Scoliosis Blog Article and Back Pain

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Bernie, thank you so much for your recent blog post about scoliosis! As always, your wisdom is much appreciated.

I've never been diagnosed with scoliosis, although I had one of my own teachers ask me this once. I have been told (by an orthopedist) that my left leg is slightly shorter than my right. For awhile I was wearing a lift in the left shoe as recommended, but 1) it was a PITA, 2) I wasn't sure if it was helping, and 3) it sometimes seemed to result in pain in other areas.

I haven't worn the lift for years. For the past several years now, I've noticed that after periods of sitting, I start to get an achy discomfort on the left side of my back, QL area. I'm sure this is related to how I'm sitting - I try to adjust often, and I haven't figured out a particular pattern, but I think it's possible that I lean more to the right at times.

I know the exact answer to this is "it depends," but would you guess that I need more strengthening on the left and stretching on the right to help counter-act this?

[Bernie]

As you have discovered, we are not symmetric, and that is okay! My latest book has a whole section on asymmetries and how they may or may not affect us or our yoga practice. Many people have one leg slightly shorter or longer than the other, but this asymmetry does not require addressing: we can be and often are fully functional despite such variations. Consider athletes: almost always one arm is larger, longer and stronger than the other and they live their lives just fine.

Similarly with scoliosis. Unless the differences are so dramatic that it affects the activities of daily living, there really is no need to worry about it. Sure, if you feel an imbalance, work to address it, as suggested in the article. In your own situation, have a friend take your cell phone and record you while you sit for a few minutes and you should be able to see if you are listing to one side or not. And, if so, you may want to change your posture and see if that helps eliminate your pain.

Or, as one physiotherapist likes to say, "you can go wrong by trying to get strong", adopt a daily core exercise regime. Doing the McGill Big 3 for a few minutes every day may be sufficient to stop your discomfort.

Good luck!
Bernie

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Bernie, I appreciate all the tips! I think revisiting McGill's work is a great idea.

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On further reflection, I have a follow-up question. I have a bit of lumbar lordosis, some of which I think is my natural body shape (ie, I have a larger bottom that protrudes, so this tends to make my S shape more exaggerated) and some of which I think is an anterior pelvic tilt that I've developed over the years. Saddle pose fully reclined is very challenging for me - even on props, my lower back tends to feel overly stretched (the 1-legged version works better).

I do know that the answer is always "it depends," but if I was trying to strengthen muscles weakened by APT and reduce low back pain (which I get occasionally, especially after standing for long periods), are there certain types of yin poses that you would recommend?

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I have a follow up question. I have a deep lumbar curve, which I think is part genetics (my bottom is larger and sticks out, exaggerating my personal S curve) and part a pattern of anterior pelvic tilt. Fully reclined saddle has always been challenging for me, as I can't seem to find a position that doesn't strain my lower back (the 1-legged version works better).

I know that the answer is usually "it depends," but still, I'm looking for recommendations. Assuming that I want to strengthen the muscles that have become weak with APT in order to avoid low back pain (which I get occasionally, especially after standing for long periods), how might it be helpful to focus my yin practice?

[Bernie]

Hello Beth

Part of what you are considering a “deep lumbar” curve is often a more horizontally orientated sacrum. Some people (human variations!) have a sacrum much more horizontal than others (I talk about this in the book Your Spine, Your Yoga…see the online appendix called Pelvic Parameters and Variations). This is related to a parameter called the sacral slope, which is the angle of the top of the sacrum to the horizontal. I write

• The sacral slope (SS) is the angle between a line drawn along the top of the base of the sacrum (also called the sacral plateau) and the horizon. (This is shown in figure 3.113 and repeated in figure 3.516; the dashed line above the SS angle is the horizon, and the short, solid, green line is the base of the sacrum. The angle between them is the sacral slope.) As you move the pelvis, the SS changes because although the horizon stays constant, the base of the sacrum moves. The amount of SS will determine the position and curvature of the lumbar spine. The greater the SS, the greater the lordosis; with less SS, less lordosis occurs. With a large SS, the sacrum is more horizontally aligned; with a smaller SS, the sacrum is more vertically aligned. Someone with a very large SS may appear to be sticking their butt out (i.e., doing an anterior pelvic tilt), but this is simply due to their greater sacral slope. Tucking the tailbone is not required for someone with a high sacral slope and indeed may be ill-advised because the pelvis is already in a neutral orientation.

All this is just to say that, maybe what you consider to be a deep lordosis is simply the angle of your sacrum!

Regardless, if a particular pose is a challenge, then you are quite correct to find variations that work for you. Saddle is a nice combination of stresses for the hip flexors and lumbar/sacral areas, deep flexion of the knees, and when arms are overhead, lovely for the upper chest and shoulders. But, there are other postures that work these areas individually. Choose your target area and then choose a pose to affect that area.

If you are convinced your anterior pelvic tilt is coming from weak muscles, then strengthen what is weak (the abdominal muscles and hamstrings) and stretch what is tight (the quads and erector spinae). Perhaps Saddle with no blocks will work better, or maybe you need to do Saddle with lots of blocks under your hips. Experiment. Supported Bridge may work even better as the knees are not flexed which may reduce the APT.

I hope this helps.
Cheers
Bernie

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All this is just to say that, maybe what you consider to be a deep lordosis is simply the angle of your sacrum!

Bernie, I'm sorry I never responded to this very helpful post from a few years back!

Thank you - it's interesting to think that the shape of my bones (sacral slope) might be the key.
I have Your Body Your Yoga - I need to get Your Spine Your Yoga!