Con Motivo de la publicación del último trabajo de Philippe Souchard (Creador del método RPG) desde el Centro de Fisioterapia y Osteopatía Eguzki revisaremos esquemáticamente el mapa que ya hicimos para guiar a los padres en el proceso de la escoliosis para que podáis hacer un cierto seguimiento del proceso de vuestros hijos e hijas. Además incidiremos una vez más en los factores de riesgo de agravación para saber de qué hay que estar alerta con el fin de comunicarlo a un profesional.

Primeramente decir que aunque, en general, no se da importancia a la escolios en “C” del recién nacido, que se presenta antes de los 4 años, en el Centro de Fisioterapia y Osteopatía Eguzki sí lo hacemos ya que consideramos la hipótesis de un origen craneal para la misma. De modo que habría que atenderla antes de la osificación del occipital a los 4 o 4,5 años.

Después tendremos en cuenta el pico de crecimiento entorno a la pubertad. La media sitúa la pubertad en los 13 años en las niñas y en los 15 años en los niños. 1 o 2 años antes y después de esa fecha se produce un crecimiento más potente. Un crecimiento de 1cm al mes en estos períodos es un signo claro de alerta para una persona con escoliosis. Y especialmente en las fases en el que este crecimiento es más importante en el tronco que en las extremidades.

De los 5 a los 10 años, el crecimiento es de 2/3 para los miembros y de 1/3 para el tronco. A los 11 años en las niñas y a los 13 en los niños estas cifras se invierten y es de 2/3 para el tronco y de 1/3 para las extremidades.

Otra cosa que tendréis que tener en cuenta es si vuestro hijo o hija es muy laxo a nivel ligamentoso ( dobla mucho los dedos hacia atrás, “saca” el codo por delante al estirarlo…). Normalmente en estos casos el riesgo es mayor ya que hay menos freno para las fuerzas musculares.

Cuando la escoliosis tiene un factor de nivel inferior también agrava la situación. Esto es algún problema proveniente de las piernas, como podría ser una luxación congénita de cadera que no haya quedado del todo bien reducida por ejemplo.

Además hay que estar atentos a los problemas sobreañadidos. Lo más habitual es que la escoliosis no duela, de tal forma que si vuestros hijos se quejan de dolor de espalda es posible que haya otro problema de distinto origen que pude causa un aumento de curvaturas en la búsqueda que hace el cuerpo de una posición indolora para seguir funcionando.

Aparte de todo esto haremos un comentario acerca de la actividad física conveniente para estos chavales. Están en una edad en la que les conviene moverse e integrarse en los juegos con el resto de compañeros y compañeras así que en principio no prohibimos la actividad deportiva. De todos modos toda actividad física implica acortamiento muscular (incluso la natación) que va en contra de lo que se intenta conseguir con el tratamiento. Así que como pautas diremos que se desaconsejan ejercicios que impliquen musculación, con actividades lordosantes (lanzamiento en baloncesto, voleibol) o con esfuerzos de tipo competitivo. Que jueguen pero de forma lúdica y haciendo actividades de bajo impacto.

Eleder Gaztelurrutia

Fisioterapeuta Col.nº79

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