Back Problems in Kids

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Back Problems in Kids

JOHN PETROZZI:     Hi and welcome to Living is Easy with John and Josh. I’m John Petrozzi.

JOSH HARPER:      And I’m Josh Harper.

JOHN PETROZZI:     And this show is about you. It’s about health and wellness and everything to do about you.

JOSH HARPER:     What’s on the show today, John?

JOHN PETROZZI:     Well today, we’re talking about back care for kids and teens. As a chiropractor, about 30% of my patient base are kids and teens. Part of the reason is because their parents come to see us and they have great results and they think, “I think my kid should be checked as well.” So they bring their kids along. And most of the time, these kids get preventative care and preventative check-ups.

JOSH HARPER:     So what else is on the program today?

JOHN PETROZZI:     We’ll be talking about things that kids can do to improve their spine. We’ll be informing all that the correct way to lift bags, the best way to carry them as well, and also talk about scoliosis.

JOSH HARPER:     So stay tuned.

We’ve received a question from Tracy from [Kujin]. She asks: “My teenage son seems to be carrying a heavy school bag full of textbooks and gym gear. He complains of a sore back and knees. Will this give him back pain in the future?”

What do you think, John?

JOHN PETROZZI:      Well that’s a great question. Thanks for your question, Tracy. I’ll try and answer it in these next couple of minutes but it might take a little bit longer, but I’ll keep it brief.

The teenager’s skeleton is always growing – rapidly growing. They’re getting stronger and they’re getting taller as well. It doesn’t take very long until we actually notice that these kids have grown.

JOSH HARPER:     At what age do we stop growing?

JOHN PETROZZI:     Well generally, for boys, it’s around about sort of 21, as that old; generally speaking, 18 and 21.

JOSH HARPER:     So this extends to the people outside of school as well?

JOHN PETROZZI:      Well that’s right. You’re exactly right. The tender years of growth are really between the young years right through to the teens. Then in early adulthood, it really starts to slow down. But muscles and joints are always getting stronger. Every single day, they’re getting stronger. A heavy school bag that is worn incorrectly can definitely disrupt this growth process.

JOSH HARPER:     Now what do you mean about “worn incorrectly”?

JOHN PETROZZI:     Well, you know, most backpacks have got two straps at the back of them. Most school bags do, actually. I don’t know any other school bag that’s just got one strap, expect for sports bags. But with the two straps, the reason for these straps is that they need to be worn on two shoulders.

Generally, the backpack is way over onto the back. But the backpack can be worn on the front as well. Often, school bags are carried on one shoulder, which means the balance of the body is off and the spine has to compensate by twisting itself.

JOSH HARPER:     You mean throwing it over at one shoulder?

JOHN PETROZZI:     Exactly right. Yes. Spot on.

So after about two or three hours of carrying a heavy school bag, the supportive muscles and joints over the spine begin to fatigue and they start to get really tired. And overtime, those tired muscles can become chronically tired as well. This leads to pain and stiffness.

So I suppose, Tracy, with your teenage son, if he does continue to carry heavy, heavy school bags overtime, he would start to get some fatigue and crank tightness of muscles. That can, overtime, start to lead to some more long-term damage and pain.

JOSH HARPER:     Now also, John, with those straps, should they be tightened up so the bags press straight up against your back?

JOHN PETROZZI:     Yeah, the general rule with having a backpack is you want the weight of the backpack to be going through your belt line. So if you’re wearing a belt, the weight should be going through the belt.

JOSH HARPER:     What do you mean by that?

JOHN PETROZZI:     Well the weight of your bag should go through your hips, because it’s a nice, hard, bony surface in the back of your spine. If the weight of the backpack goes through the soft tissues around the shoulders or through the mid-back, then you’ll find that you start to get some crank tightness of the muscles that become very, very sore.

JOSH HARPER:     So you do this by just tightening the straps?

JOHN PETROZZI:     Just tighten the straps – that’s right. I don’t know if it’s still cool these days but when I was at school, kids used to have backpacks that used to be, the straps used to be really, really loose. What tends to happen if the backpack is down too low, say, down to the hips or even further down? What tends to happen if the backpack is heavy, your body has to compensate by leaning way, way forward. So if you’re leaning forward, it means the head’s jutting forward, the posture and shoulders are rolled in, and that will affect the spine as well.

JOSH HARPER:     And do you have any ideas to prevent these?

JOHN PETROZZI:     Yeah, for sure, Josh. Prevention is so important. It’s just so easy to actually help somebody by preventing these things from happening in the first place. It’s very, very hard once someone has these pains that we need to try and get rid of them and it takes a lot longer. So prevention is so important.

So I’ve got a couple of tips for school kids or teenagers or actually anyone who actually carries things in a backpack for long periods of time. If you’re at school, the first major thing that comes to mind is really empty out all the unnecessary items from the bag. So if there are some textbooks that you only use once or twice a week but you’re carrying them every day, then leave them at home or leave them in your school locker. But definitely, keep them out of your bag because it’s just weighing you down.

Try to keep bulky items and heavy items at the bottom part of the backpack, because that means that the backpack is actually a little bit more stable so it’ll be sitting correctly on your spine.

So leave some of your things in the locker, carry the bag on two shoulders – not one. If you’re carrying it on one shoulder, the obvious is going to happen. You’re going to raise one shoulder up, your head will tilt to one side, and your spine will have a bend in it, which is not meant to happen.

JOSH HARPER:     Now sorry to interrupt but what do you think about sports bags and also the laptop bags that business people wear?

JOHN PETROZZI:     Yeah, I know the ones. They can be worn correctly but most of the time, you see people walking down the street and they’re actually holding it incorrectly.

JOSH HARPER:     Is there a correct way?

JOHN PETROZZI:     There is, yeah. So for instance, with the sports bag that’s got one long strap, or a laptop bag, keep the laptop straps actually across your body, so if the laptop’s sitting here on your left hip, the strap should actually be over your right shoulder. Yeah, so the strap’s actually crossing across your body, because what that helps with is actually helps with the center of gravity-

JOSH HARPER:     So it sort of balances the weight.

JOHN PETROZZI:     Exactly right. It balances the weight.

JOSH HARPER:     Okay.

JOHN PETROZZI:     And it’s the same deal with sports bags as well.

JOSH HARPER:     So do you have any other tips?

JOHN PETROZZI:     I do, yeah. This one’s here’s a bit daggy. I’ve suggested it to a couple of young patients at the office. Some of them are doing it. Others think, “No I can’t do that.” What I suggest is actually, if you’re carrying a lot of books or lots of textbooks or sports gear, you should actually carry it on a second bag that’s got wheels on it. You know that type? The ones that you use on a luggage carousel or the ones you can take when you go traveling. They’ve got a long pull-out handle then they’ve got wheels on it as well. That works a trade. All the weight is actually down the ground. It’s not heavy on your shoulders.

JOSH HARPER:     I’m sure some teenagers would do that.

JOHN PETROZZI:     Yeah, I think so. Obviously, I [just want to] convince some of the people coming to my place to start using those sorts of techniques.

But prevention is so important and when we come back from this break, we’ll be talking about some more preventative measures that not just teens and young kids can put into place but also adults can put into place, too. So stay tuned.

[break]

JOSH HARPER:     Welcome back to Living is Easy with John and Josh.

For those who’ve just joined us, we’ve had a question from Tracy from [Kuji], concerning her teenage son that always seems to be carrying a heavy school bag. She’s concerned this might give him back pain in the future.

What are your thoughts, John?

JOHN PETROZZI:     Well definitely, there’s going to be implications for back pain in the future if Tracy’s son doesn’t actually take some steps now to prevent the problem from getting worse.

JOSH HARPER:     Okay. What are those steps he can take?

JOHN PETROZZI:     There are lots of steps.

Just cast your mind back to a person who’s actually got back pain at the moment and I’m sure they would just run over hot coals to try and prevent these problems from occurring in the first place. Some people get back pain that radiates into their legs and into their feet sometimes – pins and needles or numbness. If this is you, just cast your mind back to all those things that you’ve done over the years or maybe over the decades that have contributed to this problem.

JOSH HARPER:     What are the things that they could’ve done?

JOHN PETROZZI:     I’ll discuss those now. Because those things, they could’ve been done better, they could’ve been done safer, or maybe even just more ergonomical. But what it takes is it takes a conscious effort to try and figure out what those things are that are damaging your spine, be mindful of it when you’re doing it, and actually try and short-fuse it and prevent it from happening.

I’m talking about simple things as well. Things like lifting something out of the car. It could just be a laptop from the back seat, it could be the groceries out of the back – out of the boot, it could be something off the front seat, it could be something very, very simple that’s causing some irritation and some problems to occur in the spine. But all it might take is to walk across the other side of the car and grab that heavy object just there and then, as opposed to twisting your body and potentially causing some nasty ramifications to your spine and health.

JOSH HARPER:     Because they all add up.

JOHN PETROZZI:     They do. Yeah, it all adds up.

Another thing, I don’t know if you do it, Josh. I do it sometimes. But again, I could be mindful of it. Bad posture in front of the TV, sitting on the couch.

Sometimes, if you’re feeling extra, extra tired, you’re going to be sort of slouching on the couch, but don’t make it a habit because overtime, what you’re going to do is actually cause damage to your spine.

JOSH HARPER:     Now it’s funny that these things that go on everyday and everyday in people’s life, what do you think they should do about it?

JOHN PETROZZI:     Just be aware of it. I’ll give you a couple of more examples. How about sitting in front of the computer for a long period of time without taking a break? Do you know how long the spine takes before it starts to fall asleep? About 40 minutes.

JOSH HARPER:     What do you mean “fall asleep”?

JOHN PETROZZI:     So what I mean is if you’re sitting at the computer for about 40 minutes, by that stage, muscles around your spine tend to respond less. And if they [stay and] respond, it means a sign of fatigue.

So if for instance, someone knocks at the door and you need to go and rush out to go and answer the door, and you’ve been sitting down for 40 minutes to an hour, and you’re going to need a quick response to try and get to the door, the muscles aren’t actually responding as quick as they should so that potentially can produce some sprain or strain in the lower back of the spine.

Yeah, it’s something very, very simple just like that.

JOSH HARPER:     What else can you think of?

JOHN PETROZZI:     Well, here’s a really common one. It’s what I used to do when I was a kid, and it’s sleeping on your front with your neck actually twisted to the side.

JOSH HARPER:     You do seem to extenuate this a lot, John.

JOHN PETROZZI:     I do. I do. It’s just one of those things that’s really common.

Can you picture this? You’re lying on your mattress face down or or your body’s faced down, your head is twisted to the side on the pillow because you need to breathe still. You can imagine all those joints in the spine getting tight, tight, tight and by the morning time, by the time you wake up and have a shower and sort of wash your hair, dry your hair and all those sorts of things, because the neck’s been twisted in that tight position all night, by the time you’re going to actually move it, potentially, you can actually cause some sprains right there and then.

I’ve had lots of people in the office who actually come in after having a shower and drying their hair or washing their hair with the shampoo, and their neck’s gone out just like that.

JOSH HARPER:     So you can’t do this at all?

JOHN PETROZZI:     What’s that? Lying on your stomach?

JOSH HARPER:     Yeah.

JOHN PETROZZI:     No. No way.

The thing that I’d like to sort of make a point of is that even though the problem happened for the person drying their hair there and then, it doesn’t mean that that was the cause of the problem. The cause of the problem actually built up years in advance. So that’s why prevention is just so important, and preventive medicine over the next decade, two decades, twenty decades is going to continue to grow. Because we know so much about prevention and preventative medicine at the moment, it’s going to be so difficult or for us to be blind to the fact that we can’t prevent diseases and problems from occurring.

JOSH HARPER:     What do you mean “preventative medicine”?

JOHN PETROZZI:     Well, preventative medicine includes things like, just like what we’re talking about today: being aware of your posture to prevent physical problems and disease; other things, like eating the right diet to prevent other sorts of malfunction in the body, thinking the right thoughts to prevent thought disturbances. That’s sort of just a preventative medicine, and there’s a whole lot more to that scope of medicine as well.

But today, I really wanted to talk about preventative measures in terms of spine and spinal care and body care as well.

So Tracy, we really appreciate your question and we hope that we’ve done it some service. We’re going to come back after the break and talk about scoliosis. So if you’d like to hear about that, stay tuned.

[break]

And welcome back.

We’re talking about back care for kids and teens. We’ve had a question already today.

JOSH HARPER:     Our second question today was from Sarah from [Bondi]. Thanks, Sarah.

She says, “My daughter has been told by a doctor that she has mild scoliosis and that she needs to see a chiropractor. What is scoliosis and what can be done about it?”

JOHN PETROZZI:     Well, thanks for your question, Sarah. We appreciate it. Good question – scoliosis. I think lots of people know what the word is, some don’t. So what I’ll do is I’ll just go through the basics of scoliosis.

Looking at the spine from the front or back view, the spine should be basically straight up and down. It should be a nice straight rod. So a scoliosis is any curvature of the spine sideways. So if the head is tilted to the side, that will constitute partly scoliosis. If the mid-back is bent out to the side, that will also constitute to scoliosis as well. This can be confirmed by X-rays as well.

JOSH HARPER:     Are there any things you can do at home to see if you’ve got a mild scoliosis?

JOHN PETROZZI:     Yeah, for sure. Well, as a chiropractor, I would check for scoliosis every single day. There are some landmarks that I tend to look for, and you could look for these as well on your kids at home. You can check on adults as well.

JOSH HARPER:     How can you do this?

JOHN PETROZZI:     Well, firstly, ask the person to stand in front of you. And their hands should just be resting by their side. What I need you to look at is look at the head and the face. Is the face looking at you or is the head tilted off to one side? Is one ear at the same level as the other side or is one ear higher than the other side?

JOSH HARPER:     Okay.

JOHN PETROZZI:     Then, look at the actual height of the shoulders. Do the shoulders look level? Does one level of the shoulder look like hitched up to one side or is one a little bit lower or sagging forward or rolled forward?

The other thing to look at is the alignment of the hips. So if they’re wearing a belt, a belt is a really good way of telling you if they’ve got a leg that’s higher or lower or a hip that’s higher or lower. So with a skirt; you can tell by looking at that as well.

JOSH HARPER:     Any other things?

JOHN PETROZZI:     Yup. Then look further down the body and look at the knees. Do the knees look like they’re symmetrical, or do they look like there’s one bent knee or does one knee look like it’s bowing inwards or outwards?

JOSH HARPER:     What do you mean? The shape of the leg is like a triangle or-?

JOHN PETROZZI:     Exactly right. Yes. So looking at the knee, you got the thigh and then you’ve got the lower leg, it should make a nice straight line.

And then lastly, look down at the feet as well because the problem can actually travel all the way down, right down to the feet. And look at the feet. Notice, does one foot turn in or does one foot flare out?

So yeah, there are a couple of things that you can look at to determine if there’s some rotational – some scoliosis in the spine. But what you really need to do is if you do see any of these, don’t take my advice over the air as gospel, but what I want you to do is pop in to see your local doctor or chiropractor or physio to be certain and they’ll give you some ideas and some treatment protocols to follow.

JOSH HARPER:     So is scoliosis a common condition?

JOHN PETROZZI:     It is, Josh; unfortunately, too common than I’d like. But the reason it’s so common is because people do bad things to their spine and it becomes bent, unfortunately. So just like we spoke earlier in the show, we spoke about prevention. Carrying a bag on one shoulder overtime if you’re doing it long enough and constantly and chronically enough, you will get scoliosis. If you are playing golf and you just swing over to one side, overtime, your spine is going to start to twist into that position; it will become hardened in that position and that would also produce scoliosis as well.

There are different types of scoliosis though, saying that. There’s one type that can’t be changed and there’s one type that can be changed. The one that can be changed is actually the most common type, so that’s good news. The one that can’t be changed is the one that’s actually made up of problems with the spine.

So you know the vertebrae in the back; if you look at them, they look like a cube. They’re basically square-cube. And if you stack these cubes up on top of each other, you’ve got a nice, long, high tower. But if one of those cubes is not square or if it is not cube-shaped or if it is triangular in shape, then you can imagine the tail starts off straight but then at the triangular bit, it actually shoots off to one side. So you’ve got a spine that’s not straight, not that common though at all.

The one that is more common is the functional scoliosis, again, which is produced by bad posture. The sorts of things that can be done conservatively to treat and manage a mild scoliosis: the first thing, you need to figure out what the cause is. And once you’ve determined what the cause of the problem is, you need to try and do something about eliminating the cause of the problem. Again, generally, it’s a postural problem.

JOSH HARPER:     And how can you do this?

JOHN PETROZZI:     Again, make a list of the ten top things that you think you do that produce bad posture and a low shoulder or a forward hip. Make a list of those things and start to really take some action today to eliminate those things from your lifestyle.

JOSH HARPER:     Is there any professional help you can get for it once it’s started doing?

JOHN PETROZZI:     Yeah, definitely. Conservative treatment involves mobilisation of the spine and also strengthening of the back as well, which we’ll discuss in a second.

The aim of any real scoliosis treatment overtime should be to mobilise the joints.

JOSH HARPER:     What do you mean by “mobilise the joints”?

JOHN PETROZZI:     What I mean by mobilise the joints is not the whole spine is stuck when you’ve got a scoliosis but only portions of the spine are stuck.

So can you imagine the letter S? If you draw the letter S out in front of you in the air, you’ll notice there’s a starting point of the S and then there’s a bending point in the top portion. And as you go through in the middle portion of the S, there’s a change in direction then the curve changes at the bottom of the S and finally finishes at the letter. So the tight bit of that curve would generally be the transition points of the curve – the transition points of the S curve.

So generally, the tight bits would be up in the neck, mid back, and then down in the lower spine as well.

JOSH HARPER:     And these are the parts we have to mobilise?

JOHN PETROZZI:     That’s right. Yeah, because if they stay stiff, then the stiffness starts to spread throughout the spine. If the scoliosis has been there for a long time, then it becomes less treatable and less changeable as well. By this stage, the child would have gone through several growth spurts. And just like a tree, you want a tree to grow nice and straight as it goes through growth spurts. It’s the same with kids. If they’ve got scoliosis or a bend in their spine, if they’re growing, we’d prefer them to grow straight up – not out to the side.

JOSH HARPER:     So children with mild scoliosis, can they eventually have a straight spine again?

JOHN PETROZZI:     That’s right. Yeah. I suppose the aim of any sort of treatment protocol that’s undertaken for scoliosis, one of the sort of spinoffs is we prefer the spine starts to straighten back out again like a beautiful straight spine again, which is possible, depending if the right work is done and measures have been taken into account.

But the thing is that most of the time, curves won’t change, but more importantly, the thing that you’re trying to do is that you’re trying to stop the problem from getting worse. And again, you’re preventing degenerative changes from occurring to that person’s spine, because overtime, if the spine degrades and degenerates, so does your lifestyle and ability to really partake in life.

So the power is in your hands. You need to make the decision today to figure out what those things are that are giving you bad posture. Take some action today to eliminate those things from your lifestyle because your future health and your future comfort depends on it.

Wow, what a show! It’s been great. Until next time, stay well and stay happy.

{End of transcript]