Friday Q&A: Yoga for Surgically Repaired Scoliosis

Q: I have a new student in my basic class who has a rod in her back due to scoliosis.  Has anyone had this experience and have any suggestions? She is young and healthy.

A: Some of our readers might think that this is an uncommon occurrence in a yoga class, but I myself have had several students over the years with scoliosis who had undergone a “fixation” procedure to try to improve the straightness of their spine, to try to prevent the abnormal curves of their scoliotic spine from getting any more dramatic, or to reduce the pain from the scoliosis. 

The first successful procedure of this kind was the placement of a “Harrington rod”—named after the doctor who pioneered the technique—along the length of the spine, usually from the upper chest (thoracic spine) down into the area of the lower back (lumbar spine). The rod is then “fixed” to the spine via wires and screws. The rod essentially immobilizes the part of the spine it is connected to from moving in any direction (see All About the Spine: Anatomy and Movements). Since the introduction of that surgical technique, several others have also been developed and are used today.

So, once a person with scoliosis (see Friday Q&A: Scoliosis) has had this procedure done, how would that affect their yoga practice? The section of the spine that is fixed to the rod is now not likely to change shape over time, but has very little movement possibilities. It turns out that the joint at the top of the spine directly above the last fixed vertebra and the joint at the bottom of the spine just below the last fixed vertebra are now the spots where the spine can still move. That means that these two areas are where forward bending, back bending, side bending, and twisting movements might be able to actually take place. But this puts an excessive burden on those two areas, and they run the risk of being overworked and becoming a future source of dysfunction and discomfort!

Fortunately for me (and you!) I ran into a local expert on yoga and scoliosis, Sandra Razieli, at the farmer’s market the other day and we talked for a while about her approach to working with this situation. I should mention that Sandra herself has scoliosis, and has used yoga to address her own challenges with the condition, as well as teaching specialty classes on scoliosis for many years. She stressed the following four goals in working with scoliosis when there are rods attached to the spine: 

1. Work on lengthening the spine. Although the practitioner should focus on lengthening the spine in all poses, I’d particularly recommend practicing poses such as Mountain pose (Tadasana), Downward-Facing Dog pose (Adho Mukha Svanasana) or variations, Plank pose (Phalakasana), Triangle pose (Trikonasana) that encourage internal lengthening via imagining lengthening from the tailbone to the crown of the head actively while in the pose. In addition, partial inverted poses where the spine lengthens with gravity, such as Standing Forward Bend (Uttanasana) and Wide-Legged Standing Forward Bend (Prasarita Padottanasana), if done without allowing the force of gravity to round the spine into forward bending shape, may also be beneficial. For Uttanasana, consider reaching the arms out to a chair seat, and for Prasarita Padottanasana, consider lengthening forward with the torso and hands, as in Downward-Facing Dog pose.

2. Stress the “strengthening” aspects of the poses. Strengthening the muscles of the front body, back body and side body enables these muscles to assist in keeping the spine long and in its neutral curves. I’d say that some of the same poses I just mentioned for lengthening will also promote strengthening, and you could add in any version of Side Plank pose (Vasithasana), Hunting Dog pose, and Reclined Leg Lowering pose (Urdhva Prasarita Padasana) as well.

3. Focus on directing your breath into the area of the rib cage where there is still compression. Breathing into compressed areas in all yoga poses can help to widen and open up the chronically narrowed spaces between the ribs that result from the curved and twisted spine.

4. Minimize twisting actions. Twisting actions can stress the two mobile spinal joints at the top and the bottom of the fixation, and can also stress (and potentially loosen) the fixation of the rods to the spine. 

Sandra also recommended looking up her good friend from NYC, Debra Wolk, who has a studio dedicated to yoga for those with scoliosis Yoga Union Center for Back Care. Debra offers classes, trainings and workshops for those with scoliosis, both with and without rods in place. This New York Times article Yoga Classes, Even With a Fused Spine features her studio and the wonderful work she is doing. 

—Baxter

Late-Onset Scoliosis is Common in Older Adults

by Nina

Reclining Nude, back by Henri Matisse

A recent New Times article Scoliosis Can Hit Well Past Adolescence by Jane Brody confirmed something I have been observing in the yoga community: late-onset scoliosis is quite common in older people. I developed the problem myself in my fifties, so I’m quite aware of the condition, and I’ve noticed a large number of other older yoga practitioners with the same problem. Here’s what Jane Brody said about this:

"Although scoliosis is generally thought of as a problem of adolescents, who often require bracing or surgery to correct the curvature, the condition is actually far more prevalent in older adults. In a study by orthopedists at Maimonides Medical Center in Brooklyn of 75 healthy volunteers older than age 60, fully 68 percent had spinal deformities that met the definition of scoliosis: a curvature deviating from the vertical by more than 10 degrees."

Even a mild version of scoliosis can result in chronic pain of different types. While your pain could be in your back, it might also be in your hip (because scoliosis can make your hips uneven) or even your leg and/or knee (because scoliosis can make one leg “virtually” shorter than the because that hip is higher).

Baxter, who teachers Yoga for Back Care, has already written about scoliosis (see Friday Q&A: Scoliosis). But I decided to write about it today because I think it’s important for us all—students and teachers alike—to realize what a common problem this is. And if you (or a student of yours) are having mysterious back pain, hip pain, or leg pain, it’s worth being checked out to see if this is causing the problem. Some people just don’t think of it! I personally know of two cases of women with pain who didn’t realize they had scoliosis. In one case, the yoga student’s teacher casually mentioned, well, of course, you have scoliosis, because it was visible to his sharp eyes. She had no idea! And in another case, it was I myself who noticed it while I was assisting a fellow student doing a backbend. I just asked her, “Do you have scoliosis?” She was surprised I had asked, but we when talked afterward, it turned out she was having quite a lot of pain, including in her hip. So I encouraged her to get checked out by a health professional, and sure enough, she did have scoliosis.

Getting checked out is not necessarily a big deal. A health professional can do a visual test that is quite simple (he or she will watch your spine as you come bend into a forward bend), although in same cases, if your scoliosis is very mild, you may need an X-ray to detect it. But it is worth knowing the source of your physical problems because, yes, yoga can help. Even Jane Brody had a yoga pose recommended to help her:

Determined to minimize further shrinkage and to avoid pain and nerve damage, I consulted a physiatrist who, after reviewing X-rays of my misshapen spine, said the muscles on my right side, where the spinal protrusion is, were overdeveloped relative to the left. He prescribed a yoga exercise — a side plank — to strengthen the muscles on the left and exert enough of a tug on my spine to keep it from protruding farther to the right. He suggested that the exercise might even straighten the curve somewhat.

That pose sounds like Vasisthasana (aka Side Plank pose) to me! And there are whole lot of other yoga poses you can do to strengthen your back and balance your curve. So if you’ve been diagnosed with this condition, seek out a yoga for back care teacher who understands scoliosis, take a Yoga for Scoliosis workshop, or check out Elise Browning Miller’s web site (she’s a long-time yoga teacher who uses yoga to manage her own scoliosis) for info on her books and DVD and other resources.

recomended product suport by amazon