Issue link: https://www.massageandbodyworkdigital.com/i/1208028
Ta k e 5 a n d t r y t h e A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 91 2 Scoliosis is defined as a lateral bend in the spine, but since the spine rotates whenever it laterally flexes, it's more accurate (and more useful, as hands-on practitioners) to think of scoliosis as a 3D spiral, rather than a flat C- or S-curve. Image from Shin 2013; used under license from the European Spine Journal. 3 Scoliosis involves the whole body, and static visual cues can be deceiving. Despite all these subjects having the same 40-degree Cobb angle (the most common 2D measurement of scoliosis's bending), they show diverse spine, shoulder, rib cage, and silhouette patterns. Image from Weiss & Goodall 2008, used under CCA BY 2.0. has its origins in the historical practice of assessing scoliosis via photography or by X-ray images later on (Image 3)—both of which give a two-dimensional, flattened- out image of the spine and its shape. Scoliosis, like people themselves, is a three- dimensional phenomenon. The next problem with the flat C- or S-curve point of view is that two-dimensional thinking leads to two- dimensional treatments. Examples include trying to straighten out the spine by stretching or lengthening the concave (curved in) side of the curve; or, by bending or pushing the convex (curved out) areas sideways across a bolster or peaked table, without regard to the need of the spine to also rotate in order to change its lateral curve. Sometimes, these single-plane (2D) interventions do actually help people feel better. But, even if we add passive rotation (for example, adding a twist to our bolstered client), we run into the issue that simply trying to stretch, push, or twist scoliosis into a straighter position will often leave people feeling less comfortable, less stable, or less satisfied with their treatments. Even worse, such well-meaning interventions can provoke painful symptoms (like sciatic, leg, or back pain) that weren't troublesome before the treatment. This is related to the next problem with the 2D model, which fortunately also suggests a solution. THINK MOBILITY, RATHER THAN POSITION A third problem with the C- or S-model of scoliosis (or even a twisting helical model, which is at least more accurate), is that those are all static descriptions of a dynamic pattern. Still photographs, X-rays, and even 3D imaging capture a single moment in time—but real bodies move. Still images are good at showing us momentary shape and position; but thinking in snapshots gives rise to static interventions, like the stretching, bending, or straightening described above. The limits of thinking and working in still pictures are not the only drawbacks of stasis. Still clients are also problematic. Encouraging your clients to move more—in their daily lives, and by incorporating active client movement into your hands-on work— will often yield the most satisfying results with scoliosis. When there is pain with scoliosis (and keep in mind that pain is no more frequent in those with scoliosis than in those without it), hands-on work that simply aims to "correct" the static position or shape of the spine is rarely relieving, and is missing the possibilities that movement affords. Movement has well-documented abilities to reduce and prevent pain in many conditions. Though some people with scoliosis are very flexible in certain directions, when overall flexibility is reduced, scoliosis pain has been shown to increase. 8 Your clients will feel better (and arguably, retain the proprioceptive effects of your work much longer) if you encourage Compensatory scoliosis