Staying In Balance

Scoliosis: some practical advice for Yoga teachers on the subject

Raquel Graham

Scoliosis is defined as a curvature of the spine that creates an imbalance in the entire system. The impact is not just felt in the skeleton but also the muscles, organs, entire central nervous system and the emotions.

Central Nervous System- the sacral line "big brain over little brain" is designed to line up and create balance. In scoliosis the inner ear has learned to adjust to the distortion created by chronic imbalance. In working with scoliosis there can be some nausea as the alignment improves. For this reason, it is important to go slow.

Bones and Muscles- when a round object i.e. the spine moves to the side, it will rotate. This is why in scoliosis the shape is the one side and twisted. And when there is this movement an empty space is created and something will move into that space. The muscles have to grip to for the bones to remain stable. This is what creates the concavity and convexity seen in scoliosis.

Convex Side- this is the side which is pushed out and where the sensation is. The muscles of the convex (rounded) side which are weakened by being lengthened and overused due to the scoliosis needs strengthened. The ribs are overextended, the muscular layer is thin. Nerves are close to the surface. In assisting touch gently, never push. On this side it is important to restrict movement and back off of the maximum stretch.

Concave Side- this is the side which drops in. The muscular layer is thick. This side needs to be spread and gently stretched so the convex side can move back into this space.This involves asymmetric efforts for both the stretching and strengthening.

Organs- structural problems created by this displacement can press on organs.

Emotions- with the twisting which occurs, energetically there is a "spiraling down". Depression is not uncommon.

As yoga works with all the systems it can be an effective tool in working with scoliosis. But given the number of different systems involved, it requires a long term commitment and patience. Begin with pain reduction and management, not structural change. Go slow. The results will be profound.

In dealing with this issue check to see if it is functional (see definitions). A good test for this is to have the student bend forward in an easy Uttanasana (standing forward bend). If the curvature disappears it is functional. However, functional can become structural if not dealt with.

If it is structural first ask a student if they have been diagnosed, or had any kinds of treatment. Especially important to know is if they have had surgery with a rod placed along the spine or the vertebrae fused. The law of hyper-rigid/hypermobile comes into play here. Just above the fusion or rod will be hypermobility. In this case, no twisting or back bends. Forward bending only form the hips.

Osteoporosis is common in scoliosis due to the chronic imbalance and the stress created by attempting to achieve balance. Pregnancy and menopause are times of deterioration.

It is important to have a skilled observer, such as a a yoga therapist, chiropractor, massage therapist, etc to look at the stretches and help adjust, and to help the participant feel what proper alignment is. In scoliosis the back may be straight in the stretch but usually the spine is not. It is more helpful to have a slight twist in the torso. This twist creates an even spine that allows the entire back to get an equal stretch.

Some Practices: lie on the side over a small bolster positioned under the area affected. Stretch the concave side by lying passively on the opposite side over the bolster. Switch sides and actively strengthen the convex side by lifting the head and shoulders (kind of a sideways sit up). Alternate sides a few times. Maintain awareness of the two elements of concave and convex throughout poses. Deep controlled breathing is an especially important part of the practice for scoliosis as are periods of relaxation and restorative poses for the back.