Scoliosis

[Dhivya]

Hi Mukundaji,

Have read over your forum Q&A on scoliosis, class notes and Melody’s paper. Have some more questions for you (note the ?? below). Have a client with a R throracic curve of 9? with a L lumbar curve of 3?. So the lumbar curve is compensating for the thoracic - and this would therefore not be an S curve - correct?? Now, from all of my reading - his R shoulder should be high, but - no - his LEFT shoulder is -tho not by much. His L shoulder rotates to R. His head does rotate and lateraly flex Right. Left ribs are high in supine position. So - this is my first question - ??? Doesn’t make sense - but there it is.

Feet are pronated or flat. Weak muscles: Quads R 4, Abd L4/ R5, Add 4, Sartorius (L&R 3), Hip ext rot L&R 3, Int rot L 4/ R 3, Glut max R 3, Hamstrings L&R -3, mid traps -3, shoulder abd L&R 3, U trap L 3.

His SI can be a problem - on a 1-10 pain scale it averages 4; more on the L. Tested L up, R stuck.

Being a psychotherapist, he doesn’t get much exercise with his work - but he tested strong (5) in key areas like the psoas, QLs, abs, shoulder flexors, extensors, adds, rotators.

For remedies, i understand strength is key. So here’s my ‘fix’: all reps with ujayi done with the following:

Si moblization - elevating to straighten lumbar curve

cat with L knee and hand a few inches forward of R knee and hand
cat bow in same position
cat bow with fingers pointing to each other
sunbird (same adjustments as cat) with flexed knee option for hamstrings
1/2 Salabasana off set to Left - 12 reps on R/6 on L
full locust off set to Left - feet together, knees bent.
cobra with upper bod offset to R with Left arm extended forward
warrior 1, L shoulder flexed, R arm not ??
parsvotanasana adjusted to straighten curves ??
trikonasana - spend 2x as much time to the R?? (emphasis for thoracic curve and L upper traps) extend L arm to R instead of vertically??
baddha konasana - sartorius, ext rot

So - should there be more emphasis on the lower body first - as you recommend dealing with the problems below the problem area and work the way up. Or…

Thanks! Ommm Dhivya

[Mukunda]

A double curve is an S curve. That is what you have assessed. One cannot say what is the chicken and what is the egg for causation of curve. It is what it is. YOu must be careful in assessing curves. Look to see if the curve you see are their in all positions - standing, lying, prone, supine, and see how it changes in spinal twists. if you are not assessing clearly there is confusion in your mind. you must persist. And make sure your vata is balanced in getting an accurate assessment.

For specific recommendations focus on understanding his aches.  You have not made that clear to me. in general work with the area of their discomfort first.  then general strategy is to work from lumbar curves upward.  Changing the lower curves makes the most difference in long term progress.

 Triangle and other postures to change spinal alignment are only affective if that is where discomfort is.  longer changes must be made from zero point of curves.  namaste mukunda

[Dhivya]

Thanks for answering, Mukunda. So, even though the lumbar curve is only 3? it is considered an S curve (i thought that 7? and above was considered a curve - not?). Is this to say, then, that R thoracic curves do not have ‘compensatory lumbar curves’; that the lumbars are ‘in line’.

His chief complaints are: SI area - level 4 out of 10. And neck and shoulders - with a feeling of needing to be stretched out in his L shoulder and pectoral area. I will do another assessment later this week to check him further from all positions, postures.

Sorry - vaguely remember you’re talking about changes being made from the zero point - please elaborate. ommmmmm luvdhiv

[Mukunda]

if any curve is 7 degrees on scoliometer there is scoliosis. any curve below that is just the secondary curve. secondary hence could be either thoracic or lumbar. There are 4 major curves - right thoracic only; right thoracolumbar or C curve; right thoracic and left lumbar or S curve; and Lumbar Region-left curve- usually thoracic-lumbar curve: extending from T9-L4 with an apex between T12-L2. A file on scoliosis is being sent to you. it is from notes presented in class. namaste mukunda