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Hello, everyone, and welcome to 

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the Doctors of Running podcast, 
where we, a group of doctors of 

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physical therapy, discuss the 
art and the science of the stuff

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that we're putting on our feet. 
I'm Andrea Myers, and today we 

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have a very special guest with 
us, Jeannie Halloran, who is a 

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doctor of physical therapy in 
Ridgefield, CT Welcome Jeannie. 

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It's so great to have you on. 
Thank you for having me. 

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Oh, yeah. 
Thanks so much for coming on. 

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I am so excited for this 
episode. 

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I think we're going to just 
bring a lot of great information

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to our listeners. 
Gee, I met Jeannie, gosh a few 

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years ago at a continuing 
education course and then we've 

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seen each other at a couple more
over the past couple years. 

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Jeannie is certified in 
something called Schroth 

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Therapy, which is a pretty well 
known treatment for scoliosis, 

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although it's well known to Pt's
but maybe not so well known to, 

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you know, everyday people. 
But the way Schrath works and 

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Jamie's going to talk about it a
lot. 

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It's a curve specific exercise 
method for scoliosis. 

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She's you're also certified in 
the scientific exercise approach

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for scoliosis, which you'll talk
a little bit more about later. 

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And Jeannie is a PT in 
Ridgefield, CT at Connecticut, 

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Scoliosis and spine. 
So anyone local who is dealing 

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with scoliosis, I highly, highly
recommend Jeannie and her 

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colleagues over there. 
Jeannie is also an avid runner, 

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which is awesome. 
And she's going to tell us a 

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little bit more about her 
running and the injury that 

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she's currently recovering from.
So welcome Jeannie again. 

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Thank you so much for joining 
us. 

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Could you tell our listeners 
just a little bit about how you 

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became a PT, how you got into 
trot therapy and then a little 

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bit about your running? 
Yeah, yeah. 

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So thank you so much for having 
me. 

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I'm excited to chat with you. 
Well, I have been running since 

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about 7th grade. 
I grew up in upstate New York 

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and you know joined the modified
track team and did things like 

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hurdles and and. 
Triple jump and high jump and 

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the one of the distance coaches 
just really influenced me so but

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and she actually happened to be 
my basketball coach for modified

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basketball and I realized I just
really enjoyed the conditioning 

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part of the basketball program 
and wasn't really that much 

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interested in in the ball. 
So by the time I was in you know

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9th and 10th grade I joined 
cross country and ended up 

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really enjoying the longer 
distance events. 

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So I. 
You know, did 3000, you know in 

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in track very often. 
And then by the time I got to 

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college I ran Division Three up 
at SUNY Oswego and Nice. 

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I ran cross country, indoor and 
outdoor and I did the 10,000 on 

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the track. 
For outdoor I did the 5000. 

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Even on indoor, but I I would 
sneak in. 

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I really enjoyed the 3000 and 
would sneak in the 1500, but 

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cross country was definitely my 
love. 

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I grew up in the Schwan Gunks in
New Paltz, NY, so I got to run 

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on trails and waterfalls, you 
know, and and jumping in creeks 

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and that kind of stuff. 
So it's so gorgeous there. 

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Yeah, it's not too far from 
where we are. 

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So Andrea happens to be probably
about 5 or 6 miles away from me 

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right now. 
We could have done this one. 

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So yeah so I try to get up there
when I can but I yeah so you 

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know just with running. 
I I I had a friend on my cross 

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country team she was she went to
school year ahead of me for 

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physical therapy and I you know 
went to when I went to Oswego. 

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I was a biology major and knew 
that I wanted to to continue so 

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I applied to programs and and I 
ended up going to NYU for PT 

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school. 
And tried to run as much as I 

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could while I was in school. 
Yeah. 

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So once I left, I I actually. 
How much running was that? 

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Yeah. 
Yeah, but then once I once I 

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graduated, I was on the 
Westchester track club. 

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I had did three half Ironman. 
I did my first marathon in 2006.

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So I yeah, I spent a lot of 
time, yeah, running. 

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That's awesome. 
Yeah, you're the perfect person 

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to come on this. 
Comcast and then, you know, from

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PT school, I worked in a lot of 
settings. 

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I worked at the New York City 
Board of Education. 

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I worked at Outpatient Ortho 
down in Westchester, NY and once

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I had kids I ended up moving to 
Connecticut and I worked in a 

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really big orthopedic practice 
and I saw a lot of post op and. 

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Just wasn't by the time I left 
there. 

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I wasn't afraid to treat 
anything because I saw so much 

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but being there you know was you
know kind of like a male you 

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just end up seeing you know a 
lot of things and I just knew I 

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wanted something more. 
I knew there was more to PT. 

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I knew I wanted to spend more 
time with with people and 

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patients and and I ended up my 
massage therapist over in 

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Ridgefield New Gal. 
So Gal Fanel is my is my current

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boss and and. 
I just called her up and I said,

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I think I want to meet you. 
And her daughter was leaving for

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college and I was training for 
the New York City Marathon. 

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I said let's meet the Monday 
after the marathon. 

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So I did the New York City 
Marathon in 2018, and I met GAIL

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the Monday following. 
A little sore. 

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Yeah. 
And I just said, you know, 

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moving a little slowly. 
I walked in the double sore, you

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know, well, you know, slowly 
walked in there. 

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And I knew, I just, I just knew 
after I looked at it, I would 

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say I just, I knew this as a 
place for me. 

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We started chatting and I was 
like, I think my daughter has 

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school, Leo says. 
I'm pretty sure she does. 

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And she's like me, you know, we 
got to get her in. 

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And I'm like, and how old is 
she? 

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And she was 8 years old at the 
time, and that's pretty young to

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think, that your child has go to
exist. 

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So we got my daughter in with 
GAIL, like the next day. 

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And I was signed up for Schrath 
2 months later and spent nine 

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days in New York City. 
Certify got my first level of 

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certification in New York with 
Hagi Burdoshevsky, who is now 

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mentor. 
Oh my gosh. 

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But I'm loving working with 
GAIL. 

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She is my true mentor and I have
been there ever since. 

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So that was from 2019 until now.
That's awesome. 

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GAIL is an amazing therapist and
she was the first one in 

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Connecticut to be Shroth 
certified, wasn't she? 

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She was, yeah. 
She got certified in the States.

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She's she's she actually brought
Shroth here from Germany and 

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went to Germany. 
Yeah. 

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And so I, you know, she did she 
she has the longest running 

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practice in Connecticut and in 
the United States, one of the 

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longest running scoliosis 
practices in the United States. 

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That's awesome. 
Again, you guys have a great 

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practice over in Ridgefield and 
I really a model for like what 

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PT should be. 
I really, really love what you 

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guys do and the people I send 
over to you love it too. 

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So thank you for taking such 
good care of my Ridgefield 

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people. 
Yeah. 

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So, definitely, yeah. 
So I guess, so you're running 

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now, you're coming back from a 
hamstring tear, right? 

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I am, yeah. 
So I guess going back to some, 

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I've never had an injury off to 
college. 

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I didn't miss one meet in high 
school, college, any race I ever

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trained for. 
I never missed from an injury Up

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until about 2019 and 2019. 
I kind of was. 

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Honestly, dabbling in yoga, 
which I love, and we can talk 

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about why that maybe had an 
impact on me personally in a not

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so great way. 
But I was training for the 

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Chicago Marathon at my my one 
injury. 

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I was training for the Chicago 
Marathon in 2017 and my back and

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my and my buttock really locked 
up and I I didn't really 

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understand why. 
I sort of selftreated and I had 

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people look at me, but by the 
time I was working at Gail's, I 

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did notice and she noticed that 
I think. 

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To have a little curvature. 
So my daughter has scoliosis, my

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husband has scoliosis, and I 
have a little curvature which 

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affects my pelvis alignment, 
which we can definitely get into

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a little bit more. 
But I have a little bit of a 

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public shift with some rotation 
there and it just kind of 

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wreaked havoc on me for for them
the next few years and I think. 

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You know, my pelvis, I was 
getting a little older and 

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things were getting tighter and 
I I was relying on my hamstrings

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to just pull me, pull me through
my runs instead of getting like 

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a nice open gig, you know, I 
guess natural what happens when 

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I get older. 
But I also had this little 

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rotation in there, so I did have
a hamstring tear from 2019, one 

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of my tendons training for the 
Boilermaker. 

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And it just, it just bothered me
for years. 

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I mean, I never could get in a 
nice groove. 

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But last September I was taking 
my dog out to Huntington, which 

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is basically exactly in between 
Andrea and I right at this 

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moment on a little casual dog 
run in Rd. bead Up Rd. 

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Shoes. 
And I went into, I hit a rock 

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awkwardly and I went into a full
split in the gravel. 

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So listen to whatever Andrea and
these guys have to say about 

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putting on trail shoes on 
trails, because I tore the rest 

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of my hamstrings and my adductor
Magnus, my big adductor muscle. 

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And I was out on trails, you 
know, hobbling and sobbing back 

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to my car with my dog. 
And honestly, I have to say it 

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was the best thing that ever 
happened to me. 

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Because I have a full repair of 
all my hamstring tendons and I 

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have less pain than I did from 
when I tore it in 2019 training 

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for that Boilermaker. 
So in hindsight and I you know 

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and I'm doing strengthening in a
different way and looking at my 

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pelvis in a different way so and
that's where I'm at. 

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So I I actually am up to around 
7 1/2 miles the other day but in

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January I was still in crutches.
My my surgery was on Halloween 

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and I I walked my first mile in 
January and I did actually did 7

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1/2 miles. 
It took a while to. 

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Yeah. 
But I feel like I'm getting 

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back. 
Congratulations on your 

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00:11:22,040 --> 00:11:24,440
recovery. 
It can be such a long road. 

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But you know, now being in July,
having that hindsight, like, 

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yeah, back in January I was on 
crutches, but now look what I 

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can do. 
And you're building up and 

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building up. 
That must be a really nice 

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feeling to be at this point. 
And it I'm slow, but I will take

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it and and I think that. 
All the research is showing us 

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that running slow makes us fast 
as long as you just be 

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consistent until you're at that 
point where you can get back on 

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track. 
But, yeah, exactly. 

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Yes. 
All right. 

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Well, today's subjective is has 
a back issue ever affected your 

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running? 
And if so, what did you do that 

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helped? 
So listeners, if you want to 

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shoot us an e-mail, leave a 
comment on YouTube, comment on 

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Instagram, Facebook, let us know
what you've experienced and what

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has been helpful for you. 
And I'd like to ask the 

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subjective of Jeannie, So we 
already touched on that a little

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bit, but how? 
So when you finally figured out 

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that you had a small curvature, 
what has helped you the most? 

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I'm guessing Schraw therapy, but
specifically, what do you do? 

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Yeah. 
I mean what so we can, we'll 

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talk a little bit more about the
specifics of Schroff in a little

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bit. 
But what we really look at with 

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Schroff is you know where your 
pelvis is underneath relative to

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00:12:42,270 --> 00:12:44,390
your rib cage. 
That's just one component of it.

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00:12:44,870 --> 00:12:48,710
So if you ever come to our 
office, the office is lined with

224
00:12:48,710 --> 00:12:51,670
mirrors and you cannot rely on 
feel. 

225
00:12:52,150 --> 00:12:53,950
Like we don't know what we look 
like. 

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00:12:53,950 --> 00:12:59,030
So I really rely on you know 
getting myself stable using 

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00:12:59,030 --> 00:13:02,230
mirrors to watch for my pelvis 
is so if my pelvis is a little 

228
00:13:02,230 --> 00:13:05,590
shifted to the right and and 
maybe a little rotated backwards

229
00:13:05,590 --> 00:13:08,590
because I'll talk about what 
scoliosis is and it really is 

230
00:13:08,630 --> 00:13:10,830
rotational a huge rotational 
component. 

231
00:13:11,470 --> 00:13:15,990
You know, my muscles then are 
not in a the alignment that they

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00:13:15,990 --> 00:13:18,860
were intended to work. 
So you know, I, you know, I've 

233
00:13:18,860 --> 00:13:23,900
had a lot of pelvis piriformis 
syndrome type stuff, you know 

234
00:13:23,940 --> 00:13:29,180
and the deep hip rotators, I 
don't typically have IT band 

235
00:13:29,180 --> 00:13:31,580
issues, but that's something 
that if you have a bigger pelvic

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00:13:31,580 --> 00:13:33,480
shift. 
And people that don't 

237
00:13:33,480 --> 00:13:37,160
necessarily have scoliosis can 
get these rotations because they

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00:13:37,160 --> 00:13:41,240
sit, they sit in cars. 
And are we sitting like nice and

239
00:13:41,240 --> 00:13:42,320
straight? 
No, we shouldn't be. 

240
00:13:42,320 --> 00:13:44,600
But maybe we're not moving 
around enough when we're sitting

241
00:13:44,600 --> 00:13:47,960
or standing up and sitting down.
So if we sit, we can develop 

242
00:13:48,000 --> 00:13:52,920
these really tight restrictions 
in a pattern that we hang out in

243
00:13:53,040 --> 00:13:55,080
all the time and it can present 
like scoliosis. 

244
00:13:55,080 --> 00:13:57,480
So I can treat, you know person 
that doesn't have scoliosis. 

245
00:13:58,170 --> 00:13:59,970
And have to pay attention where 
the pelvis is. 

246
00:14:00,010 --> 00:14:02,890
And then you strengthen on top 
of that once you've maybe 

247
00:14:02,890 --> 00:14:07,010
managed some of their soft 
tissue and use mirrors and do 

248
00:14:07,010 --> 00:14:09,890
all the strengthening things 
that we really need to be doing,

249
00:14:10,730 --> 00:14:14,750
like lunges. 
And yeah, it's it's so common 

250
00:14:14,750 --> 00:14:18,350
for people to come in the clinic
complaining of like knee pain or

251
00:14:18,350 --> 00:14:21,030
ankle pain. 
And they've been to doctors, 

252
00:14:21,030 --> 00:14:23,110
they've been to two other 
physical therapists. 

253
00:14:23,110 --> 00:14:25,550
And no one can figure out why 
their pain doesn't go away. 

254
00:14:25,950 --> 00:14:29,070
And it's so obvious that they 
have a pelvic rotation or some 

255
00:14:29,070 --> 00:14:33,790
other SI joint issue that nobody
has evaluated or addressed. 

256
00:14:34,170 --> 00:14:38,170
And when you fix that more 
proximal issue, suddenly that 

257
00:14:38,170 --> 00:14:42,890
near that ankle problem either 
goes away completely or becomes 

258
00:14:42,890 --> 00:14:45,930
a lot more manageable, and then 
you're able to actually get rid 

259
00:14:45,930 --> 00:14:49,570
of those symptoms. 
I mean 100% that tends to be are

260
00:14:49,570 --> 00:14:50,930
the people that walk in our 
door. 

261
00:14:50,930 --> 00:14:54,530
If they don't, if they have 
failed, maybe more traditional 

262
00:14:54,530 --> 00:14:57,450
PT where you know they just 
didn't get the eyes on them. 

263
00:14:58,300 --> 00:15:00,460
You know, a lot of times we'd 
noticed that, you know, maybe 

264
00:15:00,460 --> 00:15:04,460
it's a 20 year old runner and he
actually has, I've seen it so 

265
00:15:04,460 --> 00:15:05,580
many times. 
He actually has a little 

266
00:15:05,580 --> 00:15:07,220
rotation and he has a little 
scoliosis. 

267
00:15:07,220 --> 00:15:09,100
It wasn't enough. 
He didn't need a brace. 

268
00:15:09,100 --> 00:15:11,740
He didn't need, but he needs to 
pay attention to where his 

269
00:15:11,740 --> 00:15:14,340
pelvis is and stabilize around 
it in that manner. 

270
00:15:14,900 --> 00:15:18,060
So we end up finding it and you 
know, you know, finding 

271
00:15:18,060 --> 00:15:20,780
scoliosis in adults and and even
kids that treated a high 

272
00:15:20,780 --> 00:15:23,500
schooler. 
No idea he had scoliosis, but he

273
00:15:23,500 --> 00:15:27,020
is a really awesome cross 
country runner and his knee was 

274
00:15:27,100 --> 00:15:28,140
he couldn't get his knee. 
Better. 

275
00:15:28,180 --> 00:15:29,380
Then he started having some back
pain. 

276
00:15:29,380 --> 00:15:33,500
Yeah. 
And and he, he had some 

277
00:15:33,500 --> 00:15:36,060
scoliosis. 
And you know, I taught him what 

278
00:15:36,060 --> 00:15:38,220
do you do with your body? 
How do you have to manage this? 

279
00:15:38,220 --> 00:15:40,660
So it's really common. 
Really common, yeah. 

280
00:15:41,300 --> 00:15:46,340
So for PTS and patients out 
there, if you're a patient and 

281
00:15:46,340 --> 00:15:49,300
you go to a PT and the only part
of your body they look at is the

282
00:15:49,300 --> 00:15:53,100
part that's hurting, that's 
probably not a thorough enough 

283
00:15:53,340 --> 00:15:57,520
evaluation. 
And PTS, just remember regional 

284
00:15:57,800 --> 00:16:01,840
connectedness. 
Look at the whole body, someone 

285
00:16:01,840 --> 00:16:04,400
coming in with neck pain, look 
at their pelvis. 

286
00:16:04,400 --> 00:16:07,640
Look at the rest of the spine. 
Because the pelvis can, Yeah, 

287
00:16:07,960 --> 00:16:10,520
drive a lot of spinal issues 
further. 

288
00:16:10,520 --> 00:16:15,080
Absolutely. 
So yeah, so I'd like to move 

289
00:16:15,080 --> 00:16:18,200
into the main segment of our 
podcast today. 

290
00:16:18,200 --> 00:16:21,240
So we're talking to Jeannie 
about two things. 

291
00:16:21,240 --> 00:16:26,150
One, scoliosis, because she is 
the expert here, but then also 

292
00:16:26,150 --> 00:16:31,550
how treating the spine and the 
pelvis can be helpful for people

293
00:16:31,550 --> 00:16:35,230
who don't have scoliosis and 
particularly how the spine and 

294
00:16:35,230 --> 00:16:39,390
the pelvis influence breathing. 
Breathing is so important for 

295
00:16:39,830 --> 00:16:43,510
everyone, but especially for 
athletes because our ability to 

296
00:16:43,510 --> 00:16:47,350
perform depends on our ability 
to bring air in and out of our 

297
00:16:47,350 --> 00:16:49,870
bodies. 
So first I just want Jeanne to 

298
00:16:49,870 --> 00:16:53,830
talk a little bit about 
scoliosis, what it is, how it's 

299
00:16:53,830 --> 00:16:58,580
diagnosed and then what you do 
in your clinic to address it. 

300
00:16:59,220 --> 00:17:04,420
So very good. 
So, so scoliosis is, you know, a

301
00:17:04,420 --> 00:17:09,700
lateral deviation of the spine. 
It can occur in one to four 

302
00:17:09,700 --> 00:17:16,380
places and there are four main 
curve patterns but the places 

303
00:17:16,380 --> 00:17:18,099
that are deviated from the 
spine. 

304
00:17:18,720 --> 00:17:21,960
Can either go right or left, and
those places that are the most 

305
00:17:21,960 --> 00:17:24,960
deviated for the from the spine 
are also the most rotated 

306
00:17:24,960 --> 00:17:27,880
segments. 
So if you think of scoliosis, if

307
00:17:27,880 --> 00:17:30,840
you see an X-ray, if you you 
know you would only see a 

308
00:17:30,840 --> 00:17:34,960
twodimensional view, but it's 
threedimensional and the areas 

309
00:17:34,960 --> 00:17:38,480
that are rotated backwards are 
the areas that you can see and 

310
00:17:38,480 --> 00:17:40,720
that's what you know. 
You may see the shift, but you 

311
00:17:40,720 --> 00:17:44,200
also can see what's called the 
prominence and that's the area 

312
00:17:44,200 --> 00:17:47,480
that you would identify first, 
so. 

313
00:17:49,340 --> 00:17:52,620
You know, it is really common 
about two to 3% of people in the

314
00:17:52,620 --> 00:17:56,500
United States have scoliosis and
that brings us to about 6 to 9 

315
00:17:56,500 --> 00:17:58,700
million people in the United 
States. 

316
00:17:59,380 --> 00:18:04,260
And the identifying scoliosis 
when you're younger is really 

317
00:18:04,260 --> 00:18:07,540
important because you know you 
can start to manage it at a 

318
00:18:07,540 --> 00:18:09,220
younger age. 
So I feel really. 

319
00:18:10,470 --> 00:18:13,470
You know, lucky that I and luck 
might not be the right word but 

320
00:18:13,470 --> 00:18:15,830
I got my daughter and quick and 
I can share a little bit more 

321
00:18:15,830 --> 00:18:18,550
about her experience. 
But as an 8 year old, you know 

322
00:18:18,550 --> 00:18:22,110
if you have some curvature, the 
chances of it progressing are is

323
00:18:22,270 --> 00:18:25,550
is is going to happen and that's
what the research shows that you

324
00:18:25,550 --> 00:18:28,270
know if you have a curvature at 
a young age and we can talk more

325
00:18:28,270 --> 00:18:32,050
about that as well, but. 
And and how you identify it, 

326
00:18:32,050 --> 00:18:34,570
summer's a great, a great time 
to identify it. 

327
00:18:34,570 --> 00:18:37,690
If you're, you know, family 
members, kids are swimming, you 

328
00:18:37,690 --> 00:18:40,850
know you want to look for these 
shifts. 

329
00:18:40,850 --> 00:18:44,210
If they bend forward, we do 
what's called an Adams test and 

330
00:18:44,210 --> 00:18:46,410
you can see some the 
prominences. 

331
00:18:46,410 --> 00:18:49,250
So if you see one side of the 
spine, we'll tell you a lot of 

332
00:18:49,250 --> 00:18:52,250
people think, oh, oh, that 
person's musculature on that 

333
00:18:52,250 --> 00:18:55,650
side is a lot more developed and
that may be the case. 

334
00:18:56,010 --> 00:18:58,430
But. 
If it's a true idiopathic 

335
00:18:58,430 --> 00:19:02,590
scoliosis, you know the the 
place that's rotated is you're 

336
00:19:02,590 --> 00:19:05,670
seeing, you know, the the spine 
and the transverse process on 

337
00:19:05,670 --> 00:19:09,310
that side. 
There are other types of and so 

338
00:19:09,310 --> 00:19:13,870
idiopathic scoliosis is a 
adolescent or juvenile 

339
00:19:14,190 --> 00:19:16,310
scoliosis. 
Juveniles, if you're diagnosed 

340
00:19:16,350 --> 00:19:19,150
under the age of 10. 
Adolescence is if you're over 

341
00:19:19,150 --> 00:19:23,100
the age of 10 but under 18. 
Is idiopathic. 

342
00:19:23,100 --> 00:19:27,180
So we don't know the reason. 
There is a lot of research, you 

343
00:19:27,180 --> 00:19:29,180
know, out there. 
It's a it's a drive in the 

344
00:19:29,180 --> 00:19:32,860
scoliosis world, but there 
really has not been one 

345
00:19:32,860 --> 00:19:36,620
identifying factor yet. 
And there are some speculations 

346
00:19:36,620 --> 00:19:39,740
about different hormones in the 
body and you know it how it 

347
00:19:39,740 --> 00:19:43,580
affects our nervous system, but 
it is a nervous system. 

348
00:19:44,580 --> 00:19:49,220
Issue so you know we describe it
as the nervous system's failure 

349
00:19:49,500 --> 00:19:52,140
of the body to control symmetry 
in the spine. 

350
00:19:52,500 --> 00:19:57,860
So you know we are, we are 
managing muscles when we do our 

351
00:19:57,860 --> 00:20:01,300
Shroth or our exercises but 
you're really trying to retrain 

352
00:20:01,300 --> 00:20:07,660
the nervous system and and you 
know teach the the person where 

353
00:20:07,660 --> 00:20:09,540
to how they can maybe put their 
body. 

354
00:20:11,920 --> 00:20:15,560
So when I also talk about it 
being threedimensional, we have 

355
00:20:15,560 --> 00:20:18,240
the curvature in the spine, the 
rotations in the spine. 

356
00:20:18,240 --> 00:20:22,040
But the pelvis is attached to 
the spine via the sacrum. 

357
00:20:22,080 --> 00:20:26,800
So we know our vertebrae in our 
in our lumbar spine or thoracic 

358
00:20:26,800 --> 00:20:30,520
spine or lumbar spine come down 
and the sacrum is the bottom of 

359
00:20:30,520 --> 00:20:36,120
the spine and it has fused 
segments and it is encompassed 

360
00:20:36,120 --> 00:20:40,790
by the pelvis. 
So the pelvis is also part of 

361
00:20:40,790 --> 00:20:42,830
the scoliosis. 
And when I'm looking at somebody

362
00:20:42,830 --> 00:20:45,470
with scoliosis I have them 
stand, I want to see does their 

363
00:20:45,470 --> 00:20:47,710
pelvis shift to the right or to 
the left. 

364
00:20:48,710 --> 00:20:52,030
And you know that's where we 
want to, it's part of our 

365
00:20:52,030 --> 00:20:54,310
management process is where that
pelvis is. 

366
00:20:55,310 --> 00:20:58,270
One of the things that scoliosis
also does, which I don't think 

367
00:20:58,270 --> 00:21:01,190
that people know is it, it does 
change the shape of the 

368
00:21:01,190 --> 00:21:02,990
vertebrae. 
And I think that's why people 

369
00:21:02,990 --> 00:21:05,630
think we don't have influence on
it. 

370
00:21:06,470 --> 00:21:09,310
Because you know, how am I going
to change somebody's bones, you 

371
00:21:09,310 --> 00:21:12,150
know? 
But with the exercises that are 

372
00:21:12,150 --> 00:21:16,470
pretty specific to that person's
curve, you're changing the load 

373
00:21:16,470 --> 00:21:21,510
on the spine as they're growing,
you can affect the way that 

374
00:21:21,510 --> 00:21:23,310
their their spine is being 
loaded. 

375
00:21:23,310 --> 00:21:26,390
And while they're growing, if 
they're sitting and standing and

376
00:21:26,390 --> 00:21:29,150
exercising into a different way 
that we are having an effect on 

377
00:21:29,150 --> 00:21:32,240
the where the bones are growing 
and how they're growing, sure. 

378
00:21:40,600 --> 00:21:43,560
I think a lot of people for 
either forget or don't know that

379
00:21:43,560 --> 00:21:46,640
bone is a dynamic tissue or 
response to load. 

380
00:21:32,680 --> 00:21:35,440
So that's that's interesting, 
but you know mostly affecting 

381
00:21:35,440 --> 00:21:38,600
their soft tissue, you know 
that's how we're managing it 

382
00:21:39,760 --> 00:21:48,600
muscles. 
So especially if you're working 

383
00:21:48,600 --> 00:21:52,440
with an adolescent that you have
a greater probability of 

384
00:21:52,440 --> 00:21:55,440
changing how that bone develops,
Yes. 

385
00:21:55,640 --> 00:21:57,640
By changing the loading, yes. 
Yes. 

386
00:21:59,130 --> 00:22:03,850
And so sometimes the bones will 
often grow a little bit more on 

387
00:22:03,850 --> 00:22:07,210
the anterior side and and cause 
us to be a little bit straighter

388
00:22:07,210 --> 00:22:10,810
in our upper body. 
And one of the other things that

389
00:22:10,930 --> 00:22:15,490
we also see, especially after 
COVID is that a lot of kids were

390
00:22:15,490 --> 00:22:20,210
living in a very flexed posture 
And our position of our lumbar 

391
00:22:20,210 --> 00:22:24,930
spine maintaining this lumbar 
lordosis that we need, that we 

392
00:22:25,050 --> 00:22:28,330
all need. 
And if we manage it and kids 

393
00:22:28,330 --> 00:22:31,570
with scoliosis, we can have a 
positive effect on the spine 

394
00:22:31,570 --> 00:22:36,090
stability at the lumbar spine. 
But certainly that is universal.

395
00:22:36,090 --> 00:22:38,930
We need to maintain what's 
called our lumbar lordosis. 

396
00:22:38,930 --> 00:22:41,490
So if you don't don't know, what
that means is if we're looking 

397
00:22:41,490 --> 00:22:45,210
at somebody from the side of 
their body, you know you have 

398
00:22:45,210 --> 00:22:48,050
your your pelvis and your 
buttock and you want that to be,

399
00:22:48,130 --> 00:22:50,410
you know, nice and level, which 
we can talk about. 

400
00:22:50,450 --> 00:22:54,530
And then you want your lumbar 
spine to have an anterior moment

401
00:22:54,530 --> 00:22:57,930
where it goes forward towards 
your belly button instead of 

402
00:22:57,930 --> 00:23:00,210
living in a flexed, really 
flexed position. 

403
00:23:00,750 --> 00:23:03,270
And then the thoracic spine is 
supposed to have a natural 

404
00:23:03,310 --> 00:23:05,150
kyphosis. 
And sometimes we think of 

405
00:23:05,150 --> 00:23:07,750
kyphosis as such a negative 
thing like we're all, we don't 

406
00:23:07,750 --> 00:23:10,070
want to become chyphotic. 
And with runners it's something 

407
00:23:10,070 --> 00:23:12,150
that we really have to think 
about because we get tight. 

408
00:23:13,310 --> 00:23:16,310
But, but with people with 
scoliosis, they develop this 

409
00:23:16,350 --> 00:23:20,590
anterior spinal overgrowth and 
they tend to be straighter 

410
00:23:20,590 --> 00:23:23,830
there, which has a negative 
effect on their curve for the 

411
00:23:23,830 --> 00:23:28,760
stability of the thoracic spine.
So we are looking at the body in

412
00:23:29,240 --> 00:23:32,720
all the directions, rotation, 
the frontal plane which is the 

413
00:23:32,720 --> 00:23:35,560
side shifting that you'd see and
if you look at somebody from the

414
00:23:35,560 --> 00:23:38,600
side and that is something that 
we should be looking at with 

415
00:23:38,600 --> 00:23:42,280
everybody too, so. 
Oh, absolutely, yeah. 

416
00:23:42,280 --> 00:23:45,600
And you know the curvature, the 
natural curvature of the spine, 

417
00:23:45,600 --> 00:23:49,360
what you're talking about 
kyphosis and the thoracic spine 

418
00:23:49,360 --> 00:23:51,800
and lordosis and the lumbar and 
cervical spines. 

419
00:23:52,300 --> 00:23:56,100
That actually is a smart design,
if you will, because it helps 

420
00:23:56,100 --> 00:24:00,260
the spine except more load as 
compared to if the spine was 

421
00:24:00,260 --> 00:24:03,780
perfectly straight. 
So people who have lost their 

422
00:24:03,780 --> 00:24:08,100
natural curves or have reduced 
curves actually have decreased 

423
00:24:08,140 --> 00:24:10,940
load bearing tolerance in that 
region of the spine. 

424
00:24:11,260 --> 00:24:13,140
Yeah. 
And what are we doing? 

425
00:24:13,180 --> 00:24:16,460
We are loading and impact with 
that impact with the running. 

426
00:24:16,460 --> 00:24:19,420
So it makes a big difference. 
So yeah, who doesn't know 

427
00:24:19,420 --> 00:24:22,420
somebody that feels like their 
spine feels stiff after they 

428
00:24:22,460 --> 00:24:24,260
run, you know? 
Right. 

429
00:24:24,460 --> 00:24:26,380
Yeah, so. 
Yeah. 

430
00:24:26,580 --> 00:24:32,540
So you talked a little bit about
diagnosing in children and 

431
00:24:32,540 --> 00:24:35,980
adolescents and like what 
parents can do, especially in 

432
00:24:35,980 --> 00:24:40,780
the summertime, to notice any 
prominences in the spine, but. 

433
00:24:41,430 --> 00:24:44,190
How do doctors like? 
Let's say you think that your 

434
00:24:44,190 --> 00:24:47,030
child has scoliosis. 
What should you do next? 

435
00:24:47,110 --> 00:24:49,470
Do you go to a PT? 
Do you go to a doctor? 

436
00:24:49,950 --> 00:24:53,630
You would go to your 
pediatrician most likely and ask

437
00:24:53,630 --> 00:24:55,350
them for a referral to an 
orthopedic. 

438
00:24:56,270 --> 00:25:01,230
An orthopedic surgeon or Doctor 
Who specializes in Pediatrics 

439
00:25:01,230 --> 00:25:04,430
specifically. 
We are lucky because we live in 

440
00:25:04,430 --> 00:25:07,470
an area in the tristate area 
that we have a lot of doctors 

441
00:25:07,470 --> 00:25:11,190
that do specialize just in 
scoliosis and Pediatrics. 

442
00:25:11,470 --> 00:25:13,550
So but you know if you're in 
other parts of the country you 

443
00:25:13,550 --> 00:25:16,870
might need to just find a 
pediatric orthopedic doctor and 

444
00:25:17,950 --> 00:25:20,550
you know you would you would 
they you would ask them for you 

445
00:25:20,550 --> 00:25:23,110
would encourage them and and 
hopefully the doctor would you 

446
00:25:23,110 --> 00:25:26,910
would give you an X-ray. 
So you would get a full spine 

447
00:25:26,910 --> 00:25:30,550
X-ray and most of the time you 
can see where the pelvis is and 

448
00:25:30,550 --> 00:25:33,550
you would you know go from the 
cervical spine down to the 

449
00:25:33,550 --> 00:25:39,080
pelvis and and from there we 
would take measurements And so I

450
00:25:39,200 --> 00:25:42,480
need to see all my patients 
Xrays because we take our own 

451
00:25:42,480 --> 00:25:44,680
measurements. 
I want to see exactly the areas 

452
00:25:44,960 --> 00:25:48,280
that we need to work on you know
and address and and sometimes 

453
00:25:48,280 --> 00:25:50,440
it's obvious and somebody will 
walk in the door and their curve

454
00:25:50,440 --> 00:25:52,760
patterns very obvious and 
sometimes it's not and if they 

455
00:25:52,760 --> 00:25:54,320
don't fit into an exact curve 
pattern. 

456
00:25:55,760 --> 00:25:58,640
So I need to see the X-ray and 
we we look at what's called the 

457
00:25:58,640 --> 00:26:01,840
Cob angle. 
And the Cob angle is, you know, 

458
00:26:01,840 --> 00:26:07,660
the angle that the curvature is 
and you measure that and you get

459
00:26:07,660 --> 00:26:11,260
a number in degrees. 
So like I said before, you could

460
00:26:11,260 --> 00:26:14,580
have one curve, you could have 
two curves, but you would want 

461
00:26:14,580 --> 00:26:19,420
to measure that and that would 
give you a level of severity, 

462
00:26:19,420 --> 00:26:23,060
you know where you're at. 
So if you have a curve that is 

463
00:26:23,060 --> 00:26:26,010
under 10 degrees, you're 
actually not considered to have 

464
00:26:26,010 --> 00:26:28,610
scoliosis. 
And sometimes we can have some 

465
00:26:28,610 --> 00:26:31,290
curvatures in there from from 
specific sports like maybe 

466
00:26:31,290 --> 00:26:32,570
volleyball or something like 
that. 

467
00:26:32,570 --> 00:26:36,330
And we do develop extra muscle 
in areas that we're overworking.

468
00:26:36,330 --> 00:26:38,530
So those are called functional 
scoliosis. 

469
00:26:39,330 --> 00:26:42,810
But if you have a curve that's 
between 10 and 25 degrees, 

470
00:26:42,810 --> 00:26:46,810
you're considered moderate. 
If you're under, if you're under

471
00:26:46,810 --> 00:26:49,530
the age of 12 and you haven't 
grown, I mean we would expect 

472
00:26:49,530 --> 00:26:52,570
and boys and girls are 
different, we would expect to 

473
00:26:52,570 --> 00:26:54,850
see some progression of that 
number. 

474
00:26:55,330 --> 00:27:00,010
And so you wouldn't ignore it, 
you would you know depending on 

475
00:27:00,210 --> 00:27:04,010
you know the the severity of the
curve you would you would incur 

476
00:27:04,010 --> 00:27:08,370
we would have everybody do show 
off or any sort of scoliosis 

477
00:27:08,370 --> 00:27:12,940
specific exercise program. 
And then if they're typically 

478
00:27:12,940 --> 00:27:16,940
what it was is over the 
curvature from 25 to 45 you 

479
00:27:16,940 --> 00:27:20,380
would do Schroth and bracing. 
But actually what's really 

480
00:27:21,220 --> 00:27:24,460
changing especially in this area
for the better is that we are 

481
00:27:24,460 --> 00:27:28,540
bracing kids at earlier ages 
with smaller curvatures. 

482
00:27:28,540 --> 00:27:31,860
So I see kids in braces all the 
time at 18 degrees because 

483
00:27:32,180 --> 00:27:34,740
they're 10 years old. 
They have so much growth to go 

484
00:27:35,100 --> 00:27:42,380
and and they're seeing huge 
positive changes in there and 

485
00:27:42,460 --> 00:27:44,660
one of the other treatment 
options and if the curve is over

486
00:27:44,660 --> 00:27:47,980
45 degrees I mean you're a 
candidate for surgery and that's

487
00:27:47,980 --> 00:27:52,660
a really big family decision and
it's it can be hard it can be 

488
00:27:52,660 --> 00:27:58,060
easy and it does shouldn't it 
shouldn't limit you and what 

489
00:27:58,060 --> 00:28:02,340
your activities you want to do 
and and people do great and 

490
00:28:02,340 --> 00:28:04,620
sometimes you can't manage 
curves or sometimes you do catch

491
00:28:04,620 --> 00:28:07,540
them a little late and that's 
why we we talked about catching 

492
00:28:07,540 --> 00:28:11,490
them early watch look at take a 
peek at kids in you know in 

493
00:28:11,490 --> 00:28:14,010
their spines or their shoulders 
shifted or their pelvis shifted.

494
00:28:14,330 --> 00:28:17,410
If you have an inkling, go to 
your pediatrician, share it with

495
00:28:17,410 --> 00:28:20,450
them and see what they think. 
So our schools still screening 

496
00:28:20,450 --> 00:28:22,970
kids for schools. 
I remember King is screened in 

497
00:28:22,970 --> 00:28:25,170
middle school again. 
Yep, that's good. 

498
00:28:25,170 --> 00:28:27,650
What age do they do this? 
I'm in middle school in the 

499
00:28:27,650 --> 00:28:30,610
state of Connecticut and I think
they do the girls at age at 7th 

500
00:28:30,610 --> 00:28:35,330
grade and they do the boys I 
think in 8th grade, which to me 

501
00:28:35,330 --> 00:28:39,990
I think is a little late. 
So you know, and it might be 6th

502
00:28:40,310 --> 00:28:43,470
grade but my kids both have done
it and they, you know, they say 

503
00:28:43,470 --> 00:28:45,950
my mom, you know, already told 
me I had some school uses. 

504
00:28:49,030 --> 00:28:52,790
But yeah, they they are. 
And actually I I one of my 

505
00:28:52,830 --> 00:28:56,270
patients this week his mom's a 
school nurse and she goes, I 

506
00:28:56,270 --> 00:29:00,110
just see something going on and 
and my own son and I, I we need 

507
00:29:00,110 --> 00:29:04,520
to manage it And she was right. 
So, so it is happening but I see

508
00:29:04,520 --> 00:29:07,920
pediatricians miss it all the 
time and depending on on kids 

509
00:29:07,920 --> 00:29:12,600
bodies, body types you it can be
hidden and certain curves are 

510
00:29:12,600 --> 00:29:16,120
just harder to see than others. 
So yeah, I'd say just really 

511
00:29:16,120 --> 00:29:18,600
show the pediatrician and say 
you know can you just look at 

512
00:29:18,600 --> 00:29:22,000
this area and and tell me what 
you think and and next we don't 

513
00:29:22,000 --> 00:29:24,480
have X-ray vision. 
So I I I encourage the X-ray 

514
00:29:24,480 --> 00:29:26,440
sure. 
I mean, especially if they 

515
00:29:26,440 --> 00:29:30,760
haven't had exposure to xrays. 
Absolutely, Yeah. 

516
00:29:31,240 --> 00:29:35,920
And there there actually is a is
a an X-ray called the EOS and 

517
00:29:35,920 --> 00:29:39,920
it's low dose radiation, it's, 
it's digital because kids with 

518
00:29:39,920 --> 00:29:42,640
scoliosis actually do need more 
xrays than kids that don't. 

519
00:29:42,640 --> 00:29:46,640
And so now this, this option is 
here for us especially, you 

520
00:29:46,680 --> 00:29:48,280
know, they're becoming more 
popular. 

521
00:29:48,280 --> 00:29:50,760
That's great. 
Just briefly because I think 

522
00:29:50,760 --> 00:29:54,520
when you talk about surgery for 
scoliosis, people you know. 

523
00:29:55,610 --> 00:29:59,130
Think the worst like they think 
about Harrington Rods and, you 

524
00:29:59,130 --> 00:30:01,570
know, fusing the whole spine, 
and that's not what they're 

525
00:30:01,570 --> 00:30:04,810
doing these days. 
So what is surgery like? 

526
00:30:04,810 --> 00:30:10,370
If you do need, if your curve is
severe enough so so they are 

527
00:30:10,370 --> 00:30:13,890
still fusing and they do try to 
fuse the least amount of 

528
00:30:13,890 --> 00:30:17,250
segments that they think that 
that the child or the person 

529
00:30:17,250 --> 00:30:20,710
needs. 
One of the things that has 

530
00:30:20,710 --> 00:30:25,790
hugely changed, I almost want to
say in the last 10 years is when

531
00:30:25,790 --> 00:30:31,190
we were talking about the 
lordosis that and the kyphosis 

532
00:30:31,190 --> 00:30:35,110
when they would fuse people 
earlier on, even adults, fusions

533
00:30:35,110 --> 00:30:37,790
without scoliosis and they 
needed it for degenerative 

534
00:30:37,790 --> 00:30:40,850
changes. 
They didn't know that you needed

535
00:30:40,850 --> 00:30:43,610
to incorporate this lumbar 
curvature. 

536
00:30:43,610 --> 00:30:47,170
So if you look at somebody that 
had a fusion prior to 10:00, I 

537
00:30:47,170 --> 00:30:49,130
could be wrong. 
Now it might even be 15 years. 

538
00:30:49,410 --> 00:30:51,410
You know they they did fuse them
straight. 

539
00:30:51,730 --> 00:30:54,490
That does not happen anymore. 
They now fuse, they're still 

540
00:30:54,490 --> 00:30:58,890
using rods, but they fuse them 
managing the the lordosis. 

541
00:30:58,890 --> 00:31:02,530
So you have this natural 
pressure reducing impact, 

542
00:31:02,530 --> 00:31:08,230
reducing curvature built in and 
they they do it and based on 

543
00:31:08,230 --> 00:31:09,950
measurements that we take in the
pelvis. 

544
00:31:09,950 --> 00:31:14,790
So everybody has specific pelvic
measurements based on their 

545
00:31:14,790 --> 00:31:17,070
body. 
So somebody's lordosis might be 

546
00:31:17,470 --> 00:31:21,150
really much more of a curvature 
than somebody else's and that 

547
00:31:21,150 --> 00:31:23,030
may be healthy for them versus 
the person. 

548
00:31:23,030 --> 00:31:25,430
Like I don't have a lot of 
lordosis, but that's because my 

549
00:31:25,430 --> 00:31:28,490
pelvis doesn't. 
I have the right amount for my 

550
00:31:28,490 --> 00:31:29,490
promise. 
So. 

551
00:31:29,490 --> 00:31:31,690
So they take all these 
measurements into consideration 

552
00:31:31,690 --> 00:31:36,970
now, which they didn't before. 
There is another type of surgery

553
00:31:36,970 --> 00:31:43,930
called tethering that is been in
the research and there it was. 

554
00:31:44,250 --> 00:31:47,210
You know we just went to a big 
conference with the Columbia 

555
00:31:47,210 --> 00:31:50,870
doctors at Columbia Presbyterian
Children's Hospital. 

556
00:31:50,870 --> 00:31:55,390
Doctor Vitali there is one of 
the leading surgeons and and the

557
00:31:55,630 --> 00:31:59,070
big conversation at that 
conference was tethering and 

558
00:31:59,070 --> 00:32:02,590
what are the implications and 
indications and and they are 

559
00:32:02,590 --> 00:32:07,470
still working it out. 
But you know other types of 

560
00:32:07,470 --> 00:32:12,710
surgeries are on the horizon. 
And, yeah, yeah, it's just, and 

561
00:32:12,710 --> 00:32:15,390
those depend on where you are 
and your growth and the degree 

562
00:32:15,390 --> 00:32:17,630
of the curves and where where 
the curve is, whether it's in 

563
00:32:17,630 --> 00:32:19,230
your thoracic spine or your 
lumbar spine. 

564
00:32:21,180 --> 00:32:24,260
Yeah, yeah, that's but activity 
level version of the people. 

565
00:32:24,300 --> 00:32:25,900
I mean, kids can run with 
fusions. 

566
00:32:26,060 --> 00:32:27,740
Kids can play almost every 
sport. 

567
00:32:27,740 --> 00:32:32,940
Yeah. 
So, you know, kids are not 

568
00:32:32,940 --> 00:32:33,980
limited. 
Right. 

569
00:32:34,180 --> 00:32:36,380
Yeah, that's great. 
And I think that I'm glad you 

570
00:32:36,380 --> 00:32:38,500
brought that up because I think 
a lot of people think once 

571
00:32:38,500 --> 00:32:42,820
you've had a fusion that you 
can't play, you can't run, you 

572
00:32:42,820 --> 00:32:46,230
can't play contact sports and. 
Really, there are very few 

573
00:32:46,230 --> 00:32:48,310
limitations. 
After those, once you've you 

574
00:32:48,590 --> 00:32:51,230
want to get them stable. 
Just like we want to get 

575
00:32:51,230 --> 00:32:53,390
somebody stable that doesn't 
have a fusion. 

576
00:32:53,390 --> 00:32:55,910
I mean, stability is important. 
Yeah. 

577
00:32:57,350 --> 00:32:59,870
All right. 
So let's talk about how Schroth 

578
00:32:59,870 --> 00:33:01,790
works. 
So let's say someone comes into 

579
00:33:01,790 --> 00:33:03,750
your clinic. 
They've got their X-rays. 

580
00:33:04,220 --> 00:33:07,940
You take your measurements. 
So how do you figure out what 

581
00:33:07,940 --> 00:33:12,260
exercises to give them and what 
might their exercises be like? 

582
00:33:12,380 --> 00:33:16,060
Yeah, yeah. 
So we first determined, you 

583
00:33:16,060 --> 00:33:18,580
know, do they have one curve or 
two or more? 

584
00:33:19,220 --> 00:33:22,220
And you want to know the 
location of the primary curve. 

585
00:33:22,220 --> 00:33:26,300
So is there a driver or primary 
curve in the thoracic spine? 

586
00:33:26,900 --> 00:33:29,100
If it's in the thoracic spine, 
it has the ribs. 

587
00:33:29,100 --> 00:33:32,220
So they often tend to be a 
little bit more easy to identify

588
00:33:32,220 --> 00:33:35,540
because you can. 
The ribs have have prominence to

589
00:33:35,540 --> 00:33:38,340
them themselves and they are 
part of the scoliosis. 

590
00:33:39,060 --> 00:33:41,340
And then you or you want to 
check to see is it in the lumbar

591
00:33:41,340 --> 00:33:45,500
spine and then you're checking 
to see do this the lumbar spine 

592
00:33:45,500 --> 00:33:49,940
and the pelvis go together or do
they go away from each other. 

593
00:33:49,980 --> 00:33:53,300
And that's that's one of our big
identifiers of of identifying 

594
00:33:53,300 --> 00:33:59,740
which pattern the person is in 
and the areas of the curve that 

595
00:33:59,780 --> 00:34:05,410
are shifted and deviated from 
the spine and are rotated in 

596
00:34:05,410 --> 00:34:09,610
those segments. 
We want to stabilize the muscles

597
00:34:09,610 --> 00:34:13,250
around the area, so we work on 
the area. 

598
00:34:13,250 --> 00:34:17,960
So the side of the curve that's 
deviated is called the is is 

599
00:34:17,960 --> 00:34:21,080
called the convexity, and the 
other side of the curve is 

600
00:34:21,080 --> 00:34:23,159
called that. 
That the curve is not deviating 

601
00:34:23,159 --> 00:34:26,960
towards on that same segment is 
called the cavity. 

602
00:34:27,440 --> 00:34:30,080
The concavity is an area of 
collapse. 

603
00:34:30,080 --> 00:34:35,280
So we want to stabilize those 
positions and our exercises are 

604
00:34:35,280 --> 00:34:41,190
designed to manage those 
specific places of collapse and 

605
00:34:41,190 --> 00:34:44,190
rotation as well as elongating 
the spine. 

606
00:34:44,190 --> 00:34:47,510
So somebody, I take everybody's 
height measurement when they 

607
00:34:47,510 --> 00:34:50,429
walk in the door sitting and 
standing. 

608
00:34:51,150 --> 00:34:55,270
And because the areas of 
rotation are kind of drawing the

609
00:34:55,270 --> 00:35:00,910
spine away from midline as we 
elongate you and give you 

610
00:35:01,030 --> 00:35:04,470
exercises which I'll get into to
bring the spine more towards 

611
00:35:04,470 --> 00:35:07,990
center and elongate, you will 
often get a little bit taller 

612
00:35:08,310 --> 00:35:12,990
not just from growth. 
And so the exercises we we do 

613
00:35:12,990 --> 00:35:16,430
are, you know we do a lot of 
work on if you've heard of wall 

614
00:35:16,430 --> 00:35:20,630
bars and they look like a ladder
and they're in our facility and 

615
00:35:20,710 --> 00:35:25,910
and they're probably the 
prominent design that you think 

616
00:35:25,910 --> 00:35:27,870
of when you think of shot 
physical therapy, you see these 

617
00:35:27,870 --> 00:35:30,350
wall bars. 
And so we always start everybody

618
00:35:30,350 --> 00:35:33,830
with a lot of shoulder stability
and getting them to start this 

619
00:35:33,830 --> 00:35:38,950
elongation process so that the 
spine isn't so shifted laterally

620
00:35:38,950 --> 00:35:40,550
and starts to bring it towards 
midline. 

621
00:35:40,630 --> 00:35:44,470
So we do lots of things that 
everybody can do and certainly 

622
00:35:44,470 --> 00:35:46,910
runners because of the impact on
our spine. 

623
00:35:46,910 --> 00:35:51,390
But you are you know getting on 
a pull up bar and doing some 

624
00:35:51,390 --> 00:35:55,750
shrugs and some pendulums and 
just doing some some hanging 

625
00:35:55,750 --> 00:35:57,910
with some shoulder control to 
elongate. 

626
00:35:58,550 --> 00:36:02,070
But then those areas of the 
spine that are shifted laterally

627
00:36:02,070 --> 00:36:05,870
and we have that concavity area,
we we do want to develop muscle 

628
00:36:05,870 --> 00:36:10,070
around the whole area. 
So we bring in breathing as a 

629
00:36:10,070 --> 00:36:16,590
tool. 
So Schroth is came from Germany.

630
00:36:17,230 --> 00:36:21,670
Catalina Schroth had scoliosis, 
and she treated herself and she 

631
00:36:21,670 --> 00:36:27,790
opened a clinic, and this was in
the 1920s, and she had 150 

632
00:36:27,790 --> 00:36:31,830
people in there at a time and, 
you know, developed this 

633
00:36:32,430 --> 00:36:35,110
breathing program. 
It was considered orthopedic 

634
00:36:35,110 --> 00:36:40,910
breathing to reshape the body. 
So we use breathing as a tool to

635
00:36:40,950 --> 00:36:44,070
help us activate muscles. 
You know, if I were to say, oh, 

636
00:36:44,110 --> 00:36:48,840
make your ribs move to the side 
yet fill in that area, you can't

637
00:36:48,840 --> 00:36:51,760
do that with just, you know, 
making your, you know, telling 

638
00:36:51,760 --> 00:36:54,480
your brain to do that. 
So we use breathing as a tool. 

639
00:36:55,040 --> 00:36:58,240
So I would encourage everybody 
if you're, you know, listening 

640
00:36:58,240 --> 00:37:00,440
and you're not driving, you 
know, put your hands on the side

641
00:37:00,440 --> 00:37:03,320
of your ribs and see if you can 
move them without breathing. 

642
00:37:03,640 --> 00:37:07,200
You know you can't. 
I I I actually, you can. 

643
00:37:08,040 --> 00:37:12,600
As you develop practicing, but 
you use breathing as a tool. 

644
00:37:12,600 --> 00:37:18,720
So you take a nice expansive 
inhale breath to find the 

645
00:37:18,720 --> 00:37:21,240
muscles that you're trying to 
activate. 

646
00:37:21,240 --> 00:37:23,720
You know and you know there's 
tons of muscles that are going 

647
00:37:23,720 --> 00:37:26,720
to be incorporated to it. 
The muscles that live inside the

648
00:37:26,720 --> 00:37:30,680
ribs, the intercostals, the you 
know, all the scapular muscles, 

649
00:37:30,680 --> 00:37:33,360
the lumbar muscles. 
You don't have to name them, you

650
00:37:33,360 --> 00:37:36,240
just need to move them. 
So if you take that nice deep 

651
00:37:36,240 --> 00:37:40,830
breath you can change the shape 
of your rib cage. 

652
00:37:41,110 --> 00:37:46,830
And so when you expand you are 
that expansion process into the 

653
00:37:46,830 --> 00:37:52,490
ribs gives the spine stability 
and that's what the people, you 

654
00:37:52,570 --> 00:37:55,050
know people with scoliosis need 
is you need the sense of 

655
00:37:55,050 --> 00:37:58,050
stability. 
So we're really specific where 

656
00:37:58,050 --> 00:38:02,370
we want them to breathe because 
the areas that the ribs are 

657
00:38:02,370 --> 00:38:05,170
shifting towards are the areas 
of least resistance. 

658
00:38:05,170 --> 00:38:09,530
So our body will naturally go 
into those areas and and breathe

659
00:38:09,530 --> 00:38:13,750
more into those areas and it 
becomes a little cycle. 

660
00:38:14,590 --> 00:38:16,790
And this also happens with 
runners. 

661
00:38:16,790 --> 00:38:19,190
You know, we get tight in our 
rib cage and where does our 

662
00:38:19,190 --> 00:38:22,270
breath go a lot of times to our 
neck, a lot of times to our 

663
00:38:22,270 --> 00:38:26,470
pelvic floor. 
So we use this thought process 

664
00:38:26,590 --> 00:38:31,630
and this plan to expand the ribs
into areas that we need to, to 

665
00:38:31,990 --> 00:38:36,230
help facilitate the muscles to 
prevent this collapse, bring on 

666
00:38:36,230 --> 00:38:40,130
stability. 
And then you know they're they 

667
00:38:40,130 --> 00:38:43,850
are very specific, the 
exercises, but they're all 

668
00:38:43,850 --> 00:38:47,490
designed to teach your body what
to do. 

669
00:38:47,650 --> 00:38:52,930
Because it's not it's it's 
complex but it's also strategies

670
00:38:52,930 --> 00:38:54,770
to get the most out of the body 
that you can. 

671
00:38:54,770 --> 00:38:57,290
So some of our exercises you're 
laying on your back, some of 

672
00:38:57,290 --> 00:39:01,850
them you're thrown kind of in a 
hands and knees position, some 

673
00:39:01,850 --> 00:39:07,640
of you're on your side and it's 
all to get the best plan for 

674
00:39:07,720 --> 00:39:10,920
your body to encourage this 
muscle recruitment with the 

675
00:39:10,920 --> 00:39:13,240
rough. 
Right. 

676
00:39:13,360 --> 00:39:16,200
There's a great saying, and I 
don't know who it's attributed 

677
00:39:16,200 --> 00:39:18,240
to, but I tell my patients that 
all the time. 

678
00:39:18,600 --> 00:39:20,560
The body knows movements, not 
muscles. 

679
00:39:20,880 --> 00:39:25,120
So if you're trying to target a 
certain area, so like for your 

680
00:39:25,120 --> 00:39:28,360
example, getting the rib cage to
expand in a certain area, you 

681
00:39:28,360 --> 00:39:32,320
can't just say, oh, expand your 
right lower, let your lateral 

682
00:39:32,320 --> 00:39:33,920
rib cage. 
It's just not going to happen. 

683
00:39:34,240 --> 00:39:36,640
But if you cure someone and 
yeah, yeah. 

684
00:39:37,230 --> 00:39:40,950
I know another shot. 
Therapist, Caroline, and she's 

685
00:39:40,950 --> 00:39:43,750
shown me some things. 
So, like, you might cue someone,

686
00:39:43,750 --> 00:39:48,110
OK, expand this and, like, 
cueing them on their rib cage, 

687
00:39:48,110 --> 00:39:52,830
breathe into here, right? 
And the brain is so much better 

688
00:39:53,230 --> 00:39:58,310
at performing a movement rather 
than thinking about engaging. 

689
00:39:58,670 --> 00:40:01,750
Oh, those particular 
intercostals and that part of 

690
00:40:01,750 --> 00:40:04,210
your diaphragm. 
Yeah. 

691
00:40:04,610 --> 00:40:09,050
So I think that's a great 
example of that. 

692
00:40:09,610 --> 00:40:12,330
The body knows movements, not 
muscles saying. 

693
00:40:12,690 --> 00:40:16,130
Absolutely. 
Yeah, absolutely. 

694
00:40:16,330 --> 00:40:19,450
But, and the body knows what it 
knows. 

695
00:40:19,960 --> 00:40:23,240
And that's why mirrors are so 
important, because you're going 

696
00:40:23,240 --> 00:40:25,080
to go to the place of least 
resistance. 

697
00:40:25,080 --> 00:40:28,240
You're going to go to where the 
body tended to, maybe develop 

698
00:40:28,240 --> 00:40:31,080
some tightness. 
So you have to use mirrors, I 

699
00:40:31,080 --> 00:40:34,280
think when you work out and when
you know, obviously you can't 

700
00:40:34,280 --> 00:40:36,800
when you're running, but what 
you do outside of running 

701
00:40:36,800 --> 00:40:41,600
influences your running. 
So using mirrors and saying do I

702
00:40:41,720 --> 00:40:43,680
look like I'm straight? 
I don't look like that I'm 

703
00:40:43,720 --> 00:40:46,120
straight, I didn't even notice 
you know And so using the 

704
00:40:46,120 --> 00:40:48,790
mirrors to guide you. 
You know, if you can see what 

705
00:40:48,790 --> 00:40:51,270
you're doing. 
We do a lot of videoing with our

706
00:40:51,270 --> 00:40:54,630
our patients and I take a lot of
photographs of them because they

707
00:40:54,630 --> 00:40:56,710
can't see their spines, we can't
see our spines. 

708
00:40:56,710 --> 00:40:58,950
We're relying on me telling them
what it looks like. 

709
00:40:58,950 --> 00:41:02,030
And so we take pictures and once
they even visualize it and see 

710
00:41:02,030 --> 00:41:04,150
it, you can make a lot more 
changes. 

711
00:41:04,270 --> 00:41:06,470
Oh, definitely, yeah. 
And how many times have you 

712
00:41:06,470 --> 00:41:10,510
treated a patient who has say 
like a SI joint alignment issue 

713
00:41:10,870 --> 00:41:14,980
and now their alignments better,
but they feel really crooked 

714
00:41:14,980 --> 00:41:18,020
because they got used to being 
off. 

715
00:41:18,020 --> 00:41:21,980
So the brain has to relearn what
you know. 

716
00:41:22,180 --> 00:41:26,220
Yes, symmetrical is. 
Yeah, yeah. 

717
00:41:26,220 --> 00:41:29,260
So we do rely on mirrors. 
And then what we do is after we 

718
00:41:29,260 --> 00:41:32,540
kind of gotten through our 
specific exercise plan, the 

719
00:41:32,740 --> 00:41:37,100
sidelines and the prones and the
supine exercises and we use 

720
00:41:37,100 --> 00:41:41,420
what's called rice bags, we we 
actually bring in. 

721
00:41:42,490 --> 00:41:46,690
You know these little wedge type
things, they look kind of like 

722
00:41:46,690 --> 00:41:50,810
cornhole tossers you know and 
and you place them in there so 

723
00:41:50,810 --> 00:41:53,850
the so people can feel where the
changes, where we want the 

724
00:41:53,850 --> 00:41:56,010
changes to occur and it guides 
them. 

725
00:41:56,010 --> 00:41:59,770
It's just a guide and it also is
a little bit of a protection so 

726
00:41:59,770 --> 00:42:02,250
that you're not pushing into the
areas that are already 

727
00:42:02,250 --> 00:42:05,370
deviating. 
But then once we get through 

728
00:42:05,370 --> 00:42:08,850
that process, we go into what's 
called integration and and we 

729
00:42:08,850 --> 00:42:13,290
integrate it into other regular.
Exercise programs, you know, 

730
00:42:13,290 --> 00:42:17,530
squatting and sit to standing 
and you know running, jogging in

731
00:42:17,530 --> 00:42:20,610
place, standing on balance 
board, standing on one foot. 

732
00:42:21,090 --> 00:42:24,170
You know you need to be able to 
do the things that we did in 

733
00:42:24,170 --> 00:42:28,810
those specific programs, in our 
specific trust program to teach 

734
00:42:28,810 --> 00:42:31,130
your body what to do. 
And then you need to be able to 

735
00:42:31,170 --> 00:42:33,930
use it more functionally, so 
yeah. 

736
00:42:34,650 --> 00:42:36,610
That's a huge part. 
It sounds like it would. 

737
00:42:37,190 --> 00:42:40,870
Is it relatively easy for people
to do these exercises at home if

738
00:42:40,870 --> 00:42:44,590
say, they install like a pull up
bar and get some rice bags? 

739
00:42:44,590 --> 00:42:47,230
Yeah, yeah. 
Yeah, a pull up bar is huge. 

740
00:42:47,230 --> 00:42:49,310
You don't, you know, you can get
the ones that are just in and 

741
00:42:49,310 --> 00:42:51,590
out of the doorways. 
They're fantastic. 

742
00:42:52,030 --> 00:42:54,550
You know, oftentimes people have
playground equipment in their 

743
00:42:54,550 --> 00:42:58,350
backyard, but every exercise 
that we give. 

744
00:42:58,840 --> 00:43:02,160
You know, we try to have a home 
option. 

745
00:43:02,240 --> 00:43:05,800
Almost everything is easily done
at home and and and when you 

746
00:43:05,800 --> 00:43:09,000
have scoliosis it doesn't really
go away all the way. 

747
00:43:09,040 --> 00:43:11,920
Even if we're managing it, we've
reduced your current. 

748
00:43:11,960 --> 00:43:14,340
You still. 
You still have a shift. 

749
00:43:14,380 --> 00:43:17,540
I mean unless you've had a 
reconstructive surgery but even 

750
00:43:17,540 --> 00:43:20,060
then you know you still have 
these these tendencies for 

751
00:43:20,060 --> 00:43:23,700
bodies to shift. 
So I my goal is for people to 

752
00:43:23,700 --> 00:43:27,220
have an understanding of what 
they need to do forever. 

753
00:43:27,220 --> 00:43:29,700
So they go to college. 
They're running or not you know 

754
00:43:29,700 --> 00:43:30,900
and their pelvis is little 
shifted. 

755
00:43:30,900 --> 00:43:34,340
They have a plan and and if they
pull out their handouts and 

756
00:43:34,340 --> 00:43:36,810
their little videos and. 
They went through it. 

757
00:43:37,130 --> 00:43:40,050
They they can end and we often 
have, you know, people come back

758
00:43:40,050 --> 00:43:42,370
after college, especially if 
they're high level athletes and 

759
00:43:42,370 --> 00:43:46,810
and do tune ups with us. 
But you do need that time. 

760
00:43:46,850 --> 00:43:49,890
I mean, the research shows you 
need that time, which I can 

761
00:43:49,890 --> 00:43:53,410
discuss, but you need that time 
with a trained physical 

762
00:43:53,410 --> 00:43:55,490
therapist to guide you, you, 
you. 

763
00:43:56,200 --> 00:43:59,280
You you it's not effective 
unless you go through that the 

764
00:43:59,360 --> 00:44:02,920
initial process of learning 
learning your curve pattern 

765
00:44:02,960 --> 00:44:05,400
because the exercise is they're.
Pretty specific they are and 

766
00:44:05,920 --> 00:44:09,200
it's complex, yeah. 
And you not to say that you 

767
00:44:09,200 --> 00:44:11,160
couldn't benefit from just 
doing, you know, some 

768
00:44:11,160 --> 00:44:15,360
elongation, but to get the the 
satisfaction and the actual 

769
00:44:15,360 --> 00:44:18,280
changes that you need to make, 
you do need that more specific. 

770
00:44:18,840 --> 00:44:21,950
Yeah. 
So yeah, you mentioned research 

771
00:44:21,990 --> 00:44:24,990
and I would love to know what 
research has been done on Troth 

772
00:44:24,990 --> 00:44:28,510
and what have they found in 
terms of like if someone comes 

773
00:44:28,510 --> 00:44:33,230
in with say a 25 degree 
curvature, what is Troth able to

774
00:44:33,230 --> 00:44:36,230
do in terms of changing that 
curve over the long term? 

775
00:44:37,230 --> 00:44:38,630
Yeah. 
So good question. 

776
00:44:40,110 --> 00:44:43,950
Sandra Schreiber and Eric Pront 
and their team. 

777
00:44:44,670 --> 00:44:46,950
They have one of one of the 
leading studies. 

778
00:44:47,730 --> 00:44:51,370
And it's the effects of Schroth 
exercises added to the standard 

779
00:44:51,370 --> 00:44:55,370
of care on the quality of life 
and the muscle endurance in 

780
00:44:55,810 --> 00:44:58,490
adolescence with idiopathic 
scoliosis. 

781
00:44:59,730 --> 00:45:04,530
And it's a blinded, controlled, 
randomized trial. 

782
00:45:05,610 --> 00:45:08,450
And it was. 
It was an awarded an award at 

783
00:45:08,450 --> 00:45:13,610
the social conference in 2015, 
and what they found was that 

784
00:45:13,610 --> 00:45:17,870
after three months. 
Of Schross in a group of of 

785
00:45:17,870 --> 00:45:22,630
adolescents between the ages of 
1810 and 18 and curve patterns 

786
00:45:22,630 --> 00:45:27,110
between the the cob angle 
between 10 and 45 degrees. 

787
00:45:28,190 --> 00:45:32,190
They found that their back 
muscle endurance and their their

788
00:45:32,190 --> 00:45:34,710
endurance to hold the 
corrections and have endurance 

789
00:45:34,710 --> 00:45:39,950
in your spine increased by 
holding by 32 seconds and the 

790
00:45:39,950 --> 00:45:41,870
control group without the 
Schross. 

791
00:45:42,300 --> 00:45:45,820
Were only to able to control 
their muscle endurance in their 

792
00:45:45,820 --> 00:45:49,820
back by 4.8 seconds. 
So that's a huge, you know, 

793
00:45:49,820 --> 00:45:54,180
number on just how you can 
measure muscle, you know muscle 

794
00:45:54,180 --> 00:45:56,460
endurance. 
And they also have found we do 

795
00:45:56,460 --> 00:46:03,220
what's called an SRS-22 and it 
is a patient reported functional

796
00:46:03,820 --> 00:46:07,260
pain, self-image, mental 
illness, satisfaction. 

797
00:46:09,110 --> 00:46:13,270
Survey that we give all actually
we give all of our patients but 

798
00:46:13,270 --> 00:46:17,430
they did it in the same study 
and the and the questionnaire 

799
00:46:17,430 --> 00:46:23,270
found very big results with the 
patients that underwent the 

800
00:46:23,270 --> 00:46:33,150
three months of shot specific. 
PT versus the numbers actually 

801
00:46:33,150 --> 00:46:37,150
went down in kids that didn't do
straw specific their their 

802
00:46:37,150 --> 00:46:39,550
qualities. 
So and that's just one of the 

803
00:46:39,550 --> 00:46:46,910
studies, another study by Peru 
and Yendell and and they're 

804
00:46:47,270 --> 00:46:50,390
they're, they did more of a 
study on the threedimensional 

805
00:46:50,390 --> 00:46:53,880
straw exercises. 
Another randomized controlled 

806
00:46:53,880 --> 00:47:00,880
study and they found that in 
that the programs had to be well

807
00:47:00,880 --> 00:47:06,440
planned and individualized 
shruff programs supervised and a

808
00:47:06,440 --> 00:47:09,360
home exercise without the 
supervision for for the first 

809
00:47:09,360 --> 00:47:14,600
three months was not actually 
effective at all in treating in 

810
00:47:14,840 --> 00:47:18,720
adolescent idiopathic scoliosis.
And they did. 

811
00:47:19,290 --> 00:47:24,090
They did find that curvature is 
definitely going to progress in 

812
00:47:24,090 --> 00:47:27,410
adolescence. 
It's inevitable, but the rate of

813
00:47:27,410 --> 00:47:30,730
progression was less with the 
shot exercises. 

814
00:47:30,730 --> 00:47:35,850
So there's a lot of studies out 
there, very similar, but you do 

815
00:47:35,850 --> 00:47:38,410
need that plan, you really 
right? 

816
00:47:39,050 --> 00:47:41,510
You really need the guidance, 
Yeah, yeah. 

817
00:47:41,510 --> 00:47:44,670
You can't just go on the 
Internet and find exercises for 

818
00:47:44,670 --> 00:47:47,030
scoliosis and expect to get you.
Really can't. 

819
00:47:47,390 --> 00:47:50,830
I mean you can do some some 
general habit changing things 

820
00:47:50,830 --> 00:47:55,030
and definitely you know in this 
we talked a little bit in the 

821
00:47:55,030 --> 00:47:57,990
beginning the scientific 
exercise approach to scoliosis 

822
00:47:57,990 --> 00:48:00,510
say as out of Italy. 
I mean, they've done a lot of 

823
00:48:00,510 --> 00:48:05,510
researches, Negrini and their 
team about just being active. 

824
00:48:06,240 --> 00:48:09,520
Has an effect on decreasing the 
severity and the cob angle. 

825
00:48:09,520 --> 00:48:14,120
So kids that are active versus 
kids that are sedentary have 

826
00:48:14,120 --> 00:48:19,640
less in general or less cob 
angle, so being active is 

827
00:48:19,640 --> 00:48:21,400
important. 
Doesn't have an effect on maybe 

828
00:48:21,400 --> 00:48:23,280
changing the curve as much. 
Maybe not. 

829
00:48:23,280 --> 00:48:31,360
But but being an active person 
and and athlete and student has 

830
00:48:31,880 --> 00:48:33,080
huge benefits. 
Yeah. 

831
00:48:33,320 --> 00:48:34,120
Makes sense. 
Yeah. 

832
00:48:34,560 --> 00:48:38,440
So if somebody wanted to see a 
Shroth practitioner and wasn't 

833
00:48:38,440 --> 00:48:41,800
lucky enough to live here in 
Connecticut and go see you or 

834
00:48:41,800 --> 00:48:44,240
one of your excellent 
colleagues, is there like a 

835
00:48:44,240 --> 00:48:47,960
database where people can find? 
There is, yeah. 

836
00:48:48,920 --> 00:48:53,080
The BSPTS is the school that I 
was trained in. 

837
00:48:53,080 --> 00:48:56,440
It's the Barcelona Scoliosis 
Physical Therapy School. 

838
00:48:57,260 --> 00:49:01,580
And they have a database, a PT 
directory and it can tell you 

839
00:49:01,700 --> 00:49:05,420
you know you could you look it 
up, you pick your state, you'll 

840
00:49:05,420 --> 00:49:08,260
see my name in Connecticut and 
it'll tell you if they're level,

841
00:49:08,260 --> 00:49:12,580
what level they're certified to.
So the the old school was 2 

842
00:49:12,580 --> 00:49:15,180
levels. 
They recently just changed 

843
00:49:15,180 --> 00:49:18,130
their. 
Their school structure, so 

844
00:49:18,130 --> 00:49:20,570
there's three levels, it's all 
the same information, they just 

845
00:49:20,570 --> 00:49:24,410
spread it out differently. 
And SSOL is a school year 

846
00:49:24,410 --> 00:49:27,370
assistance by online learning, 
even though it's under online 

847
00:49:27,370 --> 00:49:31,810
learning, they are, they do in 
person training just like the 

848
00:49:31,810 --> 00:49:33,850
Barcelona. 
They have also their own PG 

849
00:49:33,850 --> 00:49:37,610
directory by state. 
So, you know, you do want to get

850
00:49:37,610 --> 00:49:40,050
somebody that's certified. 
Yeah, definitely. 

851
00:49:40,330 --> 00:49:43,610
And we'll throw those links into
the show for our listeners, if 

852
00:49:43,610 --> 00:49:46,670
you want to check those out. 
All right. 

853
00:49:46,670 --> 00:49:49,390
So now I want to move on to 
talking about running with 

854
00:49:49,390 --> 00:49:53,350
scoliosis, because I think there
are a lot of people who think 

855
00:49:53,350 --> 00:49:56,590
that if you have scoliosis, you 
can't run, which is not true. 

856
00:49:56,950 --> 00:50:00,950
So can you talk a little bit 
about, if you're a runner and 

857
00:50:00,950 --> 00:50:04,910
you have scoliosis, what are 
some things to consider in terms

858
00:50:04,950 --> 00:50:09,470
of exercise, just preventative 
measures? 

859
00:50:09,710 --> 00:50:12,230
What do you do with the runners 
that you see in your clinic? 

860
00:50:12,630 --> 00:50:16,470
I mean so. 
I assess everybody's strength, 

861
00:50:17,270 --> 00:50:20,190
obviously. 
I watch them run, I watch them 

862
00:50:20,190 --> 00:50:25,590
walk with or without scoliosis. 
And what we typically see is, 

863
00:50:25,590 --> 00:50:29,070
you know some, some pelvis 
weaknesses, whether it's the 

864
00:50:29,070 --> 00:50:32,510
glute meat or the glute glutes 
or you know some of the 

865
00:50:32,510 --> 00:50:36,360
abdominal muscles, but. 
If somebody has a school the 

866
00:50:36,400 --> 00:50:39,560
assist, a lot of times they're 
pelvis 3 out of the four curve 

867
00:50:39,560 --> 00:50:42,760
patterns, their pelvis will 
shift to one way or the other, 

868
00:50:42,760 --> 00:50:48,360
and with the shift that the 
curve has given the person, the 

869
00:50:48,360 --> 00:50:50,640
curve drove the patient to have 
the shift. 

870
00:50:52,120 --> 00:50:54,480
You want to strengthen the 
pelvis so you would watch them, 

871
00:50:54,680 --> 00:50:57,320
you know stand on one foot, 
which you would probably do with

872
00:50:57,320 --> 00:51:00,520
runners that are not don't have 
scoliosis and and check their 

873
00:51:00,520 --> 00:51:04,640
stability there. 
So you would develop a plan and 

874
00:51:04,640 --> 00:51:08,360
a program that had them watch 
what their pelvis was doing. 

875
00:51:08,360 --> 00:51:11,000
You know, it could be simple 
exercises such as bridges, but 

876
00:51:11,000 --> 00:51:14,360
if every time you do your 
bridge, one hip is going. 

877
00:51:15,240 --> 00:51:20,120
Higher than the other or more, 
you're getting more out of it 

878
00:51:20,120 --> 00:51:22,360
than what's happening to that 
other other side. 

879
00:51:22,360 --> 00:51:23,600
You're not getting that 
activation. 

880
00:51:23,600 --> 00:51:27,360
So we use a lot of things like 
dowels to put on their hips to 

881
00:51:27,360 --> 00:51:29,560
see where they're at as far as 
while they're doing their 

882
00:51:29,560 --> 00:51:31,440
exercises. 
If it's not a short specific 

883
00:51:31,440 --> 00:51:37,440
exercise, you know, and we we 
give them up towards exercises 

884
00:51:37,440 --> 00:51:42,800
that are promoting their curve 
to be more neutral as well with.

885
00:51:43,230 --> 00:51:47,710
As well as maintaining their 
corrections, such as exercises 

886
00:51:47,710 --> 00:51:49,630
as hip abduction. 
But if you're doing a hip 

887
00:51:49,630 --> 00:51:52,190
abduction exercise, which is 
bringing that leg out to the 

888
00:51:52,190 --> 00:51:56,590
side and your whole spine is 
shifting while you do it, well, 

889
00:51:56,590 --> 00:51:58,830
you're probably going into your 
shift. 

890
00:51:58,870 --> 00:52:02,670
And so you want to manage that. 
So you know you learn how to be 

891
00:52:02,670 --> 00:52:06,670
in your corrections while you do
squats while you do. 

892
00:52:06,670 --> 00:52:09,910
So if you're squatting and your 
one tush is going down and your 

893
00:52:09,910 --> 00:52:12,510
your your buttock is sinking, 
you know you want to use that 

894
00:52:12,510 --> 00:52:16,390
mirror. 
So after doing the Schroth 

895
00:52:16,390 --> 00:52:19,550
program, I would, you know, I I 
would have them do more of like 

896
00:52:19,670 --> 00:52:21,990
you know, the things that all 
runners need to be doing. 

897
00:52:21,990 --> 00:52:26,390
You know deadlifts, single leg 
deadlifts and squats and lateral

898
00:52:26,390 --> 00:52:30,670
step downs and single leg stance
and and then hopping on and off 

899
00:52:30,670 --> 00:52:32,710
the wall bar to get that 
elongation. 

900
00:52:35,210 --> 00:52:38,490
And also then you know going 
into what where they're 

901
00:52:38,490 --> 00:52:41,810
breathing is at. 
So you know, encouraging them to

902
00:52:41,810 --> 00:52:46,330
expand into those concavities 
and into those places to get the

903
00:52:46,330 --> 00:52:50,650
most that you can out of your 
lungs and and preventing that 

904
00:52:50,650 --> 00:52:55,250
collapse so that you're you're 
becoming more efficient with 

905
00:52:55,250 --> 00:52:59,400
your own. 
But that's all about efficiency.

906
00:52:59,800 --> 00:53:01,520
And that it is and we can get 
into that. 

907
00:53:01,520 --> 00:53:06,040
But you know watching the pelvis
is is huge. 

908
00:53:06,040 --> 00:53:09,960
And one of the things that I, I 
ask all all my patients and 

909
00:53:09,960 --> 00:53:13,160
clients is you know if you are a
student and you're running in 

910
00:53:13,160 --> 00:53:16,560
college or high school or you're
you work at a job or you're 

911
00:53:16,560 --> 00:53:19,520
sitting at a desk. 
We sit more than than we 

912
00:53:19,520 --> 00:53:21,680
probably wish we were. 
We probably wish we were running

913
00:53:21,680 --> 00:53:24,280
all day. 
But if your pelvis is is, you 

914
00:53:24,280 --> 00:53:25,720
want to think of it like a 
bucket. 

915
00:53:26,170 --> 00:53:29,650
So if your pelvis is dumping 
backwards and you'd think that, 

916
00:53:29,690 --> 00:53:32,130
you know, you'd imagine that 
water dumping out the back of 

917
00:53:32,130 --> 00:53:36,090
your pelvis, you're sitting in 
that real posterior pelvic 

918
00:53:36,090 --> 00:53:38,130
shift. 
You know, you don't want to sit 

919
00:53:38,130 --> 00:53:40,490
like that all day. 
You just put then, you know, 

920
00:53:40,490 --> 00:53:43,370
shortened some muscles and 
elongated others and you lived 

921
00:53:43,370 --> 00:53:47,450
there for 30 minutes to four 
hours plus, you know. 

922
00:53:47,730 --> 00:53:51,210
So thinking about where your 
pelvis in that sense, not just 

923
00:53:51,210 --> 00:53:53,650
the side shifting but the the 
pelvis. 

924
00:53:54,400 --> 00:53:58,200
In the same sense, you know, 
bringing it back to running, if 

925
00:53:58,200 --> 00:54:01,320
we are getting, we're feeling 
tired at the end of a long run 

926
00:54:01,320 --> 00:54:05,400
and our pelvis shifts and dumps 
forward and we're not, you know,

927
00:54:05,400 --> 00:54:08,680
maintaining that abdominal 
recruitment now you're going to 

928
00:54:08,680 --> 00:54:12,440
lose all this energy and you're 
going to, you know. 

929
00:54:13,160 --> 00:54:16,000
Your back will get tight. 
You're probably taking deep 

930
00:54:16,000 --> 00:54:19,080
breaths into these accessory 
muscles because now your your 

931
00:54:19,080 --> 00:54:22,240
diaphragm, which we haven't dove
into very much today, but you 

932
00:54:22,360 --> 00:54:25,080
should. 
The diaphragm is conditioned in 

933
00:54:25,200 --> 00:54:30,240
in a in a less advantageous way.
So you can't recruit this 

934
00:54:30,240 --> 00:54:33,720
breathing muscle that we have 
and we end up using our 

935
00:54:33,720 --> 00:54:36,160
accessory muscles. 
I mean, how many runners have? 

936
00:54:36,740 --> 00:54:40,020
Tight necks and tight backs, you
know, because we're not moving 

937
00:54:40,020 --> 00:54:42,700
our middle, you know, So if you 
don't move your middle and your 

938
00:54:42,700 --> 00:54:46,300
ribs, your spine, your your 
cervical spine and your lumbar 

939
00:54:46,300 --> 00:54:49,540
spine will take the load and 
you're just not going to be as 

940
00:54:49,540 --> 00:54:52,700
efficient. 
And we certainly want, want to 

941
00:54:52,700 --> 00:54:56,660
be efficient. 
We're going to get to the 

942
00:54:56,660 --> 00:54:58,460
diaphragm. 
And actually, I think we could 

943
00:54:58,460 --> 00:55:02,420
have made an entire episode just
talking about the respiratory 

944
00:55:02,420 --> 00:55:05,660
diaphragm, but we'll try to hit 
on the key. 

945
00:55:07,290 --> 00:55:10,610
For runners with scoliosis, 
though, is there anything that 

946
00:55:10,610 --> 00:55:17,130
you tend to see with them? 
Is it more common to have pain, 

947
00:55:17,130 --> 00:55:21,290
let's say, in the knee or the 
ankle or the hip because of that

948
00:55:21,290 --> 00:55:24,210
curvature? 
And if So, what should those 

949
00:55:24,210 --> 00:55:26,290
runners do? 
So. 

950
00:55:27,490 --> 00:55:30,290
Like I said, there's curve 
patterns that the pelvis shifts.

951
00:55:30,290 --> 00:55:34,930
So if your pelvis is shifting to
one side, then you often you 

952
00:55:34,930 --> 00:55:36,970
could have knee pain on either 
side. 

953
00:55:36,970 --> 00:55:38,810
It depends. 
You know, I don't always see one

954
00:55:38,810 --> 00:55:42,890
particular side, but if your 
pelvis is shifting, your femurs 

955
00:55:42,890 --> 00:55:45,410
are going with it. 
Your femurs are your bones that 

956
00:55:45,450 --> 00:55:48,450
are connecting to your knees. 
So I do see and I was thinking 

957
00:55:48,450 --> 00:55:49,970
of that high school runner that 
I saw. 

958
00:55:50,810 --> 00:55:52,090
Who didn't know he had 
scoliosis? 

959
00:55:52,130 --> 00:55:55,130
I mean, you know, Patella 
femoral, you know, you know, we 

960
00:55:55,130 --> 00:55:57,890
talk a lot about, you know, in 
running Patella femoral issues 

961
00:55:57,890 --> 00:56:00,770
or IT band issues or greater 
trochanter bursitises. 

962
00:56:01,730 --> 00:56:05,930
So if you have this deviation, 
your tendons and ligaments and 

963
00:56:06,090 --> 00:56:09,850
muscles are set up to work in a 
specific alignment. 

964
00:56:10,130 --> 00:56:14,370
If it's deviated too much, you 
know you're going to develop. 

965
00:56:14,900 --> 00:56:18,980
Overuse in those areas that are 
just getting, you know, a strain

966
00:56:18,980 --> 00:56:22,100
from not being in that alignment
and it all the way goes down 

967
00:56:22,100 --> 00:56:24,380
which could totally be another 
broadcast all the way down to 

968
00:56:24,380 --> 00:56:26,460
the foot. 
So if your pelvis is shifted and

969
00:56:26,460 --> 00:56:28,900
then you know your your foot's 
only strong is what your pelvis 

970
00:56:28,900 --> 00:56:31,300
can manage. 
But if you have to work you have

971
00:56:31,300 --> 00:56:33,740
to check it all out. 
But if your pelvis is shifted 

972
00:56:33,740 --> 00:56:36,340
and your knee? 
You know you want to watch your 

973
00:56:36,340 --> 00:56:39,940
knee in the mirror when you're 
doing some of these exercises 

974
00:56:39,940 --> 00:56:43,220
that we already discussed. 
Or you want to, you know, put 

975
00:56:43,660 --> 00:56:46,940
videotape yourself running or or
have somebody watch you run. 

976
00:56:47,180 --> 00:56:50,220
If your knee is diving in 
because your pelvis is shifting 

977
00:56:50,620 --> 00:56:53,900
well, you could do quad sets and
you know some, even some squats 

978
00:56:53,900 --> 00:56:55,900
to the cows come home. 
But if you're bringing your, not

979
00:56:55,900 --> 00:56:58,540
bringing your pelvis back 
underneath your ribs, it's going

980
00:56:58,540 --> 00:57:01,100
to come back. 
Right. 

981
00:57:01,180 --> 00:57:04,820
So so I, you know it's it's just
kind of fine tuning those areas 

982
00:57:04,860 --> 00:57:09,420
that need more strength and 
support and alignment so that 

983
00:57:09,420 --> 00:57:11,820
you're not getting the overuse 
of the tendons. 

984
00:57:11,820 --> 00:57:15,500
So the knee injuries most of the
time, either coming from the 

985
00:57:15,500 --> 00:57:20,980
foot or the pelvis, yes, and and
the knee is often the victim of 

986
00:57:21,180 --> 00:57:23,060
the joints above or below it. 
Exactly. 

987
00:57:23,380 --> 00:57:27,140
So that's really common in 
people with scoliosis, but it's 

988
00:57:27,180 --> 00:57:29,460
also really common in people 
that don't have scoliosis 

989
00:57:29,460 --> 00:57:32,190
because. 
It's hard to control our pelvis 

990
00:57:32,190 --> 00:57:34,150
every moment of every step that 
we take. 

991
00:57:34,550 --> 00:57:39,070
And that's right. 
Yeah, I think that's a really 

992
00:57:39,070 --> 00:57:42,310
good general point. 
And we talk about this very 

993
00:57:42,310 --> 00:57:43,790
often here at Doctors of 
Running. 

994
00:57:43,790 --> 00:57:46,470
But you have to look at proximal
control. 

995
00:57:46,470 --> 00:57:50,160
So the pelvis and the spine. 
If you know you've had an 

996
00:57:50,160 --> 00:57:53,480
Achilles problem for three years
and nothing you're doing is 

997
00:57:53,480 --> 00:57:56,680
helping, well, maybe you need to
look higher up to see what's 

998
00:57:56,680 --> 00:57:59,440
going on there. 
And that should really be the 

999
00:57:59,440 --> 00:58:02,600
case. 
For every problem a person has, 

1000
00:58:03,080 --> 00:58:06,280
look at the whole kinetic chain,
not just the area that is 

1001
00:58:06,280 --> 00:58:09,320
hurting. 
Yeah, So, so, yeah, I would say,

1002
00:58:09,400 --> 00:58:11,560
you know it is very similar to 
everybody else. 

1003
00:58:11,560 --> 00:58:15,800
It's just that they're. 
You're you're have more I guess 

1004
00:58:16,000 --> 00:58:19,920
more of a chance of developing, 
you know some of these types. 

1005
00:58:19,960 --> 00:58:22,520
But I I don't always. 
I don't, you know. 

1006
00:58:22,520 --> 00:58:25,240
But like I said, somebody walks 
in my door they've seen a lot of

1007
00:58:25,240 --> 00:58:27,320
Peaches. 
They they'd end up having a 

1008
00:58:27,360 --> 00:58:30,200
little, a little scoliosis, a 
little curvature and they didn't

1009
00:58:30,200 --> 00:58:32,720
know it and it's been wreaking 
havoc on them for a while. 

1010
00:58:32,880 --> 00:58:37,000
So yeah. 
So are there any exercises or 

1011
00:58:37,200 --> 00:58:41,480
interventions that runners or 
people with scoliosis in general

1012
00:58:41,480 --> 00:58:46,350
should avoid? 
So one of the things that is is 

1013
00:58:46,350 --> 00:58:51,150
discussed is the aspect of 
rotation. 

1014
00:58:51,150 --> 00:58:55,150
So we all need some degree of 
rotation to be efficient with a 

1015
00:58:55,150 --> 00:58:58,350
running and you want to take 
advantage of all that that 

1016
00:58:58,350 --> 00:59:01,310
natural rotation or when you 
have scoliosis you have too much

1017
00:59:01,310 --> 00:59:05,630
rotation. 
So we avoid excessive rotation. 

1018
00:59:05,630 --> 00:59:09,130
We do. 
You know, if somebody walks in 

1019
00:59:09,130 --> 00:59:12,850
my door and they love yoga, you 
know, I just try to have them 

1020
00:59:12,850 --> 00:59:17,050
modify the exercises so that 
they're not hanging out in their

1021
00:59:17,050 --> 00:59:22,280
extreme rotations for too long. 
I have to say, so we just avoid 

1022
00:59:22,280 --> 00:59:25,560
you know over and you know just 
like the flex postures, you 

1023
00:59:25,560 --> 00:59:28,880
know, I we avoid sit ups. 
Sit ups are just not you know, 

1024
00:59:28,880 --> 00:59:31,960
you're forcing yourself into a 
flex position. 

1025
00:59:32,240 --> 00:59:35,320
I do not let my kids, you know 
and if they're taking the PE 

1026
00:59:35,320 --> 00:59:38,320
class test and it's one day, you
know as long as they're not in 

1027
00:59:38,320 --> 00:59:39,680
pain. 
I said One day is not going to, 

1028
00:59:39,760 --> 00:59:43,110
you know, really. 
You know, damage your spine, but

1029
00:59:43,710 --> 00:59:48,150
you know, avoiding over flexion 
for the upper curves, you know, 

1030
00:59:48,150 --> 00:59:52,430
we do try to avoid like 
prolonged extension, you know, 

1031
00:59:52,430 --> 00:59:55,150
if they have a lumbar disc 
something we treat them, you 

1032
00:59:55,150 --> 00:59:58,820
know, with our traditional. 
You know, lumbar, extensive type

1033
00:59:58,820 --> 01:00:01,620
exercises. 
But rotation is our big concern 

1034
01:00:01,620 --> 01:00:05,420
because you're already rotated 
in segments more than you need 

1035
01:00:05,420 --> 01:00:08,660
to be. 
And even in my experience with 

1036
01:00:08,660 --> 01:00:11,260
not knowing that I had some 
curvature, I loved yoga and I 

1037
01:00:11,260 --> 01:00:13,540
loved the way rotation felt. 
I pushed myself. 

1038
01:00:13,580 --> 01:00:16,900
I was, you know, trying to get 
all that and and that actually, 

1039
01:00:16,900 --> 01:00:20,420
I think that's what set me up 
for some of my personal failures

1040
01:00:20,420 --> 01:00:25,100
with running was that I I ended 
up rotating so much that I 

1041
01:00:25,140 --> 01:00:28,560
caused these. 
Excessive shifts and rotations 

1042
01:00:28,560 --> 01:00:30,280
in my screen. 
So that's just my personal 

1043
01:00:30,280 --> 01:00:34,360
journey. 
But there are people that do 

1044
01:00:34,360 --> 01:00:37,360
yoga and have scoliosis and 
they're not limited and they 

1045
01:00:37,360 --> 01:00:40,080
don't have pain. 
So it's pretty individualized. 

1046
01:00:40,960 --> 01:00:45,120
I think you're back. 
It's pretty individualized, but 

1047
01:00:45,120 --> 01:00:49,080
that's that's the sense of of 
just avoiding extreme rotation. 

1048
01:00:49,240 --> 01:00:51,680
Yeah, great. 
Thank you for that, but I I do 

1049
01:00:51,800 --> 01:00:53,400
not tell my kids that are 
gymnasts. 

1050
01:00:53,400 --> 01:00:55,840
If they have that you play your 
sport. 

1051
01:00:55,920 --> 01:00:59,040
You know, maybe we modify few 
things, but you you I want them 

1052
01:00:59,040 --> 01:01:03,400
to enjoy their activities. 
So let's talk a little bit about

1053
01:01:03,400 --> 01:01:06,520
the importance of spinal 
mobility and rim mobility for 

1054
01:01:06,520 --> 01:01:09,430
all runners. 
I think we tend to just focus on

1055
01:01:09,430 --> 01:01:12,590
our legs and forget about the 
other half of our body, but the 

1056
01:01:12,590 --> 01:01:16,630
other half is just as important 
for proper running gait and 

1057
01:01:16,630 --> 01:01:21,790
efficient running pattern. 
So can just give us a brief 

1058
01:01:21,790 --> 01:01:26,270
overview of what role the spine 
and the ribs and the pelvis play

1059
01:01:26,270 --> 01:01:31,110
in running gait, what are they 
doing in stance and swing phase 

1060
01:01:31,950 --> 01:01:34,950
and what are some common 
deviations that we might see in 

1061
01:01:34,950 --> 01:01:39,080
runners. 
So, so each vertebrae in our 

1062
01:01:39,080 --> 01:01:43,240
thoracic spine should have about
3 degrees of rotation. 

1063
01:01:43,440 --> 01:01:46,240
We have 12 of them. 
So you should get about, you 

1064
01:01:46,240 --> 01:01:49,720
know, we should have you know 
around 30 degrees or more 

1065
01:01:49,720 --> 01:01:52,360
rotation in our in our thoracic 
spine. 

1066
01:01:52,360 --> 01:01:56,520
And we need that to get 
ourselves to have that 

1067
01:01:56,520 --> 01:02:00,990
reciprocal pattern. 
And just like at the pelvis, you

1068
01:02:00,990 --> 01:02:04,270
know, we need to have that 
reciprocal motion so that we can

1069
01:02:04,270 --> 01:02:07,910
open up and expand and get into 
the lower extremity extension. 

1070
01:02:09,400 --> 01:02:12,920
But our our ribs have a lot of 
movement and they get the they 

1071
01:02:12,960 --> 01:02:16,640
get often on the back burner. 
And if we don't have, you know 

1072
01:02:16,640 --> 01:02:20,160
the ribs connect to the front of
the sternum and into the back of

1073
01:02:20,160 --> 01:02:25,160
the spine in the thoracic spine.
And if the ribs don't have good 

1074
01:02:25,440 --> 01:02:29,680
excursion or lateral movement, 
our lower ribs move sort of like

1075
01:02:29,680 --> 01:02:35,860
a bucket handle, we we lose our 
efficiency. 

1076
01:02:35,860 --> 01:02:38,460
So if they're tight and I'm not 
sure, I just want to make sure 

1077
01:02:38,460 --> 01:02:43,700
you guys can hear me because 
your screen is so we lose that 

1078
01:02:43,700 --> 01:02:47,660
we, you know, as we run and as 
we get older we do, we get tight

1079
01:02:47,660 --> 01:02:49,740
in our rib cage, we take a lot 
of breaths. 

1080
01:02:49,780 --> 01:02:54,220
I mean we are breathing you 
know, you know significant high,

1081
01:02:54,300 --> 01:02:59,820
high amounts and and that force 
with especially with a faster 

1082
01:02:59,820 --> 01:03:03,580
run or longer runs and if we're 
not getting those ribs to 

1083
01:03:03,580 --> 01:03:08,340
laterally deviate then you're 
going to push the, you know, 

1084
01:03:08,380 --> 01:03:10,900
you're going to push that loss 
of motion into the cervical 

1085
01:03:10,900 --> 01:03:14,500
spine of the lumbar spine. 
And if we use our diaphragm, if 

1086
01:03:14,500 --> 01:03:18,660
you think of the diaphragm, it's
a Dome underneath the rib cage 

1087
01:03:19,020 --> 01:03:22,060
and it connects into the front 
of the ribs, into the sides of 

1088
01:03:22,060 --> 01:03:26,650
the ribs, into your back. 
And, you know, I would take 

1089
01:03:26,650 --> 01:03:29,130
another moment and ask 
everybody, you know, take a nice

1090
01:03:29,130 --> 01:03:33,170
deep breath and where does your 
body move? 

1091
01:03:33,170 --> 01:03:36,370
And if you're not getting some 
movement into the sides of your 

1092
01:03:36,370 --> 01:03:38,890
ribs, then you're probably not 
using your diaphragm very 

1093
01:03:38,890 --> 01:03:42,010
efficiently. 
And if you're not doing that 

1094
01:03:42,010 --> 01:03:45,210
when you're sitting, how imagine
that you you're probably not 

1095
01:03:45,210 --> 01:03:48,700
doing that while you're running.
So when you know, and I think 

1096
01:03:48,700 --> 01:03:51,780
that you know, going back to 
yoga, that we've learned about 

1097
01:03:51,780 --> 01:03:54,780
belly breathing, it's a little 
bit oversimplified because you 

1098
01:03:54,780 --> 01:03:57,780
don't want to just push air into
the front of your abdomen. 

1099
01:03:58,140 --> 01:04:02,380
You need the ribs to move. 
So when you take a full inhale, 

1100
01:04:02,660 --> 01:04:05,380
your diaphragm is dropping, 
you're filling up your lungs and

1101
01:04:05,380 --> 01:04:09,140
those ribs need to move outward.
And that's one of the things 

1102
01:04:09,140 --> 01:04:12,380
that I think we got back to 
Shroff is that stability comes 

1103
01:04:12,380 --> 01:04:16,700
from that expansion moment that 
we have when we inhale. 

1104
01:04:16,700 --> 01:04:21,500
We're using it again as a tool. 
And so if you can open up those 

1105
01:04:21,500 --> 01:04:26,620
ribs, you get more oxygen to the
places, you know, it's not just 

1106
01:04:26,620 --> 01:04:30,140
oxygen, but you're getting more 
use of other areas in your 

1107
01:04:30,140 --> 01:04:33,020
lungs. 
You can probably hang out and 

1108
01:04:33,020 --> 01:04:39,430
run longer without without 
compensating and without losing 

1109
01:04:39,430 --> 01:04:41,910
the pelvis. 
So if we lose that, you may have

1110
01:04:41,910 --> 01:04:44,590
some extra pressure down into 
your pelvis, you may have some 

1111
01:04:44,590 --> 01:04:47,350
neck, you know trouble. 
And if you're not getting the 

1112
01:04:47,510 --> 01:04:51,110
ribs to move laterally your 
pelvis, you might get these 

1113
01:04:51,110 --> 01:04:52,750
dumps in your pelvis. 
And those are one of the 

1114
01:04:52,750 --> 01:04:56,710
patterns that we often see is 
you know the leg that's 

1115
01:04:56,710 --> 01:04:59,990
stabilizing you while you're on 
your stance phase needs that 

1116
01:04:59,990 --> 01:05:04,700
stable moment of of the ribs as 
well and the abdominals on the 

1117
01:05:04,700 --> 01:05:07,700
swing phase need to hold that 
pelvis up. 

1118
01:05:07,700 --> 01:05:11,620
So if you kind of lost that 
natural pumping system of our 

1119
01:05:11,620 --> 01:05:14,900
diaphragm, your stance phase 
can't support you. 

1120
01:05:15,020 --> 01:05:17,700
You might and your abs are not 
supporting you on your swing 

1121
01:05:17,700 --> 01:05:23,170
phase you might drop and that's 
that's that that you know common

1122
01:05:23,610 --> 01:05:26,570
pattern that we see or you might
develop more of a crossover 

1123
01:05:26,570 --> 01:05:29,010
pattern because you got to get 
your foot on the ground quicker 

1124
01:05:29,450 --> 01:05:32,170
because you're not you're not 
being you're not as stable as 

1125
01:05:32,170 --> 01:05:34,730
you can be. 
So I use this, I use expansion 

1126
01:05:34,890 --> 01:05:39,490
and think of it as stability and
and finding those areas in the 

1127
01:05:39,490 --> 01:05:44,090
lungs that that we can to be 
more efficient and getting that 

1128
01:05:44,090 --> 01:05:50,720
drop on that lift which affects 
with our with our viscera and 

1129
01:05:50,720 --> 01:05:53,640
our organs. 
We rely on that diaphragm as a 

1130
01:05:53,640 --> 01:05:56,560
pump and if you don't, you know 
things breakdown. 

1131
01:05:56,600 --> 01:05:59,560
Yeah, yeah. 
The and gosh, we could do a 

1132
01:05:59,600 --> 01:06:04,120
whole segment on how all of the 
diaphragms in the body interact 

1133
01:06:04,120 --> 01:06:07,040
with each other and the movement
of them, but we'll leave that 

1134
01:06:07,040 --> 01:06:10,000
for another time. 
But I think something people 

1135
01:06:10,000 --> 01:06:13,130
might think about is if. 
The diaphragm pump isn't working

1136
01:06:13,130 --> 01:06:15,130
correctly. 
That's going to end up putting 

1137
01:06:15,370 --> 01:06:20,090
abnormal pressure on your pelvic
diaphragm and runners who might 

1138
01:06:20,090 --> 01:06:23,810
experience urinary incontinence 
when running jumping. 

1139
01:06:25,170 --> 01:06:27,970
Looking at the respiratory 
diaphragm can actually be quite 

1140
01:06:27,970 --> 01:06:32,450
helpful in addressing those 
incontinence symptoms, yeah, for

1141
01:06:32,570 --> 01:06:33,730
sure. 
Yeah, yeah. 

1142
01:06:35,090 --> 01:06:39,060
So that was I think. 
The information about just the 

1143
01:06:39,060 --> 01:06:42,620
lateral rib cage expansion is so
helpful for people. 

1144
01:06:42,620 --> 01:06:45,620
So that would be a simple thing 
for them to work on is to just 

1145
01:06:45,940 --> 01:06:49,740
put their hands on the sides of 
their rib cage and work on 

1146
01:06:49,740 --> 01:06:53,660
getting that outward expansion 
instead of just focusing on 

1147
01:06:53,660 --> 01:06:58,820
belly breathing. 
Let's just very briefly talk a 

1148
01:06:58,820 --> 01:07:01,020
little bit about the sacroiliac 
joint. 

1149
01:07:01,510 --> 01:07:04,550
And its relationship to the 
spine and lower extremities, 

1150
01:07:04,550 --> 01:07:08,190
because I think that that's 
another overlooked thing in 

1151
01:07:08,190 --> 01:07:10,870
evaluating runners. 
But it can be a source of pain 

1152
01:07:11,150 --> 01:07:13,310
at the SI joint. 
It can be a source of pain 

1153
01:07:13,310 --> 01:07:16,710
elsewhere. 
So just tell our listeners what 

1154
01:07:16,710 --> 01:07:19,950
the SI joint is and a little bit
about what it does and how it 

1155
01:07:19,950 --> 01:07:25,030
influences our case. 
Yeah, so as I described earlier,

1156
01:07:25,030 --> 01:07:27,430
we have our lumbar spine. 
There's five segments and at the

1157
01:07:27,430 --> 01:07:31,070
base of it is the sacrum, and 
the sacrum is encompassed by the

1158
01:07:31,070 --> 01:07:33,430
pelvis. 
So where that pelvis meets the 

1159
01:07:33,430 --> 01:07:38,430
sacrum is a horseshoe shaped. 
Really there's quite a lot of 

1160
01:07:38,430 --> 01:07:40,870
surface area, more than you'd 
probably think. 

1161
01:07:40,870 --> 01:07:42,830
You really have to pull out a 
skeleton and look. 

1162
01:07:43,550 --> 01:07:49,470
But of that joint, the SI joint,
and we need the SI joint, you 

1163
01:07:49,470 --> 01:07:51,590
know, there's a lot of 
speculation that you don't need.

1164
01:07:51,630 --> 01:07:54,630
You know, we're talking 
millimeters of movement that we 

1165
01:07:54,630 --> 01:07:58,630
need there. 
But what what often happens is, 

1166
01:07:58,630 --> 01:08:02,540
you know, if we have a shift or 
we're not as stable with maybe 

1167
01:08:02,540 --> 01:08:05,700
our stance phase, you know, and 
every time you hit that leg on 

1168
01:08:05,700 --> 01:08:07,740
the ground, your other hip 
drops. 

1169
01:08:07,740 --> 01:08:12,060
I mean that SI joint is taking 
the load or it's going to freeze

1170
01:08:12,060 --> 01:08:15,860
up and not take the load to try 
to become stable and you lose 

1171
01:08:15,860 --> 01:08:18,870
millimeters of movement and that
believe it or not it's very 

1172
01:08:18,870 --> 01:08:22,550
painful. 
So you're just building pressure

1173
01:08:22,550 --> 01:08:26,910
in an area that doesn't want 
that much pressure and it can 

1174
01:08:26,910 --> 01:08:29,950
affect you know, the way that 
you activate you know the 

1175
01:08:29,950 --> 01:08:33,950
pelvis, the hip muscles, the 
deeper hip rotator muscles that 

1176
01:08:33,950 --> 01:08:37,430
cannot the sacrum to the femur 
and they they get tight. 

1177
01:08:37,430 --> 01:08:39,670
I mean who doesn't want to roll 
out their bottom when they come 

1178
01:08:39,670 --> 01:08:41,790
home from a run? 
I mean those muscles are working

1179
01:08:41,790 --> 01:08:44,189
every step we take. 
Is that going to fix all your 

1180
01:08:44,189 --> 01:08:44,990
problems? 
No. 

1181
01:08:44,990 --> 01:08:48,350
But you know it gives you some 
relief if it becomes, it's quite

1182
01:08:48,350 --> 01:08:49,990
painful. 
You may need you know somebody 

1183
01:08:49,990 --> 01:08:53,590
to assess your flexion and your 
extension and what is happening 

1184
01:08:53,590 --> 01:08:56,229
with the secret while you're 
moving, not just when you're 

1185
01:08:56,229 --> 01:08:59,870
static to see. 
And that would be a key to 

1186
01:08:59,870 --> 01:09:02,710
knowing you know if you're 
seeing the person that you need 

1187
01:09:02,710 --> 01:09:04,750
to be seeing is are they 
checking you what you look like 

1188
01:09:04,750 --> 01:09:06,910
while you're moving not just 
when you're standing there. 

1189
01:09:07,830 --> 01:09:10,870
And so you need those millimeter
movement in that joint and it's 

1190
01:09:10,910 --> 01:09:14,069
it can be very uncomfortable if 
it's not moving efficiently 

1191
01:09:14,149 --> 01:09:17,700
effectively if you don't get 
those little nice shifts to 

1192
01:09:17,899 --> 01:09:20,180
absorb the load of the run. 
Right. 

1193
01:09:20,700 --> 01:09:23,620
And because your sacroiliac 
joint is essentially the other 

1194
01:09:23,620 --> 01:09:25,420
half of your hip joint, if you 
will. 

1195
01:09:25,420 --> 01:09:29,939
Because sacroiliac joint, sacrum
and ileum, your ileum is part of

1196
01:09:29,939 --> 01:09:33,060
your hip joint. 
If your ileum isn't moving 

1197
01:09:33,060 --> 01:09:36,460
normally, or if it's not 
positioned correctly, that can 

1198
01:09:36,460 --> 01:09:39,939
affect the alignment of the hip 
joint, which then can either 

1199
01:09:39,939 --> 01:09:43,380
cause hip issues, cause Patella,
femoral issues, potentially 

1200
01:09:43,380 --> 01:09:47,359
cause foot or ankle issues, so. 
Your SI joint is essentially the

1201
01:09:47,359 --> 01:09:50,240
thing that connects your spine 
to your leg. 

1202
01:09:50,720 --> 01:09:56,000
So if it's not doing its job to 
transmit force, that force is 

1203
01:09:56,000 --> 01:09:58,440
going to go somewhere else and 
cause problems, right? 

1204
01:09:58,520 --> 01:10:00,000
Yeah. 
When I talk about the pelvis, I 

1205
01:10:00,000 --> 01:10:03,600
mean, the pelvis is the socket 
to your your femur, your hip, 

1206
01:10:03,640 --> 01:10:05,760
your your true hip joints. 
Yeah. 

1207
01:10:07,080 --> 01:10:08,960
And that's what's the essay. 
Yeah. 

1208
01:10:09,360 --> 01:10:13,840
So I loved the suggestion about 
working on lateral rib cage 

1209
01:10:13,840 --> 01:10:17,160
expansion. 
Are there any other general 

1210
01:10:17,160 --> 01:10:21,080
exercises that runners might do 
to improve their thoracic 

1211
01:10:21,080 --> 01:10:24,640
mobility? 
So going back towards some of 

1212
01:10:24,640 --> 01:10:27,760
the the hanging on the wall bar?
I mean if you get that nice 

1213
01:10:27,760 --> 01:10:30,560
length and hang you can do your 
your shrugs from there and 

1214
01:10:30,560 --> 01:10:33,280
opening it up. 
This is not a scoliosis 

1215
01:10:33,280 --> 01:10:38,800
exercise, but I do encourage my 
runners to do some kind of like 

1216
01:10:38,840 --> 01:10:41,680
a thread the needle type 
exercise where you are on your 

1217
01:10:41,680 --> 01:10:45,250
hands and knees. 
And a lot of times if you see 

1218
01:10:45,250 --> 01:10:49,410
the exercise being done, you 
think of your hand. 

1219
01:10:49,410 --> 01:10:51,490
So you're on your hands and 
knees and you're in your nice 

1220
01:10:51,490 --> 01:10:53,130
alignment. 
Your knees are underneath your 

1221
01:10:53,130 --> 01:10:56,250
hips, your hands are underneath 
your shoulders, Your neck is 

1222
01:10:56,250 --> 01:10:58,890
nice and long. 
You would slide one of your 

1223
01:10:58,890 --> 01:11:03,530
hands between your knee and your
shoulder, between your knee and 

1224
01:11:03,530 --> 01:11:06,850
your hand underneath you to get 
that rotation and and what I 

1225
01:11:06,850 --> 01:11:12,020
encourage people to do is make 
your ribs move. 

1226
01:11:12,020 --> 01:11:15,820
You don't just slide your arm 
underneath you and and sort of 

1227
01:11:15,820 --> 01:11:18,700
hope for the best. 
You take your nice deep breath 

1228
01:11:19,140 --> 01:11:22,860
and on your exhale you use the 
ribs and the muscles. 

1229
01:11:22,860 --> 01:11:25,980
We've been describing this, that
whole universal core and trunk 

1230
01:11:26,340 --> 01:11:30,030
to guide your body into that 
rotation. 

1231
01:11:30,030 --> 01:11:33,030
So and being on your hands and 
knees is a nice safe position to

1232
01:11:33,030 --> 01:11:35,750
work. 
You know, especially from so I 

1233
01:11:35,750 --> 01:11:38,030
do that thread the needle 
exercise, but again I really 

1234
01:11:38,030 --> 01:11:43,990
focus on on that rib motion, but
really I incorporate the 

1235
01:11:43,990 --> 01:11:46,950
expansion breathing into 
everything else that we do. 

1236
01:11:46,950 --> 01:11:50,110
So if you're, you know, doing 
your hamstring stretches, if 

1237
01:11:50,110 --> 01:11:54,160
you're doing your squats, you 
know it's really something that 

1238
01:11:54,160 --> 01:11:56,800
you need to do with other 
things. 

1239
01:11:56,800 --> 01:11:59,840
There's not that many specific, 
just you're just doing their 

1240
01:11:59,840 --> 01:12:02,920
breathing exercises. 
I do a lot of shoulder extension

1241
01:12:02,920 --> 01:12:06,880
pulling down it when you're 
laying on your back and you know

1242
01:12:06,880 --> 01:12:11,600
using rubber bands sort of like 
a lap pull down even you can do,

1243
01:12:11,600 --> 01:12:15,640
but you're focusing on the 
inhale and up, exhale and down. 

1244
01:12:16,400 --> 01:12:19,240
So you incorporate inhale with 
your expansion. 

1245
01:12:19,480 --> 01:12:23,560
When you're exhaling, you want 
that stability as well and you 

1246
01:12:23,560 --> 01:12:29,920
want to engage that, those 
anterior ribs bringing the ribs 

1247
01:12:29,960 --> 01:12:32,400
back inward when you're 
exhaling. 

1248
01:12:32,520 --> 01:12:37,560
So, and I do it on my slow, long
run, Slower, even shorter runs 

1249
01:12:37,560 --> 01:12:40,240
where you're not really focusing
on speed, you don't have a 

1250
01:12:40,240 --> 01:12:43,800
workout, you're not in a tempo. 
That's when you can take those 

1251
01:12:43,800 --> 01:12:45,880
nice expansion breaths and just 
count out loud. 

1252
01:12:45,880 --> 01:12:51,960
Like in 2-3, four out, 234 and 
slowing your breathing down 

1253
01:12:51,960 --> 01:12:53,560
while you're on a long a slow 
run. 

1254
01:12:53,600 --> 01:12:57,960
Yes, so. 
Yeah, and even where, you know, 

1255
01:12:58,640 --> 01:13:02,280
as a cyclist, one thing that I 
really worked on was being able 

1256
01:13:02,280 --> 01:13:04,400
to slow down my breathing while 
I was going hard. 

1257
01:13:04,400 --> 01:13:09,140
Like getting out of that like. 
Chest breathing pattern and 

1258
01:13:09,140 --> 01:13:12,420
taking slower, deeper breaths. 
Which one, makes you feel a 

1259
01:13:12,420 --> 01:13:15,060
little calmer and less like 
you're over the limit? 

1260
01:13:15,460 --> 01:13:18,500
But two, it actually has 
physiological benefits in terms 

1261
01:13:18,540 --> 01:13:23,620
of how you feel. 
Your heart rate, just your 

1262
01:13:23,620 --> 01:13:26,780
overall rate of, I mean that 
could be a whole nother podcast 

1263
01:13:26,780 --> 01:13:29,660
with the moving of the diaphragm
and the veins, nerve and your 

1264
01:13:29,660 --> 01:13:31,980
sympathetic nervous system and 
all of that, yeah. 

1265
01:13:33,820 --> 01:13:38,460
All right, we're making a list, 
but I guess. 

1266
01:13:38,540 --> 01:13:42,180
Once a month, but getting those 
ribs to move, Get those ribs to 

1267
01:13:42,180 --> 01:13:44,300
move. 
Don't don't neglect them, just 

1268
01:13:44,300 --> 01:13:46,700
incorporate it into your into 
stuff you're already doing. 

1269
01:13:46,700 --> 01:13:49,820
And if you're not doing stuff, 
do a little bit more but. 

1270
01:13:51,080 --> 01:13:51,800
Right. 
Yeah. 

1271
01:13:51,800 --> 01:13:54,680
It doesn't have to be, truly. 
It's just you gotta ignore. 

1272
01:13:54,760 --> 01:13:56,840
It, yeah, Yeah. 
Yeah. 

1273
01:13:58,040 --> 01:14:03,520
So any other, like we said, we 
could talk so much longer on so 

1274
01:14:03,520 --> 01:14:05,400
many more topics. 
But do you think there's 

1275
01:14:05,400 --> 01:14:09,240
anything we haven't touched on 
that our listeners might benefit

1276
01:14:09,240 --> 01:14:11,640
from with what we've already 
discussed today? 

1277
01:14:12,560 --> 01:14:14,490
I don't think so. 
So I mean, I don't think I got 

1278
01:14:14,490 --> 01:14:17,090
into, you know, I think I 
touched upon, you know, getting 

1279
01:14:17,090 --> 01:14:19,170
that pelvis, thinking of it like
a bucket. 

1280
01:14:19,170 --> 01:14:22,930
To me, that's pretty key when 
you're sitting, when you're 

1281
01:14:22,930 --> 01:14:27,290
running, actually, I would say 
when you're running, you know, 

1282
01:14:27,290 --> 01:14:30,730
if you notice that your pelvis 
doesn't feel like it's level, 

1283
01:14:30,730 --> 01:14:33,650
put your hands on your hips and 
say, Oh my gosh, my front of my 

1284
01:14:33,650 --> 01:14:36,210
hips are way in the my front of 
my, my pelvis. 

1285
01:14:36,210 --> 01:14:40,570
Those Iliums are tilted forward.
You know, pull them back under 

1286
01:14:40,570 --> 01:14:44,210
just a little bit and you're 
you'll make your breathing more 

1287
01:14:44,210 --> 01:14:46,890
efficient, your pelvic pelvis 
more efficient. 

1288
01:14:46,970 --> 01:14:50,170
The connections from your rib 
cage, You know, I think one 

1289
01:14:50,170 --> 01:14:52,610
thing that I didn't touch upon 
is stacking, and it's so 

1290
01:14:52,610 --> 01:14:56,330
important in shroff are set up. 
Stack your rib cage on top of 

1291
01:14:56,330 --> 01:14:59,880
your pelvis just, you know, a 
bit more and think of it while 

1292
01:14:59,880 --> 01:15:02,600
you're in the run. 
Don't let yourself get too. 

1293
01:15:02,840 --> 01:15:05,400
And it's not about being like 
super tight and rigid. 

1294
01:15:05,840 --> 01:15:09,360
It just put just acknowledge it,
bring it back to your, you know,

1295
01:15:09,560 --> 01:15:11,880
a little bit of your cognition 
of when you're out there. 

1296
01:15:11,880 --> 01:15:14,880
But if your pelvis is dumping 
forward and you really feel 

1297
01:15:14,880 --> 01:15:18,080
those front bones coming down, 
you're gonna run into trouble. 

1298
01:15:18,440 --> 01:15:20,960
And so just pull that pelvis 
back a little bit. 

1299
01:15:20,960 --> 01:15:23,440
Don't flex your spine. 
You're just going to neutral. 

1300
01:15:24,360 --> 01:15:27,320
They talk about it in the movie 
Prefontaine in kind of a funny 

1301
01:15:27,320 --> 01:15:28,880
way. 
I won't bring it up, but if you 

1302
01:15:28,880 --> 01:15:32,000
wanted to watch it, that would 
be, you know, he touches upon 

1303
01:15:32,000 --> 01:15:35,520
it. 
But yeah, just, you know, 

1304
01:15:35,560 --> 01:15:38,760
finding that pelvis underneath 
you, I think I didn't address 

1305
01:15:38,760 --> 01:15:41,000
enough with, you know, while 
you're while you're running. 

1306
01:15:41,080 --> 01:15:44,360
That's a great tip, you know, 
and maybe it would be helpful 

1307
01:15:44,360 --> 01:15:47,330
for people. 
Like check your pelvis in the 

1308
01:15:47,330 --> 01:15:51,330
first like couple miles of your 
run once you're warmed up, and 

1309
01:15:51,330 --> 01:15:54,570
then compare that to what you're
doing at the end of 100%. 

1310
01:15:54,810 --> 01:15:58,690
Because like you said, everybody
is going to have a different 

1311
01:15:59,130 --> 01:16:02,970
normal pelvis position, so 
you're not going to know what 

1312
01:16:02,970 --> 01:16:05,850
that is for you unless you feel 
it before you get tired. 

1313
01:16:06,050 --> 01:16:09,030
So that might be a good way to. 
Check yourself. 

1314
01:16:09,350 --> 01:16:11,790
I mean, I look at it this way as
like, we're willing to take 

1315
01:16:11,790 --> 01:16:16,070
supplements and vitamins and 
electrolytes and awesome shoe 

1316
01:16:16,070 --> 01:16:18,710
gear. 
You know, just pull this into 

1317
01:16:18,710 --> 01:16:21,590
just, this is just like it's 
it's pretty effective. 

1318
01:16:21,590 --> 01:16:24,310
You can be more efficient with 
just a little bit of attention. 

1319
01:16:24,830 --> 01:16:28,030
Right. 
And it's free shoes are much 

1320
01:16:28,070 --> 01:16:33,350
more expensive, right. 
All right, one last question, 

1321
01:16:33,350 --> 01:16:34,990
Jeannie. 
What shoes are you running in 

1322
01:16:34,990 --> 01:16:37,260
right now? 
Oh, gotcha. 

1323
01:16:37,380 --> 01:16:41,740
So I wear, you know I wear 
ultras. 

1324
01:16:42,780 --> 01:16:45,140
I I really like the wide toe 
box. 

1325
01:16:45,420 --> 01:16:49,540
But I'm experimenting. 
I I just bought some some 

1326
01:16:49,540 --> 01:16:55,020
sockonies that I used to wear 
and I'm I I'm going to go get 

1327
01:16:55,020 --> 01:16:58,340
the I and I wear some topo and I
don't know which ones they are, 

1328
01:16:58,340 --> 01:17:00,580
but I'm going to go get the ones
that you recommended because I 

1329
01:17:00,580 --> 01:17:03,260
think after listening. 
Oh, the cyclone? 

1330
01:17:03,260 --> 01:17:05,780
Yeah, I think that one's for me,
honestly. 

1331
01:17:06,620 --> 01:17:10,140
So, So that's my next on the 
list, but I'm kind of going back

1332
01:17:10,140 --> 01:17:12,540
and forth between some topo, 
some ultras. 

1333
01:17:12,540 --> 01:17:15,540
I I really like the wide, wide 
toe box for me. 

1334
01:17:16,420 --> 01:17:18,980
Yeah and yeah, ultras coming 
out. 

1335
01:17:19,140 --> 01:17:22,860
I think I read with a nonzero 
drop shoe soon, so I'm excited 

1336
01:17:22,860 --> 01:17:25,340
to test that one out. 
So and because I'm coming back 

1337
01:17:25,340 --> 01:17:27,940
from my engine repair, I'm just 
bringing on the mileage. 

1338
01:17:28,180 --> 01:17:31,060
I will probably listen, you 
know, and pick out a shoe when 

1339
01:17:31,060 --> 01:17:33,460
I'm back towards you know, 
gearing up for racing. 

1340
01:17:33,460 --> 01:17:37,280
But I have a whole year ahead of
me, just some nice base training

1341
01:17:37,280 --> 01:17:39,720
and. 
Yeah, yeah. 

1342
01:17:40,000 --> 01:17:42,560
Build yourself back up. 
Yeah. 

1343
01:17:43,040 --> 01:17:45,240
Awesome. 
Well, Jeannie, thank you so much

1344
01:17:45,240 --> 01:17:47,760
for joining me today. 
This has been just an awesome 

1345
01:17:47,800 --> 01:17:49,600
episode. 
I think our listeners will learn

1346
01:17:49,600 --> 01:17:52,520
a lot. 
We're going to put in the show 

1347
01:17:52,520 --> 01:17:55,000
notes where you can find Jeannie
online. 

1348
01:17:56,480 --> 01:17:59,880
Please leave us a review. 
You can find us on YouTube. 

1349
01:18:00,780 --> 01:18:05,620
Instagram, Facebook, LinkedIn, 
anywhere you find your podcasts.

1350
01:18:05,620 --> 01:18:10,180
Apple, Spotify, Anchor. 
We really appreciate your 

1351
01:18:10,180 --> 01:18:12,380
reviews. 
They help us grow as a podcast. 

1352
01:18:13,180 --> 01:18:15,060
So thank you everyone for 
listening. 

1353
01:18:15,100 --> 01:18:18,220
And thanks again, Jeannie. 
Yeah, thanks for having me. 

1354
01:18:18,220 --> 01:18:20,020
I hope to maybe run with you 
someday. 

1355
01:18:21,020 --> 01:18:23,260
Yes, let's do it. 
All right. 

1356
01:18:23,260 --> 01:18:24,460
Have a great day everyone.