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90 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 2 0 technique THE SOMATIC EDGE Rethinking Scoliosis By Til Luchau Scoliosis is mysterious, and often surprising. Consider that: • Up to 85 percent of scoliosis is idiopathic (that is, it seems to arise spontaneously and without a known cause). • An estimated 80–90 percent of idiopathic scoliosis is rounded on the right (dextroscoliosis, Image 1), while left-rounded scoliosis (levoscoliosis) is rare. 1 • Scoliosis is more frequent in people with inner ear abnormalities, but less frequent in deaf people. 2 • Our hominid ancestors, like Australopithecus, seem to have had scoliosis more often than modern humans, but paradoxically, scoliosis has not been found in chimpanzees or gorillas. 3 • In fact, idiopathic scoliosis has never been observed in any animal in their natural environment (with the puzzling exception of guppies and their relatives). 4 • Though scoliosis is often thought of as a teenage issue (and it does affect 2–5 percent of teens, and is up to 10 times more common in girls than boys), it is only recently coming to light that scoliosis is even more common later in life. Scoliosis affects up to 40 percent of all adults, men and women, equally. 5 Scoliosis often bewilders hands-on practitioners in other ways, as well. More than a few have scratched their heads at scoliosis's resistance to change, and its unique power to induce confusion and dyslexia. ("Is the spine right convex thoracically if the left shoulder is higher?" Answer: Not usually, but it depends.) Not only is its severity hard to gauge without X-rays (Image 3), but the idea that most scoliosis does not cause pain, discomfort, or disability 6 confounds many of us whose original training emphasized alignment as the touchstone of spinal health and integration. And, as many well-meaning but overly ambitious practitioners have found, methods intended to passively straighten the spine can just as often make people with scoliosis feel worse. These are only a few of scoliosis's strange paradoxes and puzzles. If you suspect it's time to reevaluate your own assumptions about scoliosis, following are some ways to start. WORK IN 3D Scoliosis by definition is a lateral curve of the spine. People are said to have a "C-curve" or an "S-curve" scoliosis, but this way of describing scoliotic curves can present problems for hands-on therapists. The first problem is that the description is not particularly accurate. In real life, the spine rotates whenever it laterally bends (Image 2) 7 —scoliosis is a twist or a spiral, rather than a flat C- or S-curve. The conventional two-dimensional definition of scoliosis 1 An estimated 80–90 percent of scoliosis is rounded to the right (dextroscoliosis). Left-rounded scoliosis (levoscoliosis) is rare.

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