The Ins and Outs of Scoliosis
Definition + Causes
Scoliosis is a deviation of the spine causing a sideways curvature. There are 3 main types of causes for spinal deviations:
Deviations following a malfunctioning of mechanisms, such as misaligned knees or hips and an imbalance in foot pressure causing improper gait.
Deviations following a disturbance of the static harmony in the stacking of the vertebrae.
Deviations caused by malformations in the development of the spinal cord.
4 main types of scoliosis
Directly after looking at the causes of spinal deviations, let’s look at the types of scoliosis and their characteristics:
1. Thoracic Scoliosis: Occurs in the T-spine, often in the presence of dysmorphic or malformed vertebrae, easily seen because the ribs form a gibbus. A gibbus is the medical term for “humpbacked”, characterized by a unilateral hyper-kyphosis. The apex of thoracic scoliosis is usually seen at the mid-dorsal hinge of T8 and looks like a “C” shaped curve.
2. Lumbar Scoliosis: Occurs in the L-spine, often due to a deviatory aspect through rotation or known as a malfunction of mechanisms, as seen above. The lumbar spine is very influenced by the hips; therefore, a torqued pelvis or unilateral psoas tightness can often cause lumbar scoliosis, furthermore we’ll often always see a displacement of L4-L5 or L5-S1.
3. Combined Scoliosis: This type of scoliosis occurs along the T-spine and L-spine, where there are 2 noticeable opposing curvatures that look like an “S” shaped curve. The top curve can span along T6-T10, where the apex is once again at approximately T8. The lower curve can span from T11-L3, where the apex is usually at L2. Of course, to be confirmed through palpation and visual tests.
4. Thoraco-Lumbar Scoliosis: Occurs along the T-spine and L-spine, but not to be confused with Combined Scoliosis, as this type of curvature is often not pronounced. The spine has a long but shallow compensation curve, which is a disharmony in the stacking of the vertebrae.
How to help scoliosis as a massage therapist or bodyworker
In theory, the ideal treatment for those with scoliosis will be to rebalance all factors external to the spine, balance all the tripods of the vertebrae, and treat compensation patterns.
Diminishing, if present, the costal gibbus through soft tissue release because it doesn’t allow a proper breathing dynamic and reduces pulmonary capacity. There after, improving the mechanical imbalances of each vertebral level creates more harmony between each level. This means concave soft tissue release through frictions, myofascial stretching and spreading, which can relieve any nerves that may be impinged on the compressed side of the curve. Along with stimulating and strengthening tissues to become tauter on the apex side or convex side of the curve. Then, improving the contouring structures of the spine such as the shoulder girdle and hip girdle will help influence the quality of an erect spine.
Effectively, no treatment is thorough without providing follow-up exercises and recommendations for the person to do at home.
How to help scoliosis at home
The following recommendations can be performed safely in the comfort of the person’s home allowing them to attain pain and symptom relief from scoliosis when needed. These exercises should include at least one technique for breathing, one for stretching and one for strengthening.
1. Unilateral breathing of the concave side: Standing, seated or lying down, lift the arm overhead and you may even grab a hold with the other hand. Next, complete 8 – 10 rounds of deep breaths, with each inhale expanding the concave or compressed side of the scoliosis.
This is localized respiration with the intention of re-educating and expanding the tissue on the tighter side.
2. Stretch of the trunk in a horizontal position: A very good stretch movement to elongate the entire spine and create space between each vertebral level in a linear line. With the help of a straight railing or doorknob (of a closed door), get into a horizontal position by hinging at the hips, folding forward, feet are hip width apart, grab a hold of the railing or doorknob.
From there, align yourself parallel to the floor and create a light stretch and light traction along the back by backing up.
Once a stretch is felt along the spine, hold for 10 to 30 seconds then release slowly, pause, stay parallel to the floor, repeat 3-4 more times.
3. Strengthening of the posterior convex musculature: Recovering the strength in the weak muscles of the convex/apex/high side of the curve is crucial to re-educating the spine in scoliosis because these tissues are constantly stretched out. To bring back functional force to a muscle, try isometric work, which is a localized contraction without movement of about 80-85% maximal force. An excellent exercise to help correct scoliosis would be isometric contractions of the latissimus dorsi. Activating your lats on the apex side of the scoliosis is easy to do anywhere!
Simply maintain a 7 to 10 second contraction and repeat 5 to 10 times.
These exercises are simple yet effective to correcting the specific curvatures in the spine cause by scoliosis. Other excellent exercises for general health of the spine and long-term maintenance of scoliosis include swimming, walking, certain yoga positions, cycling and cross-country skiing, weather permitting. Gliding-type activities or bike riding are often recommended for scoliosis because they minimize shock absorption to the vertebrae.
Therefore, generally avoid high impact exercises as this can further increase damage to the spine.