Yes, yes it can. Despite what the medical professionals may say, exercise can help with scoliosis and I have seen first-hand the positive benefits that exercise (in my case Pilates) can achieve in scoliotic clients, including, but not limited to, improved posture, reduction in pain, improved breathing function and reduction in curvature. Below I will share some information of my experience in working with these clients as well as one or two of my favourite exercises.
But first let me share this video of an amazing young lady who attended one of my workshops. She was diagnosed with scoliosis when she was 13 and told she may need surgery. Her mother researched her options and ended up taking her to a physiotherapist in central London. He gave her a set of exercises to do every evening and she did them religiously every night before bed. This is the result. When the video starts you can see her spine in its natural curvatures (which is not natural for her anymore and I had to ask her to “sink into her curves”). By the end you will see her regular posture. Note the difference in her spine, but also the difference in her feet and leg positions. So, can exercise help with scoliosis? She would say, definitely yes!
What is Scoliosis?
I now specialise in teaching Pilates to clients with scoliosis. My journey to become the only Scolio-Pilates instructor in the UK began years and years ago with my grandmother. Grandma had a quite severe scoliosis. From a very young age I was aware of the term “scoliosis” and that it meant a curvature of the spine. I was also aware that my grandmother was not in any pain, that one shoulder was higher than the other and that she was incredibly stylish for a lady in her 70s, then 80s, then 90s. She passed away at the age of 92 and only started complaining about back pain in the 6 months or so before that. She was a remarkable lady and I could go on and on about her but won’t (except to say look out for my upcoming blog on Grandma’s salmon cutlets).
When I went through my Pilates teacher training in 2006, the instruction I was given in dealing with clients with scoliosis was very limited and mainly consisted of trying to bend the spine sideways in the opposite direction of the curve to try to uncurve it. Or rotate the spine in the opposite direction of the spinal rotation to try to derotate it. Over the course of a few years I had a few clients with scoliosis come to my mat and reformer classes in my studio which was then in Greenwich. They all loved Pilates and continued in the classes for quite a while and said that Pilates helped to relieve their pain. However, the next week they would be back with the same pain again, which would then be relieved after the class. It was nice to be able to help with the pain levels, if only for a short period of time, but one thing that I couldn’t ever reconcile myself to was the fact that their spine never looked any different. I didn’t SEE any positive changes. And, more importantly for them, the pain kept coming back.
Was I doing something wrong? Everything I read said that I was going about things in the right way, but somehow it didn’t seem right to me. Something kept niggling at me saying “surely there must be more that I can do”.
That niggle led me to good old Google to look up “Pilates for scoliosis”. And that search led me to the Scolio-Pilates website where I found just what I was looking for. A book written by the amazing Karena Thek all about how to work with clients with scoliosis to achieve lasting change. So it was possible after all!
So I read the book cover to cover and, I’m ashamed to say, did absolutely nothing about it. There was so much information that I was a bit scared to delve right in on my own. But the noticeable thing about it was that it made sense! So much sense that it made me wonder why everybody wasn’t onto it. No more side-bending and no more rotating. Side-bending an already bent spine and rotating an already rotated spine makes no sense. And explains why clients weren’t getting any better.
Anyway, the Pilates gods must have been smiling on me that year because shortly after receiving the book a Scolio-Pilates instructor in London (who is no longer practicing) offered a 2-day workshop on the method. I attended and then had enough confidence to go off and start to work on my own clients. Then, as luck would have it, Karena herself came to Paris and I attended her 2-day workshop there. I should have gone to California that September to attend a 4-day mentorship programme (which would enable me to become a Scolio-Pilates practitioner myself) but adopted a 9-month old baby boy instead and couldn’t possibly leave him. I would have loved to go the following September but again fate intervened, in a much less pleasurable way, and at the time of the mentorship I was finishing up my treatment for breast cancer.
Karena Thek is an expert in treating physical pathologies with therapeutic exercise. She has worked with over 500 people with chronic pain at her studio, Pilates Teck, and has authored a number of books including OsteoPilates and The Pilates Golf Athlete. Karena has scoliosis herself and as well as using the methods to help manage her own pain, she further volunteered her time for 2 years to help others with scoliosis. As a result, Scolio-Pilates was born. Karena lives in Oxnard, California. For more information see the Scolio-Pilates website: https://www.osteopilates.com/scolio-pilates/.
Finally in 2017 with the “all-clear” from the breast cancer, I made it to California…
completed the mentorship programmes, met Gus T Bassett Hound (who is something of a celebrity)…
and am now the only Scolio-Pilates practitioner in the UK.
Since my first 2-day workshop with Karena I have had the pleasure of working with many clients with curvy spines and seeing actual, tangible results. What I love best about Scolio-Pilates, and there are many things that I love about it, but what I love best is that I can actually see the client’s spine lengthening and uncurving throughout the exercises.
How does it work?
The components of a Scolio-Pilates program consist of the following:
- Moving the spine to a more neutral alignment
- Strengthening (with Pilates)
These will be explained in more detail below…
Scolio-Pilates exercises are based on principles that have been around for thousands of years. It just brings them all together and adds Pilates to it. A Scolio-Pilates program begins with lengthening or elongation. Scoliotic spines are affected by gravity more so than “straight” spines. People with scoliosis often feel that their spines are compressed and doing simple hanging-type exercises allows the spine to lengthen out (and feels really nice as well). This is nothing new, in 400 BC scoliotic patients were hung upside down on a ladder which was then shaken. Luckily, our exercises are a little more humane now and I like to use the reformer and tower to help achieve a lovely elongation. One of my favourite elongation exercises is to lie on my back with my feet on the footboard and hold onto the foot bar which I have moved to the top of the reformer (which is possible on the Allegro 2). This is something that I do with all my clients, not just those with scoliosis.
Move the spine to a more neutral alignment:
Another integral part of the Scolio-Pilates program is to try to bring the spine into a more neutral alignment. This can be achieved through breathing techniques, hands-on guidance and the use of scolio-wedges to “prop what’s dropped”. So, for example, placing a scolio-wedge underneath a client’s thoracic convexity (or “rib hump”) when they are supine (on their back) helps to pop the ribs forward and glide them in the opposite direction, thus correcting the curve in the sagittal and coronal planes.
We would also work with the client to help to de-rotate the ribs, thus covering the transverse plane as well. And this is very important: Scolio-Pilates addresses the curves in all three planes of movement. It is, in effect, three-dimensional exercise. And this is what sets it apart from many other scoliosis exercise programs. It is not enough to just address the sideways bending of the spine – we must simultaneously address the rotation and the kyphoses/lordoses (forward and back bending).
It also isn’t enough to work only with one curve – we need to address all of the curves. So when placing the wedges, additional wedges may be placed underneath the pelvis, lower back and/or shoulder (as in the photo of Rika on the reformer above).
As well as wedging, the client will be given instructions on how to make the corrections by themselves so that they can apply this to their everyday life. After all, we can’t walk around with wedges stuck to our body can we?
Breathing techniques also form an important part of Scolio-Pilates (just as in regular Pilates). People with scoliosis often will have limited breathing capacity due to the rotation of the ribcage which in turn can restrict the expansion of one or both lungs. Many of my scoliotic clients suffer from asthma and nearly all of my clients with scoliosis performed poorly on a peak flow test (this measures the amount of breath the client can forcefully exhale). My grandmother always used to have a little cough – it kind of sounded like she was trying to clear her throat. It didn’t bother her and she didn’t know what caused it but I have since discovered that this can be associated with scoliosis – again due to the restricted lung capacity.
Once the client with scoliosis has been moved into a more neutral alignment, it will place the ribcage and lungs into a better position to allow for a more full inhalation. So I try to queue my clients to exhale fully and then exhale a little more. Once all of the air has been exhaled then the in-breath can happen naturally. Breathing can also be used to aid in de-rotation of the spine. This is a technique used in the Schroth method (developed in the 1920s in Germany by Katharina Schroth and still used throughout the world today). Breathing is encouraged into the concave side of the upper back thus encouraging expansion of the lungs on that side and also helping to derotate the ribcage.
Only once a more neutral alignment and elongation has been achieved and we have spent some time working on breathing would we then add strengthening exercises. We want to strengthen the muscles around the spine to enable it to hold the new, more neutral alignment.
What types of exercises could we do? The Pilates world is your oyster. I personally love using the reformer with my clients – exercises such as footwork, feet in straps, elephant and a modified version of rowing are all very effective.
On the mat – toe taps, side-lying legs, variation on the series of five and side-plank.
On the chair – leg presses seated or standing, side-lying balance or prone arm presses are great.
Exercises NOT to do
There are a number of movements of the spine that we should not do as they could exacerbate the existing curves. These include rotation, side-bending and extension. And again, when I was learning I was taught that if a client’s spine was curved so that the upper back was bending to the right, then we should have them bend in the opposite direction to uncurve the curve. And yes, this might address the curve in the upper back, but what about the rotation of the upper back? And what about the curve in the lower back that is in opposition to the one in the upper back? If we bend the spine in the direction that will help the upper back curve, won’t this then make the curve in the lower back worse? The answer is, yes it may well do. We have to look at the body as a whole and this applies to the spine. We need to address all of the curves at the same time and then, and only then, can real progress be achieved.
What can we reasonably expect to achieve?
The question that most people want to know is whether Scolio-Pilates can help to reduce their curvatures. This is difficult to measure as it would involve the client having x-rays immediately before and at various points throughout the program. However, reductions in curves have been noted in the past and studies are currently underway at a children’s hospital in Ohio.
So it is important not to get hung up on the actual curvature angle but rather to look at the positive effects that are felt by the clients. My main goal is to help my clients with scoliosis to live their life to the full. For most of them this involves:
- a reduction in pain
- improvement in breathing capacity
- improved posture
- improved strength
- increased flexibility
- improved mobility
- just looking more symmetrical
Some of my clients with scoliosis enjoy skiing, walking, dancing and one young lady was into Taekwondo. After a number of sessions they found that they were better able to participate in activities without pain and one young lady with asthma no longer had to resort to using her inhaler. And I would like to think that if my younger clients continue with their program that they may be able to avoid having to have surgery in the future.
Is it easy? No, it is not, nor is it a quick-fix. Clients are expected to do exercises as homework on a daily basis and this needs to be kept up for the long-term. I tell my prospective clients that if you want to do the program then you need to be prepared to work. It isn’t easy but is incredibly rewarding!
So where do I go from here?
If you would like further information about Scolio-Pilates or to book a session with a Scolio-Pilates instructor outside of the UK then have a look at the Scolio-Pilates website – https://www.osteopilates.com/scolio-pilates/ . If you are an instructor and would like to use Scolio-Pilates with your own clients then I highly recommend starting with a 2-day workshop with Karena. Dates and venues can be found on the Scolio-Pilates website. If you are based in the UK then I am hoping that Karena will be coming over here to present her 2-day workshop in 2019.
If you or anybody you know has scoliosis and live in the UK and would like to come see me then I work from my home studio in Eltham, Southeast London. We would start with an initial assessment and then if you decide to continue, the program consists of five, one-hour sessions. For those that live further afield, I do offer 3-day intensive programs. Either way, please contact me by email (firstname.lastname@example.org) or through my website – http://www.pilates4scoliosis.co.uk/.
Yours in fitness, curves and cake,