Scoliosis - strengthen & stretch or strengthen & sti

There are often many questions about Yin Yoga and specific spinal conditions. Feel free to ask your question here, or check out other posts or contribute input from your own experience.
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Joined: Sat May 09, 2020 7:35 pm
Location: Bonaire & Europe

Scoliosis - strengthen & stretch or strengthen & sti

Post by janebakxyoga »

Hello Bernie,

I hope you are well.

I have a question for you. I have a friend, Gerjanne, who did a Yin Yoga TTC with me a few months back.
She is a pilates and yoga teacher and has scoliosis. I will send you the x-ray of her lumbar spine in an email separate.
She has been having more pain this year than before and so she went to see an orthopaedic doctor.
He said she should stop stretching. He believes in only strength and stiffness to protect the back.
We both feel though that strength and flexibility/mobility is what's best.

This is what my friend wrote herself to explain a bit more about her situation:
This year I have had more back problems than before, and I did start (more) with yin this year. But honestly, I don't have the feeling that one thing comes from the other. Rather, I was attracted to yin BECAUSE I got more back pain. Then I also decided to do the Yin TTC.The best for me feel twists against the rotation (scoliosis) of my spine (my back is not only tilted sideways but also twisted). Figure 4 / square-like postures for my right hip also provide relief. And bending over / forward folds are nice.
I always feel very mild pain in my right lower back/hip and leg. Compared to the left, the right side feels heavy, stiff and tense. As if there is very light electricity going through it. I think the muscles on that side are always more tense/tight because they want to 'protect' me/my spine. The radiating pain is probably because a nerve is hit by two slightly protruding intervertebral discs or somewhere in the rotation of my back. The pain increases after overload (a day of weeding / lifting heavy groceries) and when standing still / hanging around for a long time. It becomes less with lying down and the postures I mentioned before.

We are both just really curious what you think about all this. Should she stop stretching? Or do you think that besides building strength it is also good to stretch and keep mobility in that area?? And can the stress on the joints/connective tissues in the lumbar actually be good?
We understand you are not a doctor, but just curious about your thoughts/view on this.

We hope to hear from you.
Thank you so much in advance.

Kindest regards,
Jane (& Gerjanne)
Jane Bakx Yoga
Posts: 1152
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Re: Scoliosis - strengthen & stretch or strengthen & sti

Post by Bernie »

Hello Jane.

Thanks for your patience. I just finished a week of training and am getting caught up on Forum questions.

As you note, I am not a doctor, so take anything I say with many grains of salt. Plus I have not met Gerjanne and have not examined her. So, what would a doctor who is also a yoga teacher say? I will defer to Dr Loren Fishman and I quote him and his work with people with scoliosis a lot in my book Your Spine, Your Yoga. Basically the plan is — stretch what is short and tight; strengthen what is weak and long. Here is what I wrote in the book; I hope it helps!



Figure 3.321 shows both a presentation of scoliosis and a theory for fixing it. Since the convex side (the open left side) is too long and too weak, it makes sense to shorten and strengthen this side. Since the concave side (the closed, right side) is too tight and too short, it makes sense to lengthen it but not strengthen it any further. A posture such as Side Plank (Vasisthasana) fits the bill nicely. As shown in figure 3.322a, the lower (left) side of the torso is contracting and strengthening. The upper (right) side is lengthening but is not bearing much load, so it is not becoming stronger.

A team led by Loren Fishman, a medical doctor and a senior yoga teacher, tested this idea on 25 scoliosis patients. Those who stuck to the practice and worked up over time to holding this one pose for 90 seconds, six days a week for seven months had a 40% reduction in the curvature of their spines. That was the average; the range of improvement was 25–75%, significant enough for several of the participants to avoid braces and even surgery.

Not all participants in the study were able to hold the full Side Plank posture, due to knee, wrist and shoulder problems, so the main posture was adapted to the patient’s needs. For wrist and shoulder issues, the version shown in gure 3.322b was used. For students with knee issues, the knees were exed and on the floor (c), but the hips were still raised. Notice that for these students, who have a single C-shaped curve, the convex (left) side of the spinal curve is on the bottom. For double-curve scoliosis, a more complicated posture was used, as shown in (d). Here both curves were worked, following the same philosophy of opening the tight side and strengthening and shortening the long side.

The researchers admit that their study of yoga postures for scoliosis was small and lacked a control group. Compliance with the protocol was also an issue, but since there were no side effects from the practice (outside of mild soreness in some wrists and shoulders) and the results were so impressive, the use of these exercises as a treatment warrants further investigation. While the patients in this study only did this posture for a minute or so each day, it would be easy to incorporate this pose and its philosophy into a full yoga practice.

NOTE TO TEACHERS: Sometimes it is okay to do only one side of a pose!

For students with an asymmetric spine, it may be a good idea to hold a pose on one side longer than on the other side, or to skip the second side completely and do the first side twice! A student with single-curve scoliosis has one side that is tight and short, while the other side may be long and weak. Rather than work both sides of the spine equally, it may be more beneficial for the student to do two side bends or two twists to the same side and not work the other side at all. For example, the student depicted in gure 3.320 has a convex curve to the left and his axis is rotated to the left, which is obvious when he folds forward. For him, it may be more beneficial to do the Side Plank Pose (Vasisthasana) twice on the left side and not at all on the right side. Since his ribcage is already rotated to the left, he may only do twisting poses to the right and skip twists to the left.

Although the definition of scoliosis is a curve of the spine of 10° or more, many people have minor curves less than 10°. For these milder conditions, it may be appropriate to work both sides of the spine but for uneven amounts of time. In my own case, I have a slight curve, convex side facing left. is causes me to sit with my head slightly tilted to the right. In my yang yoga practices, I will hold a Side Plank Pose with the right side low for 45 seconds, then do the left side low for 90 seconds. In my yin yoga practice, I will first hold a twist to the left for three minutes but then hold a twist to the right for six minutes. In this way, I can maintain the range of motion of my left side and the strength of my right side while enhancing the range of motion of my right side and the strength of my left side. Awareness of my slight curvature has also led me to change some habitual movement patterns: I remind myself to carry things in my left hand or draped over my left shoulder rather using my more comfortable right side, and to sit straighter with a slight, conscious tilting to the left. These little techniques are helping me to reduce the curvature and prevent it from getting worse. They may help you or your students too.
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