On the occasion Scoliosis Awareness month, June 2020, and International Yoga day 2020,  Dr. Mayura Kudva Interviewed Marcia Monroe about Managing Scoliosis through Yoga. With the intention to answer most frequently answered questions of people with scoliosis, to learn about it from a person who has experienced and managed her scoliosis very well.

 

The following are answers to questions that could not be answered due to time constraints.

 

  1. From the time Scoliosis is diagnosed to the time it can be corrected, does it have to be continuous or can it be done with breaks in between. Also, does it depend upon the age of the person as to how much it can be cured? I am referring to Yoga or exercises to therapy.

Marcia: thank you for your question. I view yoga as a lifestyle that requires ongoing and modified practice depending on health condition, age, and lifestyle. It is important to have a teacher to help and guide with the progress and process of the student.  It is also important to have a medical follow up. 

Dr.Mayura: I agree with Marcia,  and be it Yoga or Schroth or SEAS or any method, one has to blend it in their lifestyle.

If you are talking of the curve being corrected by exercise during the growth phase, yes it has to be continuous and consistent. Being compliant to exercises in Mild scoliosis, and Brace and exercise in Moderate scoliosis is the only way you can achieve any correction.

 

Compliance is the Key

 

  1. My left leg is shorter than my right leg (The left leg’s femur/tibia is shorter) which has led to curvature the spine. I am using a foot raise for the shorter leg, but can yoga help?

Marcia: Thank you for your question. Yoga is a discipline that requires practice under a qualified teacher.  I am not sure the data and research on leg length discrepancy and Yoga. 

  1. I also feel that my muscles around the back and hamstrings are really stiff. I recently joined a yoga class, but I am always conscious and fearful about hurting my back. Any suggestions?

Marcia: The teacher has to be knowledgeable on the subject and in case of pain it is a signal that the practice is not conducive.   Also, Doctor Mayura can help from her physiotherapy experience.

Dr.Mayura:  Iyengar Yoga would be a good option with the use of props and accessories to work towards an asana. Also, if you are having scoliosis, then you have to have someone who can guide you through Yoga, with the curve in mind.

If there is extreme hamstring stiffness, we have other ways to work on it with. Also, remember that it is not a lot of flexibility that we want everywhere.  Too much flexibility can worsen curves. There has to be good stability.

 

  1. Will the degree of the curve increase every year even after the growth period? If scoliosis was diagnosed at the age of 15. Does it affect if we don’t work on a curve with a moderate degree of scoliosis?

Dr.Mayura: The research says that, if the curve is 50° Cobb at the end of the growth phase, then the curve may increase at the rate of 1°per year.

End of growth phase means the Bones should have reached the maturity, which we call as Risser staging. This may be at a different age for each child in their growth period and cannot be decided by the age you have quoted.

Also, a Moderate curve is somewhere between 25° to 34°. Until the growth phase ends, this has to be managed and an attempt needs to be done to maintain the curve below 30° so that one does not have much risk during aging.

So whether one wants to wait and watch if it progresses, or work towards it so that it does not progress is what one has to make the choice. The progression is not predictable. Also, sometimes in spite of the best treatment, curves progress. But, we give our best effort to avoid progression as research has shown that bracing and Specific exercises have helped.

Having said this, a fit and active lifestyle will definitely help one in a lifetime.

 

  1. Will Yoga help all types of curves?

Marcia: A modified yoga systematic practice can help to bring integration and overall feeling of elongation,  space, spinal decompression, stability, balance. Therefore it is a science-based on integration and health. It is important to have a qualified teacher to understand the specificity that each curve requires.

 

  1. My daughter has a curve of 45° at the age of 10 years. Can yoga help her manage her curve? If I don’t want to think of surgery. If yes can you suggest what kind of yoga?

Marcia: Medical advice is very important, please refer to Dr. Mayura she has been exposed by very good methods.  Yoga can help to elongate, strengthen,  and improve self-esteem, and well being. But the child has to be engaged.

 

 Dr.Mayura:  For a 45° curve at age 10, you will need to have a very disciplined lifestyle with bracing and exercise until the end of her growth phase. So there is a long way to go for her.  With regard to exercises, a blend of  Physiotherapy Scoliosis Specific Exercises can work best for her.

An Intensive Schroth therapy and then Home exercise program can be organized at our center, Physio4You, Scoliosis Rehab Center, Bangalore.

 

  1. There are different types of scoliosis. Which scoliosis can benefit from Yoga?

Marcia: Yoga is a practice for the health of mind, body, and soul.  I would say that there are systems of Yoga that might be more appropriated for scoliosis.

  1. Does scoliosis happen due to bad sitting postures?

Marcia: If It is postural scoliosis unhealthful habits can trigger muscular imbalances.  There are many kinds of research on scoliosis and you might be able to find a study on this specific theme.

Dr.Mayura: Structural/bony scoliosis does not happen due to bad sitting postures. But it is a vicious cycle and someone with scoliosis in bad sitting posture will aid in the progression of scoliosis.

If there is a functional or habitual listing of the spine due to bad posture, this has to be managed with Posture correction and strengthening program specific for you.

I am 40 years and have neuromuscular scoliosis 100+ and now my son has scoliosis and he is 9 years old. Nearly 25°

  1.  Can this be controlled for him with any of these methods?

Marcia:  Please consult with Doctor Mayura she has been exposed to the various methods and will be able to guide you.

Dr.Mayura:   PSSE  – Physiotherapy Scoliosis Specific exercises have shown evidence and is recommended in Idiopathic scoliosis.

These exercises definitely can help improve his overall posture. If he is 9 years old and has a curve around 25°, then you have to be careful as he is just about to enter the growth spurt age. Bracing can help to avoid progression in this phase. A very compliant bracing and Scoliosis exercise regime can help him maintain his curve along with other physical therapy needs for the neuromuscular cause.

 

  1. What are your tips for people with scoliosis who have desk jobs and have to spend long hours in front of a computer?

Marcia: Good anatomical chair for back support and prevent slouching.  Avoid long fixed sitting, and if possible stand up to stretch.

Dr.Mayura:  Good ergonomics and also several small curve specific corrections will help. Long hours of sitting is not good for anyone. Frequent breaks, walking around is advised for everyone with a desk job.

 

  1. Does anyone know a good Iyengar yoga centre in Chennai?

Marcia:  Gayathri Ramesh teaches in Chennai – Her email is [email protected]

Dr.Mayura :  Teachers of Iyengar method

http://bksiyengar.com/modules/Teacher/teacher.asp

A Senior experienced Iyengar yoga teacher may be able to help

someone with scoliosis.

 

  1. How does scoliosis change as you age? Does the curve always increase with aging?

Marcia:  It is my understanding that degenerative scoliosis progresses with aging but it is my hypothesis that the progression is also related to a sedentary life, and diet.  There are scientific researches on this theme that you could search for.

Dr.Mayura:  It does not progress so rapidly as in the growth phase, but as one is aging, and degenerative changes occur the progression might be there.

Again depends on the lifestyle. A healthy and fit lifestyle could help you avoid much progression.

 

  1. Once the skeleton has matured hope the curves angle progress will not be there.

Marcia:  Medical follow-ups are important for management.

Dr.Mayura: The answer is the same as to question no 12.  But yes, the follow-ups are important once you have matured. Depending on the curve, if mild once in 2 years and if moderate to severe an annual check-up is good unless you notice any worsening or difficulty.

  1. Any yoga poses you would suggest someone to include in their everyday practice for a healthy spine?

Marcia:  It is the combination of postures and sequence that helps spinal and overall health. If you are a student of the Iyengar system the teacher should be able to guide you.

  1. Are there any exercises for preventing scoliosis

Marcia: Not that I know of but intelligent exercises help to strengthen the back and avoid deterioration.

Dr.Mayura: Unfortunately there has not been any research proving that these sets of exercises can prevent scoliosis.  But definitely a good posture and a good set of strengthening exercises can perhaps prevent scoliosis in someone with a family history of scoliosis.   But these are again general strengthening exercises and anyone with mild scoliosis will have to consult a scoliosis exercise – specialized physiotherapist as these exercises are very specific to each curve.

 

  1. Are there any exercises you should not do if one leg is longer than the other.

Marcia: Probably you would need to use a lift to avoid injury due to the neuromuscular imbalance. I don’t know a specific example of exercise. Please consult your physical therapist for suggestions.

Dr.Mayura:  If one leg is diagnosed to be shorter than the other by your specialist then you may need to have a foot raise.  Once the pelvis is level in standing, I don’t think any exercises would be a problem. Exercises in sitting and lying are not affected by your leg length as much.

 

However, if the leg length is different due to scoliosis, your therapist or consultant will let you know if you need a raise or not.  It is not always necessary to have a foot raise in this case.

 

 

  1. Can you give some suggestions on asanas where you don’t need any tools? When traveling etc and not at home with bars and all equipment.

Marcia: Are you a student of the Iyengar system? If so please consult your teacher she will be able to guide you.

Dr.Mayura:  Be it Asanas or any scoliosis specific exercises, they all have modified versions so that they can be done even when one is on the go. So one has no reason not to do the exercises. Do consult your yoga teacher or physiotherapist for your specific needs.

 

  1. Can you kindly explain the arch of the feet’ relationship to scoliosis? Do you mean the arch in one of the foot has collapsed and that is what causes tilt in hip and thus in the spine?

Dr.Mayura: This can be both ways.  Sometimes due to a problem in the foot, a dropped arch, the pelvis may tilt and in turn impact the spine.  Or due to scoliosis the pelvis is tilted and has an impact on the foot.  Whatever the cause may be, the corrections are done from the foot upwards. It cannot be just working on the spine.

 

  1. Can we access this video later?

Dr.Mayura: Yes, you can watch the video anytime you want on my YouTube channel.

https://www.youtube.com/watch?v=xOUqKtgI7c0&t=399s

 

  1. Will there be any training during this webinar?

Dr.Mayura: This webinar was an interview with Marcia with regard to how she has managed her scoliosis through her lifetime,  as an insight for people going through the same. The training for scoliosis is not very generalized and has to be guided according to the curve.

We will definitely let you know when we organize a training session in the future. Also do subscribe to our Instagram, Facebook, Twitter pages for constant update.