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Scoliosis is a sideways curvature of the spine. The scoliosis can be a single curve of the neck, thorax or lumbar curves or can involve them all. If one views a normal spine from behind, it should essentially be straight with both right and left side of the body being symmetrical. With scoliosis the spine will have a curve or curves in it. Most easily recognized is usually a thoracic curve, although there may be curves in the lumbar and or cervical spine. See x-ray Sc 1 and link
nlm.nih.gov
True Scoliosis
One can be born with a scoliosis (congenital), however most often they develop during pre-
adolescence for no apparent reason. See link nlm.nih.gov
If detected early the curve is usually monitored and treated with exercise. Once a curve increases to a moderate size and bony maturity has not been reached, treatment can involve a hard plastic body jacket and exercise. See link nlm.nih.gov
If the curve still continues to increase despite conservative treatment and bony maturity has not yet been reached, surgical straightening and fixation with a rod is usually recommended.
See link nlm.nih.gov
As the sideways scoliosis increases and there is an accompanying rotation of the ribs backward on one side and forward on the other. This is what is crudely called a rib hump. Often the thoracic curve also increases in the forward/backward dimension creating what is called a kyphoscoliosis. See link nlm.nih.gov
There are many different chiropractic systems that purport to treat scoliosis. They have varying reports of success. One thing seems to be true that the earlier one catches and treats a developing scoliosis in a child, the more success conservative approaches have in slowing or stopping its progression.
Functional Scoliosis
A curve in one's spine can develop any time vertebrae are not correctly aligned or if there is a shortness of one leg. Weakness of spinal muscles due to neurological conditions can also cause a scoliosis.
A person having a "short leg" will usually have an accompanying spinal imbalance.
A true short leg is called a "structurally short leg". Common causes are: having a broken or injured leg as a child, childhood growth plate problems, injury or surgery that leaves the hip or knee permanently bent.
Knee and hip replacements often leave one leg shorter than the other. Sometimes there is no discernable reason.
More commonly people have a "functionally short leg". It can be caused by imbalances either in their skeletal alignment or weakness in ligaments and muscles. Poor standing habits, hyperextension of the knee, a fallen arch, misalignment of the first cervical vertebra, pelvic torsion problems or a sprained sacroiliac joint can all contribute to a functionally short leg. (See Sc 2)
It is commonly thought that most people have some asymmetry and that a short leg of 1/8 to 1/4 inch is no big deal.
If a person is having symptomatic neck, back, hip, knee or foot pain, structural alignment needs to be evaluated. If left uncorrected it may cause considerable problems over a lifetime. The Leaning Tower of Pisa may have started out with a small structural fault but over the years the result has become very obvious.
Assessing and Attaining Structural Balance
When I see a patient I evaluate them for structural imbalance. Are the shoulders level? Is the pelvis level? Hips, knees are they level? Is the head to one side? Is there a visible scoliosis? Is the person standing with one knee slightly bent, the other straight?
How high are the arches? When lying down are the leg lengths equal? (See Sc 3)
Treating Functional Scoliosis
If the history indicates any injury-related reason for an asymmetry, then that is treated first. If there is no obvious cause, I begin by teaching a procedure for balancing the pelvis, along with some gentle stretches. I let these work over a period of about month and keep checking the pelvis, re-balancing it again if needed and this is accompanied by work to neck and cranium. Most often the imbalance can be corrected or partially corrected.
If some imbalance remains then I refer my clients to a NUCCA practitioner for evaluation of their first cervical vertebra (C1).
I would not have believed it if I had not experienced myself the instant effect of a C1 adjustment. Legs become equal length, the pelvis is level and weight becomes balanced through both legs as soon as the first cervical is put back into correct alignment. Read more about NUCCA at advancedspinalcare.com Find a practitioner in your area nucca.org
Occasionally I do recommend a shoe lift, but only if a person has had a C1 correction and they still show a true shortness in their leg. Then, it is best to start with half the shortness and then increase it incrementally as tolerated.
The Alexander Technique helps a person become more aware of the habits of activity that can create one-sided mechanical distortion of the body. Position and activities we get into often tend to influence the shape of our body over time. Learning to expand one's spine into length and width has an enormous impact of reducing the compression that increases the size of scoliotic curves.
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The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Movementwise makes no representation or warranty regarding the accuracy, reliability, completeness, currentness, or timeliness of the content, text or graphics. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. Any duplication or distribution of the information contained herein is strictly prohibited. Copyright 2006-2011
MovementWise Christine Inserra P.T.
Certified Teacher of the Alexander Technique & Feldenkrais Method
Physical Therapy serving Chicago and the Greater Chicagoland Area
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