It’s been about two years now since I found out I have a minor S-curve type of scoliosis (left lumbar/right thoracic). This turned out to be kind of helpful, in the long run, because it’s the same kind of curve that one of my favorite students, Leilani McGonagle, also has. In our yoga sessions, Leilani and I have been working to develop more rotational strength in the thoracic spine. In the last scoliosis post I discussed slow and fast twitch muscle fibers and how yoga can address the imbalances that come along with scoliosis. Today I’m focusing on rotational strength imbalances and what this means for students with scoliosis.
First, let’s back up a bit. It’s helpful to understand the terminology of scoliosis. In surfing, if you’re riding a wave to your left it’s called a “left” even though to someone watching on the beach you’re going right. Scoliosis is like that too: right thoracic means the curve in your upper back (thoracic area) is moving toward your own right shoulder. And left lumbar means the lumbar spine is curving to your own left side. It can also be challenging to visualize in space not only the direction of lateral curve (to the left or right) but also the rotational component (forward and backward) that is always involved in scoliosis.
To visualize the way a spine with scoliosis rotates, picture the way a highway overpass not only curves, but also tilts so that the outer edge of the road is higher than the inner edge. Engineers build this tilt into the road so drivers can maintain speed throughout the curve. If you’re having trouble with the image, use your right hand like a little toy car for a moment, and swing your car (palm down) through an imaginary sharp right turn. Notice how the pinky finger side of your hand naturally lifts? The rotational component of scoliosis is just like this. People with an S-curve (the vast majority of S-curves are left lumbar/right thoracic and no one knows why) are dealing with two separate rotational components. Their yoga practice will need to address both of them, but the emphasis should be on correcting or de-rotating the primary curve.
Studies have shown that the rotational strength of girls with idiopathic scoliosis is significantly weaker when rotating away from the midline toward the concave side (versus when rotating toward the convexity). The rotational strength (when rotating toward the concave side) of the girls with scoliosis is also significantly weaker against a control group (girls with no scoliosis). This means that someone with right thoracic scoliosis will find it more challenging to twist to their upper torso to the left than to the right. It also means that if we can use a yoga practice to strengthen against this inherent weakness, the de-rotation may allow the spine to also straighten a little. In students with S-curves, the matter is complicated by the fact of the lumbar spine rotating more easily to the left, so we need to be very careful in the way that we practice twists.
When working with scoliosis, there isn’t an ideal “goal” of completely eliminating the curve, rather we are working toward finding balance, grace, ease, and awareness. I like to find muscles that are “sleeping” and wake them up, and also to explore muscles that are overworking and try to let them rest a little. A balanced yoga practice should target both the lumbar and the thoracic spine. Work with not only lengthening and strengthening, but also with derotating, which is definitely the most complicated aspect of scoliosis. The next time I write about scoliosis, I’ll include photos of some of the asanas and sequences that work best for S-curves. Stay tuned!
Other Posts You May Enjoy:
Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study