Yoga for scoliosis? Please share your thoughts


#1

Hello all,

I’m a chiropractor who specializes in rehab based scoliosis treatment and I get A LOT of questions about the usage of Yoga and effectiveness of Yoga in regards to the scoliosis condition.

I’m hoping some of you are willing to share your thoughts, experiences, and/or knowledge with Yoga as it relates to scoliosis, so I can better inform my patients to it’s benefits and potential dangers.

Thank you all very much! :smiley:

Please feel free to address me as “Clayton”…I only used “Dr. Stitzel” as a log in name, for reasons of full disclosure. Again, thanks for you time and help.


#2

Hello Clayton,

I often hear of both M.D.'s and D.C.'s referring patients to Yoga. And my follow-up to them is “does your health care provider have a yoga practice?”. To which the answer is almost always no. So I’m relieved to know that some are actually exploring that which they hope to reference. To that end, I prefer the referrer to have some practice experience so that said referral is not a blend of anecdote and pop culture.

Fortunately, you are in a field that is regulated. I am not. Someone can be “earn” the title of Yoga Teacher in a 22 hour weekend. Ergo the first caution to patients should be “find a skilled teacher”. To me that means a minimum of 500 hours of training (for me it was 2,000) in a program which is comprehensive and includes A&P, with therapeutic modules, and an ongoing re-certification process. Purna Yoga teachers (at the 2,000 hour level) are certified by the State of Washington. But we can not simply say “take some yoga, that should help” just as we canot say “eat well”.

The second caution is to examine the style, flavor or expression of Yoga. Of course there is only one wisdom, one vast sea, but then human beings enter the picture and from there, all bets are off. Since you are asking about scoliosis I’ll simply say that such things require a robust practice, not merely an hour of some choreographed postures. Instead, the practice of yoga as therapy has to offer three major prongs; the physical, the emotional, and the nutritional. Offering only one is a partial protocol and partial protocols yield partial results.

Finally, in yoga we learn that there should be a balance between the masculine and feminine energy in each person (this is not male/female). The masculine energy is the one of double-blind study and empirical data. It is a nature that says “if this can be replicated in a population of people then it is true”. The feminine force is just the opposite. It says that if something can be replicated for everyone it cannot be true as all human beings are unique and therefore all solutions should be unique. My point here is that while we do “know” some things we must treat each person with a custom-tailored approach.

Scoliosis is a significant therapeutic issue. It can be dealt with but it takes time and patience. And the person who truly hopes to rectify the curvature has to be brave enough and willing enough to address the deeper issues which manifest AS scoliosis.

gordon


#3

Hello Clayton,

I am new to the site, but I am not new to the practice. I have been practicing yoga for over 30 years and I am now a Certified Yoga Instructor (Yoga Alliance).

I started practicing Ashtanga because I “have” scoliosis. I do not regard myself, though, as someone with a back problem because yoga (from the very first day) made my back feel better and gave me the freedom from pain that I was seeking. I wanted to be able to live an active life without being immobile from my back pain. I stuck with the practice and can say because of my “bad back” (& finding yoga) that I have had the most amazing life. I stopped thinking of myself as someone with scoliosis until I had my first child (at 30 years old, 10 years after starting yoga practice) and the doctors could not get an epidural down my “crooked” spine, so they had to knock me out for a C-section. The reason I am sharing this is I do not think of myself as having scoliosis (because of my yoga practice) but know it is still there. If I go for any length of time without yoga, my back will start to feel “a little funny” and I go right back to the mat.


#4

Hello Gordon,

Thanks for taking the time to give such a detailed and well written responce. You opened up my eyes to an entire new world of concepts and possibilities with in 500 words or less. Impressive.

Please continue to provide any insight and experience you can afford to share…including some books you can recommend on scoliosis and yoga, since there seems to be quite a few out there.

[QUOTE=InnerAthlete;50533]So I’m relieved to know that some are actually exploring that which they hope to reference. To that end, I prefer the referrer to have some practice experience so that said referral is not a blend of anecdote and pop culture. [/QUOTE]
The one thing we know for sure in scoliosis treatment is that we don’t know enough!

[QUOTE=InnerAthlete;50533]Fortunately, you are in a field that is regulated. I am not. Someone can be “earn” the title of Yoga Teacher in a 22 hour weekend. Ergo the first caution to patients should be “find a skilled teacher”. To me that means a minimum of 500 hours of training (for me it was 2,000) in a program which is comprehensive and includes A&P, with therapeutic modules, and an ongoing re-certification process. Purna Yoga teachers (at the 2,000 hour level) are certified by the State of Washington. But we can not simply say “take some yoga, that should help” just as we canot say “eat well”. [/QUOTE]
Chiropractic went through the same process in the 1970’s and has emerged stronger than ever. Yoga will do the same as long as they continue to raise the standards for certification. The real trick is raising the expecations once the standards are sufficiently raised. That is the part Chiropractic is struggling with now.

[QUOTE=InnerAthlete;50533]Instead, the practice of yoga as therapy has to offer three major prongs; the physical, the emotional, and the nutritional. Offering only one is a partial protocol and partial protocols yield partial results. [/QUOTE]
Interesting. We have come to the same conclusion. Scoliosis is a muliti-factorial condition (Genetic predisposition + Environmental Factors = Scoliosis) and requires a multi-faceted treatment approach. The 3 catagories of environmental factors seems to be breaking down into…

  1. Bio-mechanical
  2. Bio-Chemical
  3. Activity related

[QUOTE=InnerAthlete;50533]My point here is that while we do “know” some things we must treat each person with a custom-tailored approach. [/QUOTE]
From you lips to God’s ears my friend. Everyone’s scoliosis is “their own” despite having similar patterns with other cases.

[QUOTE=InnerAthlete;50533]Scoliosis is a significant therapeutic issue. It can be dealt with but it takes time and patience. And the person who truly hopes to rectify the curvature has to be brave enough and willing enough to address the deeper issues which manifest AS scoliosis. [/QUOTE]

Agreed. Our patients already engage in 1.0-1.5 hours of home rehab a day…often for 3-4 years. It is a tough road for a young person to travel, but sure beats wearing a brace or surgical fusion. We have found that eliminating confusion is the #1 factor in gaining long-term compliance with the program.

Thanks and please keep the great discussion going…I have no secrets and am willing to share any info I can to help us all find a better way to treat scoliosis in the future.


#5

Hi Stephanieyogini,

Thanks for sharing your story. “Quality of life” ranked second on the Society Of Scoliosis Orthopedic Rehabilitation Treatment (SOSORT)…basically all non-surgical treatment… concensus for scoliosis treatment outcomes. These are the treatment goals I believe yoga can offer to the scoliosis patient.

Ranking Importance of factors in scoliosis according to SOSORT

  1. Aesthetics
  2. Quality of life
  3. Psychological well-being
  4. Disability
  5. Back Pain
  6. Rib hump
  7. Breathing function
  8. Progression in adulthood
  9. Needs of further treatments in adulthood
    10 Knowledge and understanding of scoliosis in general and their specific pattern
    11 Balance
    12 Scoliosis Cobb degrees (radiographic lateral flexion)
    13 Self control of posture
    14 Movement of the vertebral column (sagittal plane)
    15 Perdriolle degrees (radiographic rotation)
    16 Kypho-lordosis Cobb degrees (radiographic lateral alignment)
    17 Sensory motor integration of the corrective ideal pattern
    18 Exercise efficiency
    19 Equality of weight bearing
    20 Improved body motor awareness and motor learning skills
    21 Improved processing of vestibular input

#6

Morning Clayton,

I think your ranking importance is fascinating. I do know, from purely personal experience, that without yoga my life would have been completely different because of my scoliosis. The “challenge” for some people (as they ask me about this) seems to be that people wish for something quickly - which I felt good very, very quickly going to yoga. Long term goals (like rib hump) still are in the picture for me. I tell people all the time it’s like having braces. You can heal yourself. I also agree with Gordon that there are more complicated issues - it really is mind, body and spirit we are talking about here.


#7

Hi Stephanieyogini,

[QUOTE=Stephanieyogini;50794]
I think your ranking importance is fascinating. I do know, from purely personal experience, that without yoga my life would have been completely different because of my scoliosis.[/QUOTE]
And that may be the best value of ANY scoliosis treatment…Yoga or otherwise.

[QUOTE=Stephanieyogini;50794]
The “challenge” for some people (as they ask me about this) seems to be that people wish for something quickly - which I felt good very, very quickly going to yoga. Long term goals (like rib hump) still are in the picture for me. I tell people all the time it’s like having braces. You can heal yourself.[/QUOTE]

Agreed. Having short and long-term goals in scoliosis treatment is paramount to a patient’s success with any given treatment.

[QUOTE=Stephanieyogini;50794]
I also agree with Gordon that there are more complicated issues - it really is mind, body and spirit we are talking about here.[/QUOTE]

Again, agreed. Virtually every multi-factorial condition is a combination of all three.


#8

Had to dash off there folks.

But i’ll just chime in here.

The yoga paradigm and the mainstream medical one are different.I don’t know if you specialise in treating scolisosis, understanding or researching it or general orthopoaedics. But it really is a “mind,body,spirit thing” from the “yoga” perspective at least and the holistic aprroach taken by yoga tends look at the bigger picture rather than look at the body as a separate organism.

There are any number of yogas out there that would help it so any effective remedy is not just confined to stretching and strengthening say muscle.

The way i have understood it i believe it is simply put :-

the brain aka nervous system moves muscles,
and muscles move bones.

Now when we are stressed, experience trauma or cannot perhaps even adapt quickly enough the signals can get mixed up.

This is to say that the root of musculo-skeletal problems are found in the nervous system and beyond.

Now in yoga they break this down into more quantum level and look at how the most subtle phenomena like how we think, our attitude, ultimtely our state of mind, how we view and treat ourselves ultimately has an affect on what we are…our propensity to feel happy etc.

My honest feelings on this is that a main problem with mainstream medicine is it suffers mainly from a severing of the mind/body not to mention spirit relationship.At it’s worst we are viewed as machines but if we wish to change ourselves from deep within or need the change sometimes we ar referred to a psychologist or counsellor or psychiatric doctor.Now i think a more intelligent approach is to treat the mind and the body as intimately connected. One would go further as has been suggessted and say that it is a disconnection to spirit that can manifest here.

How do we treat it? well in mild case some simple asanas might work for some etended period…for more difficult cases you may need a broader yoga. If you’ve been read much of info. available here you’ll find the insistence that a holistic apporach is necessary to treat difficult cases…all the limbs, as many yogas as possible. But ulitmately treatment from the yoga paradigm depends very much on the individiual making use of the toools available once they are shown how.This may take some time…the learning bit…

When you go to a chirporactor, which i don’t know that much about, he makes an adjustment here, perhaps there. But unfortunately many folk end up reliant on the health care healer. A better approach for the sufferer or patient is and would be to teach that patient, empower them with the ability to treat themselves. The body will heal itself it is left to it’s own devices i believe alot of the time… homeostasis is their term…not always… that reliance may well be fed by economics or commmerce…

A therapeutic treatment will involve empowering the patient with the tools to treat themselves without reliance on the doctor/healer of choice for them.

Mainstream medicine has crossed the frontier where the mind and body are not viewed or treated AS separate entities but as intimately connected, inseparable even, and this wil be reflected in the treatment startegies available. It is still a young science in the relative dark ages i think.It has to mov beyond veiwing and treating the body/mind as a machine or mechanical entity.

I can just picture your M.D handing out a prescription for deep meditation…20 mins twice a day.And don’t eat much.:slight_smile:

Food for thought?

It’s agood for crisis medicine but not so good at tacking the root causes behind illness and disease both in mind & body,tends to over-look the quamtu dimension,how we breathe, how we view ourselves etc. The good news is yoga can definitely treat these things but it will require in more difficult cases a broad spectrum of practices not just to confined to stretching and strenghtening muscles alone…No… The root of this is in the nervous system… and beyond.lifestyle habits also,diet, our perception of ourselves etc.


#9

Hi Core789,

[QUOTE=core789;50802]The way i have understood it i believe it is simply put :-

the brain aka nervous system moves muscles,
and muscles move bones.

Now when we are stressed, experience trauma or cannot perhaps even adapt quickly enough the signals can get mixed up.[/Quote]

Sounds like you have a pretty good handle on the problem, but it not quite that simple. Just like there are many forms of yoga, there are many forums of scoliosis…generally grouped by age range (infantile, juvenile, Adolescent (80+% of cases), denovo (adulthood) or condition (neuromuscular, hysterical, trauma induced).

Again, the main scoliosis problem is Adolescent Idiopathic Scoliosis which makes up the vast, vast, vast majority of these cases. Generally the young female’s spine is perfectly normal until they begin hitting a growth spurt and everything goes haywire. We know there is a genetic pre-disposition, but what in the world is the environmental trigger(s)? (rhetorical)

[QUOTE=core789;50802]When you go to a chirporactor, which i don’t know that much about, he makes an adjustment here, perhaps there. But unfortunately many folk end up reliant on the health care healer. A better approach for the sufferer or patient is and would be to teach that patient, empower them with the ability to treat themselves. The body will heal itself it is left to it’s own devices i believe alot of the time… homeostasis is their term…not always… that reliance may well be fed by economics or commmerce…[/Quote]

Agreed…And that is coming from a Chiropractor. You would love the CLEAR Institute scoliosis program. All of our patients are given extensive home rehab programs and learn to continue the healing process on their own. It is the only way to convert them from a victim into a soldier.

[QUOTE=core789;50802]A therapeutic treatment will involve empowering the patient with the tools to treat themselves without reliance on the doctor/healer of choice for them.[/Quote]

Agreed. This the goal. We call it 3-D Auto-correction.

[QUOTE=core789;50802]It’s agood for crisis medicine but not so good at tacking the root causes behind illness and disease both in mind & body,tends to over-look the quamtu dimension,how we breathe, how we view ourselves etc. The good news is yoga can definitely treat these things but it will require in more difficult cases a broad spectrum of practices not just to confined to stretching and strenghtening muscles alone…No… The root of this is in the nervous system… and beyond.lifestyle habits also,diet, our perception of ourselves etc.[/QUOTE]

Again, agreed, but more specifically the problem seems to start off as an under development of the involuntary postural control centers in the brain stem. So we would need a yoga style that would stimulate the automatic posture re-adjustment reflexes to “learn” the new and improved body schema.


#10

Not much more to add to the valuable information on this page.
The best way to experience the benefits of yoga, would be to try it.
Find a good class, establish a daily practice. Experience the benefits firsthand.


#11

Good MORNING Dr StITZEL,

Yes we’re not a colllection of parts. We are more than that…

And the best way to get or understand yoga is indeed to practice it.

Well done Terence!!


#12

[QUOTE=Terence;50852]Not much more to add to the valuable information on this page.
The best way to experience the benefits of yoga, would be to try it.
Find a good class, establish a daily practice. Experience the benefits firsthand.[/QUOTE]

Agreed. First hand experience of anything is the best teacher, but I don’t have scoliosis (so much for the first hand experience) and my primary aim is to help my patients utilize the full spectum of benefits Yoga can provide for them. [U] I’ve heard there are specialized yoga programs for scoliosis and at the very least I’m hoping someone can point me in the right direction in terms of “scoliosis specific” yoga regimes.[/U]

I’m also very interested in hearing anybody’s experience with yoga and scoliosis to help me identify any potential pitfalls or hazards I can warn them about ahead of time.


#13

This is still my first week on this forum and, again, I am both amazed at and grateful for the wealth of information available here. Plus I am inspired to realize that there are so many honest seekers “out there” who are lighting up the world! :smiley:

This is a good thread!

[QUOTE=Dr. Stitzel;50807]
Again, the main scoliosis problem is Adolescent Idiopathic Scoliosis which makes up the vast, vast, vast majority of these cases. Generally the young female’s spine is perfectly normal until they begin hitting a growth spurt and everything goes haywire. We know there is a genetic pre-disposition, but [B]what in the world is the environmental trigger(s)?[/B] (rhetorical)[/QUOTE]

Just my thoughts here, but I have given this a lot of thought over the past few years.

I believe that our western societies have not “supported” growth in young girls, at least not to the extent that teen-aged boys are. What I mean to say is that it is uncommon for girls to be encouraged to “stand up” for themselves and for what they want in their life experiences. Rather than star as the lead role in their own life story, often they have been relegated a “supporting” role in a man’s world. She is constricted. She must “twist” herself to conform to society’s expectations. This is hopefully changing.

Also, another tragedy I see is that rather than being honored in her body’s changes, she is bombarded with the sexual exploitation of the female body. What is beautiful and should be empowering actually signals an end to her freedom. The way she begins to view herself is against a backdrop of sexual objectification that is so overwhelmingly prevalent and socially accepted. It’s literally everywhere she looks!

I am interested to know if there are so many cases of female adolescent scoliosis in tribal societies.

(I hope all this makes sense!)


#14

[QUOTE=core789;50874]
Yes we’re not a colllection of parts. We are more than that…
[/QUOTE]

Agreed 100%. It does seem a little illogical that the sum of a person’s pieces doesn’t equal the sum of their whole, but that does seem to be the case. Go figure.

I guess it could be said that Yoga puts the “whole” in “holistic”? :grin:


#15

Hi Sparky,

[quote=sparky;50887]I am interested to know if there are so many cases of female adolescent scoliosis in tribal societies.
[/quote]

The incidence of scoliosis remains pretty consistant among all populations and ethnicities across the world, but does show brief “spikes” in populations from time to time (generally for unknown reasons). It’s really wierd.

Anyway, there is undoubtedly an emotional component to certain scoliosis case, but it appears to be the minority of them.

Here is a 90 FLASH presentation we put together that discusses the role of environmental factors and genetic pre-disposition in the development of adolescent idiopathic scoliosis. Most people don’t realize the incredible impact the new Scoliscore genetic test will have on scoliosis treatment in the future. I hope this helps.


#16

When you can experience and understand how Yoga aligns your spine, you can gain a better understanding of how Yoga can heal a patients spine.

The ancient Eastern approach is generally to experience firsthand, then learn theory. That way theory is thoroughly absorbed and understood.

So to understand pitfalls in the practice of others, you must understand the pitfalls in the practice yourself. If you want to know the full spectrum of benefits in Yoga, you must experience those benefits, regardless of having a condition that matches that of your patients.

The best info I’ve come across for Yoga asana to cure specific diseases of the spine, is in Iyengar Yoga remedial classes. That would be a good starting point for a patient with scoliosis.

I’d also recommend looking at Pilates, both matwork and machine based.

2 books highly recommended, Light on Yoga by BKS Iyengar and A Pilates Primer by Joseph H Pilates.


#17

Hi Terence,

This is excellent. Thanks.

Any experience with “Bikram Yoga” for scoliosis treatment?

[quote=Terence;50899]The best info I’ve come across for Yoga asana to cure specific diseases of the spine, is in Iyengar Yoga remedial classes. That would be a good starting point for a patient with scoliosis.

I’d also recommend looking at Pilates, both matwork and machine based.

2 books highly recommended, Light on Yoga by BKS Iyengar and A Pilates Primer by Joseph H Pilates.[/quote]

Pardon my complete ignorance, how are Pilates and Yoga different from a physical stand point?


#18

[QUOTE=Dr. Stitzel;50891]
Anyway, there is undoubtedly an emotional component to certain scoliosis case, but it appears to be the minority of them.[/QUOTE]

Yes, it’s the emotional component in the environment that I bring up.

Hormones are active in adolescence which commonly explains swinging emotional states. (Although I am pretty sure it’s much more involved than just that. I’m trying to stay on topic here. By the way, yoga helps greatly improve hormone balance and function.)

What I’m suggesting is what [B]InnerAthlete[/B] brought up in your other Scoliosis thread and I’ll quote him here:

On the other hand we don’t want to place a thought in a powerful mind that can become a self-fulfilling prophecy… the power of the mind can also create conditions. … lacks the mindfulness to realize they are placing thoughts in the readers consciousness.

Although I might be quoting out of context here, the principle remains that our minds are powerful and create our physical limitations. Being in an environment that may force an unnatural conformity could explain some of the unknown causes of a spine struggling in its growth. The physical result is the expression of the mind’s struggle.

If I am overstating myself, I apologize. Remember though the power of the mother picking up a car to save her child. How does one who is focused mainly on the physical environment explain that phenomenon without considering the powers of the mind and its connection to the emotions and hormones?


#19

You’re welcome :slight_smile:

I haven’t tried Bikram Yoga, but out of all the forms of Hatha Yoga (basically this term describes the physical practice of Yoga, ie ‘asana’) I would recommend remedial Iyengar Yoga as a starting point, for a student who suffers from spinal disease/degeneration. The Iyengar teacher would then give the OK for the student to enter open classes when appropriate.

Its very important to build good technique in Yoga, a common mistake is to do too much, students feel pressurized to stretch as far as they can without awareness. This is how people get injured. Its important for students to work at their own pace, building a regular practice over time.

On a physical level, you could say that Pilates and Yoga have the same aim, to bring the body into good health by alignment of the spine. Muscles are evenly toned, breathing is corrected. Joseph Pilates called his method Contrology, based upon based his study of Yoga, Karate, Greco wrestling, western boxing and gymnastics. Well worth looking into…


#20

Hi Sparky,

You are 100% correct in the neuro-hormonal component of scoliosis, but the hormonal levels seem to remain relatively normal until the curvature becomes quite advanced, so that would suggest that hormonal changes are probably a secondary consquence of the condition and not a primary cause…But, that has yet to be definatively proven.

[quote=sparky;50903]What I’m suggesting is what [B]InnerAthlete[/B] brought up in your other Scoliosis thread and I’ll quote him here:

Although I might be quoting out of context here, the principle remains that our minds are powerful and create our physical limitations. Being in an environment that may force an unnatural conformity could explain some of the unknown causes of a spine struggling in its growth. The physical result is the expression of the mind’s struggle. [/quote]

There are psycho-somatic scoliosis cases called “hysterical scoliosis”, but they are extremely rare and most of the young females whom develop scoliosis generally don’t display any other mental health issues.