 And welcome to Movement Matters. I'm your host, Christine Linders, physical therapist and board certified orthopedic clinical specialist. This show is designed to bring you not only the most effective physical therapy tips, but also holistic information to help you achieve total body wellness. Today, I'm going to teach you how to unwind your scoliosis curve, get out of pain, and back to living life to the fullest. Scoliosis is a subject that is close to my heart. My grandmother had it. One cousin had her spine fused at 15 years old because of it. Another cousin suffered from low back pain for 20 years before I helped her unwind her curve and free herself from pain. I'll highlight her curve at the end of the show today. Oh, and recently I discovered my mom has it. And of course, so do I. Thanks to becoming a physical therapist, however, I developed a biomechanical approach to treating scoliosis that I've successfully used on myself. My patients from age 12 to 88 and have presented at the national level for the American Physical Therapy Association. It works. So how does scoliosis affect those of us who haven't? Scoliosis takes on a three dimensional curvature in the spine that creates muscle imbalances and asymmetry throughout the body, which over time creates risk for pain in your neck, your shoulder, anywhere in your back, your hip, your knee, and even in your ribs. And depending on the severity of the curve, you can suffer breathing difficulty as well, especially on the inside of the curve. So why do some of us get pain with scoliosis? As we age, the muscles on the inside of the curve get held in a shorter and shorter position and then gravity never takes the day off. And so the muscles on the outside of the curve continue to be under strain over time. So let's look at image number one to help explain that to you. In this image, what you see is the curvature that in the upper body is bending to the left and in the lower body is bending to the right. And if you notice on the right side, I'm looking at this young woman from the back, her right shoulder is elevated there. And so when the right shoulder is elevated, the curve pushes the shoulder blade forward on the rib cage, and then the muscles on the right side of your neck have to pull this way to keep your eyes level. So people get neck pain here, they get headaches or eye grains, as one of my patient calls it, they get shoulder blade pain on that side. And sometimes on the other side on the left side in that image, they'll get rib pain from where the ribs are kind of cramped in there near the pelvis. Now in the low back, most people complain of pain on the side of the round side of the curve, the outside of the curve, not so much on the inside. Sometimes people will complain of hip pain in the front on the inside of the curve or radiating leg pain coming down later on the inside of the curve. But on the outside, people complain a lot of back pain, SI joint pain, gluteal pain, numbness and tingling. And that is a problem with scoliosis. So one of the first things that you need to do to figure out how to use corrective exercise to help you unwind your curve is get to know your curve. And so when you come to see me for physical therapy, whether you're seeing me in the clinic, or we're doing a virtual assessment over a platform like this so that I can see you emailing me your photos, I will draw out your curve for you so you can learn what muscles are held in the shortened position and maybe tight, so to speak, and what muscles are under strain. So we know what corrective exercise is to do to open up your curve and then strengthen your curve. So let's look at image number two, where you can see how you can identify the curve. In the x-ray, we're looking at the back and you can see that the curve is bending to the right. So the muscles that are on the right side would be relatively shorter and the muscles on the left side are relatively longer or under strain. Now if you look at the person sitting in the chair, what I did for this curve was I folded a small hand towel underneath the buttocks on the left to bring that side up so that when this person is sitting their spine will be level and you could see by the lines I drew on her back that levels off the curve. The key with scoliosis is that you have all these muscle imbalances and asymmetries that all day long sitting, standing, bending, doing any of your activities of daily living is your brain is sending messages to fire certain muscles to hold you in certain ways. And so now when you're sitting, let's say I sit in a desk all day and I have this curve, I am sitting in a wrong position. So my brain is firing muscles on one side, straining muscles on the other side. I'm tilted, which means now my head has to tilt up. That means all the muscles on my neck are going to get tight. But as soon as I put that folded towel under my left butt cheek, it levels off my pelvis. It levels off the brain needing to send messages to the spine. And so now they're sending both sides. And that's why small corrective exercises like that will work. But you won't know what to do unless you identify your curve. So let's look at image number three. So this is the person who came into the clinic the other day. And she was having some numbness symptoms and a little bit a little bit of back pain when she bent to do her shoes and things like that. So I said, okay, well, let me, let me draw you really quick. So from the back, I drew her. And I gave it to her because I said, on your left side, you're bending that way and your hips are up like that. And why that's a problem is because when you're washing dishes, if you're standing around, this is causing that asymmetrical muscle firing on your body. If you're standing in line for a long time, I told her just unlock your left knee to bring the pelvis down to level. And when sitting for her, she's going to need to put the folded towel underneath her right butt cheek to bring that right side of the pelvis up when she sits, open up that left side of her spine and level it off. So she gets symmetrical muscle firing. If you have a lumbar curve or a thoracic lumbar curve that's either bent to the left or bent to the right like that, you're going to need to try to put that towel underneath there. You can have somebody take a picture of you from behind, before and after, and you'll see the difference the alignment has. And also, if you're sitting for 30 minutes like that and you have pain in sitting, you're going to notice less neck tension if neck tension is your complaint, less shoulder blade pain, less back or SI pain, it's going to make a big difference. So usually what I tell people is you can do a few things. You can have a friend, a family member take a picture of you from the back with your shirt off, but you can have your bra on if you're a female or just without a shirt if you're a male and your pants line there and just take a straight shot of you from the back just standing as you would. That's how you stand. And that's what you feel is straight. And that's important for you to learn that. What you need to do then is bend forward and have somebody take a picture of you as well so that you can see any kind of asymmetries which we'll see in picture number four. So you'll see this is very subtle. This is me actually and I have a slight left thoracic curve. It's just to the left of that bra strap you see a little bit more skin. I apologize for the image quality. I had some technical difficulties, but I am rotated to the left there. And so if you look at the picture that my dad drew it shows the curve bending to the right because with a scoliosis it takes on the mechanics where rotation and bending occur in opposite directions. So I am rotated to the left in my thoracic spine, which means I'm going to bend to the right. And so the reason why that's important is because to undo your curve or unwind your curve, as I say, excuse me, you need to know the position of your spine because you're going to go absolutely opposite. So if this was me, I am rotated to the left and I am bent to the right. In order to do a sitting strategy for me, I need to bend to the left. I just shift my ribcage over. My buttocks are still in the same spot. My weight is equal on my sit bones. And then I turn to the right. That's two dimensions. And then I lift my chest up three dimension. Inhale, exhale, drop my chest down. So I am still bent to the left at my ribcage area. Turn to the right. And then I go up and down to the flexion extension. It's a great unwinding curve to do in sitting, whether you sit for work or not, you sit at some point. So I'm doing it now and it makes me feel good. It gets rid of a lot of neck tension. It gets rid of a lot of back pain. So let's look at video number five, where it shows you how to do it. So before we play it, I just want to let you know I shot it in selfie mode. So listen to the words. It's reversed kind of everything that you see, but listen to the words. And let's see video number five. If you have this curve right here, you're going to be short or tight on your left side. You'll be getting a lot of compression there. So to stretch out and to sleep, you're going to want to put a pillow in the right side to straighten out that curve and support it all night long so you don't wake up in pain. So here's where you'll be short like this. You can see the photo like that. So you're going to want to open up this side. So you'll want to lay with the pillow here on your right side to open up this nice left side. As a stretch, you can stretch your leg out and raise your arm up over your head and take some nice deep breaths right into here. Breathe in, open up that rib cage. You can raise your arm and breathe in. You could probably see how that really opens up. If that's too much, you can bend your knees. Breathe in, open up that side that get one dimension and then also you can rotate back like a bow and arrow and really stretch. Breathe in, go outside of that curve and stretch all those tight muscles. Breathe in and then when you go to bed, if this is too much, you can just flatten it out and what it'll do, it'll support your waistline so your curve doesn't sink in all night long. Enjoy. Okay so the thing to take away from that video is when you see yourself from the back, the side that's in here, the side that you're bent towards, you want to keep that side up. So you're going to lay on the opposite side of that to open up that curve like that even though my right left was reversed. Just know that whatever side you are bent towards, you keep that side up in the air when you're going to be stretching out and you also need to put the pillow in your waist to support yourself whether you're sleeping on that side or the other side because gravity is going to pull you either like this or like this all night long and it's not going to feel good unless you support that curve. So I have a couple of questions. So how can someone set up a virtual appointment with me? It's simple, you email me at clindersrun at gmail.com. It's C like my initial Christine, linders, l-y-n-d-e-r-s run, r-u-n at gmail.com. I actually had someone email me yesterday from New Mexico about getting a virtual assessment done for her scoliosis and so thanks for that question. And the second question is does very mild scoliosis cause problems? It can and it cannot. Just like very severe scoliosis, I've seen it. This woman, she was 86, she didn't have pain anywhere until she was about 80 and she has a severe curve. Her doctor was Dr. Cobb, the man that came up with the Cobb angle which is how you determine the curvature of your spine. So you can have trouble with mild scoliosis. I have seen young girls and people my age who I have a mild scoliosis who have problems and I have some problems because my shoulder blade has been sticking into the chair all my life. So I'm always trying to fix this because it tips forward on my rib cage there where it's a very mild curve. It's under 10 degrees but it always bothers me. So in movies, in chairs, I'm always fixing it. So now I've done the right exercises since I've developed my own approach and I don't have to worry about that anymore but it bothered me for 35 years. So thank you for the questions. So the video I just showed you was for the lumbar curve. So let's look at video six that shows if you have a higher curve, a thoracic, or a thoracolumbar curve. You can do the same thing for your thoracic curve or your thoracolumbar curve. So if you can see I am rotated to the left. So I am rotated over here. You can see it protruding. So I want to go the other way. I am turned this way. So I want to turn this way. So I'm going to lie on that side with the pillow kind of right around the bra strap region in the axilla here and I'm going to let my head fall down. So now I'm going the opposite way and I want to breathe. Inhale and I also want to do the bow and arrow. So I'm going to open up and I use my hand to pull the ribs back gently. There's no pain. Breathe. You can come back and forth as an exercise to exercise the muscles on the open side of the curve. Enjoy. Oh that's fantastic. So Garfield and Pookie were making their debut there. I didn't even know it until I flipped the camera around. But that's another great correction. I apologize for saying that I'm rotated left and then the video shows right. Again it's selfie mode so it flips it. But what you need to know is whatever way that you're rotated towards you're going to go the opposite way. Whatever way you're bent towards you're going to go the opposite way. So let's look at video number seven. Here's a nice sitting correction I showed you earlier too. Excellent stretch to open up your thoracic curve is to do this. So let's say your curve is bent this way. You're going to need to go this way to open up these ribs. So you're going to grasp one elbow if you can and press your shoulders back and your curve is bent this way. So we're going to bend opposite and then turn the other way. You're going to feel it get tight and then you're going to breathe lifting your chest and then exhale. Breathe lifting your chest and then exhale. So if your curve is bent this way you're going to go the other way. You're going to lean over to the opposite side pulling your arms back. Turn your chest up towards the sky. Breathe in lift your chest. Exhale and drop your chest. Breathe in lift your chest. Exhale lift your chest. So that's a great three-dimensional way to unwind your upper and your thoracic curve. These are simple tips to get you started on opening up your rib cage and going opposite of the direction of your curve which not only opens up the rib cage and stretches the tight muscles it also is facilitating the muscles that are being strained or on the outside of the curve. I have such individualistic exercises that I give people for how to activate this stretch that in the clinic but for everyone this is going to help you unwind. This is like the first course of action to get you moving out of your curve safely and get you out of pain but also giving your nervous system that input to fire the muscles that are on the stretched elongated side stretch the muscles on the short crunch side so to speak and free yourself from those muscle imbalances and asymmetries that are happening throughout your body, my body, everybody that I know that comes in that has scoliosis. So let's look at video eight for another sitting correction. A curve like Rachel's who is bent to the right to do an auto correction in sitting you would hug yourself shift your rib cage to the right so that your body bends to the left but doesn't lean to the left turn your chest to the right making sure that your right shoulder stays higher than the left and then you breathe in and out lifting your chest up and lifting your chest down to get a three-dimensional correction out of the direction her curve is. So that's that's very easy it's one of my go-tos and usually what I do is I have someone sit behind me so I can show them how to do it and I'll just say like the reason why I have my hands here is because if my curve is bent this way I want to go this way to come out of it and how I do that is I use this hand to just drop my shoulder down and then I use this hand to pull me around to the other way so it's kind of like a hug and then you don't have to worry about whether you're leaning outside you don't want to lean so I just drop it down shift my rib cage turn the opposite direction and breathe and I just have someone sit behind me so that they can see what I'm doing. So let's look at video number nine for a standing correction this is fantastic everybody loves this and I'll show you the modification after we watch the video. So for a curve like Rachel's we want to focus on going out of the curve so you could stand against the wall with the shorter side of the curve's arm up on the on the wall bend the same side knee so you're bending left and then you could take your left hand and reach back and forth through to get the rotation component. So that's a way to get like the two-dimensional stretch so you've got your hand up on the wall you drop that leg you feel the immediate stretch on the right side and then you start feeding that through which exercises the rotation in the opposite direction it feels good the stretch feels good on that right side your ribs are moving away from your pelvis the connecting muscles in between that are tight because you're bent that way in your curve you're rotating your rib cage your abs are getting a stretch you're breathing opening up the intercostal muscles in your ribs and lifting your chest gets a great expansion there so that's a stretch and an exercise another thing you can do is if you just put your hand on the wall and reach up to the wall and bend that knee you can just breathe and turn your chest a little bit to the right or to the left until you feel the greatest amount of stretch and breathe into those right lower ribs in imagine like you're pushing your hand away on a lower rib cage on the right breathe in and exhale you would do the same thing if you were side bent to the left for your curve so as promised we're going to show a little case study this was a 45 minute session I did getting ready for my talk on how to identify the curve so if you see in the leftmost image I just put little stickies with her bending forward to show that her curve is bending to the left because hers is mild and you can also see in standing there's that little bit of a skin fold there on the left which is indicating that she's bent to the left and also her pants line is slightly up on the left now you can't always look at that because sometimes we our pants are shifted but that was a great visual in this picture and then also on her right low back you can see it looks full in the standing picture and that's what I meant by saying it's a three dimensional curve so she's bent to the left and also turned to the right and if you look at the image that my dad drew I was trying to show for people that the muscles on the inside are relatively shorter and the muscles are on the outside are relatively longer so every time you bend or move or sit your curve is bending to the left and your brain is telling the right side muscles to resist that and so they get strained over and over and over again so what we did very simply was we went through some of the stretches that I went through two weeks ago and dropped the mic on back pain so if you want to see some of the low back stretches that video has them all for you and let's go to image number 11 to show the other anti-curve stretches so I basically had her on her hands and knees and I had her walk her hands over to the right to open up the left side and I had her try to push her buttocks over to the left and I had her breathe because again you want to make sure you expand those muscles you want to make sure you open up that curve open up the intercostals now in the image to the right I wanted to give her something too because some people can't go down like that on their knees I know my knees have taken abuse from years of sports and injuries hiking and things like that doing fun things in Switzerland so I can't been like that for very long so the other one I had her go into a lunge position with her left leg forward and then reach her hand hold on to the surface on the right reach her hand over and open up that cage we did some transverse abdominis activation and I showed her how to hug her knees into her chest and her knee to her opposite chest and she woke up the next day she texted me I'll never forget this was like six six years ago or something and she said this is the first time I've woken up in 20 years without back pain and those are the things that make me so happy that I gave someone very simple corrective exercise to do now when I see someone in the clinic I release muscles I do some soft tissue muscles on the shorter side to enable you to get in that position and that's why I emphasize to you because I'm not seeing you to really breathe to enhance that elongation because I'm not in there massaging those muscles and they have been in this shortened positions for however many years whether you're younger or older obviously if you're older they've been in that position for a lot longer and they're going to need more finesse to open them up so to wrap up what you learned today it's important with scoliosis for you to identify your curve where your curve is bending which way it's rotating so that you can go out of the curve in two and three dimensions to stretch it's okay to stretch in one dimension like I showed you laying over the pillow it's also really important if you're a side sleeper to support your curve regardless of what side you sleep on so that your spine stays like this all night and doesn't start to do this all night because that's when you'll wake up in pain in the morning regardless of what side you sleep on so get to know your curve email me if you need help try some of these exercises email me if you have questions it's really important to focus on alignment breathing and giving your nervous system a different input to fire some of those muscles it works for me it works for my patients and I know it's going to work for you so thank you so much for tuning in today thank you thanks to kawaii our sponsors and donors for allowing us to bring this to you and as always life is better when you listen to your physical therapist aloha everyone