By Sara Picken-Brown

June is scoliosis awareness month. According to scoliosis.com approximately 

4% of people worldwide (i.e. approximately 1 in 25 people) are affected by this issue. It can occur in any individual regardless of age or gender; however, it is most commonly found in adolescent girls.

What is scoliosis?

Scoliosis is a condition involving an abnormal sideways curvature of the spine.
It can be caused by congenitaldevelopmental or degenerative problems, but most cases of scoliosis actually have no known cause called idiopathic scoliosis.”

~ Spine-Health.com

What makes treating the condition challenging is that each each person with scoliosis will have a unique postural distortion. There is no one size fits all solution, so speaking to a professional about your unique needs is important. Get a variety of opinions and ensure that you consider both Yoga & Pilates exercises as a treatment and management option before resorting to surgery and the fusing of vertebrae or getting a steel rod put in your spine.   

In scoliosis, the spine forms an S curve (or reversed S) from side to side down the back, and at the same time the back of the spine rotates toward the concave side of the S, twisting the rib cage and making the sides of the back uneven.

The 4 major S-patterns

1- In a right thoracic scoliosis, the major scoliosis is concentrated in the thoracic (mid-back) region, and the spine curves to the right.

2- In a left lumbar scoliosis, the major curve is to the left and is concentrated in the lumbar (lower back) region

3- the right thoraco-lumbar, where the major curve is to the right in the thoracic and lumbar region. 

4- the right thoracic-left lumbar combined curve, where the major curve is to the right in the thoracic region, with an equal counter curve to the left in the lumbar region.

Scoliosis can be either structural or functional. The structural variety is much more serious and develops as a result of unequal growth of the two sides of the vertebral bodies. It usually appears during adolescence, and its causes are not well understood—approximately 70 percent of all structural scoliosis are idiopathic, cause of development unknown. 

Functional scoliosis only affects the back muscles and does not structurally alter the body. It can result from such things as poor posture or repeated unbalanced activity, such as always carrying books on one side. It is much more common than structural scoliosis, usually much less noticeable since the degree of curvature is less, and almost always reversible.

How do I know if this is me?

Often, back pain is the first sign of scoliosis in adults. The pain may be from bone damage in the back — not the scoliosis itself. As the spine curves, it can put pressure on nearby nerves and cause symptoms like weakness and numbness.

In adults, scoliosis causes symptoms like these:

  • Uneven shoulders and/or hips
  • Bump in the lower back
  • Numbness, weakness, or pain in the legs or down one side into the hips
  • Trouble walking
  • Trouble standing up straight
  • Tired feeling
  • Shortness of breath
  • Loss of height
  • Bony bumps (spurs) in the joints of the spine from bone and joint damage
  • Feeling full quickly while you eat. This is because your spine is putting pressure on your belly.

QUICK TEST: To determine whether a scoliosis is functional or structural, bend forward from the hips. If a lateral (side to side) curve is visible in standing disappears in this position, the scoliosis is functional; if the curve remains, it is built into the ribs and spine, and the scoliosis is structural.

Key areas to focus on :

  • Iliopsoas conditioning: Keeping this muscle well toned aligns the lower limbs with the torso and frees the spine.
  • Scapula-To prevent the upper back from rounding (a common problem in people with scoliosis)
  • Strengthen your Powerhouse-core-If the abdominals are weak, then it causes the back muscles to overwork and therefore tighten
  • Breath- Awareness of the breath is perhaps the most important thing to focus on while doing the yoga poses. Usually very little air enters the lung on the concave side of the spine. Sending the breath into the collapsed rib cage on this side can actually stretch the intercostal muscles and create more lung capacity. This creates more openness and evenness on both sides of the chest, from the inside out.

As a coach, my approach to the best modality to use with a client is dependant on a few factors, so I invite you to be open and use whatever works best for you and what you enjoy the most. Combinations of exercises and styles can often be most beneficial. 

(see the video series at patreon.com/valetudovirtualwithsara for the Scoliosis management tutorials)

The Yoga Approach:

  • Psoas lengthening: Warrior 1 and Warrior 2 are both lunging poses that help release the constricted psoas muscles. The Iliopsoas muscle becomes contracted with a lumbar scoliosis. Elongation of the psoas relieves tension and will de-rotate your spine
  • Core strength: The research on scoliosis is conclusive that a strong core is very protective to the spine and benefits all people with scoliosis, especially adults.
  • Hamstrings: Rewire the posterior line fascia and lengthen the hamstrings with forward folds.
  • Upper back strengtheners: yoga poses that are strengthening for the upper back are excellent. You also want to practice poses that help stretch the upper spine.
  • Savasana on a foam roller to realign and balance spine
  • Engage your bandhas: Find your pelvic floor and deep abdominal muscles: Practice the Maha Bandha ‘great lock’ with viola breath technique 

The Pilates Approach

  • Finding your pelvic floor (tilt prone position)
  • Cat/Cow and side C-curve stretch toward the your S-curve
  • Plank to  knee drops
  • Standing Balances on block with lateral pelvic tilts & knee raises
  • Kneeling Balances in opposition in table top
*Note that additional abnormalities of the spine can look like the above and is often what I would term Tech. Posture.
A rounding of the upper back, tilting of the pelvis which increases the lower back curve. This type of posture can lead to back issues, breathing issues, depression and shoulder pain; radial nerve impingement and more.