Scheuermann’s Disease

Scheuermann's Disease

 
Article by S. Armfield, A. Clarke
back-pain

What is Scheuermann’s Disease?

Scheuermann’s disease is a developmental disorder of the spine. It is also known as Calvé disease and juvenile osteochondrosis of the spine. Scheuermann’s disease causes the abnormal growth of usually the thoracic (upper back) vertebrae, but it can also present in the lumbar vertebrae.

In Scheuermann’s disease, one side (the back) of the vertebral body grows at a regular rate whereas the front grows more slowly. This growth rate leads to a vertebra with a distinct wedge shape. This growth rate difference in turn leads to an increase in the bend in your upper back called an increased dorsal kyphosis.

Along with this wedging of the vertebra, there is also a change to the bone-disc interface. These are called endplate irregularities. Some of the intervertebral spinal discs then protrude into the vertebra. These bone depressions are called Schmorl’s nodes. You can visualise on an X-Ray. These Schmorl’s nodes are present for life but are do not appear to cause any problems in the future. People may have an X-Ray when they are older for an unrelated condition and find that they have Schmorl’s nodes but have never experienced back pain.

What Causes Scheuermann’s Disease?

Scheuermann’s disease has a familial tendency and no apparent gender bias. Its cause is unknown but appears to be multifactorial. Factors include juvenile osteoporosis, malabsorption, infection, endocrine disorders and biomechanical factors including a shortened sternum.

What are the Symptoms of Scheuermann’s Disease?

scheuermann's-disease

Scheuermann’s disease usually causes pain in and around the thoracic spine. It can also lead to an increased thoracic or mid/upper back kyphosis (bend). This structural change can then lead to some restriction in range of movement, especially into extension (bending backwards).

The pain can be made worse by activity, including sports that require a lot of twisting, or forceful bending or arching backwards such as cricket, gymnastics, cricket or athletic field events.

How is Scheuermann’s Disease Diagnosed?

A simple plain X-Ray is usually sufficient to diagnose Scheuermann’s Disease with it showing the classic wedging of the thoracic vertebrae and sometimes the Schmorl’s Nodes. MRI will show additional detail.

Scheuermann’s Disease Treatment?

PHASE I – Pain Relief & Protection

Managing your pain is the main reason that you seek treatment. In truth, it was the final symptom that you developed and should be the first symptom to improve.

Scheuermann’s Disease inflammation it best eased via ice therapy and techniques or exercises that de-load the inflamed structures.

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include ice, electrotherapy, acupuncture, unloading taping techniques, soft tissue massage.

Your doctor may recommend a course of non-steroidal anti-inflammatory drugs such as ibuprofen or pain relievers such as paracetamol.

You will need to avoid heavy loading of your thoracic spine and vigorous bending exercises such as crunches or sit-ups.

PHASE II – Restoring Normal ROM, Strength

As your pain and inflammation settle, your physiotherapist will turn their attention to restoring as much range of movement as you can. It is essential to regain as much extension as you can.

It is also essential to restore or improve the muscles that control the movement and posture in your back. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you, specific to your needs.

Please ask your physio for their advice.

PHASE III – Restoring Full Function

There is no reason why people can not return to full activity, including all sports, but they may need guidance on responding to action that involves twisting or sharp bending. You will also need to be progressed through exercises to regain sport or activity specific strength as the period of rest can lead to a lot of de-conditioning.

PHASE IV – Preventing Future Dysfunction

There are some things that you can do to reduce your chances of having any problems in the future. Maintaining excellent flexibility in your back and keeping the core muscles healthy so that you maintain better posture and reasonable control over the vertebra will all help to limit any future problems.

Scheuermann’s Disease Prognosis?

The pain from active Scheuermann’s Disease will eventually pass, and for the majority of people, they will have no further trouble from their thoracic vertebrae. Some people will have a reduced range of movement, and if the disease caused significant kyphosis (bend), then they can get ongoing postural issues.

For more information, please contact your physiotherapist.

Scheuermann’s Disease Treatment Options

Sometimes a posture brace is used to help keep the back in as much extension as possible. This brace works to remind you where your spine should be and encourage the correct muscles to work.

Surgery for Scheuermann’s Disease

Rarely the amount of wedging of the vertebra is so significant that surgery to restore a better position for the thoracic spine is required. Surgery only occurs it the disease process is substantial. Your physiotherapist will be able to monitor the amount of flexion that you have and if it appears to be increasing to greatly an orthopaedic surgeon may need to make an assessment.

What is the PhysioWorks Difference?

You'll be impressed with the experienced physiotherapists, massage therapists, allied health team and reception staff who represent PhysioWorks.

To ensure that we remain highly qualified, PhysioWorks is committed to participating in continuing education to provide optimal care.

If you've been searching for health practitioners with a serious interest in your rehabilitation or injury prevention program, our staff have either participated or are still participating in competitive sports at a representative level.

We also currently provide physiotherapy and massage services for numerous sports clubs. Our experience helps us understand what you need to do to safely and quickly return to your sporting field, home duties, or employment.

How You'll Benefit from the PhysioWorks Difference?

At PhysioWorks physiotherapy and massage clinics, we strive to offer our clients quickeffective and long-lasting results by providing high-quality treatment.

We aim to get you better quicker in a friendly and caring environment conducive to successful healing.

With many years of clinical experience, our friendly service and quality treatment is a benchmark not only in Brisbane but Australia-wide.

What are Some of the BIG Differences?

Our therapists pride themselves on keeping up to date with the latest research and treatment skills to ensure that they provide you with the most advantageous treatment methods. They are continually updating their knowledge via seminars, conferences, workshops, scientific journals etc.

Not only will you receive a detailed consultation, but we offer long-term solutions, not just quick fixes that, in reality, only last for a short time.

We attempt to treat the cause, not just the symptoms.

PhysioWorks clinics are modern thinking. Not only in their appearance but in the equipment we use and in our therapists' knowledge.

Our staff care about you!  We are always willing to go that 'extra mile' to guarantee that we cater to our client's unique needs.

All in all, we feel that your chances of the correct diagnosis, the most effective treatment and the best outcomes are all the better at PhysioWorks.

Youth Spinal Pain

Teenager Neck & Back Pain

teenager back pain Teenagers can be particularly vulnerable to back pain, mainly due to a combination of high flexibility and low muscle strength and posture control.  The competitive athlete and most individuals who exercise regularly or maintain a level of fitness and core stability control are less prone to spine injury and problems due to the strength and flexibility of supporting structures. Your physiotherapist can assist the resolution of any deficits in this area. Luckily, issues involving the lower lumbar spine are rare in athletes and account for less than 10% of sports-related injuries. Injuries do occur in contact sports and with repetitive strain sports. Sports such as gymnastics, cricket fast bowlers, and tennis have a higher incidence of associated lumbar spine problems related to repetitive twisting and hyper-bending motions. Spondylolisthesis is a significant concern and needs to be appropriately treated by a physiotherapist with a particular interest in these type of injuries. Luckily, most injuries are minor, self-limited, and respond quickly to physiotherapy treatment.

Common Adolescent Spinal Injuries

Lower Back (Lumbar Spine)

Midback (Thoracic Spine)

Neck (Cervical Spine)

Pelvis

For specific advice regarding youth neck or back pain, please seek the professional advice of your trusted spinal physiotherapist or doctor. Common Youth & Teenager Sports Injuries Common Youth Leg Injuries Common Youth Arm Injuries

What is Physiotherapy Treatment?

Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques, education and advice.  Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.

There is a multitude of different physiotherapy treatment approaches.

Acute & Sub-Acute Injury Management

Hands-On Physiotherapy Techniques

physiotherapy treatment

Your physiotherapist's training includes hands-on physiotherapy techniques such as:

Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.

Physiotherapy Taping

Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.

Alternatively, your physiotherapist may recommend a supportive brace.

Acupuncture and Dry Needling

Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.

Physiotherapy Exercises

Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly skilled in prescribing the "best exercises" for you and the most appropriate "exercise dose" for you, depending on your rehabilitation status. Your physiotherapist will incorporate essential pilates, yoga and exercise physiology components to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.

Biomechanical Analysis

Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.

Hydrotherapy

Aquatic water exercises are an effective method to provide low bodyweight exercises.

Sports Physiotherapy

Sports physio requires an extra level of knowledge and physiotherapy to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports & Exercise Physiotherapist.

Vestibular Physiotherapy

Women's Health

Women's Health Physiotherapy is a particular interest group of therapies.

Workplace Physiotherapy

Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstations set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.

Electrotherapy

Plus Much More

Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your problem, please get in touch with your PhysioWorks team.

How is Kinesiology Tape Different from Conventional Strapping Tape?

Rigid strapping firmly wraps around your injured structures. Most standard strapping tapes are non-elastic. They aim to provide rigid support and restrict movement. These rigid strapping tapes can only be worn for short periods, after which you must remove them to restore your circulation. and mobility. kinesiology tape Alternatively, kinesiology tape has some unique elastic properties that allow it to provide active support, protect muscles or joints, and allow a safe and functional range of motion. Rather than being entirely wrapped around injured joints or muscle groups, kinesiology tape is applied directly over or around the periphery of troublesome areas. This non-restrictive characteristic of kinesiology taping allows most applications to continue for several days. This period reinforces therapeutic benefits to accumulate 24-hours a day for the entire time they’re worn. You can wear kinesiology tape during intense exercise, showering or swimming. It quickly dries after a quick pat with a towel. More info: Strapping & Supportive Taping

Article by P.Xu

As we slowly start getting into the cooler seasons, many people will begin to notice sore joints waking up in the morning, or that movement has become stiff, or even headaches increasing in frequency or severity. Why is this? It turns out that cold weather can have a significant impact on your body’s tissues. Notably, the connective tissue gives our muscles and joints the ability to move as they do, called elastin. As the name suggests, elastin is one of the critical components that provide our joints and muscles with the ability to bend, stretch, and move as they need to get you through the day.
Now, imagine putting a rubber band in the freezer for a few hours. You take it out and then stretch it as hard as you can without warming it up. It’s either not going to stretch as well as it should or break in two. Elastin shares these properties. Under cold temperatures, the tissue cannot stretch or bend as well as it is supposed to, causing stiffness or soreness. Coupled with a few other common changes in the cold, vasoconstriction causes a decrease in your blood circulation. Plus, the tendency to stay home and not move our body makes many of us unaccustomed to cooler temperatures feel the full brunt of these effects moving forward. The good news is, it’s a relatively easy fix. Stay warm. If you’re planning on exercising, make sure to perform a dynamic warm-up to decrease the risk of injury, rather than pushing a cold muscle past its limit (remember the rubber band). If a joint feels stiff in the morning, remedy this with a heat pack or a hot shower. If you suspect your headache cause is the cold, slap on a beanie. This head-warming has the added benefit of hiding a bad hair day. Another excellent fix is getting a massage. Soft tissue therapy such as massage excels at combating several things caused by the cold. The physical act of heating a muscle or joint with friction provides warmth to deep tissues that a heat pack may not reach, allowing the elastin to function as it should. Trigger point work into deep muscle fibres may also bring longer-lasting relief than superficial heat therapy or static stretching. If you’re prone to feeling the cold effects, massage therapy may be the fix that you have been looking for if you want to achieve long-lasting relief from stiff or sore joints and muscles this winter.

Back & Neck Pain Prevention Tips

Here's some beneficial advice to help you prevent back pain and enjoy life to the maximum.

Posture

I'm afraid that your mother was right. If you slouch, you'll end up with problems. Just one of those problems is back pain. You'll find other problems elsewhere on this website. Think "Grow Tall".  Imagine that you have a string screwed onto the back of your head, just above your hairline. Then think that someone is dragging you up off the chair you are sitting on. Hold this "grow tall" position for 10 seconds and repeat every half hour. As well as greatly reducing your chances of back pain you'll note that your chest has lifted, shoulders are relaxed, the chin is tucked in, the head is level and stomach muscles have contracted.  Not bad for such a simple exercise. This posture can be repeated in sitting, standing, sleeping, walking or running. Try it, and the physio will work for you too!

Lifting

The best method to avoid back pain from lifting is delegation. If this isn't an option for you, try the following:
  • Use back support to lift loads over 15 to 20kg.
  • Bend at the hips and knees with your feet shoulder-width apart.
  • Firmly grip the load and hold it close to your body.
  • Think "grow tall" to tighten your stomach muscles and look upwards to straighten your back.
  • Stand using your strong thigh and buttock muscles to lift.
  • Once upright, turn by using your feet. Avoid twisting your back.

Sitting

Use the "grow tall" principle each 15 to 30 minutes while sitting. A supportive chair or lower back cushion is essential if you must sit. If possible, don't stay seated for too long. Regularly stand up, stretch your back and walk short distances for a variety of posture. After all, we were designed for hunting and foraging - not sit in front of a computer!

Exercise

Fitness has many benefits. Stronger, more flexible muscles and less weight to stress the bones and discs. PhysioWorks specialises in the provision of exercise programs to keep your back flexible, strong and pain-free. Exercise can involve aspects of flexibility, strengthening and postural control. Consider Real-Time Ultrasound Retraining to ensure you are doing it right!

Sleeping

A quality pillow and mattress are necessary for a healthy spine. You do spend somewhere between one-quarter (1/4) and one-third (1/3) of your life sleeping. Do it in comfort!  You'll need to consider a new mattress if you wake up through the night or in the morning with back pain.  Please ask your PhysioWorks therapist for advice at your next visit.

Driving

Use the "grow tall" principle each 15 to 30 minutes while driving. The combination of sitting and bumpy roads is a recipe for back pain. A  lower back cushion is essential if you must drive any distance. If possible, don't stay seated for too long. Regularly break your travels to have a walk and perform simple stretching exercises for a variety of posture and a healthy spine. After all, we were designed for hunting and foraging - not sit in front of a computer!

What are the Symptoms of a Heart Attack?

Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening: chest pain Shortness of breath. May occur with or without chest discomfort. Chest discomfort. Most heart attacks involve discomfort or heaviness in the chest's centre that lasts more than a few minutes or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one (commonly left) or both arms, the back, neck, jaw or stomach. Other signs include breaking out in nausea or vomiting, cold sweat, or dizziness/lightheadedness. If you think you or someone with you is having a heart attack, Call 000 Immediately! Don't wait longer than a few minutes (no more than five) before calling for help. Call 000. Get to a hospital urgently.

What are the Symptoms of Chest Pain Originating from Your Spine?

Your spine is a prevalent cause of chest pain. Treating your thoracic spine and rib cage is usually the solution. However, chest pain originating from your spine won't kill you, but a heart attack can! Spinal Discs can refer to pain through your chest wall like a knitting needle. Coughing or Sneezing hurts. Thoracic Facet Joints refer to pain around your rib cage. Trunk movements will aggravate or ease your pain. Rib Joints send pain down and around your rib cage. Pain can increase with coughing, deep breathing and trunk or shoulder movements. Back Muscles will generally be more painful in sustained postures, e.g. sitting at a computer. These are commonly felt between your shoulder blades and can be relieved by massage.

What to Do Next?

As mentioned earlier, if you suspect a heart attack, Call 000 immediately and get to the hospital straight away. If your symptoms are not heart attack related, consult your physiotherapist to assess your spinal and chest joints and muscles. Most of your muscular or thoracic and rib joint pain will be relieved after your very first consultation. For more information, please consult your doctor or physiotherapist.

More info:

Thoracic & Chest Pain

What are the Advantages of Good Posture?

good-posture-sitting

Good Posture Benefits:

  • It keeps your bones and joints in the correct alignment.
  • It helps to decrease the abnormal wearing of joint surfaces.
  • It decreases the stress on the ligaments holding the joints of the spine together.
  • It prevents the spine from becoming fixed in abnormal positions.
  • It prevents muscle fatigue.
  • It prevents any backache and muscular pain.
  • It contributes to a competent and confident appearance.

To Achieve Good Posture You Will Require the Following:

  • Good muscle flexibility
  • Normal motion in the joints
  • Strong postural muscles
  • A balance of muscle forces on both sides of the spine
  • Awareness of your posture, plus knowledge of proper postural position, leads to conscious correction.
Practise the correct posture for standing, sitting, and lying down (as described below) to gradually replace your old position.