Scoliosis is an abnormal curvature in the spine, often diagnosed in children and adolescents, but can occur in adults too. Usually, mild cases do not need treatment unless they progress significantly. However, moderate scoliosis needs treatment, for it may progress with time and might cause several health risks. While it is not possible to completely reverse Scoliosis and fix the curve, it is indeed possible to lessen the problems and also prevent the progression of the condition with exercises and therapies such as yoga.
Lura, an experienced teacher and yoga therapist, has helped several people with scoliosis. And, here, in this article, she, through her profound experience, talks about scoliosis and how yoga can help manage the condition.
Lura, in her words…
My first encounter with scoliosis
The very first client I remember with scoliosis was a real awakening for me, ten years ago when a young woman in her late 20’s came to a regular yoga class. As we progressed, I started to notice her imbalance was quite severe, and she began to tell me about her chronic pain.
I ask if she has ever been diagnosed with a problem. At first, she said no. Then, a few days later, she returned to tell me how much the class had shifted things in her body, something had eased an old pain, but new sensations developed too.
She had remembered that in high school, she was told she needed a back brace but told her parents she would never wear it, and she did not. And, here she was at 28 years with one hip raised and her waist shortened and chronic lower back pain. She had Scoliosis.
So we got started, and it took time. We could not undo all of it, but we could lengthen muscles that were tight, we could firm what was soft, we could create flexibility, we slowly created a balance in her physical being. That lent support to the spine. (Now she has changed her life, she is back in Germany and is a yoga teacher).
What Is Scoliosis?
Scoliosis is a sideways curve in the spine shaped like an S or a C. Often, it is first noticed in children between 10-15 years, physically by a doctor. It occurs equally in both genders, and you are more likely to have scoliosis if your parent, brother, or sister has it.
Scoliosis itself is painless in youth, but normal ageing related degeneration of the spine and daily lifestyle/habits may lead to a number of issues in the lower back-lumbar spine, the rib cage along the thoracic spine, the hips or legs, pain in their lower back and physical fatigue associated with extended sessions of standing or sitting. Further, untreated scoliosis can progress at 7% per year and result in disability and life-threatening health risks. Yoga can help well in preventing scoliosis progress further.
Signs of scoliosis
Common signs of scoliosis include,
- A visible curve in your back.
- Shoulders, a waist, or hips that look uneven.
- One shoulder blade looks bigger.
- Ribs that stick out farther on one side of your body than the other.
- In your clothing, one sleeve or pant leg may habitually be too long.
The angle of the curve
The angle of the curve may be small, large, or somewhere in between and usually is a number that decides the type of treatment.
- A mild curve is less than 20 degrees and might be visible to other people.
- A moderate curve is between 25 degrees and 40 degrees. Typical advice would be to surgically place a flexible metal rod (called the brace) along the spine.
- A curve with more than 40 degrees angle is severe and is usually advised for surgery.
Types of scoliosis
1. Idiopathic scoliosis is scoliosis without a known cause. In as many as 80% of cases, doctors don’t find the exact reason for a curved spine.
2. Congenital scoliosis begins as a baby’s back develops before birth. Problems with the tiny bones in the back, called vertebrae, can cause the spine to curve. So, the vertebrae may be incomplete or fail to divide properly. Doctors may spot this rare condition when the child is born. Or they may not find it until their teen years.
3. Neuromuscular scoliosis is caused by a disorder like spina bifida, cerebral palsy, or a spinal cord injury. These conditions sometimes damage your muscles, so they don’t support your spine correctly. That can cause your back to curve. This type is structural scoliosis, and a reversal is not possible.
4. Degenerative scoliosis affects adults. It usually develops in the lower back as the disks and joints of the spine begin to wear out as you age.
Yoga and scoliosis
Knowing what scoliosis is, commonly noticed signs, and the types, let us move on to how yoga can help in scoliosis.
Why is the spine important?
The spine is of utmost importance in yoga. It supports our entire torso giving space to all the organs and room for the diaphragm to move, engaging our breathing (Pranayama – life force energy).
It is considered the energy conduit for our physical and mental states as it carries the vagal nerve to the brain driving our central nervous system.
Called Sushumna in Sanskrit, the traditional Indian medicine Ayurveda refers to these channels as nadis. Traditional Oriental medicine called them the meridians through which energies such as prana of the physical body, the subtle body and the causal body flow through the spine. Within this philosophical framework, the nadis are said to connect at special points of intensity, the chakras.
In the physical body, the nadis are channels carrying air, water, nutrients, blood and other bodily fluids around. They are similar to the arteries, veins, capillaries, bronchioles, nerves, lymph canals, etc.
In the subtle and the causal body, the nadis are channels for so-called cosmic, vital, seminal, mental, intellectual, etc. energies (collectively described as prana) and are important for sensations and consciousness.
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Yoga Asana – working on imbalances
In Yoga Therapy, we often work on imbalances. We develop balance in the body, breath, and thoughts with yoga practice.
Asana is the physical practice of yoga where we combine Breath, Movement and Awareness to develop a link between the internal and external body.
To stretch, strengthen and balance the body. This is where yoga practice for scoliosis begins. So we work with Scoliosis in young bodies and old, for different reasons, looking for different results.
Approach to treatment
Our treatment is geared towards relieving symptoms, improving posture and creating strength and balance in the trunk of the body and not necessarily fixing the curve. We can release tight muscles, but we can not change bones. The goal is always to decrease pain and improve function.
The treatment is individualised depending on the age, the angle of the curve, lifestyle habits, habituated actions, and physical discomforts.
So, first, I must know which is convex and the concave side of the torso.
- Concave means “hollowed out or rounded inward”. It is easy to remember because the surfaces “cave” in. More specifically, the tissues on the concave side of the curve are shorter and tighter.
- The opposite of concave is Convex, meaning “curved or rounded outward.” Rib displacement on the convex side is widely separated. As the vertebral bodies rotate, the spinous processes deviate more and more to the Concave side, and the ribs follow the rotation of the vertebrae. The posterior ribs on the Convex side are pushed posteriorly, causing the characteristic rib hump seen in thoracic scoliosis. The Convex side is continually lengthened and most likely weaker.
And then, based on age, we work towards different goals.
With teens, I commonly work on strengthening the core and back muscles to help support the spine. Most scoliosis in adolescents occurs in the thoracic or rib cage portion of the spine.
We evaluate the spine and the referring doctors’ notes to create a daily plan of breathing and asana to create habits for sitting, standing and further look at the other activities they spend their time doing. (Computers and Video games are very bad for the head, neck and spine.)
With youth, we can work to prevent a worsening condition, from how and where they sit during activities to awareness of habituated standing and breathing patterns (these can also be helpful for musicians, vocalists, dancers or taking part in sports.)
In older clients:
We generally can not do much for the curve that’s been created over time. But, we can work on creating strength and lengthening other muscle groups to alleviate the back, hip, and leg pain. Again, we are looking to ease stiffness and pain and increase function in specific areas.
The majority of cases of adult scoliosis does not need surgery. You can manage through regular observation by a doctor and core-strengthening exercises to strengthen your abdomen and back and improve flexibility.
However, the main concern in adults is typically in the lumbar or lower spine. This is because this portion of the spine is most susceptible to the changes seen with ageing or degeneration.
Besides, lifestyle habits, standing, sitting, work desk arrangements, sports, and child care – all of these develop habituated patterns that may worsen the condition.
I remember my grandmother keeping a nest of pillows in the corner of the sofa so she could accommodate her higher hip while she sat and read.
So, in adults, we look at various factors such as age, lifestyle habits, pain, etc. and devise treatment plans.
Along with core-strengthening exercises, there are other neutral yoga poses for back release and relaxation that may release pain in the hips, the lower back, and the thoracic spine as needed by the scoliosis patient.
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The following are for adolescents and youth.
After understanding the concave and convex curves, we practice 3 asanas daily, building strength over time.
The yoga poses help to strengthen the supporting muscles. In youth with scoliosis, the exercises can possibly correct or keep curves from worsening when used daily for a sustained period of time.
It would be best to practice daily, increasing your time in each pose for up to 2 minutes for 3 – 22 months.
- Asymmetrically strengthening the convex side of the primary curve; with daily practice of the Side Plank – Vasisthasana, done with the convex side down
- Flying Side Plank – Vasisthasana version feet raised onto a chair, done on the concave side
- Half Moon Pose – Ardha Chandrasana – done on the concave side
Remember to finish Resting Pose in Savasana – to relax and breathe and let the body return to its normal state.
The following are for the older clients. If you can get on the floor, I suggest,
- Wind relieving pose – Apanasana
- Happy Baby – Ananda Balasana
If not, try these poses against a wall,
- Halfway Downward Dog – Ardho Mukha Svanasana against the wall or the back of a chair.
- Legs up the wall – Urdhva Pradrita Padasana with support under the buttock, buttock and legs touching the wall as straight as possible, Feet flexed to engage leg muscles
- Wall plank – Vasisthasana – angled leaning version. One hand on the wall, feet away from the wall
There is little possibility of reversing scoliosis. However, you can certainly train your muscles for strength and flexibility with yoga. Further, you can prevent the progression of the curve. Without exercise training, your condition might progress and may lead to various severe health risks.
This article lets you know the benefits of yoga therapy in managing scoliosis. Please visit a yoga expert who can provide suitable guidance. Also, please remember to see a qualified practitioner, a certified Yoga Therapist, Physical Therapist or Doctor if you have pain or a current injury, degenerative or herniated disks.
Edited by love4wellness | Images: canva.com
- Dr Loren Fishman M.D. & Yoga Therapist, Manhattan Physical Medicine & Rehabilitation, who has spent 25 years in yoga therapy research.