Human body functions more efficiently and effortlessly when it is in a better alignment, we cannot move properly if we do not start from a proper position. This alignment is compromised in a spinal deformity known as, Scoliosis, Scoliosis refers to the presence of an abnormal lateral curvature or side bending in the Thoracic and/or Lumbar spine. It is a highly variable condition as each patient experiences different severity levels, curvature locations, and condition-related symptoms. Not every patient with scoliosis experiences mobility limitations, but it is important to maintain flexibility in the spine and its surrounding muscles as much as possible. Therefore the focus is laid on building strength and resilience in the body and this can be achieved with the help of trained and experienced physiotherapists. The physiotherapist designs an exercise-based approach to reduce the abnormal spinal curvature, helps to strengthen the spine and its surrounding muscles, improves posture, and the brain-body connection. Today in this blog we have discussed scoliosis and various stretching exercises that can be done by the patients having scoliosis.
What is Scoliosis?
Scoliosis is characterized by a tilted head, winged scapula, uneven shoulders, uneven nipple height, rotating torso, a rib hump, uneven arm gap, uneven muscle bulk, asymmetrical abdominals, hip hike and leg length discrepancy. Scoliosis occurs due to two main reasons, Structural and functional reasons.
1: Structural Scoliosis occurs due to genetics or as a result of fused joints.
2: Functional Scoliosis is determined by how the body habitually the person holds him/herself up as he/she attempts to maintain an upright posture against gravity. The spine gets used to using certain muscles in a certain position, which over time makes the person habitual to hold this abnormal posture. For example, asymmetrical sitting posture, playing sport with the dominant arm only, always carrying the bag on one side, always sleeping on one side, etc.
The spine's surrounding muscles play an important role in providing it with optimal support and stabilization Scoliosis in the spine can limit the amount of flexibility and mobility in the spine which may negatively influence posture and movement.
Exercises for Scoliosis
In case of scoliosis 2 or more curves might be present in the spine, one is primary and the others are compensatory curves. The compensatory curve is formed to maintain an upright posture as a response to the primary curve.
The position of the pelvis has a significant influence on the orientation of the entire spine, the pelvis must be in a neutral position while addressing scoliosis. It is important to know where the concave curve is located. Stretching exercises should be given to the muscles which fall within the area of the concavity as these muscles will tend to be tight and/or overactive.
Apex is where the spine bends the most, this area needs to be targeted, and stretching should be felt in the region of concavity at the level of the apex.
Stretching exercises for Thoracic area:
Side stretch on the floor:
- The area to be targeted is the side of the rib cage, side of the thoracic spine.
- The patient is asked to lie down with the side of concavity towards the ground.
- While keeping the waist pinned down to the ground, push the torso upright.
- The patient should feel a stretch on the side of the rib cage and the thoracic spine.
- Take a deep breath into the area while the patient feels the stretch also push the ribs and belly out as much as possible.
Side Stretch with Flexion:
- The area to be targeted is the side of the spine.
- The patient is asked to sit in a chair.
- Bring the upper back region forwards by making a curve.
- Aim to curve the spine at the level of the apex.
- Bend the spine away from the side of concavity.
- Pull the head towards the armpit that is on the opposite side of the concavity
- The patient should feel a stretch on the side of the spine.
- Take a deep breath into the area and feel the stretch.
Stretching exercises for Lumbar area:
- The patient is asked to stand with feet wide apart with left foot turned out to the side.
- With arms outstretched, the patient starts to bend to the left side.
- The patient should reach the upper arm as far to the left as possible.
- Keep the body in line with the left leg, but do not rotate the body and keep the legs straight.
Stretching exercises for Spine area:
- Hanging from a bar is a good and easy way to give traction to the tight joints in the spine.
Traction or Hanging:
- The patient is asked to hold onto a horizontal bar.
- Dropdown, attain a squat position, and allow the bodyweight to completely hang off the arms.
- Make sure that the feet are gently resting on the floor for support.
- Lean slightly backward.
- Round the upper torso forwards.
- Tuck in the chin while looking downwards.
- The patient should feel a stretch in the upper back region.
- While doing so take a deep breath in between the shoulder blades to increase the stretch and hold this position for 30 seconds.
Step down and one-arm reach:
- With whichever leg appears longer place it on a stepper.
- Lower the opposite leg down to the floor while bending the knee.
- The patient is asked to lower the leg and raise the arm on the same side as high as possible. For example, if the right foot is lowering to the floor, raise the right arm.
- Perform 3 sets and repeat 10 times. Don't perform the exercise on the other side.
Upward and downward stretch:
- The patient is in a prone plank position with arms stretched out straight, push the hips back and up as far as possible.
- Hold this position for 2 seconds, and then lower the hips back down toward the floor.
- Try to go as low as possible without discomfort or pain.
- Perform 3 sets and repeat 10 times.
Split stance with arm reach:
- Step forward with the longer leg in front in a slightly hyper-flexed stride length.
- Keep the torso as upright as possible.
- Begin to shift the weight back and forth, allowing the knee in front to bend and feel the weight shift onto it.
- While shifting the weight forward, raise the arm that is opposite to the front leg as high as possible.
- While the arm is reaching upward, reach the other arm back as much as possible with the palm up. This movement causes the torso and spine to turn toward the side of the front leg.
- Perform 2 to 3 sets and repeat 10 times.
Cat and cow position:
- The patient is asked to attain 4 points kneel sitting position.
- Round up the upper back as much as possible
- Rotate the torso to one side.
- The patient should feel a gentle stretch at the back.
- Make sure that the pelvis does not move.
- Repeat 20 times.
- The patient is instructed to get into the plank position such that the face is towards the floor and the bodyweight is taken on the elbows and toes keeping the head, back, and legs straight in one line.
- Place the pelvis in a neutral position and the lower back should not sink in.
- Hold this position for 30 seconds.
- The patient is in a standing position with arms wrapped around a Swiss ball, trying to touch the fingertips.
- Emphasize rounding over the areas where Scoliosis is located.
- Round the spine, one vertebra at a time as the patient proceeds down.
- Then reverse the movements back to the beginning.
- Repeat 20 times.
There are varying degrees of Scoliosis, it is advised that as these exercises are specifically designed and prescribed for the individual, therefore should be done under the guidance of a physiotherapist.