Forms of Yoga and/or Pilates

[2kids]

So we are in the dreaded "waiting and watching stage" with my daughter. We asked all the doctors we have spoken with about exercise or physical therapy as a method of reducing the curve or keeping it stable. They all say it will not make one bit of difference. Ahh! This seems odd to my husband and I. We understand it is a skeletal problem, but don't the muscles support the spine? We were told we could try yoga or pilates if we wanted, but received no further guidance. Physical therapist specializing in scoliosis did not exist. Hum!

So...I do not know the first thing about either form of exercise. Although, both yoga and pilates are offered at my gym. I was thing about taking my daughter with me to try a class. Beginner Yoga is tonight. However, a friend just told me there are many forms/types of yoga. Does anyone know if I should be looking for a specific type? Do you think a class is a bad idea? Should I be trying a private lesson instead?

Also, I have a DVD on order from the library called "Yoga for Scoliosis". I thought we should try it out a few times before I buy it. Has anyone tried this program?

Thanks!

[WNCmom]

2kids:

I have Yoga for Scoliosis and really like it; unfortunately my 12-year-old son was not willing to do yoga (we had a private lesson)--his hamstrings are so tight he got completely frustrated trying to do the postures. He is much better about doing the exercises we got to go with his Spinecor brace (we'll try again later with the yoga).

My understanding is that Elise Browning Miller is the expert on yoga for scoliosis, since she has scoli herself and developed the program after she declined surgery as a young woman. She did the video. Sometimes kids enjoy classes more, but this video has specific exercises for different kinds of curves, so it would be a nice resource regardless.

You didn't ask for suggestions about other options, but I hope you don't mind if I offer one--since you are waiting and watching and brought up the issue of muscles, you might look into myofascial release massage (or even structural integration, which is Rolfing). This is intended to interrupt muscular patterns that may be helping hold the curve in place. My son enjoys the massage and looks forward to it every week. We will find out tomorrow if this is helping make a difference, since we go for the first six-week check-up for the Spinecor brace.

Good luck!

[txmarinemom]

Most definitely, exercise - and particularly yoga, pilates or any type that focus on stretching and core strength - is good.

I would think any beginning yoga class would be fine: Most likely it's slow, simpler, longer held stretches (probably Hatha). There are forms (like Ashtanga) that are more of a cardio workout - it's a rapid paced shift between poses - but this isn't generally a beginner's class.

Unfortunately, what you've been told is correct: Exercise won't hold or correct a curve. Muscular involvement is almost always secondary to structural involvement - and the muscles will stretch *far* before they hold the spine static.

What exercise *can* do is keep your daughter (and her curvature) flexible - and it could eliminate or lessen pain.

Best regards,
Pam

[vndy]

I am a big fan of yoga, and have practiced both Hatha and Vinyasa flow. The benefits, I believe, are core strength and mental focus. I cannot explain how much my yoga practice has helped me calm down as I prepare for surgery. Please don't advise your daughter to do it with the sole intent of stopping the curve's progression; It will make her stronger and more focused, both of which will help her cope with scoliosis, but I don't believe it can stop progression.

[Carmell]

http://www.iscoliosis.com has several exercises posted for teens (and adults) who have scoliosis. The exercises concentrate on the abdominals and obliques supporting the spine. Being as healthy and active as possible will help in the long run. Good luck.

[emma12]

We were also told by several doctors that no specific exercise would help, but just to keep my daughter active. I guess that I don't know that exercise will reduce the curve, however, some of these techniques listed above certainly sound like they would be worth trying. We went out on our own and used an exercise ball along with some pilates type exercises for it. It certainly seemed to keep her flexible, even though we were seeing rapid progression of curves. She also seemed to enjoy the many stretches over the ball (hanging against her curve...). I actually bought 2 balls so that I could do the exercises along side of my daughter. I can't believe that our doctors didn't recommend anything like this, but, it seems that many don't. Good luck.

[gardenjen]

We wish we had known for sure that our daughter had scoliosis at 12. She was not officially diagnosed until 17 (~45/45), and we were also told no
exercise, bracing, etc. would make a difference. Bought Yoga for Scoliosis
DVD and workbook - she tried but was frustrated, "couldn't feel what 'normal' should be like", couldn't do it. I think it might be great if a kid had a few private sessions with an expert, though. Took her to the Schroth clinic in
Wisconsin - would definitely recommend that. She got that stuff down and
seems to be holding her own...Good luck with whatever you choose to do.
Feel good about whatever you decide as a family!

[WNCmom]

gardenjen:

Thanks so much for mentioning you have attended the Schroth clinic in Wisconsin. I have a 12-year-old son with scoliosis (T45 L 34) and am looking at that as an option. His is currently in a Spinecor; I emailed the clinic and they said they'd be willing to work with a patient in that brace, but I wanted to get more info from folks who had used them.

I would so appreciate any information you can provide on your experience at the clinic. I hope you'll be willing to share. Exactly why would you recommend it? When did your daughter attend and what was it like? What is offered, etc.?


Mary Ellen

[structural75]

2Kids,

We asked all the doctors we have spoken with about exercise or physical therapy as a method of reducing the curve or keeping it stable. They all say it will not make one bit of difference. Ahh! This seems odd to my husband and I. We understand it is a skeletal problem, but don't the muscles support the spine?

In the case of structural scoliosis the bony deformities will be the primary limiting factor in non-surgical correction, stabilization or slowing of progression. So it will be of little or no consequence what you do to the muscles, or soft tissue.

However in the case of ideopathic scoliosis, methods that effectively address the fascial tissues and muscles (made of fascia and muscle fibers) can potentially have a positive effect in achieving one of the above goals. It really comes down to the cause, known or not, of the scoliosis. If it is a result of a neurologic condition or connective tissue disorder then it will likely ring true that exercise and otherwise would be ineffective.

Yet for many others without such systemic conditions contributing to or causing the scoliosis then exercise and such could prove helpful, especially when used specifically to target the asymmetric imbalances.

Unfortunately, what you've been told is correct: Exercise won't hold or correct a curve. Muscular involvement is almost always secondary to structural involvement - and the muscles will stretch *far* before they hold the spine static.

In the context of ideopathic scoliosis, structural should be viewed as the entire physical form seeing as there is no real 'structural' problem... as in hemivertabrae, fused ribs and such. What often arises as structural problems/involvement such as wedging, is a direct result of the soft tissue holding the spine in a curvature for an extended period of time thus causing bony deformation. So what starts as ideopathic with no structural problems will eventually lead to structural/bony changes with time.. which then commit the pattern to the confines of those shapings.

Remember, in the case of ideopathic scoliosis, soft tissue moves and re-shapes bones... Bones do not move by themselves nor do they re-shape without the necessary mechanical loads and tension to inform them to do so.

So muscles, or more accurately fascia, will actually hold the curve (on the shortened concave side) thus allowing gravity to assert itself and put further strain on the muscles/fascia on the convex side... Resulting in the subsequent stretching you mentioned. So the key is to use exercise to try and strengthen the convex side while, most importantly, stretch the concave side to help lengthen and keep the spine mobile and adaptable.

Without exercise or regular movement the spine is far more likely to loose mobility, adaptability, length and will likely progress faster. There is the reality that the muscles/fascia are fighting the force of both the cause of the scoliosis and gravity alike... This is the primary reason that "stabilization" or "permanent corrections" have trouble remaining static (meaning that we can't expect them to given the laws of physics, especially if the cause is still present). Any slight curve that is left in direct opposition to gravity will be subject to more curvature due to the laws of physics.

So I would say trust your skepticism about the Drs 'opinions' of exercise... Keep moving... the more intelligent and direct you can be in regards to the curvatures, the more likely you'll do some good.

Best to you,
structural

[txmarinemom]

Structural,

Let me start my response with my respect for the tone of *your* posts. I will endeavor to maintain the same.

As a person who's lived with AIS for the last 30 years (and, no ... no hemi-vertebrae, fused ribs ... neural tube defects - along with several other things not mentioned here), I have to disagree with your assertation soft tissue can absolutely dictate spinal, structural changes - lateral and/or torsional.

I will agree with you 100% the muscles (and certainly the fascia - I tried myofascial release for 3 years before traditional pain mgmt techniques) can affect how the pain from a curve is ~always~ FELT. Does it always help (even the pain) in the long run? No.

Bending against the curve - and stretching the concave side - can be beneficial ... for the muscular involvement - but not to the extent it affects the structural nature.

As I approach surgery (same as the last 30 years), part of my daily exercises include leaning into a doorframe to stretch my chest wall (and no LMT, Rolfer, Chiro, D.O., or PT has ever refrained to remark of the lack of tightness there) - and walking/standing backbends to maintain extension.

The fact remains, I'm flexible as hell ... and no amount of exercise, massage or manipulation will hold my spine straight.

[structural75]

Sorry if you took my tone in the wrong way... my apologies.

I will have to disagree though because I see the deformation abilities of soft tissue daily in my practice. That is how osteophytic growths form (bone spurs), spinous and transverse processes become curved and deformed, etc... Tension of the soft tissue pulls the periosteum around the bone (muscles don't attach to the bone, but the perioteal layer of fascia wrapped around the bone). When this happens it sends a signal to the receptors in the periosteum to produce more bone at this site... Tension and compression can and will dictate where bone is formed and broken down. Change the degree of tension and compression and you change the physiologic processes at play. This is a known physiologic fact.

I didn't say exercise or otherwise would work all the time... "always" as you put it.
Myofascial release is a good start, but a positive effect is not reliant on the technique alone, but more importantly where and when it is applied... That is why I don't recommend myofascial release unless the practitioner has a thorough knowledge of structural/postural biomechanics and patterning. Otherwise you run the risk of releasing tissue that is trying to hold the curve back. There's more to it than opening the chest or doing backbends... a good start but maybe something more precise and directed in the hands of a professional would be more effective... exercise or whatever... Again it isn't going to have the same effect on everyone but that's no reason to dismiss its importance altogether. That's all I'm saying here.

Please don't insuate anything about my "tone" because that's not an accurate assumption here. I'm sorry if it sounded that way.
structural

[txmarinemom]

Structural, my initial statement,

Let me start my response with my respect for the tone of *your* posts. I will endeavor to maintain the same.

was, I fear misunderstood - as can often happen with the written word. I was sincerely stating I DO respect you tone - non-combative, and I truly believe you are trying to help. I merely was trying to express my appreciation and willingess to hold a respectful conversation. I wasn't assuming anything about your tone other than I found it mature. Apologies if is was mispercieved.

I do disagree myofasical, tension/compression can help correct a structural curvature (and yes - even with lateral/torsional scoli there IS a structural issue - although not to the point of hemivertebrae) for correction, but that's just me.

I know it feels good and it does keep encourage flexibility, and you can't ignore that. Certainly as AIS moves into adulthood.

We'll just have to agree to disagree ... and I'd like to think adults can do that ;-).

Best regards,
Pam

[structural75]

Pam,
My apologies again... I didn't read your post correctly... the initial sentence. A bit slow I suppose, but I hear it now. Thank you.

I do disagree myofasical, tension/compression can help correct a structural curvature

I think I was in agreement that 'structural' curves probably cannot be helped much, if at all. But I also see what you're saying about less serious/dramatic structural types... wedging for instance or deformation of the spinous and transverse processes in rotations and lateral flexions... just to name a few. From a physiological standpoint, deformations of such variety that form over time in adulthood and are not present to start always contain the physiologic capacity to 'deform' again, but in a more positive direction. They certainly won't if the rotation/flexion is still present and progressive. But they certainly can change if you reverse the forces acting on them... there is no reason why it can deform more and more over time in one direction and not the other... you just don't see the other occur very often because the concept or reality of trying to change that process is difficult and under-recognized. But physiologically, it is possible... deformation happens as a result of the chronic positioning and imbalanced forces acting on bone... change those forces for the better over time and you will see a positive change in the bone... even if that just means slowing or halting the process at least.

As a practitioner, I've seen these confirmed with x-rays in cases other than scoliosis (kyphosis, spondylosis) so I like to work with the physiologic fact that these processes can go in one direction or the other... I won't resign myself to any other reality just yet, especially not by ignoring the biological facts involved. That's just my stance on it until the human body proves me wrong.

I agree that it's good to have an intelligent and mature conversation... thank you for that.

structural

[txmarinemom]

I meant I do NOT agree MF release, manipulation, etc. can correct a structural curve, but it CAN help the pain - and it CAN encourage/maintain flexibility.

No more posting until I'm fully awake, I promise ;-). It's POURING here, and it's been one of those "slow to get mentally moving days" - LOL!

Anyway, I'm glad we cleared up our stances.

Best to you,
Pam

[Karen Ocker]

In an ongoing Polish study, I cited on a couple of earlier forum posts, an inherited "syndrome of contractures" --- shortening of connective tissue in the groin and perhaps other places in the body-- was noticed in infants and toddlers who later developed scoliosis. This seems to be consistent with the article just posted by Structural. In that study early intervention with a specific PT seemed to reduce the onset of scoliosis later on in those particular subjects.

If I had a young child now with "idiopathic scoliosis" I would definitely try Rolfing also known as Structural Integration rather than "watching and waiting" for the thing to get worse.
My Rolfer is covered by insurance because she is also a PT.