Scoliosis – What to do - 2

The extent to which an integrated therapy of opening fascial adhesions and movement exercises can relieve the pain of individuals with mild scoliosis can be learnt from the case of Naama (pseudo name). 
A few months ago Naama (a young woman aged 29) arrived at my clinic for treatment. 
A quick glance revealed she was suffering from very mild scoliosis. During the diagnostic session she complained about chronic back pain: "At times” she related, "the pain is in the upper back; sometimes it wanders down to my lower back, and at others it may permanently stay in one place and not move.” 
At first glance it was obvious that Naama’s posture was unbalanced. Her left shoulder was higher than her right, and there was an unsymmetrical leaning to one side of her pelvis, but it seemed that she was neither constricted nor experiencing high muscle tension (Tonus). Based on her former experiences in other therapeutic sessions, Naama asked for intensive deep tissue work, otherwise, she said, she would feel nothing. 
From the outset it became obvious that Naama’s back really did call for deep tissue work, since the tension held in her back muscles was of a very high degree. 
During that first session we decided to start applying the Rolf`s Structural Integration technique to open adhesions of the spinal column muscles. (It is quite uncommon to start using Rolfing in a first session, but her need of intense work was so clear that it was pointless to wait.) I explained to Naama that opening these adhesions had the benefit of both decreasing pain and extending muscle length. Such muscle lengthening results in lowering the amount of stress exerted by the muscles on her spinal column, releasing and diminishing muscle tonus. Diminishing muscular tension may also have the effect of a reduction of pressure which causes the pain.

I’m pressing simultaneously on both sides of the backbone vertebrae. The pressure reduces the level of pain. The problem is that when I release the pressure, the pain returns. I continue to apply pressure along the constricted area at Namaa’s left upper back and Naama continues to report significant relief of pain. However, when I proceed to treat her right side, I become apprehensive that if the scoliosis generates the pain, the treatment might restore Naama to her "regular balance” and the relief will be replaced with the recurrence of the usual pain. Fortunately, the constriction on the right side of the spine is unlike the left one; it is not at the same height but much lower down the spine below and therefore I focus on the lower part of the back. 

While opening more adhesions at the hip area, suddenly a new abdominal ache emerges. This pain indicates to possible pressure at the most central muscle of the body – the Iliopsoas – which is hidden behind her inner organs. 
I’m hoping that the process of opening the adhesions in the Psoas would result in decreasing the muscle-induced pressure upon her inner organs, but it is too early in the treatment cycle to do so, certainly not while Naama is in such pain. 
At the end of our first session Naama feels a distinct alleviation of her chronic pain, which many physicians and therapists failed to understand or knew how to teach her how to release. It is important for me to share my diagnosis with her, that undoubtedly her scoliosis is the cause that effects her functioning, and that it is possibly a twisted spine scoliosis, something that will need to be tested during the following sessions. 

Time passes and we continue with the process following the amazing "recipe” Dr. Ida Rolfdeveloped during the 1950’s. We methodically treat the entire muscle and posture system. 
The further we release muscular pressure around the spine, all the areas in which the vertebral column is unbalanced and "ostensibly-twisted” are reveled. Indeed it’s embarrassing to be "apparently straight” at the beginning of a treatment session and to be a little more bent at its end, but at least much more released as well! 
Naama receives tools to cope with her spinal asymmetry. She learns to identify where her physical center is, notwithstanding the natural asymmetry of her spine. Naama learns how to evenly divide her body weight to both legs and the right movement of the knee along the bisecting plane of the legs. As the process advances we eventually come to treat the functioning of the mid-muscle – the Iliopsoas, the self same muscle that caused her abdominal pain during our first session. Naama is less sensitive in this area now, and it’s possible to gently tune the muscle correctly: it should remain at the rear at the waist area during forward movement of the knees. Meaning, while walking, the waist should stay behind and contrasted to the forward movement of the knees. This gait prevents the chronic shortening of the muscle at the waist, the forward thrusting of the belly and its resulting sensitivity to contact and pressure, and promotes the relaxation of the lower back instead of its excessive overarching. Another intriguing and exiting thing is happening. Naama’s sense of inner existence inside her own body is gradually changing. Her body is receiving a new existential space – its physical center. Her bodily sensations become clearer and unmistakable. Her body is no longer separated compartments of different units but a construction of lengthy planes of existence at various layers and depths.

Naama’s movement becomes more graceful now since it possesses continuity, a continuity that discloses her sense of inner existence that prevails throughout her body. This sense of inner existence shows itself outwardly in a manner that cannot be missed.

Naama also starts to experience the possibility of life without the pain because there is something different and positive attracting her attention. Pain is replaced by a pleasant feeling, a sensation of continuous physical existence that pervades from the ground supporting her feet, through the legs and up through the body. Naama can feel how the inner side of her legs takes part in transmitting this support directly to the spinal column and flows to the neck and head.

It’s true, Naama’s spine is not straight, but she has found inside herself a no less valuable place. She has found her central axis, her inner balance.

The central axis runs through the physical center of the body. Compared with this central axis the spine looks like an S-shape and acts as a shock absorber for the central axis. Naama’s spine is also somewhat twisted: occasionally one side of her pelvis has a slightly more forward disposition compared with the other side, and at other times her bellybutton turns to the exact opposite side while her ribs are turned in the other direction again. The neck area also has a minor opposite twist, but now all these small twists, that can be seen, cease from producing immense pressure upon the spine as previously.

In contrast, the central axis is a straight vertical line and all these spinal twists do not confuse Naama as to where her central axis is.

Naama didn’t start the therapy to learn correct posture. It simply happened during the process. She just learned how to avoid rebuilding the pain-generating tension.

As previously mentioned, treatment must be integrated: the opening of adhesions and doing exercises. Without a near daily practice of a series of exercises based on Dr. Rolf’s doctrine, Naama wouldn’t have been able to preserve the sensation of the inner existence within her central-axis. These exercises can be found in a DVD disc I created which teaches the use of the central structure – the central axis – to reduce and at times eliminate the pressures from the spinal vertebrae as a proactive tool against pain

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Learning how to live from within the central axis is significant for those who do not wish to live from within the tension. But frankly, without the exercises, treatment success chances diminish significantly.

Why do I emphasize this so? Because this treatment method offers even more advantages to children and adolescents who are still in the fast growing stage. With Rolf`s Structural Integration these youngsters can not only stop the development of their scoliosis, but also straighten back up to a significant extent (10 to 15 degrees).

If we succeed during the growth stage to partly straighten the spine by opening up muscular shortenings that can be opened in those muscles that pull at the vertebrae, then the curvature will be rolled back and its worsening avoided. If guidance as to correct body usage attends this opening there is no reason the body should twist back again. As for parents who are despondent reading the words "guidance as to correct body usage”, thinking of their unmotivated children, I urge you to not give up. Don’t start with exercising; begin with educating your children with knowledge and understanding, begin with the basic knowledge about exploring the whereabouts of the center and with the understanding of what is movement that is earth-supported through the central structure and what unsupported movement is. It is quite likely that motivation and change will spring from these understandings.

The Structural Integration course in which the patient is actively involved, consists of ten sessions. As this schedule progresses there is a consolidation of symmetry around the central axis. The patient/student learns how to use this axis in order not to exacerbate the scoliosis. After ten sessions the needed knowledge and basis for continued self-practice of a new, correct posture, exists. 
The exercises that are practiced regularly at home and in the clinic during the therapy must be performed also after the ten sessions are over, as part of the effort to maintain the new posture and balance. And no less importantly: maintaining the connection with the central axis and experiencing a good and pleasant sensation of existing within your own body. Rolfing-based exercises are one way to treat scoliosis. 

 

Traslated by Guy Malbec Guymalbec@gmail.com