The Spinal Rollercoaster

Hello. Last I left you, I promised to speak more about the spine and scoliosis, another interest which goes hand in hand with ballet. How did this interest happen? Well, after completing pre-pointe assessment after pre-pointe assessment over the years, I was finding that approximately 1 in 5 dancers I screened were presenting with scoliosis. That's a lot for such a small population of adolescents right? A simple forward bend "Adam's test" with a rotation or "hump" of 5 degrees or more flags a physiotherapist to send for further investigation. This is generally by EOS or x-ray, which ever is most available to the patient. Now these children were obviously all female, as it's only females that 'graduate' to pointe work. So I wonder how many undiagnosed growing males there are out there? It's true the prevalence of adolesent idiopathic scoliosis (AIS) is higher in females and typically occurs between the age of 10-15 with the biggest change when the female commences mensuration until what we call Risser 3. Risser is the term used for closure of the growth plates along the iliac crest or top of the pelvis. But let's stay 'enpointe' shall we..... Approximately 2 generations ago, in my parent's school era, there was mandatory scoliosis screening in Australia within schools.  Now days there are none!! NONE! So how many teenagers do you think grow into adulthood not knowing they have a spinal condition, which is actually causing them pain, and sometimes very debilitating pain. Sadly I know a few. There's an online resource from Scoliosis Australia for 'self-detection'. But honestly, who would think of actually doing this? I'll give you an example, I screened, for pre-pointe, a young 13year old girl. With no obvious curvature signs in stance, her Adam's text was 15 degrees in the upper spine and 15degrees in the lower spine. My heart raced as I knew deep down this wasn't going to be great. So as per protocol, I sent her off for a scan which returned x2 50+degree curves. Now if you can imagine a spine that's completely straight to bending like an 'S' giving 50+degrees curvatures, how do you think the adolescent would feel? She attended for a POINTE assessment. Unfortunately it was this day when her rollercoaster of emotions started. She was referred to the specialist, the specialist says, 'you're a candidate for surgery', what would be going on through this young mind? The rollercoaster may not end until she stops growing, or carry through the rest of her life with potential pain if this spine is left to it's own devices. The good news is, there's help. The best evidence for moderate to severe curves would initially be specific scoliosis exercises by a trained physiotherapist or health practitioner, plus the potential of a brace. A BRACE? The patient screws up her face, 'Im not wearing a brace'.... the loop of the rollercoaster is coming...On the contrary, I have certainly seen dancers who have completely 'embraced their curve',... excuse the pun. And this is what I absolutely encourage. Provide them education, give them all the information to make informed decisions with their family, Dr's and allied health team. Compliance is key, they have about 18mths, sometimes less, sometimes more to make the greatest most positive change to their spines. Try to avoid the rollercoaster, although sometimes this is unavoidable as we all know how hormones and adolescent girls work... arrr.  BUT, it doesn't stop a dancer from pointe work. It doesn't stop them from enjoying ballet and life, it shouldn't stop them from doing anything, just a little TLC is required for a short period of time to keep them from pain in adulthood. It's like brushing your teeth.... Why brush your teeth I ask them? Up next.... time in 'ISO' and the rollercoaster COVID-19 has caused the world. Take care, stay 'enpointe' and be sure to check your spines. ;)Mel