I’ve been helping people take a whole-body approach to their scoliosis for years. 

One of the reasons for this is that we can’t ignore the rest of the body when dealing with scoliosis. Dentists and researchers have long postulated imbalances in the teeth (1) may play a role in idiopathic scoliosis, and many other disciplines have good theories about what causes scoliosis. There is, currently, no ‘smoking gun’ when it comes to the cause of adolescent idiopathic scoliosis. However, it is worth looking at the rest of the body for anything that could contribute to scoliosis or prevent it from improving. 

One area I’m particularly interested in is the pelvis.

I view the pelvis as the foundation of the spine. If we drop a midline or ‘plumb line’ down the front of someone’s body it would follow their spine and then dissect the pelvis in half. However, my scoliosis patients often have their pelvis rotated or shifted to one side.

Often, this is an adaptation to scoliosis, but what if it’s an adaptation to something with the feet or hips that is actually making the scoliosis worse?

Let’s look at some common causes of pelvic imbalance and see what we can do about them. 

• Apparent Leg Length Deficiency: This condition arises when postural muscle imbalances cause one side of the body to draw up the leg despite equal lengths. The solution is to find which muscles are tight and how they affect the joint. For example, tight hip external rotators will externally rotate the hip, making the hip a little longer. Tight hamstrings, popliteus, and calf muscles can flex the knee, causing the leg to appear shorter. Stretching and mobilizing the joints and muscles will help in these cases.
• A collapsed arch on one foot pulls the hip down on the same side. Foot strengthening exercises and, in some cases, orthotics can help with this. 
• True Leg Length Deficiency: There is an actual difference in bony length between the left and right sides. This is best corrected with a lift on the shorter side. 

However, sometimes, the anatomy of the scoliosis can also drive the pelvis into rotation and an oblique tilt. This has to do with the weight shift that happens when scoliosis isn’t balanced. In an S-curve, this occurs when one curve is larger than the other, but it’s also common in adult degenerative lumbar spine scoliosis. But this is then compounded by postural habits that tighten up muscles. Assessing the hips in all six cardinal directions is essential before starting any corrective-type exercise.

In the Scoliosis Correction Protocol, we use 22 different body tests to build a picture of imbalances in our patients before we get them to do any specific scoliosis exercises. This allows the scoliosis exercises to be more effective as they are not ‘fighting’ against muscle imbalance elsewhere in the body that could be adding to their scoliosis. 

Understanding the interconnectedness of pelvic and lower extremity imbalances with scoliosis progression underscores the holistic approach required for effective management. By addressing these contributing factors through tailored interventions, we can optimize postural alignment and mitigate the impact of scoliosis on overall spinal health. As healthcare practitioners, we must learn to recognize and address these intricate relationships to provide comprehensive care for individuals with scoliosis.

I hope you found this information helpful. If you want my help to see if we can use specific exercises and lifestyle medicine to help you recover from pain, injury, or illness, please reach out to me via ed@edpaget.com

1. https://www.researchgate.net/publication/7842106_The_Influence_of_an_Experimentally-Induced_Malocclusion_On_Vertebral_Alignment_in_Rats_A_Controlled_Pilot_Study

Understanding Disc Bulges and Herniations

Up to 85% of us will experience back pain at some point in our lives. For most, this pain is temporary and resolves within a few days. It is often caused by a pulled muscle or ligament. However, for some, the pain may be the result of a disc bulge or herniation.

In a disc herniation, the gel-like liquid at the center of the disc, known as the nucleus pulposus, is squeezed out of the surrounding ring, much like jam being squeezed out of a doughnut. This “jam” can then push on the nearby nerves, causing inflammation, which leads to pain that radiates down the leg, a condition known as sciatica.

Disc bulges and herniations are common when the joints of the lower spine are overused, such as in individuals who frequently bend forward or have tight hips, causing the lower back to compensate by moving more. While disc bulges are very common, they don’t always cause pain. For example, up to 84% of people in their 80s have disc bulges without any pain, but they sometimes do cause pain.

Avoiding Surgery for Disc Issues

Some people may consider surgery for disc issues, but studies have shown that there is not much difference in long-term outcomes between those who undergo surgery (1) and those who do not. Dr. John Sarno, a renowned physician, believed that simply providing information and education could help many people overcome their back pain. (2)

While information is valuable, it doesn’t always relieve the pain. That’s why we’re going to explore four exercises that can help pump out inflammation, relax the muscles, and keep the spine strong and mobile.

Exercise 1: Somatic Flower

This exercise involves lying on your back and using your breath and movement to mobilize the spine. Start by taking a deep breath, feeling your belly expand. As you exhale, allow your back to arch slightly off the ground. As you do this, let your knees drop outward, relaxing the muscles in the front of your body.

As you exhale, rotate your hands externally, pulling your shoulder blades together. Then, on the next inhale, rotate your hands inward. Repeat this sequence 5-8 times, moving slowly and in control to help pump out inflammation and improve mobility in the lower back and hips.

Exercise 2: Prone Extension and Leg Lift

For this exercise, you’ll start by lying on your stomach, with your head turned to the side and your hand resting on the ground. Lift your head and chest off the ground using your upper back muscles rather than your lower back. This is important as it helps to avoid further straining the already irritated area.

Next, lift the opposite leg off the ground, focusing on pushing the pelvis down into the ground to stabilize the lower back. Avoid arching your lower back as you lift your leg. The key to this exercise is to engage your upper back and your glute but not extend or move your lower back too much.  Repeat this movement 3-5 times on each side, then try lifting your whole arm off the ground as you lift your leg and head.

Exercise 3: Spinal Flexion and Extension Cogs

For this exercise, you’ll need a chair. Sit up tall, with your hands dangling down by your sides. Begin by rotating your hands backward, which will gently arch your lower back. Imagine there’s something on top of your head that you’re trying to push up towards the ceiling.

Next, rock to the back of your pelvis, flexing your spine and allowing your chin to come forward slightly. Avoid letting your ribs flare out. Repeat this sequence of arching and flexing your spine, breathing in and out 5-10 times. This exercise helps to mobilize the spine in both flexion and extension, complementing the previous lying-down exercises.

Exercise 4: Nerve Flossing

The final exercise is designed to help move or “floss” the nerves that may be irritated by the disc issue. Start by sitting up tall and extending one leg out in front of you, but don’t push into any pain. Just as far as you can go before you feel a stretch. Look up as you do this.

Next,  breathe out and slowly slide your leg back to a normal sitting position, allowing your chin to tuck towards your chest. Then, repeat, as you breathe in, use your back muscles to extend your spine, look up towards the ceiling, and slide the leg out in front of you again.

Repeat this sequence of flexion and extension 10-15 times, focusing on keeping the movement smooth and controlled. You may feel some tension down the back of your leg, but the goal is to stay within a pain-free range of motion. Repeat on the other side.

Remember, these exercises are designed to help pump out inflammation, relax the muscles, and improve mobility in the spine and surrounding areas. If you have any specific concerns or questions, don’t hesitate to reach out to a healthcare professional for personalized guidance.

I hope you found this information helpful. If you want my help to see if we can use specific exercises and lifestyle medicine to help you recover from pain, injury, or illness please reach out to me via ed@edpaget.com

1. https://pubmed.ncbi.nlm.nih.gov/20949289/
2. https://www.nytimes.com/2021/11/09/well/mind/john-sarno-chronic-pain-relief.html