When I was a young girl, my sister and I loved watching the Miss America pageant and dreamed about becoming beauties when we grew up. We would practice our walk down the “runway” in our bedroom and wonder about what kind of talent we could demonstrate. The only thing I was good at was swimming, but that is hard to do on stage.
The other thing I remember about the pageant is the day my pediatrician told my mother that I would never win the Miss America title. The reason? Adolescent idiopathic scoliosis, or a lateral curvature of the spine of unknown cause. I was going to be fine, but was terribly insulted.
This is an posterior-to-anterior X-ray of a case of adolescent idiopathic scoliosis. (Photo credit: Wikipedia)
My mother first observed the changes in my back when I was 12, and we went shopping for a two-piece bathing suit. My shoulders were uneven, and my curves were not symmetric. She kept asking me to straighten up. I told her that I was standing up straight! She was right, though; I was crooked. So off we went to the pediatrician and then to an orthopedic surgeon.
The most common type of scoliosis is adolescent idiopathic scoliosis. About 2-4 percent of children age 10 to 16 years will have some degree of scoliosis. It often occurs in young teenagers during a growth spurt. Scoliosis is a rotation of the spine and a lateral curvature. When the upper back is involved, the shoulders and shoulder blades may be at different heights, and the rib cage is more prominent on one side. When the lower back is involved, the hips may not be level. Both upper and lower back may be involved forming an S curve of the spine.
As stated before, the cause is still unknown, although genetics account for some cases. It is known that it is not caused by carrying heavy bags, sleep position or leg length differences. A quick test to see if a teen may have scoliosis is to have the teen bend forward at the waist and put his or her hands between the knees. When viewed from behind, a child with scoliosis will have a rib hump where one side of the rib cage sticks out more. Occurring in boys and girls, scoliosis is both more common and more likely to progress to require treatment in girls. With a small curve, observation is usually all that is needed. If it progresses to a moderate curve, then bracing is ordered to prevent further progression. Large curves require surgery to protect the function of the heart and lungs.
As an adolescent girl, having a crooked posture or having to wear a brace can have a significant emotional impact. Clothing may have to be chosen to accommodate a brace, which is a plastic shell formed around the chest and hips and worn beneath clothing. Even if a brace is not worn, fitted blouses don’t fit and clothing may slip off a shoulder.
This is where moms can play an important part, not only in altering some clothes, but by letting the girl know she looks beautiful and she is more than her spine! Encourage her participation in a sport or activity. A sport strengthens her core muscles, which is good for her back, and it makes her feel strong and competent. Belonging to a group activity or club will help her to see that she is important and has something special to offer. Also, the other girls often bond around the sport or activity and not around superficial qualities.
I always considered my curvature a variation and not a deformity. It never defined me or stopped me. I have one dress hanging in the archives of my closet that makes me smile. I wore it to a fancy party years ago. It is a long, black, slinky, velvet gown with poufy, white chiffon around the neckline and draping down along the deep v-shaped open back, ending in a train of chiffon folds. I felt so glamorous. I didn’t care that my back was on full display. All I needed was a tiara and an arm full of roses. I was finally Miss America.
Heidi Eve-Cahoon, CNP
Breast Care Navigator
Summa Health System
