20: Running + Scoliosis: What the Research Really Says (with Dr. Jenn Warren)

Is running actually bad for scoliosis—or is that just a myth?

Join Dr. Beth and Dr. Laura for a fascinating conversation with repeat guest Dr. Jenn Warren on what we really know about running with scoliosis. Dr. Jenn is a scoliosis- specific physical therapist and running specialist, joining once more to drop some knowledge on what we know, and what you should know as a runner with scoliosis (or someone who works with them).

From teen athletes on the track team to adults returning to running later in life, this conversation tackles one of the most common fears in the scoliosis community: Is it safe to run?

You’ll learn:

• Why running is not inherently dangerous for people with scoliosis
• Key considerations for teen athletes, especially during growth and puberty
• What Relative Energy Deficiency in Sport (RED-S) is—and why it matters for runners
• How to spot red flags like fatigue, recurring injuries, or under-fueling
• The role of strength training and cross-training in protecting your spine and improving performance
• How to approach running after spinal fusion
• Why listening to your body matters more than following rigid rules

Together let's unpack the importance of mindset, resilience, and giving yourself permission to move with confidence.

Bottom line: Your body is adaptable, capable, and stronger than you think.

Resources & next steps:

If you're interested in a deeper dive on this topic, check out this blog:

• What is the pelvic floor?

RED-S (Relative Energy Deficiency in Sport):

• Learn about RED-S (Stanford FASTR)
• RED-S overview & educational resources (Stanford FASTR)

Helpful Overview Articles:

• Medical overview of RED-S symptoms & causes
• Mayo Clinic: RED-S and injury risk in athletes

If you’re curious about working virtually with a scoliosis-trained pro, connect with Dr. Laura or Dr. Beth: 

• Dr. Laura's website
• Dr. Beth’s website

 Join the conversation:

Have questions about scoliosis-specific PT or want help finding a trained therapist? Reach out to Dr. Laura or Dr. Beth.

And don’t forget to follow, rate, and share ScoliPod to help more people discover evidence-based scoliosis care.

Finally, don't forget to subscribe to ScoliPod on your favorite pod catcher so you never miss an episode!

• Listen on Apple Podcasts
• Listen on Spotify

Transcript

SPEAKER_01 0:00

Welcome to Scolypod, the show that's rewriting the rules about living with a curved spine. I'm Dr. Beth Taranova and I'm Dr. Laura Glazebrook.

SPEAKER_02 0:09

As experts in the field of scoliosis and scoliosis superheroes ourselves, we're bringing you research-backed solutions, expert interviews, and real success stories that prove one thing. You are more than your scoliosis diagnosis.

SPEAKER_01 0:26

Together, we will dispel the myths and mixed information, sharing helpful insights and tips based on the most current research and knowledge of scoliosis care. If you have scoliosis, spinal fusion, or support someone who does, whether as a movement pro, family member, or anatomy enthusiast, get ready to transform your perspective on living with scoliosis. Now let's dive into today's episode.

SPEAKER_02 0:55

Welcome back to Scolopipod. I am Dr. Beth Terranova. And I'm Dr. Laura Glazebrook. And we have here today a special guest who has been on the podcast with us before. Welcome back, Dr. Jen Warren. Hi, thank you. And um, Dr. Jen, we uh we gave your background last time, but also a scoliosis specialist physical therapist trained in many different schools of Strough Method, Rego concept, and working with population of scoliosis, adolescents, adults, but really having a focus in running. Um, so today we're going to be talking more about that piece running with scoliosis. Um, because I'm sure in conversations with people, we've had many conversations with people where they're told running is dangerous for scoliosis. Ah, so we want to talk a little bit about how that's not necessarily the case and things people want to learn. So thanks for joining us today.

SPEAKER_03 2:10

Thank you for having me.

SPEAKER_02 2:11

Yeah. Yeah. So why don't we start from like, let's say someone is a teen, they're diagnosed with scoliosis, but they're on a track team. Um, that's their sport. They love to run. Maybe they're doing cross country, maybe they're sprint, whatever their, whatever their event is, kind of like where where do they are there any things that they need to know, or like how do they how do we address running with that population? And then we can kind of like go from there.

SPEAKER_03 2:43

Well, the first thing I always tell them, like, let's assume that teenager doesn't have pain, is that it's totally fine for them to keep running. We know some sport is protective. Um, it's a symmetrical sport. So props to that, like they're still getting the bone loading. So I always tell them, like, we have nothing to say it's not safe, like that they can keep doing it. And we just kind of go from there and see how they feel. We do have a little conversation to make sure, which should have been checked at baseline, I think, if they have been diagnosed with scoliosis, but the vitamin D conversate supplementation conversation, I think, is really important to have with those that are running. And yeah, we just kind of start from there. I always ask them if they can name anyone they know with scoliosis that can run or prove that it can be done. And I'm sure you too can think of the one that comes to mind. So Hussein Bolt.

SPEAKER_02 3:48

Hussein Bolt, I mean one of the greatest. I mean, is he still considered the fastest man alive?

SPEAKER_01 3:55

Yeah, I think that's a good one. I think he officially lost the title. Yeah, but I mean, he's still very impressive. And I mean, his he has like a 46 plus degree comming role. So I feel like every time someone tries to to talk any smack about running or like power sport with scoliosis, I'm like, actually.

SPEAKER_03 4:14

Same. I'm like, yeah.

SPEAKER_02 4:17

I also read, and I don't know how like true this is, but there were some that felt his scoliosis was an advantage because he could actually run the turns better on the track. Did you ever see that?

SPEAKER_03 4:29

I've seen I've seen that I've seen that argument made. I I think the better argument for runners pending where their curve is is like the hurdle advantage conversation.

SPEAKER_00 4:42

True.

SPEAKER_03 4:42

Like you're using it, like, and yeah, use it. It's your body, like no one else can run in it. Like it's not like you can run differently. So, like, yeah, right.

SPEAKER_02 4:56

Keep running how you can run. Exactly, exactly. And it doesn't, it didn't stop him really at all. And and and the few quotes that I've seen for him about it were just saying that, you know, if he did have back pain, he did a lot of weight training, like his cross training was a big, a big piece of that. And I think that's something we'll talk about a little later as well. Yeah. Um, so if your teens are running, they have no pain, that's great. You telling them like just keep going, you know, don't, don't stop that. Um, but maybe like what are some things that might pop up that you would say, okay, maybe we do need to adjust, or maybe maybe this isn't the right thing for you right now, or or something like that.

SPEAKER_03 5:41

Yeah, I've recently had like a few people, which this happens inside and outside of scoliosis, but with our propensity to have a little less bone density with scoliosis in certain spots. I think about it for this population more in that reds or red S, and which is relative energy deficiency. And it can be part, it used to be called the female triad, so it can be part of this like shin splint stress fracture, but actually it also for females specifically, when I think about a female scoliosis track, someone who's running track with scoliosis, it's also that important conversation to say, like, is your body meeting its nutritional needs? Going all the way to like maybe like the red flag being loss of a period. And I know in scoliosis at that age, we're always we're talking about bone age, and we're looking specifically for that first period to give us a sign of like, yeah, I am almost ungrowing or I'm out of my peak velocity growth, which is the most risky time for progression. And I think about it a little more in my girls that are running because we need to make sure they're in meeting their calorie needs to then extra even use them to have their first period. So I don't know, I don't know if you've seen in the literature. I haven't specifically seen any, if it happens a little later in scoliosis in general, or vice versa.

SPEAKER_01 7:30

So I was thinking I I know that the three of us know a relative, you know, we know about reds and red us, um, however you want to describe it. But for the people listening who haven't, who don't have a medical background, who maybe don't have that sport background, could you describe a little more um like what it means? And we can talk a little bit about like the symptoms, like how you would know. Um, because I think that for people that are tuning in that don't have the background, they may um they may need a little more explanation.

SPEAKER_03 8:00

Oh, yeah. That's a brand new term for you. It is not actually specific to physical therapy as a practice, so it's a little outside of our scope to talk about. So you would still need to ask an MD. And I would then if true diagnosis happens, I'd recommend like a sports dietitian. But generally, I start thinking about maybe someone is has relative energy deficiency, meaning like we are in a caloric deficit, whether on purpose or on accident. And it the a teen would come to me. I'm trying to think what a teen would say, if like someone like that person would come and say, I I had a girl come and say, She's like, I was getting faster, and I was getting faster, and I'm just so tired at the end. Like I'm eating my extra snacks, like I'm doing the things, and I'm just I'm just getting so tired. Or they've started to be a little more ache and painy, but it like goes away when we wake up and they just like feel like they can't for no reason. And it's a little, it's more than teenage tired. I think it gets brushed off a lot.

SPEAKER_01 9:11

Yeah, I think for the the athletes that I see, sometimes it also looks like like recurrent like little micro injuries, yeah, or like like a like an injury that's not healing all the way. Like, oh, I I sprained my ankle in practice a couple of weeks ago, or I just I have this kind of nagging pain. And then you look at them and you don't see necessarily something that's going on.

SPEAKER_03 9:30

Um, I don't know if you're seeing that as well, but that's one of the things that's kind of what I meant by like those little like aches and pains that I think, particularly for like the imaginary person we were talking about, the high school track girl that has scoliosis. Like for that Beth, right?

SPEAKER_02 9:47

Yeah, Beth did track. I had shin splints for sure. Yeah, I don't know the imaginary person is Dr. Beth. Yes, when I started track, I weighed 99 pounds.

SPEAKER_03 9:57

So, yes, potentially I was on that borderline of I could have fallen into that red area, but yeah, I think the other question important to at least like if this is something you suspect, like this little cloudy picture is something that we're and there's a there's actually a couple of great screening tools online. Um, I really follow the Stanford Faster F-A-S-T-R out of Stanford University, like has a program, and there's a few great people, then they have links to screening tools if you're a clinician or a parent that's concerned.

SPEAKER_02 10:33

I would imagine, I don't know that we have like research connecting the two, but I would imagine that potentially girls with scoliosis who are running track and doing more endurance sports might actually be more at risk because I think they tend to have lower BMIs in general. So I would imagine that there that also is a potential risk factor for breads or not necessarily.

SPEAKER_03 10:59

That's where my brain has gone, but I couldn't find anything definitive looking at the population. It's also just a very like new hot topic, newer hot topic buzzword that I think people are starting to see in the general population, but we still have ways to go for research there. And so yeah, for this specific population, I don't know anything, but that's the same. That's exactly where my brain goes when I start seeing like my teens come in that start to have this picture.

SPEAKER_01 11:35

I think also, I think, um, and this is I I see also, you know, boys with scoliosis as well, but those we were spoke speaking a little bit before we hit record about those weight-driven sports. Like you have to meet a certain weight. Um, so you know, like our wrestlers or um like those anything where you're looking at weight class, you know, um, are they fueling appropriately? I think that's a that's a something to consider too. Like if you're a therapist or a clinician working in this space, like is this a sport where maybe they're intentionally not eating enough?

SPEAKER_03 12:10

I I agree. And the it's I think I've had to change my thought process for boys too. Like I have to really listen to those, like a common word you'll hear in in runners. I don't know if weightlifting has another or other spurts have another term, but the one that I hear a lot is niggles, because you don't want to call it an injury, but they'll say, Oh, I just have all these niggas. That's what I almost said when you were saying that earlier. But I'll really hear that. Yeah.

SPEAKER_02 12:42

That comes from the UK. A lot of my clients from the UK say that it's kind of like a little like um like something that's bugging them, but it's not necessarily an injury.

SPEAKER_03 12:53

Yeah, or we don't want to call it one. Or I've also heard it called like glimmers or like some shiny, like implying that it goes away, or really hope it goes away, but really paying attention to those, like you said earlier, um, especially for boys, because we I mean, I hope that all of my girls with scoliosis or all of my runners like listen to their body that well, but if we get so far along, we don't have that red flag for boys, like that loss of menstruation. And so I think we do have to be extra diligent about them as well, especially like weight-based sports or even in cross-country. Like I think boys also sorry, go ahead. Uh no, I was just gonna mention like because it's like running isn't necessarily quote unquote like a weight-based sport, but I think subconsciously, like you can you can sit here and we can picture the average image of a cross-country team, right?

SPEAKER_01 13:57

Yeah. I I think also just historically, at least here in the US, I feel like a lot of boys and men tend to under-report symptoms too, or feeling symptoms, almost like that that whole um, like don't complain, be a man kind of um, you know, culture, I feel like can cause them to gloss over some stuff. So it's it's almost like you have to really pay attention to, you know, listen to what they're saying and ask a lot of clarifying questions, like, is that thing actually bothering you? Because it seems like there might be something. Agreed. Yeah. So I know um one of the things that I really am curious about. I talk a lot with my um teen athletes uh right around puberty time, especially when I'm thinking about girls. And we know that girls, when we hit puberty, we actually have a change in the alignment, like as your pelvis gets wider, it kind of changes the alignment of how your hip is and how your knee is. And just because of that, we tend to be more prone to injuries as we adapt to that, unless we're doing like the strength training and the stabilizing work and whatever. And I'm not sure if there's anything in particular that you're that you're doing, or are you advising the the runners or the athletes that you're working with to do specific things to sort of overcome or just be protective of that?

SPEAKER_03 15:29

I think it's extra important for my teens and really for everyone, but specifically for reasons we said for my runners with scoliosis to strength train. Like you strength train. I also, especially if they're young, like I want them to love, I would ideally want them to love another form of cross-training. I don't care if it's softball, like that has a running component, but also some multi-directional other things. Like, I don't care what else it is, but if should they ever feel a glimmer, like I want them to have another outlet. And we know that we've talked about it before that that variety is great for them anyway, but they should strength train. Like, and when I it doesn't have to be like formal, they're planning to power lift, but again, getting that load so that their body, even if they are like truly in their brain, like identify as a runner, I frame it for them as like, well, let's make sure your body can do even more than run. Because if you look like look up like how many body weights you're sending through each leg when you run, like let's make sure your body can accept more than that in a controlled manner. And then we can start. That's when I like will incorporate their scoliosis specific corrections because that's the time that their brain can slow down. And like, if I can if they can learn to push this weight in a more balanced way, I don't have them, I actually don't have them think about it while they run. I tell them that I'm like, while you're doing the thing, the one thing you love, you do not have to think extra about your body, just go move your body and yeah, it would slow you down too.

SPEAKER_01 17:22

Yeah, you can't hold your corrections and run quickly.

SPEAKER_03 17:25

Like, it would be impossible. B like I don't, but I don't I like at least like try to make an extra point to relieve them from like the brain energy of that part. But for their cross-training, especially like something slow, like that where the movement is purposeful, like weightlifting. I'm like, no, you get to think about it then.

SPEAKER_02 17:45

Sorry. Yeah, I'm the same. When when clients are doing their sports, they can have a break from um from worrying about correction. It's it's funny because um you mentioned before, like I ran track in high school. That was kind of my introduction to weightlifting. And a big reason why they had the girls at my high school weightlifting was because my high school had been all boys for years. That's right. And it turned co-ed, I think, like four years before I came in. So they just trained the girls similar to how they trained the boys. They didn't really like they had trained boys for so many years. They're like, Yeah, you can go down to the gym and lift weights. Like, we'll bring you down there. But I didn't realize at the time that wasn't like a common thing. Like, I'm like, no, no, all the girls on the track team are lifting weights, like all the other teams. Um, but but yeah, so it it can make a big, a big difference. But I think it's more so coming into like the arena of like, yes, you can run, but you need eat another sport, or you need to also be strength training. Um I think that's now people are doing more of both.

SPEAKER_03 19:00

Yeah, especially during growth and the the bone loading, say, like for the study we talked about last time, not particularly in that population, but even just applied, like when we were talking about hopping or jumping, which is great for bone loading. I really like to use that as a warm-up, but like doing that earlier, like there is better like long term. Like, I can I can't go back, or no one can go back and do jumps when they are 15.

SPEAKER_01 19:34

Like I think that's yeah, I actually I recommend the agility ladder. I'm like, you can get one little cheap online and you can be creative, you know, you can hop one-legged, two-legged, forwards, backwards, sideways. You should be doing all of them and you know, make patterns almost like make it like a hop scotch type game. And I find that that's that's a great way, especially those really shy teens, to like pull that out and like put on music that kind of like open up. Um I I think we were we were going to talk a little bit about the core component. So you had mentioned the obviously if someone is seeing a scoliosis therapist, they probably do have some form of scoliosis correction that they should be doing. But what types of core work are you suggesting for um, you know, warm-up, uh cool down, or how to modify for somebody's scoliosis? Is there any kind of general advice that you're giving for people with scoliosis?

SPEAKER_03 20:34

I generally tell them so if I, which like we're all our own worst patient. So even like ideally, if I was going to do what I preach, my running warm-up would be some hops, like multi-directional hops, like eight to thirty or some drop downs, and then which in theory would address the bones and some tendon return. And then I would I personally would do a third like a 30-ish second side plank on each side. And then maybe a center one do some of the average like dynamic hip mobility while holding myself in proper loading correction posture. And so it's not a super big modification for them, really. The only the core part, if I have taught, like if that if you are a person with scoliosis and you know some of your more advanced, like non setup exercises for Shroth, I would have them go there. So some of the maybe some of the standing ones, because I think we've all been there. And even as someone without scoliosis, I have been a demo for those courses, like. My core shakes with or without scoliosis. So I think I would just that's one way that I use to like incorporate it in. And then if they have whatever modification they may need to do for general core is totally fine for me.

SPEAKER_02 22:20

Yeah, I like this. Having the warm-up, I think, and the cooldown is so important because a lot of times coach just sends them like, go run a mile to warm up for running more, right? So they're not getting maybe those specific muscles activated, those those stabilizers activated that they need a little bit more of for their routines.

SPEAKER_01 22:44

Yeah, I I don't know. I I also realize that we all practice in different regions within the eastern, even just like with that, we're still all in the eastern section of the US. But for instance, I notice a big difference in some of the athletes that I'm seeing whose coaches are recommending some cross-training. And then that there are some coaches, to Beth's point, who are either not recommending it or like they aren't doing it. So then, you know, it's it's I feel like it's part of my responsibility as somebody on this family's care team to kind of talk about why we should be doing cross-training and what you know what we should be doing and why it's important. So if you were um put yourself in the shoes of someone who's listening who maybe is like a family member with uh who's dealing with this. So if if maybe, or you're a teen, if you are doing a sport or like your child is doing a sport and you don't know if they're getting this type of advice, like what um what would you what would you tell them? What would what would they need to know and how would they start?

SPEAKER_03 23:59

Well, if they want me to talk to their coach, I will be glad to talk to their coach, is the first thing I'll say. But they are also plenty capable of standing up for themselves and their child. They like just to know that it's safe, like they can reference, I won't send them down the research rabbit hole unless they really want to, but to provide them the resource to say, hey, no, I really think even if you frame it, especially for a coach and PTs, honestly, like if you frame it in terms of performance, especially performance and safety. So say, like, I think my child or myself will have better performance and it will be safer for me, and I will enjoy this activity more, like really just having an honest conversation with them, yourself or the coach, like whatever the barrier seems to be for that cross-training, and then see how that response goes. I've seen plenty of coaches that just say, absolutely not, and then my patients just kind honestly kind of have to do it on their own, which is sad. But I I thankfully, like in frequency, think that that is fading as we have more of these conversations.

SPEAKER_01 25:23

Yeah, I think when I I've tried to frame it from like an injury prevention perspective. And I think for at least here in the in the southeast where I am, um, the the coaches tend to be more receptive, even if they don't understand the benefits of it. Like, oh, if it's gonna keep my kid, like keep this kid from being benched, you know, like keep them from getting injured. But yeah, it is interesting. There's um there's so much discrepancy like between like one school or one team to the to the next. It's really like the wild west.

SPEAKER_03 25:55

Yeah, and you could even point, because like right, elite teams, elite teams are doing it. Like, even say, hey coach, like I saw that all these Olympians are strength training. Like, that's usually a good like point. And say, and I've had a few, I have a few teens that like in just in terms of modifying or doing something different, they need to like my some of my teens are shy about doing a different core work while their team is doing something else. And so occasionally I'll need to give them something that like looks similar. Side plank usually works there. I've had a few ask about like doing full sit-ups, like that's for whatever reason, part of their yeah, for whatever reason that's still there.

SPEAKER_01 26:57

And people just aren't creative, they're like, oh well, sit-ups work. Yeah. We always done sit-ups for 30 years. We've done sit-ups. Why should we change it now? And we can still run.

SPEAKER_03 27:07

Awesome. Like, yeah, I think I think usually it's more now the run-in with the coach that I have for like those little things, like small, quote unquote, like smaller differences where like a teen and I will have that conversation, or parent can have that conversation of like just as a team activity, like maybe we change this routine up.

SPEAKER_02 27:32

Absolutely. I think that I think that makes sense. And yeah, like you guys said, there's a mixed receptiveness to that. So um, I'm curious your thoughts because obviously these teens are gonna grow up um and become adults who either continue to compete in track or you know, potentially have now recreational running as like their hobby or their um their sport that they like. So do things change as we get older with scoliosis and running? Have you how do you work now with maybe an adult who has scoliosis and wants to be a runner as their their sport?

SPEAKER_03 28:18

Oddly enough, the answer is pretty similar. Like, especially if they have a background in running. I have told you all the story of the lady I had who got told just not to run for no reason. She was having like some aches and pains, but we brought her right back to running just like gradually. She at least had been there and so like kind of knew the motions to go through, like, start with a walk run. Um loading wise, I think the harder person for me to think about is maybe they want to newly start running, which I honestly like I think is fine as long as you are honest about listening to your body. So, and I think there are also running screens like hops and jumps, almost like which are technically, I believe, researched as return from injury. But if you can making sure your bone, like your body feels okay doing these hops, like that warm-up almost then, like not officially, but kind of functions as a test. Like, am I ready to low load my bones in this way? Like, am I ready to mold my muscles in this way? And hops don't have to be full hops, they can be like heel drops, like going up on your toes and then just like forcefully going into your heels. And yeah, they can still slowly like progress towards their goals as long as we're honest with listening to our body.

SPEAKER_01 29:50

Yeah, um, I almost find it more challenging to work with the adult who was who was a runner and maybe even a longer distance runner who has fallen out of it for years, sometimes, you know, like a decade, and is wanting to get back in. Because I feel like to your point, Jen, it's it's like sometimes, and I've been guilty of this as well, like after having a kid, you know, do you just you you stopped by doing a five-mile run? Like, why can't I just get right back into a five-mile run again? Um, and so I find that sometimes that conversation, at least in in my my experience, that conversation is almost harder because it's like there's that motivational interviewing of like maybe we don't start immediately with five miles, maybe we start with a half mile and then go to a mile and maybe we work up to it.

SPEAKER_03 30:38

Yes. This also one of those things. If I did what I told recommend you do. I I understand, and actually thinking it's funny because the the heel dropdowns I actually got from one of my great like postpartum pelvic PT colleagues and like progression to like right, that's still a progression to hopping, which is a very typical part from what I understand of a postpartum return. And there are specific postpartum return to run providers online that you can find. I'll be glad to guide you and I can guide you, but they're even more niche than that as well.

SPEAKER_01 31:21

There's uh Dr. Grania Donnelly out of um out of Ireland. I don't know if you're using hers, but she she's one of the first ones that developed like a true like return to run protocol when it was very much just like individualized, like we're just gonna try all these things and see what works and see what doesn't. But I I like her stuff a lot.

SPEAKER_03 31:40

Yeah. And as as I said the sentence ago, I'd else say it again. Like, as long as you I feel like that sentence could also be applied postpartum in general. Like, as long as you listen to your body, these timetables are or what you can achieve and get back to or exceed from before are so great. So yours may not look exactly the same as everybody else you're running. Form may not look exactly the same as everybody else. The research is actually very split on spatiotemporal like differences in scoliosis. I think all the studies I saw are on adolescent, like AIS. But so, like, does their our step length look the same, et cetera, et cetera? And I couldn't find anyone with like super meaningful concrete results. And even I could find about evenly like some people say there are these differences, and here some say no, none of these were significant. So they also made no conclusions, therefore, they're just looking at the differences themselves. So we still have no causation correlation things.

SPEAKER_01 32:58

Yeah, it's super interesting. I was I was about to say, can you define spatio-temporal? But I guess I guess you kind of did. Like like kind of step length, how someone's one side versus the other. I think sometimes as PTs, we can we can forget like the um the the words that we use that are actually quite, you know, um quite niche.

SPEAKER_03 33:18

Correct. I I like my partner sometimes. We have vast different interests in podcasts. And I'll just send him things and he's like, that is a different language, Jen. Like you are gonna have to summarize this podcast for me. I'm not gonna listen to it. Even when it's about running, and he's a really like he's a big runner. So he's like, I get the running pieces, I can listen about shoes, but yeah. Everyone always please stop us if we a PT does that to you. Please.

SPEAKER_01 33:52

We can forget. We can forget sometimes that we're speaking a whole different language.

SPEAKER_02 33:57

Yes. Awesome. Yeah, yeah. Uh the uh the other question talking about these like changes, because it sounds like with scoliosis, uh we don't we don't have concrete evidence to say like, okay, people with scoliosis run differently than a person uh without scoliosis. But what about if that person had a fusion? I think that fusion can I've seen some research, although I don't know that it's like very sh big studies, that after spinal fusion, your running gait can change. But um, do you work with clients who've had spinal fusion? And then another question too there is these are really the clients that I'm hearing a lot of the doctors telling them to stop running because they're worried about um issues with the discs above or below the fusion. So I'm curious how you how you educate people as well.

SPEAKER_01 35:00

Um I'll even piggyback onto that because I feel like it's related. I have some some athletes, like especially teen athletes, who get the fusion, and then of course, gate feels different, right? So it's it's almost like having to get used to that sensation of like that almost like there's like a jarring, like that we know, like there's there's nothing inherently dangerous, but it can be very like nerve-wracking when you're running to just feel like oh wow, like there's it just feels different.

SPEAKER_03 35:31

Yeah. Um, Beth, I think I know which like studies you're talking about. They obviously like those sample sizes are pretty small. Some do find like it's again, it's all mixed. I wish we looked at it more because I think we'd need that to say if there's any difference in injury rates in it and anything else. But I've had some really not to say like I know my own like mental catalog of patient outcomes returning to run after a spinal fusion. I do work with patients after a spinal fusion. As long as you're patient with your timelines, I think that's one of the number one times I see that trap of like, oh, I used to be able to run and it felt like this. And just give yourself a really long runway. Be honest with yourself. If we really need a mental health provider, a like especially like I've seen some incredible results in conjunction with sports psych. Like, especially for if we're talking about a high school athlete who still like has their whole life aspirations or not, like, or someone that wants to return to doing triathlons or anything else, like you are the elite athlete of your own like biggest goal, and I think that's really important. So I do think it's very typical like to see some frustration and some changes in gay. It's just a question of like whether it's meaningful to you, because we don't really have great research guidelines out there for that.

SPEAKER_01 37:18

And uh the I have a it's an N of one, but I have I was gonna say sports psych, sports psych for anyone who doesn't understand is like sports psychology. So there's there's a group of people who who work with uh mindset and athlete, like people who are athletes and that are having a hard time with the emotional component. So I just wanted to clarify correct.

SPEAKER_03 37:40

Yes, there are psychologists that specifically specialize in sports as well as other mental health providers. So finding someone, as I recommend, all your doctors if you can, finding someone who understands how treating athletes might be different physically and mentally and in terms of their goals. And yeah, the end of one that I think of is I have a really excuse me, inspiring colleague outside of these two. I have even another inspiring colleague who is fused. And she she's actually had two surgeries, I believe. And she's still out there. She has said to me before, she's like, Yeah, it waxes and wanes and her her runways may be years between each, but it was her biggest goal to get back to doing ultra distances. And I think as long as we accept, like, if this is my goal outside of hurting myself, like in terms of form, like how this looks, if I can return, I can walk ultra distances, and that's okay. I am still a runner, I am still myself, and I can still complete those distances. I think thinking about that from those multiple perspectives is beneficial.

SPEAKER_02 39:11

Ultra distance is greater than a marathon.

SPEAKER_03 39:15

A marathon is 26.2 miles. Yeah. So that that's a whole separate funny yes, yes, the definition of an ultra marathon being just anything longer.

SPEAKER_01 39:30

Yeah. I've I have some friends and colleagues that do like hundred milers. And um, I I think that's a whole different breed. Like I I couldn't I could not imagine just the the the mental and physical um aspects of running for 100 miles. Yes, boggles the mind. It can be done. Not by me, I'll tell you that right now.

SPEAKER_03 39:55

That was like I personally, it is not one of my personal goals. But I I am very familiar with those for who it is, scoliosis and without.

SPEAKER_02 40:09

If I had to run anything over 400 meters, it was a punishment. It was it was Spath, you weren't training hard enough this week. I saw you, so guess guess what you're racing this weekend?

SPEAKER_01 40:22

Oh no. I I see little teenage Beth's face right now. Yeah, I can feel the eye roll. I I feel it.

SPEAKER_02 40:31

Oh, it's even worse when when you're on like the G team, so your team's already been lapped a few times, and then you have to run 800 meters basically by yourself. That's that's really like I never slacked again after that.

SPEAKER_00 40:50

Oh my goodness.

SPEAKER_01 40:52

No, it's it's too funny. Um, I think one thing that I I feel like we could use, and I I know we've talked, I think we talked even in the last episode that you did with us, Jen, on um how there isn't like enough research on just in general on scoliosis or spinal fusion, even on their own, much less looking at athletes like in and sport. And I think that there's more. So in an ideal world, you know, I think we in all of our spare time would be able to like pull together, yeah, yeah. Listeners, there is no spare time. There's there's never spare time. It's always build. Um, but I think you know, we we um would have more research or we would do more research. But I think one good thing to kind of bring up too is just because there's not a bunch of research doesn't mean that we don't know, um, we don't know the like what am I trying to say? Um the we don't know why these things are beneficial, right? Like why strength training is beneficial, why why running is not inherently dangerous, why like our bodies can withstand. So I think that um, you know, as as we kind of like wrap that all up, I think it's important to know that like our bodies are resilient. And even with scoliosis, even with severe scoliosis, let's talk again about like Usain Bolt or you know, these athletes with severe curves or spinal fusion, like Kyrie um Condi? Is that her name? Kyrie? Kira? Yes, Kira. That's it. I should know that. But yeah, um, I think that it's that's also another thing that I try to tell the athletes that I work with too is like just because you have this thing doesn't mean that you're any less powerful or any less strong of an athlete.

SPEAKER_03 42:41

She posted a video yesterday of her like picking up I swear it was like 150 pounds with her fingers for climbing training. See, weightlifting there too.

SPEAKER_01 42:54

Yeah. I mean, I don't know if you guys have ever done like a full day of climbing, like the next day, it's like your gripper fingers and the forearms are just like oh yeah, I but that was like after less than an hour.

SPEAKER_03 43:08

I yeah.

SPEAKER_01 43:09

I I yeah, it's it's intense.

SPEAKER_03 43:11

That also counts as another sport. Like 100%. That also can be your cross-training. That's how I would think about it when I was climbing. I was I really loved the bouldering gym when I lived in Texas. And that was my arm day. Because as a self-identifying sometimes runner, I forget I have arms sometimes. And they also need to be trained.

SPEAKER_01 43:45

Yes, you you do have arms, Dr. J. I do. You you need them to to do things. I do.

SPEAKER_03 43:51

Everyone. All of your limbs are important. Let's keep them as strong as they can be.

SPEAKER_02 44:01

Great. Well, is there anything that we didn't chat about, Jen, or that you wanted to add, or maybe like if you're talking to the people who are listening to this, any like closing remarks for them?

SPEAKER_03 44:15

I mean, I would always love to keep talking to you. I think especially I don't want to go further into the rabbit hole, but the first conversation of really digging into red to red us is interesting, but they can they can see those resources explained a lot better than I would right here. And I think I'll just yeah, I'm gonna leave them with exactly with what we just said is that your body is resilient.

SPEAKER_01 44:49

I think we can also in the show notes just leave a little description of like what is Red S and what does it mean or what are the signs that you that you would look for? Um, because I I think that it is still even in the athlete population, I think it's it's still not as depending on where you train or you know who you work with, you may have not even heard of it. So yeah, we can apply to just teams. Or just women or just girls, or yeah. Even though it's it tends to be more we see it more in girls and women. Correct. Cool. Yeah. Well, thank you so much again for taking some more of your precious time to chat with us and kind of break down the what we know about running and scoliosis infusion and um just uh being with us. We always enjoy talking with you.

SPEAKER_02 45:42

Yes, you too as well. Thank you. Thank you, everyone, for tuning in, and we'll see you on the next episode.