Setter and rising ninth grader Hope Lapsley, 13, from Cary, N.C., thrives on the competitiveness and intensity of volleyball. Hope started playing just three years ago but already sees herself continuing all the way through high school. Committing to two-hour practices four days a week, she plays all year long for her school and a club team. Her dedication helped her middle school team win their conference last year.
Her prospects seemed very different three years ago when Hope thought she wouldn’t be able to compete in any sport at all.
Hope began to experience back pain during and after gymnastics practice, which she couldn’t seem to cure with extra stretching and visits to the chiropractor. During her annual physical, Hope’s pediatrician became concerned by the curve she observed in Hope’s back. A follow-up X-ray revealed an S-shaped curve, confirming that Hope had adolescent idiopathic scoliosis (AIS).
AIS occurs when the spine twists and develops an S- or C-shaped sideways curve. Typically, scoliosis appears between the ages of 9 and 13 (or until skeletal maturity), and often the cause is unknown, though it has been shown to run in families and is more common in girls than boys. While AIS is fairly straightforward to diagnose, the diagnosis doesn’t paint a picture of what to expect in the future. Because progression varies, some patients just require monitoring, whereas others will need long-term bracing or even surgery in the most severe cases.
As could be expected, Hope’s parents were alarmed when Hope was diagnosed with AIS.
“I was surprised because I thought she just had a pulled muscle,” said Hope’s mother Tamara, “but then I remembered that years ago my husband was seeing a chiropractor who remarked that he had scoliosis, too. Hope’s diagnosis made more sense after I realized that.”
Hope’s doctor, pediatric orthopedic surgeon Keith Mankin, M.D., from Raleigh, N.C., recommended that she continue with her activities in order to build her core strength. Hope was attracted to volleyball because she wanted to be part of a team.
“As a setter, you’re the leader of the team,” Hope said. “You have to call all the plays and I love the competitiveness of the game.”
Dr. Mankin suggested that, in addition to having Hope continue with sports, the Lapsleys have Hope take a genetic test called ScoliScore Test, which could help predict how her scoliosis would progress over time, thereby allowing him to personalize Hope’s treatment strategy. To take the validated test, Hope had to spit into a test tube and then wait for lab analysis. Four weeks later, Hope’s ScoliScore results (based on her genetics and her X-ray measurements) revealed her score was 179 out of 200, a very high score.
A high score means that Hope’s curved spine is predicted to get even worse as she grows. Therefore, Dr. Mankin prescribed bracing for Hope. Luckily, because her curve was caught relatively young, she only needs to wear it at night and not during school or volleyball practice.
“Nothing keeps me from playing volleyball,” Hope said. “I can warm up and play as hard as everyone else on the team. Sometimes, I’ll have some back pain if I practice my jump serve over and over, but that’s not a big deal. Volleyball is a great sport and I love how exciting and competitive it is. It’s intense and fun. Having scoliosis doesn’t mean I have to quit this sport that I love. Having scoliosis doesn’t prevent me from doing anything I want to do.”
“Kids, like Hope, who have adolescent idiopathic scoliosis do not have to give up volleyball or any other activity they enjoy,” confirmed Dr. Mankin. He said that playing sports is a nice way to compliment the benefits of wearing a brace. “I encourage patients like Hope to exercise and strengthen their backs.”
No matter the shape of your spine, pick up that ball and play!
>> For more information on adolescent idiopathic scoliosis, visit the National Scoliosis Foundation at scoliosis.org. For more information on the genetic test visit scoliscore.com.
Originally published in November 2013