Winning Hands Massage

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Treatment Work - Conditions

Scoliosis and Spinal Curvatures

A “normal” spine has three curves: Lordotic in the lumbar region, Kyphotic in the thoracic region, and Lordotic again in the cervical spine. (Lordotic stands for the posture of eyes raised toward heaven). All three curves are pronounced C curves. The lumbar and cervical curves are convex toward the anterior body. The thoracic curve is convex toward the posterior body. When viewing someone “face on,” the spine should be straight, with no pronounced side-bending curves. The three most common abnormal spinal curvatures are Hyperlordosis, Hyperkyphosis, and Scoliosis. Hyperlordosis and Hyperkyphosis are exaggerated curvatures of the normal convex pattern. Hyperlordosis of the lumbar spine is often referred to as Swayback. Scoliosis presents an S curvature of the spine when viewed face-on.

The first distinction that must be made when working with Scoliosis is to determine whether Structural or Functional Scoliosis is involved. The causes, and therefore the treatments, are decidedly different. Structural Scoliosis is caused by an actual physical deformation of the spine and rib cage. The condition worsens over time, resulting not only in a pronounced, lateral, S curvature of the spine itself, but also a caving in of the rib cage on one side accompanied by an expansion or barrel-chest appearance on the other side. Probably the most common treatment protocol for Structural Scoliosis is surgical implantation of rods in the back that anchor the spine in a straight position and thereby prevent further deformation.

Functional Scoliosis is an entirely different animal. Outward appearance of the lateral S spinal curvature may be identical between the two types when in a standing position. When prone on a table, however, the curvature remains unchanged with Structural but lessens or even disappears altogether if Functional Scoliosis is involved. The reason is that Functional Scoliosis is a soft tissue issue and not an osseous one. There are a number of possible muscular, fascial, visceral or ligamentous soft tissue dysfunctions or imbalances that can cause the SYMPTOM of Functional Scoliosis. There is also the possibility of simply having poor posture, using shoes with uneven heel wear, or carrying a wallet in a hip pocket and then sitting on the wallet all day which puts the spine in an abnormal alignment. These abnormal postures can lead over time to chronic contractions of various muscles that pull the spine out of alignment and create the S curvature.

To repeat, successful treatment of Scoliosis REQUIRES first determining if it is Structural or Functional. Secondly, if Functional, it is then necessary to determine the cause. This includes postural and gait analysis, assessment for fascial restrictions in the back, and determining if any muscles are in chronic contracture. Where connective tissue dysfunction such as Ehlers-Danlos Syndrome is involved, laxity of spinal ligaments needs to be considered. Even something as seemingly remote as abdominal adhesions, scar tissue, or a prolapsed visceral organ exerting a unilateral stress on one of more of the vertebrae can lead to Functional Scoliosis. Unfortunately, most treatment protocols fail to look beyond the obvious symptom. Consequently, any relief provided is just illusory and temporary. If the underlying cause is not identified and treated, the condition (symptom) will just keep returning.

As a bit of side information, I USED to have a slight thoracic scoliotic curve between about T3 and T12. I also stood with a very pronounced anterior tilt to my head. When I took my second lymphatic drainage class in September of 2002, one of my classmates gifted me with two 60-90 minute each sessions of Craniosacral therapy on two successive nights after class. By the end of the second session, both the scoliotic curve and the anterior head tilt were gone. That is part of what threw me onto the continuing ed path I have been on. I was like Will Smith in "Independence Day" when he took off in the alien space craft – "I GOT to get me one of these!" Also as info, after spending between 30-35 years with at least 3-4 "adjustments" per year in good years and two to three dozen per year in bad years, I haven’t had ANY spinal adjustments at all since then.

In terms of bodywork treatment protocols, I know from personal first-hand experience on the receiving end that Craniosacral Therapy can be a very effective way to treat some kinds of Functional Scoliosis. Myofascial Release can be very effective if fascial restrictions are involved, as are several of the Structural Integration modalities. Another excellent modality is Polarity Therapy, particularly the Spinal X Technique that energetically works with actual vertebral misalignments. If the cause is chronic muscle contracture, most forms of standard massage and Physical Therapy can also be effective.

The approach I personally use is a combination of techniques that incorporate many of the above modalities plus a couple of others for good measure. The first thing I do is a visual, postural evaluation. Are the shoulders even or does one droop compared to the other? Are the hips even at the top? Is there a side-bend at the waist? Is there lateral flexion of the head to either side? Any rotation of the head/neck? Do the arms and hands hang straight with the lateral edge of the hand (top of the thumb) pointing straight ahead? Or are the hands, arms and shoulders medially or laterally rotated? How do the clothes hang on the body? Any evidence of tension pulls through the fabric? All of these are clues as to potential underlying physical dysfunctions - fascial, muscular, or skeletal.

The next thing I do is physically palpate the spine, checking for possible rib or vertebral subluxations. If pain is present when palpating the center of the spine (the spinous processes), either in the center or radiating out bilaterally, it is suggestive of a subluxed vertebra. After palpating down the center, I repeat, but palpating in from the sides toward the transverse processes (TVPs). If pain is present on one side only, it is suggestive of a subluxed rib. This is verified by palpating on the lateral edge of the sternum, same side of the body. If pain is also present about 1-2 inches lower in front than in back, it is almost certainly a subluxed rib. (See sections on Spinal Snake and Rib Head Release in Treatment Techniques).

The third assessment is a visual comparison of standing posture versus prone on the table. Does the curvature change or remain constant? This is followed by checking for fascial restrictions in the back. (See Myofascial Release in Treatment Section).

After completing the evaluations, the treatment steps would be to first do a Spinal Snake and/or Rib Head Release if warranted to address any skeletal issues. In many cases, this is all that is necessary to achieve the desired results. The next primary technique would be the Cranial Vault Hold to address any neck issues. This would be followed by the Back Release.

The above steps would be followed if I were limited on time and focusing specifically on these issues. The reality is that the actual treatment routine would be much longer and address related and compensatory issues at the same time.

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