I recently heard that the daughter of a friend of mine has back issues due to Scheuermanns disease.(Kyphosis).
She is seeing a physiotherapist, but is still limited in her activities…
16 years old , athletic type but now gaining some weight due to inactivity and frustration.
Probably fysio has her doing extension exercises and some abdominal and posterior strenght work…
Being a barbell-/ weigthttraining rehab discipel myself ( Reumatoid arthritis , total hip and knees replacements) I would like to know how to proceed with her.
My guess is that form is very important ( back in extension ! ) and load should be very conservative in progress, but are there also lifts or exercises she should avoid. ?
As far as I know the shape of the thorassic vertibrae prevents a normal position ( this is what I meant with extension) of her spinal cord.
Sorry there , no native speaker of English.
This is also what I am most afraid of. That loading for lets say squat will increase the offset and or pain.
Hey - we can’t really give advice for your friend without consulting with her. However, I’m not aware of any contraindications for training this population. I would likely aid with education about pain’s meaning and how best to handle it and then train them like I would anyone else based on their desired goals.
Scheuermann’s does not have any contraindication for resistance training. As will all things, the heuristic is get good at the basics, slowly increase load, reap the rewards. Typically the “physio work” for this population is repeated work into extension but there is not evidence that this leads to a regression in the curve and I have never seen evidence for any activity leading to progression of kyphosis. This is a common thing seen in teenagers but it will not stop her from doing anything.
I’m just chiming in because I happen to have a 65deg structural thoracic kyphosis. I guess this could be termed “scheuermann’s disease” but a specific name wasn’t given wasn’t given when I was diagnosed some 22 years ago. Basically, x-rays showed I had wedge shaped vertebrae. To be honest, it’s not that big a deal.
Press - I have a bit of a lean back to compensate for the forward upper back tilt. My final position is more over the front of my head than the center. No big deal.
Deadlift - The curve is very pronounced visually, but doesn’t really affect anything. I have some specific queues that work for me but it might also be due to my very long torso.
Squat - If she can get into low bar position, then it doesn’t matter. I also have an SSB for when my shoulders bother me.
Pendlay Rows - I find this exercise helps me with some of the general soreness I may get from trying to stand up straight all day.
Bench - Bench is the most affected. When I lay down on the bench, my head is 3-4" off the bench. Over a minute, I stretch out a bit. I still tend to bench with my head in the air. I have to bench with a bit of an arch and a lot of leg drive just to get my scapula on the bench. This is something I didn’t know when I was younger. Sitting up from benching, I often get little bursts of back spasms as my back resumes its more natural position. I also get this anytime I lay down on a hard flat surface and let my spine extend. This is the one area where some back extension work helps you get more accustomed to the transition. Someone who is a teenager is probably not going to get this. I’d imagine people with normal curvature could also have this effect if they tried to start benching with a very high arch coming from a more typical setup.
Basically, with my back at my natural posture, my discs are evenly loaded, and I can lift heavy weights. Trying to achieve some kind of serious thoracic extension to mimic a more typical spinal curve is not going to be beneficial. I take my natural posture and treat all extension and flexion cues as relative to that.