This is a topic that I can speak about from personal experience, both as an RMT and as a patient. While my spinal curve may not be extreme, it IS typical of what I see commonly in my practice and does affect me personally on a daily basis. For as long as I can remember I have had back pain, most likely a combination of unfortunate genetics and poor posture from a lifetime of slouching from being so tall (I'm 6 ft). On my Mother's side it is known as the "Karpiak back" since almost everyone has chronic and often crippling back problems. As a young girl my Mom knew I would be at a disadvantage so she encouraged me to exercise and use physical therapy, which is where I was first introduced to Massage Therapy, Chiropractic and Physiotherapy. Over the years I have found a few things that help ease the pain, short-term and long and have watched, felt and experienced profound change on my massage table when doing scoliosis treatments. It is more common then you may think and often I am the first person to mention the curve in my clients spine. As RMTs we are in a great position to notice these sometimes subtle changes and help educate our client so that they can best take care of themselves.
First you must understand a little bit about scoliosis. Scoliosis, by definition, is a medical condition in which a person's spine curves from side to side. If viewed from behind the person's spine appears to have an S or C shape instead of being perfectly straight as it should be. It can be either congenital (you are born with it) or idiopathic (acquired later in life, cause unknown but can be the result of another condition).
Want to know which yours is? Grab a friend and try this easy test:
- ask your friend to feel your spine when you are in a seated position (they should feel the curve from side to side as they follow your spine up your back with their fingertips)
- bend forward as far as you can and have them feel your spine again
- if the curve remains while you are bent it is congenital
- if the curve disappears, it is idiopathic
What causes scoliosis? For some it's the result of bad genetics, for others the result of another imbalance in the body such as one flat foot, one leg being shorter than the other or the consequence of years of bad posture. And sometimes, most frustratingly, there isn't an obvious reason at all.
Scoliosis can present in many different ways throughout the spine as you can see above. Take a close look at the posture in each image and how it is affected by the scoliotic curve, particularly the balance between the right and left shoulders and hips. The image on the far right is of an S curve type scoliosis. Notice how the posture looks balanced but the spine is far from being straight. This is often our body's way of trying to correct a problem - when we have a curve in one part of the spine, another curve appears to balance the posture. It certainly doesn't eliminate the pain or problems though!
A lot of the pain associated with scoliosis comes from the muscles that surround the spine and from the direct affect from the curve itself. When the spine curves, all of the muscles on the inside of the curve (concave) become tight and begin to pull on other parts of the body where they attach such as the hip, ribs and shoulder. The muscles on the outside of the curve (convex) are overstretched and irritated and generally weakened. You become very a-symmetrical and over time this curvature worsens as your muscles get even tighter, weaker and your posture is pulled more and more out of proper alignment.
But wait - before you panic and feel doomed to pain and suffering, take a deep breath and relax. There are all kinds of things that you can do to correct this imbalance and manage your pain and discomfort. And the good news? They don't have to cost a fortune.
1) Hydrotherapy: basically, the use of heat and cold for a therapeutic purpose. One of my favourites is the basic salt bath, it has amazing restorative powers. There is nothing like a good, hot, salt bath to take away the aches and pains. Salt is also relatively inexpensive and easy to come by and helps to detoxifying your muscles and joints while infusing them with essential minerals. I prefer himalayan sea salt but you can use dead sea salt or epsom salts. The basic recipe is 1-2 cups for an epsom salt bath, 1/4 - 1/3 cup for a sea salt bath, add it to hot water and soak for 20 minutes. You can also find relief at the end of a heating pad targeted to your worst area or an ice pack when you've overdone it and have inflammation. And when you have a chance - saunas, steam rooms and hot tubs will be your best friend.
2) Massage Therapy: whether massaging yourself, getting massage from a friend or a professional RMT, it is a great tool to have in your healthcare regime. Tools like the Acuball and Acuback (above) are handy for at home care and giving yourself relief any time of the day or night (they even heat up!). There are many different self-massage tools out there, but in a pinch a hard tennis ball or even a dog toy (believe me I've been there!) will do the trick. The general idea is to focus on the concave side of the back to try and relieve the pressure on the muscles there. You will be using your body weight to apply pressure onto the ball and in turn your muscles to get the relief you desperately need (be careful to avoid the actual spine itself). I also recommend seeing a professional Registered Massage Therapist about once a month to keep everything on track and in alignment. They have very specific training and know exactly how to release shortened/tightened muscles and can even apply joint mobilizing techniques to the spine itself. It's pretty amazing how much of a difference massage can make on scoliosis. Since a lot of scoliotic curves are there because of imbalances in the muscles, you can reverse it significantly or even entirely by releasing those imbalances.
3) Spinal Mobilization: with Scoliosis, the more mobile you are the better for both the short-term and the long. Keeping your spine loose and limber is key to your wellbeing. The yoga pose above is one that I recommend to my scoliosis clients a lot, it's called "Cat/Cow". Think of arching your back like a cat and then bending the opposite way and upwards to "Moo" like a cow. Go back and forth 10x every day. Another great exercise in this position is to curve your back from side to side, turning your body into the shape of a "C". And don't forget to add spinal twists to your routine! I would also recommend seeing a professional - either an Osteopath or Chiropractor on a regular basis. They are spinal specialists who can loosen areas of restriction in your back. I've felt a huge weight lifted off my back on many chiropractic visits and thought "no wonder I was in so much pain!". Aim for about once a month for maintenance.
4) Strength Training: long-term, strength is your best bet. The stronger you are the more able you are to handle day to day physical stresses and manage your pain and mobility. The only trick? Not to overdo it! Which is why I recommend starting with an expert such as a Physiotherapist, Clinical Pilates Instructor or a Personal Trainer with a strong medical background and knowledge. They can get you started and do it safely and effectively, which is important because your training will be a little bit asymmetrical. The focus is on increasing strength to the side of your back that is overstretched and weakened (convex), which will help bring your spine back into alignment. The "Superman" exercise above is easy to do at home and can be done just on one side of the body. Simply lay face down and bring your arm and leg up at the same time, engaging the back muscles and then release back down. Repeat 10 times.
5) Regular Stretching: it's free, you can do it almost anywhere and it feels oh so good. It's also an important part of self-care for scoliosis. Focus your stretches on the concave section of the back and spine, aiming to release the tightened sections of muscle on that side. Torso lengthening stretches like the one above are ideal. This video by Elise Browning Miller is a great start for home practice:
Yoga For Scoliosis
6) Postural Awareness: Pay attention to how you do things during the day - are you sleeping or sitting often to one side? Tend to use one side more then the other? You know that old saying if you keep your face like that it will stay like that? It's true! The more time you spend in a certain position, the more your body will tend to stay in that position. So every day, make the conscious effort to move and stand in a straight alignment. Imagine that there is a piece of string running through your body all the way up through the top of your head. And like a marionette you are being pulled up and lengthened. Many scoliotic curves are caused by improper posture, so by changing your postural habits you can often change the scoliosis altogether. It's not easy, since many of our bad postural habits begin in adolescence and our very hard to break, but day-by-day make your best effort to recognize these bad habits and change them and along with strength training and stretching it will become easier over time.
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