Stretching is an extension of Posture and Proprioception training
The most important part of scoliosis treatment is posture and proprioception training, which I discussed in detail in previous blog articles. I start the process of training posture and proprioception with Mirror Work, where my student learns to correct her or his posture, and – most importantly – integrate this correction into their awareness of a more symmetrical, more upright posture in everyday life.
It’s interesting to note that when you are making a correction during Mirror Work you are creating a stretch, although perhaps it is a less recognizable, more subtle stretch than a hamstring stretch or a backbend.
Stretching is best used as an extension of Mirror Work. In your stretching routine your goal should be to use each stretch position as a way to bring yourself into a more symmetrical posture. Anyone can do a hamstring stretch, but to perform a one-leg hamstring stretch while resisting your scoliotic habit, and instead standing with an improved symmetry, is extremely challenging, and also extremely beneficial.
The core stretches I use are:
One leg hamstring stretch
Seated and standing forward bend
Kneeling backbend
The secondary stretches I use are:
Wall assisted V stretch
Wall assisted twist
Side leg hang
The importance of Sagittal stretching
Sagittal is the term used to describe the plane of movement that is front to back. When an archer draws back their bow string, the movement happens along the sagittal plane. Forward bends and back bends also happen along the sagittal plane. Nodding your head is a sagittal movement, while shaking your head is not – it is a movement along the transverse plane.
An example of a forward bend.
Sagittal stretches are very useful for treating scoliosis, because those of us with scoliosis have muscles on either side of our spine that don’t match. When you do a side bend you affect one area of shortness and, if you build a stretching routine entirely of side bends to work on your compression areas it will be difficult to have a somewhat objective idea of what progress you’re making in creating symmetry. In contrast to this, if you are sitting on a chair and you bring your torso forward 30 degrees – if you have been able to come forward symmetrically – you know that you have required an equal amount of stretch from each side of your torso. If you have a lumbar compression area and a lumbar expansion area, the compression area will have been asked to stretch more relative to what it is used to, the expansion side will have been asked to stretch less than what it is used to, and they will have lengthened the same distance. While not being an example of perfect scientific measurement, this approach provides a more reliable way of assessing progress than side bending. It is also a stretching experience that you can more easily integrate into your daily life than side bending. This is because you are more or less upright during the stretch, as you are most of your normal day, and you are moving along the sagittal plane, which is more common in everyday movement than side bending is.
Stretching along your medial line
The medial line is the midline of your body. In scoliosis the lateral curves of your spine mean that your spine is not organized entirely along your medial line as it is with people with no scoliosis. When I say that the purpose of scoliosis treatment is to support you in having a more symmetrical and upright posture, another way of wording it would be to say that your goal is to support your spine in being as organized along your medial line as possible. This is another reason why I consider side bending exercises to be of secondary usefulness rather than core exercises. While side bending exercises are useful for encouraging volume and vitality in the compression areas of your torso they are not particularly useful for teaching you how to maintain your spine along your medial line. The most efficient way to help you learn where your centre line is rather than side bends, is to do stretches and exercises that directly involve working on your centre line while in positions that you are most likely to be in during your everyday life – standing, sitting, walking around, etc. The postural corrections that you work on when doing sagittal stretching directly aim towards finding your medial line more clearly in everyday life.
Get your torso supple first, then work on straightening
As I emphasize in all of my writing the goal of scoliosis treatment is to support yourself in being as upright and symmetrical in your posture and coordination as possible throughout your daily life. The effectiveness of treatment sessions or home exercises is measured by how well they have contributed to this goal.
An essential step in being more upright and symmetrical is increasing the volume and vitality in the compression areas of your torso. The stretching routine I recommend contributes towards this need in three ways.
By making your body generally more supple.
By including stretches that target the compression areas of your torso.
By providing an opportunity to improve your posture and resist your scoliotic habit while performing a stretching movement. Performing any movement is such an opportunity.
I often find with my new students that they have a hard time making the postural corrections that I cue them to make, not because they don’t understand my instruction, but because their muscles aren’t supple enough to accommodate the necessary change. Stretching is an effective way to make these rigid muscles more supple, especially in conjunction with manual treatment, which I talk more about in my blog article Manual Treatment for Scoliosis.
Don’t worry if at first you struggle to make postural corrections that improve the symmetry of your torso. Over time consistent use of stretching will loosen rigid muscles and make postural corrections easier.
Mobility Work
The value of mobility work
Stretching and strengthening exercises are both effective ways to create volume and vitality in the compression areas of your torso. Another effective way is to use mobility exercises. When you do stretches you are encouraging muscles to loosen and lengthen as your approach to creating volume and vitality. When you do strengthening exercises you are encouraging muscles to become larger and more powerful to create volume and vitality. Mobility exercises create volume and vitality by having your muscles engage and relax as they move you through a range of motion. Tight muscles have a hard time changing efficiently between being engaged and relaxed, so mobility exercises that require this efficient change will help make tight muscles more supple. Remembering that scoliosis is both a condition of asymmetry and also rigidity, you can understand that the ability of mobility work to make muscles more supple is very useful.
Standing hamstring off.
Standing hamstring corrected.
Spinal rotation
Although scoliosis is usually described as a side curve of the spine, practitioners all agree that as the spine curves to the side it also rotates. Understanding that the rotation caused by structural scoliosis is said to be impossible to treat without surgery, and rotation caused by functional scoliosis may be effectively treated you would want to ask the question: how much of my rotation is structural and how much is functional. I don’t think that it’s possible to know the answer to this question except by doing. Start working on your ability to rotate through your spine and whatever improvement you get in your scoliosis was functional and whatever you are unable to change was structural.
The thoracic section of the spine is much more designed for rotational movement than the lumbar spine. For this reason, my goal when working on rotation is to aim for an equal amount of left and right rotation in the thoracic section of the spine. I have no particular goal for rotation in the lumbar spine.