one, you know, that can be a challenge for people to see their backs because who holds a mirror or like takes photos of their backs. So a lot of people haven't seen their own back and Maybe ever. Um, so that can be kind of a hard thing to, to walk through during that first visit, but it is important to have an understanding of where you're starting from and, um, having that awareness so that you can begin to make some changes. Yeah, it's one of those things I feel like there's just like this delicate balance probably of not scaring people But also like they're neat just making them aware, but also empowered but also not like hey, like this is fine You know, I feel like I struggle with that sometimes in health care is like hey how much to get people concerned But not so much that they're just panicking and so I find that that that's a delicate balance when it's something can be severe And I'm going to throw this out there, that sometimes if you go to a scoliosis specialist who doesn't have scoliosis, It can be hard, it, um, it can feel, um, a little bit like a personal attack at times because that person has a symmetrical spine. And then they're analyzing like all of these things that you're doing wrong, um, the way that you're holding yourself, you know, it, it can be really challenging. I actually just had, um, a client of mine who's PT. She has. Severe scoliosis. And she went to training had a horrific experience where she was the only person in the group that had scoliosis and she just felt like nitpicked the entire time. And, you know, the instructor was like looking at the way that she was like picking up her backpack or carrying her backpack and like raised her eyebrows at her and she was like. That's awfully heavy, isn't it? And she's like, this is my course material and my laptop. I'm not like a fragile piece of veal. You know, I'm, I like to snowboard. She likes to snowboard. She's Pilates instructor, you know, she's very active person. So she was like, I'm really grateful that I worked with you before I went into that experience because You know, you understand, and then you also like kind of prepared me for a lot of what I went through during that time. So, um, yeah, I don't know how, how to take that. I think it's important to note, you know, I think. Um, every condition can be a little bit different. I know that I've heard people say with pelvic floor PT, like, Hey, I don't want a PT that hasn't had a child. And obviously it's different. Right. But like that kind of was a dagger into my heart because I struggled with infertility and I, after cancer, I'm just like, I'm, I'm good. I'm not having kids, but when you're actively in infertility and you hear people say that, it's like, Oh, man, like that's, that's a dagger, just cause I didn't have a child. Meanwhile, I do see though, how it's different with scoliosis, because it's like, you know, scoliosis isn't necessarily like some people accidentally get pregnant, but some people choose to get pregnant too, right? So there's in that, and it's, you know, a nine month period versus like, Scoliosis is a lifetime. And so I could totally see how that, I think it's just the lack of being trauma informed, to be honest. I think that. We have an issue in healthcare where it's so easy to do that. I mean, even in pelvic floor training, right. We'll do pelvic floor assessments and people start talking about somebody's vagina literally in front of their face and be like, well, this, this, I feel this and this, and then you're like, is there something wrong with my vagina? You know, Oh God, I can't even, my vagina is not even right. You would have a vagina. That's correct. What's going on? You know? And I've heard the instructors be like, you guys have to be careful. These are people that we're working with here. You know, even though I think for some reason, when you take these trainings, people just think like, Oh, everybody's fine. Like we're all practitioners. No, we're all human beings. With heightened emotions right now, because there's a lot going on in the world and a lot, everybody's processing a lot right now. And so add on any criticism and it's not, yeah, that's not, that's not great. No. And I think it's exactly what you said in that non trauma informed is super important. And also there's nuance to what you learn in a continuing education course. You can't just. Cookie, copy and paste with each person, the material that you learned, you know, you have to use your critical thinking brain and think, okay, neutral spine isn't. Um, sustainable to maintain the entire course of the day, which that's what you're taught. And a lot of these scoliosis specific courses is neutral spine all the time. So what happens when that person wants to go and play their sport or go dance ballet, do something they love? Are you going to sit there and tell them that they can't do that anymore? Because that is a lie. And, um, You know, that's going to make things worse because the more inactive you are, the more that scoliosis is likely to progress. Yeah, it's a balance because it's like I do think sometimes actually when I when I learned dry needling like 13 years ago that the instructors were very like a long time ago. Yeah, I started needling like right person. I was like, I invented it. I just took the needle and just started. No, I, yeah, I was, I think like, cause I'd moved to Austin 2011 and took the training at the end of 2012, beginning of 2013. So I guess it was 12 years. Maybe I lied. So yeah, needling for 12 years. But the first training I took, They were like, just stab the muscle until it stops contracting. That's what they said. Like, just put the needle in and keep going until the, the contraction stops. And when I started doing that, I was like, everyone's flaring the fuck up right now. And they're blaming me. And I'm not, you know, I'm a new grad, right? So I'm listening to what I'm supposed to be doing. But then I go, no, no, no, no. So I toned it back and was like, no, I'm going to go into the muscle, get the twitch. How do they feel? Great. Okay. Next area. I'm more gentle with it, but I had to kind of distill what I had learned about how does that actually translate into practice? Right? You can needle somebody over and over, but that's just going to cause the same issue. You're just re tightening the muscle again versus sticking a needle in it and allowing it to contract and relax. But. Sometimes that's, yeah, it's, it's interesting when you go to these, these trainings and stuff too. I went to a trauma training, trauma healing, um, training about somatic healing, um, a few months ago and it was not trauma informed at all. And I was like, this is crazy to me. It's that's a big thing too, is sometimes the trainings are not trauma informed, which if people are getting into trauma to help people with trauma, they've probably been traumatized themselves in some capacity. So then they're working through their own stuff so they can hold space for somebody else. And so, yeah, that's, that's interesting. I just went on a ramble. No, it's okay. It was all connected. It is, it is because, well, it's, it's like. It sounds like scoliosis, like you, it sounds a little bit more like pelvic floor physical therapy too and it is very intimate and it's very, you know, feeling aligned with your practitioner, feeling like you can talk to them and you're not being judged. And if you feel like there's that, maybe some open communication and seeing, but you know, and seeing how they react. And that, that's the tricky thing because there aren't very many specialists, so it's almost like you get what you get when you're trying to find somebody in person, unless you're in a big city, you don't really have that many choices. But there's not many in Austin either. I'm thinking like the next PT, so I'm hiring somebody in the next few months. And the next person, I think after that, I'm going to see if we can get somebody that does scoliosis, because I think there's only like one or two people in Austin. That's crazy. I mean, I don't know. I haven't necessarily looked recently, but last time I looked it was, it wasn't, it wasn't that much. But I do think that there is a lot of the public might feel like it's too good to be true. Right. Do you find that too? Um, I kind of, it's definitely more of the older generation that is that way, where Cause they were told that? They were told that and they're Not as, um, I don't think they do, I don't want to make a sweeping statement about that because I have plenty of people who are in an older generation who do their research, but I just feel like they are more likely to take what their doctor says at face value and not question it. Whereas our generation, we're like, yeah, no, you know, I'm going to. And if I don't like what I hear from my doctor, I'm going to continue to search for an answer that suits my life and suits my goals a little bit better. Yeah, it was a different time. My parents are like that. It's like, like you have to, that's the discernment too. It's like, okay, that's one person's opinion and now who else can you go to? And so it's, uh, yeah, it's definitely interesting how each generation has. You know, handles their health in different ways because something it wasn't acceptable even back then to challenge your doctor It's not like you need to challenge them and be an asshole about it. It's just like hey, what are the other options, you know? So one of the other things that I've I've found and, and want to know your opinion of this is I've seen some emerging evidence on how potentially low progesterone can cause scoliosis. What are your thoughts on that and like, what are you, you know, just tell me what you think about all that. Yeah. Um. Thank you. So I just actually did an interview with someone. Um, his name is Dr. Mark Morningstar, and he's doing a lot of research on genetic components and factors that influence the development of scoliosis. And there's two genes that came up over and over again for being higher, higher likelihood of developing scoliosis. And that's I'm waiting to mess it. M. T. M. T. H. It's M. T. H. F. R. or something. F. R. Yep. M. T. H. F. R. and C. O. M. T. Um, and both of those influence, like if you have those genes expressing themselves. On that person, then there have a higher likelihood of developing scoliosis and that scoliosis progressing. So what he was talking about, and I'm like really terrible with a lot of this stuff, like remembering like the different, um, genetic and yeah, it's a whole, I had to bring somebody on. Yeah. To explain like estrogen dominance, cause I was like, I need you to break this down. So then, and then tell, you know, people, because this isn't, I can help people with the symptoms, but this is a whole nother realm. Right. Yeah. And it had more to do with melatonin and with estrogen being lower in those two things. Lower in melatonin and actually, I think higher in estrogen. So I don't know if that works inversely with, Oh, okay. Wait. So they have high estrogen and low melatonin. Definitely low melatonin. And I can't remember what it was for estrogen. I can't remember if it was high or low for that. Okay. Yeah. Well, have you seen anything on progesterone? I've, I've not. Okay. Um. That doesn't mean it isn't a thing. No, I was just wondering because you and I have talked previously about this and how like there's a there hasn't been anything necessarily linking the two but childhood trauma repeated trauma while we're developing and a link between scoliosis and I just wondered Have you seen that? You've seen that pretty consistently? I've seen consistently that and or, um, having a very dominant, um, parental figure. Usually it's a mother. Really? Oh, interesting. Well, just on the reason I brought up progesterone too, is because when in our estrogen dominance episode that, um, we talked about how, when under chronic stress, the body prioritizes, so it goes down the similar pathway, the body prioritizes making cortisol. So the stress hormone over progesterone. And so I was just wondering like, as. In childhood, so say that like the repeated exposure to chronic stress, maybe we thought it was normal at the time, right? I was just thinking like, I wonder if there's a correlation between the two. And I did do a little research and I saw some, some stuff popping up, but there wasn't anything linking the two. And I think because we just don't know as much about hormones as we, we thought. And, and I think that there's just, A massive amount of research that still needs to be done and understanding of hormones affect, um, these symptoms, but it's just, what are some other correlations that you've seen? A higher incidence of people developing scoliosis with certain sports, like gymnastics and ballet or dance, That's usually, I think it's more of a causation type of thing than it, not causation, um, correlation. So people who are naturally bendy. Uh, probably have connective tissue stuff going on there, more likely to go into those things to begin with. So if you have that, and then you have also the predisposition to developing scoliosis, I think it's just the combination of all of that together. Um, but there's no proven thing that says that dancer gymnastics causes scoliosis. Yeah. Yeah. And like I said, I didn't, there's nothing correlating necessarily the progesterone. Um, I, I saw preliminary studies, but I just thought that was interesting because then I added on the link of, okay, how much of this? Cause I just see, I'm just down this whole path of like understanding how. So, you know, genetics can be expressed, right? There's one piece, but some people can still have the genetic factors, but not express things. Right. And in the study that I've been, in the research I've been doing with trauma and like needing help processing it and getting out of the constant fight or flight, I've seen that those are, you know, Like say we have two people with the genetic factors, right? So, I've heard them use the example of smoking, right? Not everybody that smokes cigarettes gets lung cancer. And there's, there's a high correlation, but if one person has smoked cigarettes and they have like a supportive partner and, um, their family and they have great communication and support system, and then you have somebody else over here that. smokes and is isolated or maybe has dealt with significant trauma that they need help processing and understanding how to move through it. This person's more likely to express it. And so there's, there's just stuff coming out about, okay, well, why in genetics, some people have stuff and others don't, right? Cause there's, there's multiple factors. And so I just think it's interesting to kind of start looking into all of that and that's not to like say, Oh, your childhood trauma, like cause scoliosis. It's just more of. Understanding, like, hey, how much the body processes trauma and, like, what can we do to kind of help with that too. And so learning about the nervous system and, and things like that. Like you said, if you're chronically in fight or flight too, you're going to be kind of like tight and hunched over and so how much of it is more that. Right. Right. And you're internally winding yourself up, uh, you're trying to protect yourself and guarding from whatever that trauma is. There's a commonality here and maybe there's not research on it yet, but it is interesting to start observing those things. Um, so what. What are your thoughts on, okay, so if somebody is listening to this and they're like, hey, I have scoliosis and it's not that bad, but how is, how are exercises for scoliosis different than kind of like generic PT? Exercises, scoliosis exercises will take into consideration what your curve is doing. So when you're going for generic PT, if you go in, usually you have to have some sort of symptom or pain in order to get there. So they'll give you generic low back pain exercises or shoulder or neck, like wherever you're having that pain point. And that PT won't do an assessment of your curve first. Um, that's what generic PT with a school as a specialist, they're going to educate you about your curve, what your tendencies are and standing and sitting, um, that are potentially feeding those asymmetries that you have baseline. And then they'll teach you strategies for countering those asymmetries. Um, what I've found to be super important that I've made a tweak and adjustment on, and through the training that, um, I've done with scoliosis is instead of right away trying to force that person into a different shape, um, than they currently are in, We need that permission from the nervous system first to actually make those changes and adjustments, because if you go in and you start forcing things and you don't have that permission, then that's when it can create even more pain if you have it. Baseline. Um, and it can create pain if you don't have it baseline. Um, I had somebody who went and she's an adult and she wanted to go to the specialist and do an intensive. They do the adult bracing and it was. Just like very forceful exercises. The brace was like really shoving her into corrected alignment. And she came out of away from that and excruciating pain. And she didn't have pain to begin with. Oh, um, we have to be smart about how we're implementing these things and understand that the person has been in this shape for however long it's. It needs to be more of a slow and steady process first, um, take a look at areas of restriction all throughout the body and see how you can teach that person to release those areas independently without your hands on them. Um, give them those tools to heal themselves and, um, then begin working on slowly but surely implementing the corrective stuff later. I like how you brought that the nervous system up with that too, because it's like kind of what you were saying. If, if you have a practitioner that you feel like there's just, it doesn't feel right. Maybe it just, maybe they're not understanding or you just feel something's off, right? Your muscles are going to be tight as well. And then forcing somebody into something. I mean, I've even seen it just from like a lighter degree of like, even when you put like a heel lift in, yeah. somebody, um, they'll put in like a heel lift, right away. like something drastic. And I'm like, you cannot, you've had that. This is why I have an issue sometimes with, and I have a question with leg length for you. But say somebody doesn't have scoliosis and they're immediately put in a heel lift. I'm like, well, if you haven't. Had pain for 40 years. And then all of a sudden you have back pain. Now I'm not going to put a heel lift in you. If you've had pain your entire life, and this is just ongoing. I'm like, let's, let's consider our list. Let's try it. Right. Cause sometimes it also can be muscular tightness as well, but. Even so, even if it's just a little bit and then they go and wear it all day, they flare up. So it's like a little bit kind of at a time. It's like new shoes, right? So what, what are your thoughts on, uh, why can't I get my words out? Um, heel lifts. Yeah, they are definitely over prescribed with scoliosis. And you want to make sure that that person actually has a true leg length. Discrepancy and difference. Most people with scoliosis, it appears like we have two different lengths of legs, but in reality, that's not the case. It's the rotation of the pelvis, it's tightness in the tissues that are kind of pulling the innominate up into the torso and causing that to appear like there is a difference. So, actually taking a true measurement and seeing, hey, does this person have a leg length difference or not. But then if they do actually have a difference, starting with as small of a heel lift as possible, like you said, um, little insert, like just a generic Dr. Scholl's thing that you slip in and, and see how they, um, respond to that and see if that actually helps to balance things out. But usually it's not a true like, like discrepancy. For those people that don't know gold standard of a length like there's gonna be a standing x ray But nobody really does that so you can you measure well the PT or healthcare Practitioner or chiropractor or whoever you're working with, it's the part that you can feel on the sides of your hips, like right in the front, and then you measure it all the way down to the top of your inner ankle, that little bone right there. And you can at least get an idea of that, even if it's just a little bit, but. It will look like you have a laying leg, but it's actually the curvature of your spine. So in, in, in essence, if you did put a heel lift in there, wouldn't it just reinforce the curve more? Yeah. Yeah. So you, you want to be careful with, with those as well. So, um, yeah, well if you want to, well, I'll just kind of summarize a little bit of what we, we said today and then I'd love to, you know, have people know your services. So what we really went over today is, you know, the common myths about scoliosis, when someone should consider surgery. Um, I think it's really important to be understanding when to use a brace in childhood or in adolescence versus adulthood, how finding the right practitioner is important, not, you know, finding somebody that scoliosis specific and how sometimes it can be that, being careful with a certain practitioner because it can feel like there's, there's, Potentially judgment or forcing things faster than they need to be. But that can be hard because not every, there's not a ton of scoliosis specialist. And so in that just learning more about your curve So that way you can understand and help prevent progression. And then. We talked about some potential associations, things that we've noticed, that's not necessarily confirmed in the research, but just something to be aware of with hormones and how that can affect it. And leg length discrepancy and, how not just everybody getting a heel lift for that and then easing into the exercise. Cause this is going to take time. Actually, before I jump into that, you did say that. Before you jump into your, your, your contact info, you did say that. Every year it progresses like 1%. And so do you, have you seen that it kind of halts and stays where the curve was when, if they continue with more scoliosis specific stuff or, and have you seen that reverse at all? Yeah. So, definitely a higher light likelihood of that halting, uh, the uneven loading of the spine. Um, and. There is a chance that it can reverse. I've seen it reverse like five, about five degrees for adults on average. Um, as long as that person doesn't have osteoporosis, um, you know, usually that's another indication that things are going to continue to progress if you're not addressing that as well. Gotcha. Yeah. And there's a lot of stuff you can do for osteoporosis too now. And understanding even just beyond medications, just. Understanding how to, to weightlift, diet, a variety of different things. I'll have to have one of the PTs that specialize in osteoporosis. But we, with a lot of the research too is around like loading. Yeah. Loading joints and getting us stronger. So that way the bones get that input of, Hey, we need to build more bone. So if you want to tell everybody where they can find you about your podcast and then your upcoming programs. Sure. Yeah. Um, you can find me, I have a podcast called ahead of the curve that's on Apple, all the different podcaster apps, and I have a YouTube channel that is also called, uh, no, it's called the scolio therapist, but I have my podcast on there as well called the head ahead of the curve. And, um, you can find me on Instagram. I'm the scolio therapist there. Um, I am currently closed for my program for the Scoliosis Strength Collective, um, but the doors are opening fairly soon for that. And I have a free training coming up. I don't know if this will be released before or after that, but it is March 9th and March 13th. It's called the Curve Lengthening Lab, where I teach you how to safely lengthen your scoliosis and your curves without increasing your pain. I love that. This won't be out by then, but will they be able to access that? Like, will you have it? It'll, it'll happen again in the fall. Okay. So getting, basically getting on your email list to kind of learn of. of all the upcoming things. Yeah. So yeah, you have a wealth of knowledge on your podcast. So highly recommend if you guys want to, if you all want to find out more, um, about scoliosis in depth and in ways to help. So thank you so much, Meg. Thanks for having me, Mary. Good to be back.

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You've been listening to TMI Talk with your host, Dr. Mary Grinberg. Make sure to subscribe wherever you get your podcasts. To learn more about Dr. Mary, head on over to drmarygrinberg. com. And make sure to follow Dr. Mary at DrMaryPT on all social channels. To learn more about Dr. Mary's integrative practice for pain relief in Austin, Texas, head on over to resilient rx. com. Thanks for listening!