How To Manage Your Scoliosis When You Can't Be At 100%

behind the brace podcast video episodes season 1 Aug 19, 2025
 

This episode is called How to Manage Your Scoliosis When You Can't Be At a hundred percent. I'm actually really excited to do this episode because these are real conversations I have in my office every day, all week, like months and months on end, and it's just real life, real people situations because as I'll tell you when you come into my office or in any conversation, there's this very nice box of diagnosis, look at the x-rays, look at the situation, get all the data. It's this very scientific process, and you put it up on the screen and you say, you know, okay, based on all of these things, this is the recommendation. This is the best treatment approach. This is how we do this. And it, at least for me, it makes me feel really good, right?

Like I'm that analytical. I like to see it out on paper. It makes me feel good to know that this is the data, this is how you do it, and if we follow the plan, everything should go as expected, and this is what we should see. But what I've learned in working with real humans is that there's also a human part to it, and life is messy and things happen and it doesn't always go to plan, even though, that can stress me out a little bit, right? As I'm sure anybody listening to this can attest to is that when things do not go according to plan, it can be stressful and it makes us uncertain and we're not as sure how to make decisions.

And so what do we do with some of these things and how do we take this very like nice linear process, where we can lay all of the black and whites out, and then how do we incorporate all the gray areas of actual life and how things are going for you and combine it together to make something work? Like that's the magic in it, right? That's where being a good clinician is being able to look at the perfect scenario, look at what's in front of us, and combine the two to get the best result that we can.

And so I'm gonna share just a few things. Some of these things might, some of these things might trigger you. If you're listening to this and you're relating to a story, it's not necessarily about you, but if it kind of triggers you, it might mean that you need to pay attention to it. And a lot of these things that I'm talking about are things that I've also experienced in different ways in my own life. But these are really the scenarios that patients come into my office with.

So first of all, I'm gonna put a disclaimer out here that this isn't to validate any of your excuses, just like any of my excuses as to why I should be doing things that I shouldn't be doing. So we all have this tug of war with what's realistic in our life and sometimes, you know, if we're just making excuses as to why we can't do something, so I'm not saying that you shouldn't be doing your stuff or you shouldn't be doing the recommended treatment or any of those types of things. But I am saying that there are times in life when we just can't do all of the things that we should be doing. And if you're a perfectionist, at least even like in my own mind and a lot of the patients that I work with, it's kind of this thought of I either have to do it perfectly -the scenario has to be perfect, it has to be. At the right time, it has to be the right space. I have to be feeling a certain way. I need to have a certain amount of time in my schedule. It like everything needs to be perfect in order to either start it -or to be able to continue it. And the reality is that time passes anyway.

And if you don't start, you'll never get started. And so there's, there's a few situations in there that we'll kind of talk about that may or may not follow that exact line. But the first thing that I want to talk about is if you have a delay or a disruption. So at least I'm speaking specifically about my office now.

So a lot of patients come in and the first thing we determine is, do we need a brace? Do we not need a brace? Where are we at in that regard? And then we follow that appropriately. And then we look at the next layer of things and we say, okay, now that we have that figured out, and any under other underlying medical things that we need to, you know, discern and make sure.

Are handled appropriately. We look at is ScoliBalance® appropriate for you? So that's our scoliosis specific rehabilitation program. And is that appropriate for you? And if so, what does that look like? What would be an appropriate prescription of care for your situation?

And then we also look at other things like coordinating other providers. So like, are they seeing other providers and are, are we coordinating with them? And how are we working that together? Because when we're looking at this, right, a lot of people have different things going on, so they might be seeing a physical therapist or they might be seeing a chiropractor, they might be seeing, like a fitness coach or a personal trainer or different things like that.

And so when we're starting something in our office, we have to be able to communicate with those people so that everybody's kind of on the same page of what are we doing to help you move forward? And I would say a majority of people have more- like it's more than just me or our clinic working with them. And so that's an important piece of that. How do we make this work in your life?

Now, once we have that laid out, obviously with any type of care, if you're at a hundred percent, that's the best case scenario, right? So say we've got somebody wearing their brace, so if they're supposed to be wearing their brace full time, so they're wearing their brace full time.

They're doing their ScoliBalance® program. They're doing, they're at home stuff, right? They're at, you know, full capacity. They're able to fit it into their day. Um, they're able to continuously work through that, and they're checking the boxes and, you know, doing all of their things at a hundred percent.

Obviously we get the best results that way, but there are multiple instances where we have a disruption or a delay or something happens. I've had patients come in as adults that were really wanting to get after their scoliosis and you know, maybe they're in that family stage and then they find out they're expecting another baby.

Well, we can't, we can't use a brace when you're, you know, pregnant. Right? So then it's like, okay, we have this little bit of a delay. But then instead of going to, "okay, well we're just going to not do anything right now until down the road, then we talk about," okay, well we can't use this tool, but what tools do we have left that we can use to help you continuously gain ground?

Until we can come back to that initial plan. Or, for example, I've had quite a few patients that have had injuries. So whether we had somebody who had a surgery, so with an abdominal surgery, they were out a couple of months. Obviously we're not utilizing a lot of the tools that we're having if you have a surgery and you're in the hospital and you're recovering from incisions and stuff like that. Or we've had people that have had some pretty serious illnesses where maybe they ended up in the hospital for a week and they had to come back out of the hospital and they had to get better and they had to heal.

And so in all of those situations, it's gonna be a little bit different for everybody. You know, what can we utilize? Um, or example, a broken leg. Multiple people that have either had like fractures in their legs or fractures in their feet or, because a lot of the people we work with are active, right? So athletes, if they are playing football and something happens, or I've had somebody that does cheer and they were thrown up and they had a fall, and so now all of a sudden we have a concussion that we have to deal with in addition to the scoliosis.

There's just these nuances that come about real life, that doesn't make it perfect on paper. And so what do we do about that? How do we work with that?

So no time is the perfect time. I will tell you that. It doesn't matter who comes in my office, there's never a perfect time to start. The key is getting started and then making realistic and reasonable decisions.

So, for example, it's summertime. Well, we're coming out of summertime and into the fall. So sports, busy season, into like football and all of the things and traveling teams. Um, so there's lots of things going on. And so one of the things that often comes up is it's like, oh, this sport's coming up. We're gonna be traveling a lot. We've got all these trips planned. You know, should I start? And so when we're talking about some of these recommendations, the thing that I ask families and that we kind of come back to is, would we do anything different? So if we're making a decision about care and we're looking into the future, whether it's: do we need to do a test? Do we need to do a brace? Do we need to do a rehab? Doesn't matter what it is, would we do anything different? Because if the answer is no, then maybe we don't do that thing. If the answer is yes, then it would be appropriate to do the thing. And so, for example, I had somebody pop in the other day and they were asking if we should start before or after something.

And one of the questions I asked them was, I was like, okay, so you're gonna be gone. You were traveling, you're in and out. Like if we sat down and did all of the x-rays and did all of the things, um, and I will, I'm going to preface this with, this was not a highly progressive case and this was not a kid.

So if you're listening to me, and this is you're 11-year-old with a 40 degree curve, this is not for you. Right. This does not apply.

So this was an adult with a stable scoliosis who'd been dealing it with it for, you know, her whole life. And, uh, the conversation was like, do we start now or do we wait? And so the conversation we had was, okay, if we saw you right now and we laid out this program and we got the first few visits in and we showed you these things, would you be able to realistically and physically do these things while you're traveling?

And after like real contemplation, the answer was no. You know, they wouldn't be likely to be able to do any of that over the next month anyway. And so in that specific case, then the answer was like, okay, well then we're going to wait and we're going to have them come in when they do have the space and they're actually going to be able to do that.

And so we postponed that for a couple of months just to be able to make sure that they had the capacity to do that, but in a different scenario. We had -also an adult. So kids are different. I'm gonna preface that kids are different. Don't take some of the things I'm saying in relation to your kids. Ask your provider specific questions if you're worried about that.

But this additional scenario. It was an adult scoliosis her whole life, same type of thing. And they're going on, uh, a trip, right? So they're traveling, they have a lot of things going on. And so the conversation we had was, okay, where are you at? How are you doing? And would we do anything different? And for them, the conversation was, "oh my gosh, I'm in so much pain. I don't know that I'm gonna be able to make the trip. I don't know that I'm gonna be able to handle the sitting and the driving, and all of those things." And so, in this scenario, the answer was Okay. Then we get started like right away, as soon as we can. We fit in as much as we can to try to gain as much ground before she has to do this thing.

And then we set up realistic expectations. So obviously if you're traveling and you're on planes and you're driving and you're on trains and all of those things, you're not going to be able to do some of these things at a hundred percent in that scenario. But it doesn't have to be perfect to help.

And so in that situation, we were able to really give her some key things, as she was coming into the office and then we were having her do things at home. We could assess those and then we really honed it in, like, okay, what are you gonna be doing on your trip? What are the things that are bothering you? And we tailored a program specifically to her and then we gave her very select things to do while she was traveling.

And when she came back, she was really happy to report that she was able to make the trip. She didn't really have a whole lot of trouble driving. They did the things that we talked about. You know, she made sure that after so much time she had gotten up, she did the different exercises that were like really easy to do in the sense of she could do them standing beside her car in a parking lot if she needed to, so that she could enjoy that trip and not be in pain the whole time.

So when we got back and we talked about that, like that's something where maybe we're doing something at 50% or 60%. Sometimes in our mind we think that that's not beneficial or that's not helpful, or we push it off because we think we, we can't hit the mark. But in reality, that might be the thing that changes your ability to enjoy some of the things that you're doing or to be able to start to make progress.

And so that's really why I wanna talk about these because almost everyone that comes in feels like it's gotta be a certain way, a certain time, a perfect fit to start. And it, it just doesn't always. But in that same right, we're very realistic that like if I've got a senior in high school and they're finishing their track season and they're in the middle of state track and they're in the middle of graduation and they have their grad party and all of their family's coming to town, and then they're leaving on like their family like celebration, vacation Memorial Weekend, right?

I'm not throwing in four visits and this massive, challenging, expanded rehab program in the six to eight weeks over that period of time, right? We have to tailor it specifically to who's in front of us, and that's where we really have that power and ability to create a plan and a program for the people coming into our office so that you can fit it into your real life.

And you've gotta have some dedication and you've gotta fit it into your routine. But we also make it realistic. We're not making these two hour long, at home programs that you need to go through. We're making it so that you can get the maximum benefit in a way that works in your life. And so that's gonna look different for everybody.

One of the other things that comes up, I shouldn't say all the time, but it feels like it's all the time. It's quite a bit actually. And it's across the board for lots of ages and it's kind of in the sense of like, we can't fix it. So, why deal with it? And I will say that most of the time these scenarios are people that aren't having pain, right?

Because if people are having pain or they're not able to do what they love, it kind of flips that switch pretty quickly where they're like, okay, I wanna be able to do the things I wanna do. But in the scenarios we're like, well, gosh, okay, we, you know, we are in our thirties, we have this 40 degree curve. It's not like we're gonna fix it, so why would we deal with it? That's where we really have the conversations about- and on a personal level for everyone, right? Everybody has a different period of time in their life and what's important to them and how that fits into their life from a time-wise and a financial piece, and all of those things.

But what's our goal with that? And so I really want to encourage people who maybe feel a little bit defeated or maybe feel like they don't have the ability to expand those areas in the sense of, you know, kind of looking at it from the sense of, well, we can't fix it, so why deal with it type situation is, even if you can't say like, quote unquote, fix it. It's about maximizing your body's ability to do the things that you wanna do, and to also protect the potential of your future.

Meaning that what we do now determines, you know, what happens down the road- 10, 15, 20 years. And there's a couple of examples that I wanna share with you today because I think it's something that it's easy to not think about, and I see this all the time with kids, right?

So if I've got somebody who's 14 sitting in my office and I'm trying to talk to them about the importance of their rehabilitation program and the importance of their brace, and they're young, they're healthy, they don't have pain, they're an athlete, and their curve is like right in the middle of the road. So it's not surgical, but it's also like just significant enough that the research shows it'll continue to progress throughout their adult life. But in their mind when they're sitting in front of me, it doesn't seem like it's a big deal. And so when I'm bringing up and I'm like, Hey, okay, but what about when you're 40? What about when you're 50? What about when you're 60 and maybe you still wanna be running, maybe you don't, but maybe you do. All of those things, it's hard for them to think about the future because it seems so far away and we're all like that. Honestly, like if I think about the things in my life, it's, it's easy to just kind of not think about 10 or 15, 20 years down the road.

But there's two scenarios that popped up over the last few weeks that really brought this to mind, and one of them was, somebody was talking about a family member that they had, had a really mild scoliosis, and they kind of knew it. It was like they ran in, it, ran in the family, and I think it was a, it must have been their grandparent. I think that had the scoliosis and so now they're older, right? They're in their eighties, like mid to late eighties and having a lot of trouble with it, and it's really affecting their ability to be mobile and to do things. But when you're in your eighties, you don't have a whole lot of surgeons knocking at the door saying, "Hey, we're gonna do a surgery" because you're in your eighties. And most of the time people aren't in the best health to be able to go under anesthesia and do all that, and their recovery would not be great. So they get stuck in this place where they don't have a whole lot of options because they can't undergo the surgical intervention, and they're already in a place where it's affecting their mobility.

But when they're 40, they're not thinking about when they're 85 most of the time. And so this is one that I really just wanna talk to you about is if you find yourself in the place where you're like, gosh, I mean, we can't fix it anyway. Like, why would we mess with that? That's why you mess with that.

That's why you take advantage of the tools that you have in front of you. And it's not like, I, I likened it to like a bodybuilder not too long ago actually. So think about, say you lift weights, and I'm sure everybody has probably seen like people who do these bodybuilding competitions, right? Most of the time people who do those, right? They have this really intensive, uh, program for a period of time. And then they do the bodybuilding competition. We all see the photos and we're like, holy smokes. I didn't know people could look like that. And then after that, right? You can't maintain that forever. They go back, most of the time they go back to more like normal life and their body looks a little bit different.

But when we're talking about some of the scoliosis things, it's almost in my brain, it kind of, connects like that, where if we have an initial diagnosis, especially as a kid, right? We have this like intensive treatment time where maybe we're doing bracing or we're doing rehab, or we're doing all these things, and then when you become an adult or as an adolescent when it's less severe or it's not surgical and we know it's not progressing, we get to this place where we're like, oh, well why would we mess with that?

So you don't have to go after it in the intensity like you would if we're worried about this high progression, but at the same time, there's a happy medi, right? Like normally bodybuilders don't go from like bodybuilding and then not working out and eating McDonald's in a six pack of Coke every day, right. And gaining 150 pounds. Like there's this middle ground where I think a lot of the people I talk to feel like it's like all in or none. And really our job is, and this is what has been really, really impactful to see is that when we're working with patients, we have this more intensive time of care where we're really working through that. And I've been doing this long enough now that some of those kids that were like 10 years old coming in, they're now graduating from high school, they're going to college.

Actually, one of my patients, this is totally side note, but she's like graduating from college, get, you know, got married, all of the things, and I'm looking at some of these things and it's. It's something that we can help incorporate it into day-to-day life as you move forward, which then protects your future of what you can do when you're 40, 50, 60, 70, even in your eighties.

And it doesn't have to look like the intensive time of treatment and care, but we find something that fits for you and all periods of life are gonna look a little bit different. So even though it might not be something we can completely fix, we can maximize your ability to be strong, to have flexibility, to not have symptoms, to be able to do the things that you love to do, to not have problems as you move forward or try to minimize those problems. You know, we can't obviously guarantee like you'll never have a problem, but we try to minimize those by giving you all of the tools and all of the things that you need so that you know that you've done the things that you can do in order to help protect yourself as you get older.

And so, this is a huge piece of this. We'll probably do more on this later actually, but, I find the most power in that because sometimes we can't fix the things in front of us, but there are things that we can do to make it better and to help support ourselves and to make our future better.

And so that's a really big key piece. Even if we can't completely fix it. We can make that better. And so I'm gonna leave that with you. We always have information on our page where you can connect with our office. You can ask questions. If you have a case that you want us to look at, make sure to reach out and let us know.

And we'll be back in a few weeks with another episode.

Thanks for spending time with me today. If you could leave a review before you go, that would help us reach more people that need this message.

To learn more about the services and resources that we have available, visit us at behindthebrace.com. This show is produced by RAYMA Team® Media. To learn more about how they can help you with your podcast, visit raymateam.com.

 

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