Your back is killing you. It is so tight and sore all the way up one side you can barely turn to look back over one shoulder. Driving is a challenge. Playing golf makes it worse. Forget yard work or shoveling snow.
You ask your doctor about the pain. She orders an X-Ray and reports your back looks fine – no arthritis, no herniated discs. She tells you your back muscles are in spasm and prescribes rest and anti-inflamatories. She mentions, by the way, “you have scoliosis.”
Scoliosis? What the heck does that mean? What is it? How did I get it? Is this causing my back pain or is my back pain causing my scoliosis? What can I do about it?
Scoliosis, simply put, is an unnatural curvature of the spine. The spine is unnaturally bent sideways either to the right or left. The curvature can be in any part of the spine but most commonly the spine curves to the right in the upper (thoracic) spine or to the left in the lower (lumbar) spine. As the spine is pulled into this sideways curve, there is a rotational impact on the individual vertebra causing them to spiral along the axis of the spine. There may be one curve creating a “C” shape to the spine, or two curves, creating an “S” shape.
Scoliosis is most often diagnosed in children just before puberty around the time of their pre- adolescent growth –spurt. Parents may notice their child’s clothes don’t hang right or one side of the ribcage and shoulder appears elevated or twisted. A number of treatments are available for children with severe scoliosis that range from prescribed exercise protocols to invasive surgeries and the attachment of hardware and rods to the spine.
Scoliosis can be moderate to severe. Moderate scoliosis is typically non-symptomatic and often goes undiagnosed and untreated. Both severe scoliosis that goes untreated as well moderate scoliosis that worsens over time can contribute to a range of muscle-skeletal complications as the spine matures. These conditions include:
There are certain neuromuscular conditions that can cause scoliosis, for example cerebral palsy or muscular dystrophy. On rare occasions, congenital abnormal bone development in utero causes scoliosis.
Most cases of scoliosis, however, are idiopathic. There is no specific cause. Genetics play a large role. If your parents or siblings have it, you are more likely to have it. Girls and women are more prone to scoliosis than are boys and men and female scoliosis tends to worsen more than the male counterpart. Individuals with leg length discrepancies where one thigh or lower leg bone is shorter than the other will adaptively develop scoliosis
Bad posture and faulty body mechanics especially in combination with repetitive movement patterns can contribute to the worsening of scoliosis and the onset of symptoms. The reverse is true as well. Improving posture and skeletal support while rehabilitating movement patterns to balance the force exertion on the spine can have a beneficial effect on scoliosis and mitigate many of the symptoms. This is where an appropriate Pilates based program can help.
Our muscles and bones adapt to the stresses we put on them. If we are routinely required to lift heavy items over our head, our arm, shoulder and back muscles adapt and become stronger. If we are routinely required to run and leap our leg and buttocks muscles become stronger. In both cases we build bone strength and density.
Similarly, if the spine is curved and rotated in one direction to the right for, instance, the muscles will adapt. Such an adaptation is necessary but often not efficient. Postural back muscles on the right side will become tight and weak, and the muscles on the left long and weak. The neck muscles on one side will have to work harder to keep the head upright. The right shoulder will be elevated putting the arm in an ineffective position and creating stress on the shoulder joint. The pelvis will rotate forward on one side and tilt to compensate for the shortness in the back muscles. One leg will rotate outward to compensate for the pelvic tilt and the ankle will roll to stabilize the rotated leg.
From the top of the head to the tip of the toe the body winds up to adapt for the scoliotic curve. It is often this adaptive muscle development and imbalanced pull on the spine that creates the pain.
A Pilates program designed specifically for scoliosis will unwind these tensions. The focus of the program is to train the deep postural muscles to support the spine while bringing balance into the global muscles that move the body. Tension in muscle and connective tissue is released, and the muscles are stretched and strengthened so that their action on the bones of the spine is more coordinated and harmonious. Breathing capacity and oxygen delivery are increased as the muscles of the rib cage and side body are mobilized. New movement patterns emerge that ease muscle fatigue and put less stress on the spine and nervous system.
In adolescence such a program can affect the spine profoundly enough to reverse the scoliosis. In the mature spine, or where the scoliosis is fixed, the scoliotic curvature may not change significantly. But the positive changes will be felt and seen as the spine unwinds and the body is free to move again.
Barbara Grant, Founder and Director of Retrofit Pilates is a movement educator, health and wellness writer and blogger, and television host. She can be seen weekly on Rogers television as the host of Shape Up with Barbara Grant. She is a Faculty Member of Balanced Body Education and has been a featured presenter at international Pilates and Yoga conferences in Canada and the US. www.retrofit.ca/barbs-blog