Simplifying Scoliosis
By Erik Dalton, Ph.D.

Ever since Hippocrates coined the term “scoliosis” to describe deformity of the spinal column, researchers, physicians and manual therapists have struggled to understand this puzzling disorder. Early treatment modalities were often crude and sometimes violent as well-meaning practitioners would walk on the scoliotic hump or apply excessive force using homemade, full-body traction devices. Yet these pioneering therapists did develop a number of sound therapeutic principles that remain as essential features in manual therapy today, including:

• Reducing gravitational exposure;
• Using traction as a basic corrective force;
• Applying gentle sustained pressure over the convexity of the curve, and
• Creating myofascial extensibility to the concave side of the spine.

Regrettably, scoliosis remains one of the most mis-assessed and mis-treated postural disorders seen in an LMT’s office. Considered by many bodyworkers as a complex and even hopeless musculoskeletal condition, successful treatment options are available if the problem is discovered in time. However, accurate assessments and corrections require a basic understanding of scoliotic biomechanics and the ‘Laws of Spinal Motion’ to help determine if soft tissue modalities are appropriate…or if referrals are in order. The primary goal is to help structurally-oriented massage and functional movement therapists develop practical ways of identifying the scoliotic types:
Are they ‘functional’ or ‘structural’…‘fixable’ or ‘fixed’?

Although scoliosis may be classified in a myriad of ways (severity, etiology, location, etc.), the most important consideration for massage therapists is the type of scoliosis. Spinal curves that improve during forward-bending, sidebending or specific rotational movements are generally referred to as ‘functional’ or ‘secondary’ scoliotic curves. If the curve refuses to straighten during any of these maneuvers, it is classified as a structural, fixed or primary scoliosis (Fig 1).

Unfortunately, many functional (fixable) curves remain in the body too long and become fixed. In the real world, most people have less than ideal posture and therefore present with some sort of functional scoliotic asymmetry due to such things as pelvic and cranial imbalances or leg length discrepancies. Poor postural alignment can compress and torsion vertebral joints, rib heads, discs, spinal ligaments, and deep intrinsic muscles causing specialized free nerve endings (nociceptors) to alert the brain of possible tissue damage. Acting as the brain’s sorting and switching station, the thalamus, may react by layering the affected area with protective muscle spasm resulting in even greater length-tension imbalances and more pronounced postural distortion. In the early stages, these bodies are usually able to make necessary structural compensations to perform normal everyday activities with only minor aches and pains. But in time, tension, trauma, poor posture, and repetitive tasks cause deformity of bony structures, myofascial and visceral collapse, and subsequent symptoms, signs and disease.

Example
When confronted with a left thoracolumbar scoliosis such as the one shown in attached live workshop video, it is important to visualize the vertebrae sidebending right and rotating left at the apex of the curve (Fig 2). This results in a convex rib hump in the left lower ribs (Fig 3). Armed with this knowledge, massage and movement therapists can quickly learn to identify which soft tissues require restoration of extensibility (lengthening) and which needs restoration of contractibility (tonifying). Specifically applied deep tissue and joint stretching Myoskeletal techniques help restore symmetry while relieving long-standing pain. These ‘hands-on’ routines produce exponential rewards through increased client satisfaction and a boon in referrals.

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Erik is taking a teaching
sabbatical... this will be his
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Myoskeletal Alignment
for Neck, Rotator
Cuff, Low Back, Hip
and Legs

Sept. 30 - Oct. 2, 2011
Tuition: $ 455.00

3 Day 24 CE
Myoskeletal Workshop

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