Scoliosis – the pathology is very mysterious, and sometimes even completely surprising. And that’s why:
• About 85% of cases of scoliosis are idiopathic in nature (that is, in such cases it develops suddenly for no apparent reason).
• About 80-90% of cases of idiopathic scoliosis occur on right-side curvature (dextroscoliosis, Fig. 1), while left-side curvature (levoscoliosis) is much less common. (1).
• Scoliosis is more common in people with pathologies of the inner ear, but less often in people with a complete hearing loss (2)
• In our hominid ancestors, such as Australopithecus, scoliosis was much more common than in modern humans, but, paradoxically, there were no cases of scoliosis in chimpanzees and gorillas (3)
• Idiopathic scoliosis has never been detected in any animals in their natural habitat (with a very interesting exception in guppies and other representatives of this genus) (4)
• Despite the fact that scoliosis is often considered a teenage problem (indeed, 2-5 percent of adolescents have it and it is 10 times more common in girls than in boys), modern studies have found that scoliosis develops more often in later periods of life.
Scoliosis occurs in almost 40% of adult men and women, and no gender differences in prevalence were detected (5). Scoliosis is often confusing for massage therapists and manual therapists. Many worked with clients whose back curvature did not give in to any techniques and manipulations. In addition, the very concept of scoliosis often causes misunderstanding, confusion in terms and many questions (“Is the spine bent to the right side in the thoracic section if the left shoulder is higher than the right? Answer: not always, it depends on many other factors”).
The severity of scoliosis is not easy to determine without an x-ray, and, moreover, in many cases, scoliosis does not cause pain, discomfort or other disorders, and many of us have been taught that the degree of curvature of the spine is the main criterion for assessing its integrity and the health of the musculoskeletal system . And, as many of my colleagues have already managed to make sure, passive rectification of the spine can only worsen the condition of a person with scoliosis.
These are just a few of the puzzles and paradoxes of scoliosis. If you want to know more about this, now I will tell you where to start.
WORK IN THREE MEASUREMENTS
Scoliosis, by definition, is a lateral curvature of the spine. When talking about the direction of curvature, terms such as S-shaped and C-shaped scoliosis are used, but such a description of scoliotic changes can be a problem for massage therapists and manual therapists.
The thing is that the description is not entirely accurate. Most know that the spine always bends sideways (Fig. 2) – we can say that it bends spirally, and not in the shape of the letter S or C.
The usual single-plane definition of scoliosis came from those times when it was diagnosed by photographs or, a little later, by x-rays (Fig. 3). Both diagnostic methods gave a two-dimensional, flattened display of the shape of the spine. Scoliosis, like the people themselves, no matter how funny it sounds, is a three-dimensional phenomenon.
The next problem associated with the terms S- and C-shaped curvature is that a single-plane representation leads to a single-plane treatment. Examples of such errors are an attempt to straighten the spine by stretching or lengthening the concave side of the bend or by bending or pressing the convex side of the bend sideways using a roller or side of the massage table. Such methods do not take into account the fact that lateral curvature of the spine can change only if the degree of its rotation also changes.
Sometimes this one-plane (two-dimensional) intervention really helps people with scoliosis. But even if we apply passive rotation (for example, add twisting when working with a client lying on a roller), we will encounter the fact that simple attempts to straighten the spine by stretching, pressing or twisting cause the client discomfort, loss of stability and just unpleasant sensations . Moreover, such actions can cause sciatica and other painful sensations in the leg or back, which were not disturbed by the client before the therapy. This is due to another problem of the two-dimensional scoliosis model, but, fortunately, it also has a solution.