Yoga and Scoliosis
by Bonnie Williams Ambrosi
Simply defined, scoliosis is a condition in which the spine is laterally curved and posteriorly rotated. It is a common condition, affecting perhaps 1 in 10. It is seven times more common in women than in men, and most often curves primarily to the right, for unknown reasons. While the principal, or primary, curve may be thoracic, lumbar, or thoraco-lumbar, there is always one or more lesser, compensating curves in any other part of the spine, including the cervical or sacral sections.
Changes in the spine affect the entire body. Depending upon its severity and location, a spinal curve can create forward or sideways head, uneven shoulders, protruding ribs on one side, compressed ribs on the other, and one hip higher than the other. In severe cases, organs of the chest and abdominal cavity can be compromised. The human body is wonderfully designed to bear the affects of gravity and the demands of standing, walking, and sitting with a fairly even distribution of effort. Scoliosis changes that. Because the spine is no longer in its optimal arrangement, the body compensates, with some areas becoming overworked, other weakened, and extra stress on some joints. All this can create pain in any of the affected parts -- neck, thoracic area, low back, sciatic nerve. It also changes the way the person feels about their body, often bringing lowered self-esteem or a sense of embarrassment or negativity towards the body.
Scoliosis can be structural or functional in nature. Structural scoliosis is an expression of the spine itself. It often appears during adolescence, or it may appear or begin a second progression (in women) in a degenerative form during menopause. Although heredity and hormonal activity appear to play a part, the causes of scoliosis are not known. The exceptions are curvatures that result from polio, multiple sclerosis, or congenital malformation of the spine.
Functional scoliosis is caused by other factors, such as asymmetrical work or different leg length. It is usually less severe and more easily corrected than a structural curve. One way to distinguish initially between structural and functional scoliosis is to observe the person's spine in a standing forward bend and in a side bend. In these postures, functional curvatures will straighten out, whereas structural curves will remain.
The practice of yoga can help people with scoliosis in several ways. In yoga for scoliosis, you might say that the body itself is used as a brace to assist the spine in assuming a more normal position. When an actual brace is used, however, the muscles become weak and dependent, whereas in yoga just the opposite is true--the body becomes stronger and more vigorous as opposing muscle groups help to draw the spine back towards the plumb line, organizing the limbs and torso more easefully, creating greater length, openness and lightness in the torso and countering the heavy, downward effects of gravity. In the process, areas of the body that may have been put out of mind for a long time can be returned to consciousness and a sense of center and balance, which is often lost with scoliosis, can be regained.
Most notably, yoga can in some cases actually decrease the degree of the primary curve. This may not always be possible, but in any case the compensating curve(s) can usually be improved. Shoulders and hips can become more level, protruding shoulder blades can rotate inwards, chronically compressed lungs can be expanded, weakened muscles can be strengthened, pain can be relieved, rigidity can give way to suppleness, and a greater sense of energy and wellness brought forth. Naturally the exact results of the practice will depend to a large degree upon the particular state of the individual's spine, musculature, and overall health and also upon the individual's willingness to practice.
The principal physical actions of yoga for scoliosis are lengthening, strengthening, and derotating: lengthening the spine and tight muscles that constrict movement, strengthening weak muscles to support a new alignment, and reversing the usual twist that scoliosis gives to the spine and torso. The foundation for these actions is the breath -- particularly slow, full breaths consciously directed into chronically compressed areas of the rib cage. This stretches the intercostal muscles and related muscles and enlarges the working capacity of the lungs. Improved breathing brings added vitality to the whole system and boosts immunity. Finally, there is continuous attention to balance, becoming aware of one's center and how to recreate a more easeful alignment.
For instance, for a student with a right thoracic curve, it will be helpful to compress the convex area of the right rib cage and to expand the concave area of the left rib cage. This relieves the overstretched muscles of the convexity and allows atrophied muscles in the compressed side to become stronger. Breathing slowly and deeply into the concavity will open areas of the lungs that have long been closed. One example of a posture for this purpose is side-lying over a bolster.
Posterior rotation is always a factor in scoliosis, and several postures address this. To derotate the spine in a right thoracic curve, for example, the right ribs and shoulder blade need to move forward and inward, while the left ribs and shoulder blade move out and back. A pose which targets derotation specifically and powerfully is the seated chair twist.
Perhaps most important of all, the practice of yoga can foster an attitude of kindly self-acceptance, self-care, and empowerment--a mindset that is vital for true health but which is often missing, particularly for those with a chronic health issue. The goal of yoga for scoliosis is to help the body to express life in the healthiest way it can. Each body's expression is unique. Just letting go of the idea that one's back should be a certain way, or that the shape of the spine is essential to one's happiness, can be a huge relief and can open the way to a freer experience of life.