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Print Posted By Lahela Hekekia on 07/19/2017

What Is Scoliosis -- And Can I Do Something About It?

What Is Scoliosis -- And Can I Do Something About It?

Over the past ten years, I've developed a specialty in Pilates, for Scoliosis.  Basically becase it's My Story.  

I had Scoliosis from childhood and used Osteopathic Sciences, modified Pilates, and therapeutic bodywork to help change my spine, hips, feet, and more.  From there, I've also attracted clients with other spinal issues such as spinal cord injury, Stenosis (a narrowing of the spinal canal), and Spondylolisthesis (a forward slippage of a vertebra).  As well as hip-related issues such as Sciatica.  And also, lots of interesting foot conditions -- including people with only one foot after an accident.  I get referrals from Physicians, Chiropractors, and physical therapists (post-PT and also during PT).  As well as sports coaches.  If you want to learn more, I'd love to hear from you!

Here are some questions which might already be in your head...  

I'll add more as they come up.  Some of these (now I'm updating them) were from an earlier blog entry:  My Scoliosis Management Workshop

1.  Q:  What is Scoliosis?  A:  It’s categorized as an abnormal curve of the spine, which can be anywhere from mild to severe.   

I have worked with many different levels, including people who have had spinal fusion surgeries.  If it's a severe or complicated case, it would be in your best interest to be referred to a qualified Osteopathic Physician (or other Physician) and/or Physical Therapist ("PT") first for assessment and directions to me.  I’m grateful to have shared ideas with a local Neurosurgeon who said that I gave him cause to think about some of the methods used in spinal surgeries, which are part of the protocol -- and therefore, what may be useful to patients with their PT, after they recuperate from surgery.

But Scoliosis is so much more than just an abnormal curve of the spine. Scoliosis affects the entire body. 

Scoliosis affects your feet, ankles, knees, hips, ribs, shoulders, arms, hands... even your internal organs. Here's a helpful article corroborating this idea.  In fact, I learned an immensely valuable exercise from my old Osteopath -- Teresa Denney, D.O. (RIP), which proved to me that Scoliosis was affecting my bladder.  (This was before I started studying Pilates or any other method).  I show this one often in one on one sessions, and occasionally in a group class if it seems helpful.  I'm so thankful to Dr. Denney for this simple exercise.   Would you like to learn it?  I'd love to know.   Let's connect!

2.  Q:  You say, you changed your own Scoliotic spine?   A.  Yes -- with daily work.  There's no such thing as an overnight miracle -- you are retraining your body.  

I also spent a lot of time trying to understand it, since it was my own journey.   I was diagnosed at age 10 and the Doctor said that there was "nothing" I could do about it.  I never stopped believing ...   At age 40, I looked at xrays with Dr. Chip Abbadessa, and he said, "Do you mean to tell me that you USED to have Scoliosis?"  That was when I was doing modified Pilates with myself.  Shortly after that, I started studying Osteopathic Sciences to understand more.  So, I say -- never give up believing that change is possible.

3.  Q:  How do you approach Scoliosis, then, Lahela?  A:  I show you a very simple way to understand and approach the condition.  I show you exercises that have been life-changing for myself -- including a different way of breathing.  And I encourage you to work at it daily.  In personal sessions, I also tend to use hands-on bodywork to help you find more ease of movement. 

I explain to clients how to approach Scoliosis, in a way that Physicians and Physical Therapists apparently are not doing.  A lot of it is based in Osteopathic Sciences.   I also get to know you in order to find the way to connect with the way you learn -- whether you're a visual learner, or need lots of detailed anatomy.  Whether you benefit most from a gentle approach, or a bit more nudging.  I work with the very unique YOU.   It also helps to know that the person working with you has lived through the process -- so it isn't just theoretical.


4.  Q:  What causes Scoliosis:  A:  Sometimes we can spot a potential cause, but it’s often unknown

Many people are diagnosed (by x-ray) in childhood or puberty, while others develop Scoliosis in adulthood.  Theories abound, including: injury; viral infections; structural abnormalities at birth; muscular imbalances that accumulate over time; spinal degeneration with age, and uneven development during puberty.  Hereditary factors may also play a role.  

One-sided athletic pursuits do seem to play a role as well.  GOLF and TENNIS come to mind.  This is just something I've noticed personally.  When I show you why, you'll agree that it's all very simple to understand.


5.  What are some visible signs of Scoliosis?  A. Here are three:  a) Uneven shoulders and hips. b) One leg appearing to be “longer” than the other.  c) A "rib hump."  

Many people with Scoliosis will notice these symptoms, although not necessarily pain. Here's a helpful test that you can do at home, with some help:  Do a slight forward-bend and have someone run their fingers along the spine to detect a lateral curvature, or that rib hump.  Here's a good illustration of a rib hump.  If your loved one has some or all of these signs and also complains of discomfort, I highly recommend making an appointment with your Doctor for an x-ray and diagnosis, especially to see if there are any complications.

6. Q:  What are some risks of having Scoliosis?  A: There are several, especially as we age:

a) According to Stott International in 2011 (now Merrithew Health and Fitness), we were quoted this statistic in a workshop: About 75% of women with Scoliosis age 65 and over have an osteoporosis fracture in the spine.   They did not elaborate as to whether this also included very mild cases, but what a scary statistic.  Osteoporosis and Scoliosis do often go hand-in-hand.  And Osteoporosis fractures are often in the spine.  One could infer that the abnormal curve, plus gravity, affects the spine to make it more prone to fracture, especially if the bones are thinning.

b) Often, Scoliosis comes with chronic pain -- and I was certainly a statistic years ago.  From age 19, I had a lot of back pain -- and it usually got really bad during exams.  From my mid-20s into my mid-30's, I had a lot of chronic pelvic pain, too.  All this pain went away within the first couple of months of daily Pilates, but it wasn’t just from attending classes.  It was also because I spent a lot of time improving my posture.  Here's an article talking about how Scoliosis deserves special consideration.

c) Severe cases of Scoliosis can even affect breathing and other organ function. Therefore, it may be medically advisable to have surgery. That is between you and your Physician.  Spinal surgeries, however, generally will not address what has been happening in the pelvis, knee joints, feet, etc., nor the muscle imbalances that have developed from holding yourself and moving a certain way for a long time.  So there are still things we can work on, after getting medical clearance.  I have worked with several people who have had spinal fusion surgery, following whatever protocols they have from their Physician.

d)  Sports injury.  It's just a given, that an imbalance in the body can make us susceptible to sports injury -- and Scoliosis is basically a chronic imbalance that can worsen over time.   We may lean more to one side of the body.  Muscles don’t do their job ideally.  Joints are not as well-protected.  All of this also affects mobility and flexibility.  Chronic imbalances set up a vicious cycle of over- and under-use, and the end result can be an injury that side-lines you from your favorite sport.  In my many years of running, all of my injuries were on the right side, including: an inguinal hernia, shin splints, ankle sprains,stress fractures in the foot and tibia (lower leg), and Iliotibial Band (IT Band) Syndrome.  In my personal and professional opinion, those were symptoms of the bigger picture -- Scoliosis.  Here's an interesting article on Scoliosis and sports.


7.  Q:  Can medications help with Scoliosis?  A: Well -- Not really, except mask the pain.  

If the doctor prescribes pain medications -- that will lessen the sensation, but it will not target the root cause.  And the curvature could worsen as you age (with degeneration of spine and disks).  In the case of osteoporosis, specific medications may help prevent bone loss, but they won’t improve the curvature that already exists -- and apparently they don’t reduce fracture risk, since the biggest risk is falling. Meds also come with side effects.  Dr. Mercola has voiced some concerns about osteoporosis medications. That said, talk to your doctor about all options and risks, then decide together.  


8.  Q:  Can surgery "fix" Scoliosis?   A:  It would be more accurate to say that surgery addresses critical risks that your Physician deems necessary but does not magically "fix" the spine into a perfect thing -- and other issues are created.   

To my knowledge, the best science offers us today (in 2017) is a type of fusion surgery.  Necessarily, parts of the spine are immobilized.  WebMD describes the surgery and risks, saying:  "The goal of surgery is not a perfectly straight spine but a balanced one, in which fusion prevents the curve from getting worse."  This is an excellent and thorough article by Spine Health.  This is something to discuss with your Physician because of perceived health risks.

9.  Q:  What else can help with Scoliosis?   A:  I have seen great results from a combination of Chiropractic or Osteopathic work and muscle re-training for mild to moderate cases; and it may also benefit you to get myofascial release, such as Rolfing.   

BUT --Before embarking on a new program, you should get a professional assessment. An xray will let you know if you have spinal degeneration or other complications.  A posture/alignment analysis will help you understand your muscular imbalances.  With that, you have a road map for your wellness plan, which may also include therapeutic massage, and exercise that is kind to your body.  

If you have a severe and/or complicated case of Scoliosis, or had spinal fusion surgery, you may need physical therapy instead of me.  At the very least, you will need medical clearance.  I highly recommend doing that before embarking on any fitness program anyway -- especially if you are experiencing chronic pain or undergoing pain management therapy.


10.  Q:  What do Scoliosis Management lessons involve?  A: Very specialized exercises on the Mat, Reformer, and Cadillac, as well as changing the way you breathe, sit, stand and walk.  YES, it involves a big lifestyle change.  

a) To make meaningful changes, you must devote a little bit of time and energy to yourself every day, whether in the studio or at home.  

b) There is a huge emphasis on Osteopathic Sciences. 

c) The mental attitude is also highly focused.  If you think you cannot, then your mind won't give your body permission.  If you think you can, that is a big part of the picture.  If you find yourself getting frustrated, I am here to help pep you up.  Be prepared to hit plateaus and brush off the frustration.  The body will not always do what you want.  Stay calm.  Focus. Communicate between mind and body to note what you feel, how a particularmovement feels today, and compare it with how you felt last week, last month,etc.

d) I give a lot of feedback from what I see with my eyes, and I also provide lots of cues, often hands-on.  If you are not comforable with hands-on cues, you are better off with someone else, because it is a big part of my practice.   

e) My program also involves exercises which were devised by a physiotherapist and other specialists.  And it includes modifications of "standard" Pilates exercises, because the standard exercises may actually encourage imbalances rather than help.  Yes -- especially on the Reformer. 

f)  These sessions are done one-on-one.  So that you get my full attention, and I get yours.  While I have on occasion done a workshop for a group, inevitably, everyone ends up getting different exercises to do because I simply must give everyone some attention. And as a result, everyone gets thinking about private lessons.  One lady even asked to film it for her own purposes.   


 11.  Q:  How long will it take to improve? A:  There is no easy answer.  

Scoliosis is something thatwe will need to work on for life.   We have unique bodies, different ages,varying jobs which tax our bodies accordingly (desk work, manual work), different diet and lifestyle habits, and widely divergent levels of ability to commit to muscle reconditioning (time, finances, etc.).

12.  Q:  Will Insurance cover sessions with me?  A:  No. 

If you would like Insurance to cover your sessions, I will refer you to a Physical Therapist.  You will need a prescription from your Physician.  It would be up to your insurance company to determine if those sessions can be covered.  

13.  Q:  Can I get a good result from a group class?  A:  The best way to do this is in a private lesson.  

You will not get nearly the same results from a group class, even if you took that group class several times a week.  Even in a regular Pilates class, those who take private lessons make leaps and bounds of improvement over those who take group lessons.  Because you're able to ask questions that you might not feel comfortable asking in a group.  Because I can spot little nuances watching one person alone, instead of managing a group.   Because we simply have more ways to connect one on one, including how you best relate to information.  (Do you learn best by watching someone else move first?  Do you like to hear detailed anatomy?  Do you prefer metaphors and colorful mental imagery?)


14. Q: Can I take your class while receiving Physical Therapy or other treatments from someone else? A: That is up to your Physical Therapist and Physician.

If they allow it, then it is possible.  Keeping in mind: you may be doing specific exercises in Physical Therapy that are different, and you may have specific limitations from your Physician. If their directions seem to be in conflict with my Method, then please -- either finish their sessions first, or have specific written instructions from them to me. I want to work with your team, not against them.

15.  Q:  Do you use "lifts" for the foot while doing Pilates exercises on the Reformer?  A:  Absolutely not.  This is dysfunctional and simply addresses an imbalance with another imbalance.  Which then causes more issues of pain and injury.

If you've had experience doing Pilates on the Reformer, you most likely have done Footwork/Leg Presses while having feet on the Reformer.  It's usually the first thing you learn.  If you have Scoliosis or a hip imbalance, you may have been told that one leg presents itself as "longer" than the other, or one hip "higher" than the other.  However, it is dysfunctional to place a "lift" under one foot in an attempt to make the legs and hips seem to be "even."   This will result in some kind of injurious movement patterns that will create other problems.

Approaching Scoliosis in this misdirected way is based on an incomplete understanding of Anatomy.  I have not seen too many people do this, but I have...

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