Why You Don’t Need a Posture Brace

Young Caucasian male in a white shirt sitting in green grass on a gently sloping hillside, looking out at dark blue mountains and pale orange clouds as the sun sets in the distance.

You probably see these type of products everywhere now. People are becoming more aware of the negative effects of sitting, and how slouching is killing us all, and as usual, we’re offered a handy “spot-check” solution.

“You slouch a lot and your shoulders roll forward? Here’s a gadget that will prevent you slouching and your shoulders from rolling forward! Presto!’

But the answer isn’t that easy.

First, we have to become more aware that, often, we seek solutions to help make our sedentary time (which is most of our time now) more comfortable, or help us move less. Cushier couches and beds, ergonomic chairs, mixers (hey, I don’t judge, but keep in mind your great-grandma was able to whip a meringue by hand), automated everything–we applaud new innovations that “save us time and help us be more productive,” without realizing that every day, we’re handing off natural human movements to machines or gadgets.

Second, we have to remember that “the site of pain is rarely the site of dysfunction.” Got a pain in X place? Our first reaction is to medicate, stretch, rest, inject, massage, physical therapy, etc. the X place.

But what if poor X is just the innocent victim of another issue somewhere else? What if the issue in Y is the real problem, and poor X is getting caught in the crossfire, and is screaming out for help, alerting you that something is wrong elsewhere?

Don’t shoot the messenger. Silencing the pain in X will never, ever fix Y, and you will likely see other problems spring up further down the road if Y is never addressed.

So, how does this tie in with the posture brace?

Combining the two topics I just pointed out–that we are moving less by outsourcing more and more movements every day to cushier or handier technologies, and that we can’t spot-check pain issues by only staring at the source of the pain and nothing else–let’s do a little experiment.

If you are able, stand up, though you can do this from a chair. Do a quick check-in: What’s your head position like over your shoulders right now? And where are your shoulders? Rolled forward? How about your low back? Does is have a big arch in it? A little one? None at all?

Now, I want you to dramatically roll your hips forward, which will naturally place a big arch in your low back. What happened to your head position? Does it feel more over your shoulders? And how about those shoulders? Did you find that they naturally rolled back together?View of Caucasian woman from the side, giving an example of extreme lordosis.Next, do the opposite with your hips–roll them backward. You should immediately go into an exaggerated slump, your low back flattening out and having NO curve. What’s up with your head position now? Your shoulders?

 

View of Caucasian woman from the side, giving an example of extreme kyphosis.

Keep that position! Now I want you to pretend you’re wearing a shoulder posture brace. Imagine it pulling your shoulders back, while your hips are rolled backward like this. What kind of strain is that placing on your neck? Your shoulders? Your low back? Do you think you could wear this brace for long, if your body’s current postural alignment was one where your hips were rolled back like this?

View of Caucasian woman from the side, giving an example of extreme lordosis with shoulders pulled back and together.

You’re probably thinking, “But nobody is shaped like this!” Guess again. This body postural condition is very common in the elderly, and I’m seeing it more and more in 20-somethings and below. It’s alarming.

Our bodies do their best to keep us upright, and rolling our shoulders forward is a natural counterweight to a misaligned hip position, or deep internal weakness in our shoulder musculature.

I’m sure someone out there genuinely needs a brace to correct their shoulders rolling forward, but for the general population, a brace that forces us to keep our shoulders back isn’t the answer, it’s fixing our lower body misalignments and reintroducing strength and movement.

 

What Does Movement Have to Do with Postural Alignment?

A young white man is relaxing by lying down on a grey couch. His face is totally covered by the magazine he's reading.

See article: Scientists have created a drug that mimics some of the health benefits of exercise

A drug that mimics (some of) the effects of exercise! It’s the dream!

Right?

We like to try to get specific and “hack” everything–hitting that one muscle in our abs to make the perfect six-pack, getting rid of that one niggling pain in our low back, finding the one supplement to end all supplements–but our bodies (and life in general) operate too holistically for drugs like this to be truly effective.

Even if there ever was a drug that fully and totally mimicked the benefits of exercise, without actually moving, there would still be one major problem:

We as humans are designed to move, and move a lot, and move dynamically.

So many of our modern pain problems can be traced back to how little we move. (Ever heard the term “zoo humans“?) Even those among us who are supposedly “healthy” and “active” are actually very sedentary, and their movements are restricted to whatever they felt like doing at the gym for 30-60 minutes a day.

When they get home, though? Zap a meal in the microwave. Relax on the couch for several hours, craning over cell phones or bingeing on Netflix. Sleep for a few hours. Wake up, commute in a car for ?? minutes. Sit for a job for hours. Go to the gym. Zap a meal. Couch time. Sleep.

How much of that “active” person’s day is actually spent moving?

My point is this: We are a massively sedentary society, even those of us who get praised for moving our bodies in some way for at least 1 hour of every 24 hour day. By the way, that’s only roughly 4% of a total day, spent moving.

Our bodies are smart. If they are asked to assume a shape, over and over again, they will begin to mold themselves to that shape, and strengthen muscles to help us hold the shape we’re requesting.

That’s why some of us still look like we’re sitting, even when we’re standing. Our bodies have gotten excellent at helping us hold the “sit” posture, because from the body’s perspective, that’s apparently what we need to do a lot.

Is it any wonder, then, why some of us get injured or feel pain when we try to move, even with non-exercise movements?

“All I did was look up to pull down a box from the closet, and boom! Neck pain.”

“All I did was reach down to pick up a receipt that had blown away, and now I have low back pain.”

“All I did was try to pick up a grocery bag, and now I have shoulder pain.”

“Well, I was stupid and signed up for a Crossfit class, and somehow injured my knee. Guess I’m just getting older, and this is just what happens.”

As a Postural Alignment Specialist, I hear stories like this a lot. What these people don’t realize is that the reason they experienced pain from these activities–ALL of them being totally normal, reasonable activities to ask their bodies to do, regardless of age–is because they took one body posture, let’s call it the “Sitting Posture,” and threw it into a posture they barely ever use, and the body couldn’t adapt to the new alignment and demand on muscles quickly enough, and pain and injury followed.

Think about it: How often do you look up? Bend over, or squat down? Pick up heavy objects from the ground? Did you throw your “Sitting Posture” body into a situation where it really needed “Exercise Bootcamp-Ready Posture” body first?

“Get straight, then strengthen.”

You must first get your body back into its neutral, God-given natural position: Head over shoulders, shoulders over hips, hips over knees, knees over ankles. Shoulders, hips, knees and ankles not twisted or elevated; body in neutral.

^THIS is the body we can ask to do everything, from reaching above ourselves to pull a heavy box out of the closet, to doing box jumps during an arduous workout.

Incorporating non-exercise movements, like bending, reaching, crawling, jumping, twisting, kneeling, and more, into our daily lives is hugely important to maintaining bodies that function well and pain free. But the lure of convenience and the threat of lost time mean that we often reach for the easiest (read: less movement required) solutions, and our bodies slowly decay over days and weeks and months and years of always grabbing the convenient, less-movement-required options.

A convenient, no-movement-required drug like this might improve fat loss and reduce cardiovascular risks, but what if we got to a point where drugs improved all the other internal conditions and diseases we’d like to avoid?

Hopefully, after reading this blog post, you can see exactly why having a society that has hacked exercise without actual movement would be totally disastrous for our bodies’ structure and our overall pain levels!

We as a society need rehabilitative therapy, like the kind of method I use for my clients at Primal Alignment, to counteract our lifelong sedentary habits. Once achieved, we can begin to strengthen those properly firing muscles, which will in turn pull our bones (read: our structural posture) back into neutral, and hold it there.

With a body in neutral, pain problems can be greatly, if not totally, eradicated. But it all starts with therapy, and moving again.

For inspiration on how to build more movement into your daily life, without it being just an extra chore to add to your day, check out my Instagram (@primalalignment), or search #stackyourlife. Stacking your life, as popularized by biomechanist Katy Bowman, is the idea of not multitasking, but simply seeking things you want to accomplish and you value, and trying to “stack” as many of those things into an activity you were going to do anyway.

It’s changed the way I see things, and I get a lot more done in a day, while still feeling like I’m hitting most of my personal, life, work, and health goals :).

Happy moving!

Continuing Scoliosis Education, with Vinny Crispino at Pain Academy

A young white woman in a grey exercise tank top looks out over a cityscape, her back to the viewer, with her palms pressed together behind her back. A quote is overlaid on the picture, which says, "If you're ever going to fix scoliosis, you have to be willing to look past the spine," by Vinny Crispino of Pain Academy.

Something I love about being a Postural Alignment Specialist is the “excuse” I have to find new information about scoliosis and pain issues in general, and binge on new research, and learning what the body is doing, and why.

So, when Vinny Crispino of Pain Academy announced he’d be offering a webinar on scoliosis, I jumped at the chance. A friend within my network of Postural Alignment Therapists found him via Instagram, recommended him, and I’ve been following and amazed by his results and his outside-the-box approach to postural alignment therapy.

This isn’t so much an in-depth post, so much as it is a reminder. As it says in the quote above:

“If you’re ever going to fix scoliosis, you have to be willing to look past the spine.”

– Vinny Crispino, Pain Academy

If you have scoliosis, (heck, even if you DON’T) take a full-length photo of yourself, front, back, and sides. Ignore your spine for a second: What do you see is happening with your shoulders? Your hips? Knees? Ankles? Anything look elevated? Rotated? “Off” somehow?

If your shoulders are misaligned, or one of your hips is rotated forward….is it possible that your spine is the victim of an epic tug-of-war, as your pelvis and shoulders refuse to align correctly with each other?

And if you force the spine to suddenly be straight, perhaps through surgery, then what happens to your poor spine when those shoulders and hips — which will most likely still be misaligned, even after surgery — keep fighting? Think your spine won’t cry out even more?

As scoliotics, we have to continue to look at the bigger picture, realizing that our spine could very likely be the symptom, not the cause, of our scoliosis!

Tongue Tie and Scoliosis Connection? {Follow-Up}

A closeup of light tan rope tied into a knot, against a dark tan background, symbolizing a tongue tie.

{This is a follow-up post to my last post, where I talked about tongue ties, what they were, how they might impact neck and shoulder alignment, and my suspicion that an untreated tongue tie might be causing some issues for me, personally. Read that post here.}

As promised, here’s my update to my 15-minute free consultation with Sandra Coulson of Coulson & Associates!

“What’s the verdict?”

*drumroll*

Ms. Coulson’s initial diagnosis is…I might have something called a “sub-lingual tongue tie.”

“Say wha?”

Yeah. I only got a few details, (it was, after all, supposed to be only a 15-minute phone call) but will provide more information when I have it. Basically, it’s not a simple “snip the little pinkish-white thing under your tongue and done” scenario, because it goes deeper than that, but I’m still learning the details. (And it’s important to point out that it wasn’t an official diagnosis just yet, but Ms. Coulson has done research in this topic, and this was her immediate thought when she did a few tests with me.)

What else did I learn?

First of all, Ms. Coulson is a fantastically nice, encouraging, enthusiastic lady. It’s wonderful to see someone who clearly loves what they do :).

Also, Ms. Coulson seems to also believe that tongue ties are epidemic, due to a generation of well-meaning but sadly misled parents who were told that bottle feeding was better than breast feeding, so tongue ties went largely undiagnosed, and many adults from that generation are possibly walking around with undue neck and shoulder misalignments (in addition to a cadre of other negative symptoms).

The therapy will consist of FaceTime sessions with Ms. Coulson, where I’ll utilize small tools she specifically designed for this therapy over the course of her 45-year career in this field. She’ll lead me in exercises that are intended to help my tongue relearn proper “posture,” and even re-teaching me how to hold my shoulders and neck, among other things. The whole process will take several weeks — perhaps longer? — and I’ll use and reuse the tools from the kit each time, and continue my “work” outside the sessions by continuing to practice what I learn during the sessions.

She was very excited to learn that I’m a Postural Alignment Specialist certified through Egoscue University, as she herself works with an Egoscue therapist in Denver, so I was encouraged that she’s also a fan of the Egoscue Method!

My first appointment is near the early part of December, and I cannot wait to get started. The more I learn about this condition, the more I’m convinced it’s part of what ails me, and I become more fascinated with this topic.

Your tongue can have poor posture, resulting in bad neck and shoulder misalignments — aren’t our bodies amazing?

I will keep updating about this topic as I go along in my journey, and if you have any questions, please ask them in the comments!

Neck Pain, Shoulder Pain, TMJ, Migraines: Is Your Tongue the Culprit?

Last weekend, my sister and I had a conversation about tongue ties. Ever heard of them?

Find a mirror. Lift up the tip of your tongue to the roof of your mouth. Is there a prominent, stretchy, pinkish-white thing connecting the underside of your tongue to the “floor” of your mouth? Then you might have a tongue tie.

Red panda lying on a log with its tongue sticking out.

OK, not a human tongue tie example, but I’ll use any excuse to use a cute red panda photo.

Both of my nieces had tongue ties at birth, which my sister discovered once she began trying to nurse, and both babies had difficulty latching properly.

My sister is fascinated by all things health and wellbeing, and she’s an amazing researcher. Not only did she figure out that tongue (and lip!) ties were a problem for her daughters, but she also investigated the ramifications of tongue ties in adults.

The effects of tongue ties in adults are pretty damning. Because the tongue is a muscle, connected to other muscles in your neck and down into your shoulders*, adults with untreated tongue ties often experience a host of symptoms, including but not limited to:

-Chronic neck and shoulder pain
-Migraines
-TMJ
-Sleep apnea
-Snoring
-Teeth misalignment (even after braces)
-Teeth grinding
-Diminished jawline
-Forward head
-Asymmetrical features (ex. one eye larger than the other)
-Even fatigue and anxiety, due to airways being slightly blocked. A tongue-tied person’s tongue likely rests on the floor of their mouth, instead of the roof, so the tongue can block airways, especially at night when that person is lying down and relaxed.

*Of course, those shoulder muscles are connected to your mid-back muscles, which are connected to your low-back muscles, which are connected to your pelvic muscles, which are connected to your glute/hamstring muscles, which are…you get the idea. You can’t mess with just one muscle in one area of your body and it NOT affect other areas.

We did a quick, unofficial check to see if I had a tongue tie. Without either of us being trained doctors, I can’t confirm that I do, but…if we were betting ladies, we’d feel pretty confident in our gamble.

“But how does this tie into body alignment? Why are you discussing this on Young, Wild and Pain-Free?”

My scoliosis recovery seems to have plateaued lately. I’m in no pain or discomfort, so that’s wonderful, and the low-back curve actually looks pretty great, last I checked on it. Still curvy, but even the chiropractor commented that my lumbar vertebrae had good spacing between them.

However, it’s the upper back curve that’s being stubborn. I can affect small changes to it that might last a few days, but there seems to be little I can do to bring lasting changes. My head still comes forward and my right shoulder still rotates forward of my body.

Coincidentally, for the last several months, I’ve been struggling with breathing at night, increased snoring, a crooked smile, lower teeth shifting (I wore braces for three years in high school), teeth grinding, and my chronic fatigue and low-grade anxiety — which I’ve always had — have been wearing me down.

Could it be that my tongue is messing with the alignment of my body and giving me all these symptoms?

Remember:

“Bones move where muscles tell them to.”

– Pete Egoscue

If I have a muscle in one area of my body that’s “misaligned,” (in this case, my tongue potentially being bound up in my mouth when it shouldn’t be) that muscle will pull/push on other muscles, which will pull/push on my bones, which will affect my overall alignment.

In this case, conceivably yes: My tongue might be the cause of at least some of my upper body misalignment issues, which makes it an appropriate topic for this blog.

Next Thursday, I have an initial consultation via Skype with Sandra Coulson and Associates, a myofunctional therapy clinic in Colorado. They’ve been in practice for 45 years, and addressing tongue tie issues is a large part of their practice. They’ll confirm whether I need treatment for a tongue tie. I’ll write a follow-up post for that appointment, so stay tuned.

Even if I don’t have a tongue tie, this is still an important issue that more adults need to be aware of, especially if they’ve been battling any of the symptoms listed above

It’s hypothesized that we’re less aware of tongue ties because of bottle feeding. In the past, when midwives delivered babies, they would immediately check the newborn’s mouth for tongue ties and lip ties, which can impede the newborn’s ability to nurse. If they found any, the midwife would use a sharp fingernail (ew) to snip the ties, right there.

However, it’s thought that as we shifted more toward bottle feeding, the necessity of searching for lip and tongue ties diminished, because bottle feeding is much easier for the baby than nursing, so the practice of snipping lip and tongue ties became less common. But with the resurgence of breastfeeding, more parents have once again become aware of the negative effects of lip and tongue ties.

That means, though, that there are likely many adults walking around with more lip and tongue ties than their grandparents or great-grandparents, or even more current generations.

How many of us are struggling with symptoms we’ve never been able to find a cure for, when it could be something as simple as treating an old lip or tongue tie?

I wanted to write this post to hopefully raise more awareness of this issue and the alignment problems it can cause, especially as it relates to adults. Stay tuned for the update about my appointment, because even if I don’t have a tongue tie, I’m sure I’ll learn more information that will be helpful to other adults who are also interested in this topic!

The logo for Primal Alignment LLC

Psst…Ever heard of Primal Alignment LLC?

No?

I’ll forgive you. After all, I just launched in June of this year ;).

Yes, I opened my own practice! After finally earning my Postural Alignment Specialist certification from Egoscue University, I opened Primal Alignment LLC, with the mission to help as many people as I can overcome chronic pain and lead pain-free lives.

But, I’m particularly interested in working with scoliotics of all ages. Obviously, this condition and its sufferers are near and dear to me, and already I’ve had a few other Postural Alignment Specialists in the Egoscue Method reach out to me for insights in their cases with scoliotic patients, and I’m glad to help however I can.

Have scoliosis? Want to work with me directly? Visit my website and shoot me a message letting me know your story and interest. I’m able to work long-distance with clients via Skype (trust me, the Skype sessions work. Even before I was certified and seeing my own clients, I was doing Skype sessions with my Egoscue therapist, and I’ve found there’s actually some advantages to Skype sessions over the in-person sessions).

Questions? Ask me in the comments below, or use that same message function on my site to contact me directly.

I’m excited to get this practice rolling, and maybe work with some of you out there who have been following this blog! Cheers!

The author demonstrates the "before" and "after" effects of using the Gokhale inner corset technique.

Cynthia Rose: The Gokhale Method for Scoliosis

This is the fourth and final installment of my series that highlights alternative management and treatment techniques for scoliosis, to celebrate Scoliosis Awareness Month. (You can see all of the previous posts here: The Egoscue Method, Yoga for Scoliosis and Nutritious Movement, and Schroth Method and Pilates.) Enjoy this post from Cynthia Rose!

When I was 12 years old, my mother took me to our family doctor for a check up. It wasn’t something we did on a regular basis, but I remember him looking at me and saying, “One of your shoulders slopes down more than the other. Isn’t that interesting!” What’s interesting to me is that the word “scoliosis” never came up in the conversation, nor was there any further investigation. As a 12 year old, I had never heard of scoliosis, so I thought my sloping shoulder was just an oddity I would live with.

It was not until many years later when I returned to school to study massage therapy that I began to notice changes in my spine which manifested as chronic low back pain. I thought it was because of the sitting I was doing in classes, or the crawling around on the floor for shiatsu practice sessions. The pain never really subsided, though I did find temporary relief through body work and the application of heat. It was a very specific type of pain that, although it wasn’t severe pain, it was quite bothersome because it felt relentless.

When I was in my early 40s, I was working with a chiropractor who took a standing X-ray of my complete spine, and this was the first time I could clearly see my scoliosis and how my lumbar vertebrae were compromising my discs. No measurements were taken, so I really don’t know what the progression had been over time. But the pain living on the lower left side of my back and into my left sacroiliac joint was my motivator to do something.

I’m now a licensed acupuncturist and a Bowen therapist, and I approached my back pain in a similar way that I approach my patients’ complaints. I think of a complaint, especially a long standing one, as a puzzle and pay close attention as I observe changes both positive and negative. For my back, some days I felt OK, but inevitably the exact same pain would return. It was difficult for me to just let it be and I kept trying different things to make it better. Exercise became a big part of my life if I did the right amount. Too little exercise meant more pain, but too much exercise had the same effect.

In 2014, I came across a blog in the NYTimes about the Schroth Method. Everything about it sounded promising, and I was ready to look in another direction. I found a group of therapists at Alta Physical Therapy in Manhattan who were all trained in Schroth, and spent about a year alternating with the three therapists in the practice. The sessions I did with them gave me a complete understanding of what was happening in my spine: not only the curves but also the rotations that compensated for the curves. I really began to understand what was weak in my back and how I needed to strengthen and stretch to relieve the pain.

The exercises were changing my upper spine more than the lower spine, and I began to feel there were gaps between doing the exercises and how I moved through my day to day life. I went back to re-read the article in the Times and noticed the many comments below the posting. They included information about other methods, techniques and braces that had helped other readers. I looked through these and clicked on every link. This is where I first heard of the Gokhale Method™. [Lindsey’s note: Pronounced “go-CLAY.”]

The Gokhale Method™ teaches you how to sit, stand, bend, walk, lift and lie in bed with respect to what Esther Gokhale refers to as “primal posture.” This is done by finding the ideal way to stack your bones in relation to gravity so that there is less wear and tear on the structure and less impingement on the intervertebral discs.

For a scoliotic, this can be difficult to feel, but the way the method is taught it can be of benefit to anyone. For me, having a clear picture of the twists and turns in my spine from my Schroth work helped me even more. I had always felt that posture was contributing to my pain, but with the Gokhale Method™ I was able to learn, with clarity, the correct way to position my pelvis and my rib cage to optimize my posture no matter what activity I was doing.

I took the six-lesson Gokhale Foundations Class in December of 2014 about six months into my Schroth sessions, and it made a big difference in how I was feeling and moving through my day. It gave me such clarity about where my body should be in space, and I almost immediately felt improvements in my pain frequency and intensity. The best part was that when I had pain I could ask myself, “How was I using my body that could be causing the pain. And what could I change that would make it go away?” With the Gokhale Method™, I had the specific knowledge as to what I had to change.

In the Gokhale Method™, you learn how to elongate the spine in both passive positions (such as sitting or lying down) or when you are active by using what’s called the inner corset. This elongation will change the shape of the curves in the spine from the scoliosis; putting a positive stressor on the bones and muscles allows them to change in a positive way. For me, this quickly translated to less pain and, over time, I can feel the changes in the muscles on either side of my spine. Please take a look at the pictures below to see my back without and then with my inner corset engaged.

The author demonstrates the "before" and "after" effects of using the Gokhale inner corset technique.

The author demonstrates the Gokhale “inner corset” technique.

The Schroth exercises taught me what it felt like to have my curves evened out and my rotations untwisted. I continued doing the exercises for a while, but eventually felt they were too complicated and needed a lot of props: poles, cushions, and multiple chairs. The Gokhale Method™ taught me how to move with the correct posture to prevent wear and tear on my structure and to reduce my pain. I was able to use what I learned throughout my day, even when I was sleeping.

Not everyone who has scoliosis has pain, as I didn’t until my late 30s. Pain is now my reminder to check how I’m using my body, but I also use mirrors and my reflection in store windows to take a glance at the shape of my spine. Often I will see the return of my old habit of tucking my pelvis or a rounding of my shoulders and can now easily make corrections.

People watching has also become a hobby of mine. The primal posture we teach in the Gokhale Method™ can readily be seen in people who are from a non-industrialized environment. I live in NYC, so there are many of these beautiful people for me to learn from.

The work has had such a profound effect on me that I trained to become a teacher of the Gokhale Method™. It has been a valuable skill for many of my acupuncture patients who have chronic or recurring pain, as I am able to teach them the best posture in a way that gives us a common language to communicate.

There are approximately 50 teachers around the world all trained by Esther Gokhale, so if you would like to know more please visit www.gokhalemethod.com and sign up for a free introductory workshop near where you live. The book “8 Steps to a Pain-Free Back” is also a good way to learn more, though when you are taught by the knowing hands of a trained teacher, you will be able to more fully grasp the depths of this fine work. If there isn’t a teacher near you, I am available to travel, or feel free to contact me with questions.

Cynthia Rose is a licensed acupuncturist, Bowen Therapy practitioner, and Gokhale Method teacher. You can visit her website here.

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A woman places her hands on a younger woman's back to help her improve her posture.

Pilates and the Schroth Method: My Interview with Lise Stolze

Continuing my series this June that highlights different scoliosis alternative therapies, I interviewed Lise Stolz, MPT, DSc,  PMA®-CPT, Schroth Barcelona Scoliosis Therapist, and Polestar Pilates Educator. Many of you have expressed curiosity about the Schroth Method, and Pilates has helped many scoliotics feel relief, so I was very excited to interview Lise, and thankful for the time she took to talk with me. Enjoy!

What is your story? How did you come to work with scoliosis patients?

My interest in scoliosis reached its peak about 12 years ago but there was a lack of continuing education courses about scoliosis for physical therapists.  The current approach was simply to treat scoliosis like a rotational imbalance and use rotation and side bending exercises and stretches to help reduce the asymmetries.  I had heard of the Schroth method and researched and found the only courses offered in the US, through the Barcelona Scoliosis Physical Therapy School (BSPTS).  When I learned of the commitment—both time and financial—I initially decided I did not see enough scoliosis patients to justify the cost.  But my curiosity for this specialized knowledge got the best of me and I took the Level 1 10-day course in Steven’s Point Wisconsin followed by the 6-day level 2 course a year later, where I was required to present a case study.  I was impressed with the information I learned about scoliosis and was surprised at how well patients responded to the Schroth Method.  I immediately began to see more scoliosis patients who were searching for alternative therapies online and found that I practiced the Schroth method.  Now my practice is about 60% scoliosis patients.

How long have you been in practice? 23 years.

What is the Schroth Method, and why does it work?  The Schroth method was founded by Katharina Schroth in Germany in 1921 and developed futher by her daughter Christa Lehnert-Schroth in the 70s. Katharina Schroth had scoliosis herself and used the image of a collapsed ball to represent her scoliosis concavity.  She imagined breathing into this ball and used internal movements to expand and de-collapse the concavity.  She called it orthopedic breathing, which now is now called rotational angular breathing.

Her daughter Christa Lehnert Schroth wrote the book “Three-Dimensional Treatment for Scoliosis,” which describes the method and contains pictures of patients she and her mother worked with in Germany.  The book is notorious for its complexity and many of the exercise positions are not used today.  The Schroth method focuses on elongation and expansion to counteract the force of gravity which constantly forces compression on the spine and scoliosis concavities.  The patient with scoliosis is taught to understand their specific scoliosis curve pattern and use specific exercises and breath to make active postural corrections to the spine and rib cage.  The neuromuscular activity is a concentric force on the convex side of the curve and eccentric contraction on the concave side.

The goal is improved posture with a more centered alignment, resulting in less compressive force on the spine.  Corrective exercises are performed in a neutral position of the spine for the most effective expansion. Scoliosis consists of both inter-vertebral torsion (rotation of one vertebra relative to another) and intra-vertebral torsion (an internal rotational distortion within each vertebra), most notable at the apical vertebra (apex of the curve). This distortion contributes to less movement at the apex of the curve ,and more at the transition points of the curve. Schroth scoliosis-specific exercise has the affect of stabilizing the transition points, where movement occurs too much, and expanding the concavity at the apex of the curve.

How do you blend Pilates with Schroth to help your scoliosis patients?  Once a patient understands their curve type, is independent with their specific Schroth exercises, and can maintain a better posture with daily activities, then they can apply this posture to any exercise or activity they like.  However, caution should be taken with exercises and activities that tend to increase curve compression such as end range motion in any plane (extreme twisting, side bending extension and flexion).  Pilates exercises can easily be modified to minimize these positions.  Since Pilates exercises emphasize similar principles to the Schroth method such as breathing, alignment, and axial elongation, they can easily support the scoliosis corrective postural positions.

However, many sports activities such as dance and gymnastics involve many compressive positions. That is why each person must be evaluated for the risk that their chosen activity will bring to their scoliosis. Considerations for age, curve type, activity frequency, and muscle imbalances must be taken. Everyone with scoliosis should be free to enjoy activities that provide quality of life and should be educated about scoliosis spine mechanics and progression, to help them make an informed decision about which activity might be best for them.

Why Pilates for scoliosis? Why not yoga, dance, or other “whole body” workout method?  Adaptations for the person with scoliosis can also be applied to yoga and other activities.  It is worth repeating that those activities that provide quality of life such as dance, swimming, tennis, etc. may be continued (subject to a full evaluation to determine individual appropriateness) as long as risks associated with compressive movements are understood and axial elongation is practiced at all times during these activities.

Who is a good candidate for this treatment? Who is not a good candidate for this treatment? Most people with idiopathic scoliosis can benefit from Schroth therapy; however, the method requires attention and discipline. Those who may not be good candidates are children under the age of 9 or those with cognitive impairments.

What’s the biggest success you’ve had to date with a scoliosis patient?  Every adolescent is a big success if they reach bone maturity without progressing to surgery.  I also consider every adult with pain who can mitigate pain through Schroth therapy a great success.

Are you available to work with long-distance patients (Skype, etc.)?  All patients must be seen in clinic for this treatment. It is a “hands-on” technique that provides tactile proprioceptive feedback to facilitate opening of concavities through. Once this neuromuscular re-patterning is learned, it can easily be duplicated at home. Some patients have traveled and stayed a week at a time for intensive training, and returned to advance the exercises when they are ready.

For people who are interested, where can they find you? Are you offering any special classes or other services/products you’d like to promote here?

www.stolzetherapies.com

lise at stolzetherapies dot com

Photo of Lise Stolze.

Lise Stolze.

Picture of author Lori Robbins. Her head is bowed, eyes closed, with her hands together like in prayer.

Lori Robbins: Yoga for Scoliosis and Nutritious Movement

In honor of Scoliosis Awareness Month, I’ve invited several guest authors from different postural alignment methods to write about their techniques, their stories, and more.

This week I’m featuring Lori Robbins, a Certified Restorative Exercise™ Specialist with Katy Bowman’s Nutritious Movement method and a Certified “Yoga for Scoliosis” Teacher with Elise Miller. Read on!

If you have scoliosis, you may have already discovered that movement and exercise can help reduce your discomfort.

Most movement programs will offer some benefit for scoliosis. The key is to first discover and understand the forces that are being placed on your spine. Once you understand this, you can move to counter the forces instead of letting them dictate.

I have been able to manage and alleviate the symptoms of my own scoliosis through “Yoga for Scoliosis” with Elise Miller and “Nutritious Movement™” with Katy Bowman. I have become a certified teacher in both programs, and can discuss the difference and similarities between them.

Yoga is a wonderful and beneficial practice that strengthens and stretches. “Yoga for Scoliosis” modifies and enhances traditional yoga so that a student with scoliosis can practice mindfully to avoid injury.

Practicing “Yoga for Scoliosis” can help a student regain strength in and access to muscles and organs that are underused because of the dynamics of scoliosis. While a student may experience a reduction in their curve with this practice, the aim is health, vitality and strength.

Elise Miller writes: “The goal of a yoga practice should not be to straighten our backs; we must learn to accept them as they are, not deny them or judge them. Instead, we must work to understand our backs and relate to them with sensitivity and awareness.”

A “Yoga for Scoliosis” class emphasizes five areas: Feet and legs, spine, psoas, scapula and breath.

Nutritious Movement™ is a biomechanical movement program created by Katy Bowman. Her teachings and books provide a model of preventive and corrective exercises with an emphasis on body alignment for optimal benefit.

Movement, just like food, provides the mechanical requirement for human tissues to thrive. Moving invigorates our tissues, cells and bones. It also hydrates and removes waste. It provides the essential vitamins for a healthy body.

“Chew your food” is a common saying. Most of us have also heard advice like, “Stand up straight,” but we rarely get detailed instructions. Since we do not hunt and gather but rather sit and type, many of us have forgotten or never learned how to move well.

If you have scoliosis, this advice takes on significant message for everyday habits and movement patterns. The hope is that practicing the corrective exercises in Nutritious Movement™ can eventually help you move with better alignment throughout your day.

If you develop a consistent practice, both “Yoga for Scoliosis” (YFS) and Nutritious Movement™ (NM) can help you train your body so that you do not fall into movement patterns that allow your curve to dictate.

The following lists examples of the different ways each addresses alignment, strength and health. Please note that these are only examples for education, and not prescription. Every individual is different, and their needs and abilities are different, so these following examples are for education only.

Alignment and standing
YFS: Tadasana
NM: Using alignment points while standing

Balance and leg strength
YFS: Tree Pose
NM: Listing (standing on one foot using the hip)

Spinal lengthening
YFS: Lengthening in Downward Dog with assistance from a partner or hanging on yoga ropes
NM: Hanging from monkey bars or tree branches

Flexible, strong feet
YFS: Inter-digit toes or Warrior One with feet up wall
NM: Walking barefoot on uneven surfaces or using the Top of Foot Stretch

Spinal flexibility and twisting
YFS: Cat/Cow or Spinal Twist
NM: Walking with proper arm swing

Abdominals
YFS: Opposite Arm/Leg, Spinal Twist
NM: Transverse abdominal activation

Psoas
YFS: Warrior One and lunge
NM: Lunge and psoas stretch

Scapula
YFS: Gomukhasana, and standing stretch with one hand at the wall
NM: Rhomboid push up

Breath
YFS: Pranayama
NM: Transverse abdominal activation

Yoga for Scoliosis and Nutritious Movement™ can offer relief for students with curved spines. The two are complementary and a student can practice both. If you decide you would like to concentrate on one, I suggest choosing based on your personal preferences and goals.

A good place to start would be to check out “Yoga for Scoliosis” by Elise Miller, or “Move your DNA” by Katy Bowman.

Happy moving!

Picture of author Lori Robbins. Her head is bowed, eyes closed, with her hands together like in prayer.

With humor and compassion, Lori empowers her students to heal and strengthen themselves. Her classes emphasize body mechanics as path to freedom from pain for all ages and experience. Her unique perspective and teaching style formed after an injury that required fusion of her lumbar and thoracic spine. She comes to teaching with the powerful combination of being Certified Restorative Exercise™ Specialist with Katy Bowman and a Certified “Yoga for Scoliosis” Teacher with Elise Miller. Visit her website at www.yogirelease.com.

Disclaimer: This post has been written for informational purposes only. In no way should it be used as a substitute for consultation with medical and health care professionals. Please consult your medical and healthcare professional before beginning any health or exercise program.

Three photos showing the before, immediately after, and "after" after results of doing my Egoscue exercises for my scoliosis, all within one day.

(2017) Egoscue Method for Scoliosis – My Review

Happy National Scoliosis Awareness Month!

It’s been nearly three years since I first wrote “My Egoscue Experience: An Honest Review,” so I figured, what better time than this month to give y’all an update on my progress with the Egoscue Method for my scoliosis?

Much has changed since I last wrote. I became a Postural Alignment Specialist (PAS) certified through Egoscue University, I’m opening my own practice (more on that, eventually!) so I can work with my own clients, and I’ve become better educated about my scoliosis and where the Egoscue Method helps, and where I’m looking to round out my education to help my clients, and my own healing process.

Lessons learned since my last review

  • Walking, and movement in general, are always a good idea for me. “Duh, Lindsey,” you say, but like most scoliotics, it’s easy for me to believe that less movement =  less discomfort, which for me is true in the short run, but devastating in the long run.
  • Moving during my workday makes a huge difference. Again, “duh.” But recently, I prioritized movement through my workday, and it’s helped me end my days in little to no pain or discomfort. I love hanging from my pull-up bar, doing functional “runs” in my apartment, crawling on the floor, doing low squats, lying in Static Back for 5-10 minutes, and whatever else I can quickly fit in. (The Stand Up app has really helped remind me to move, even when I’m immersed in work!)
  • There are many wonderful postural alignment modalities out there that complement Egoscue. But more on this in a moment ;).

What’s new?

Oh, my spine is still stupid, of course—this condition still doesn’t have a lot of research on it, and no known cures—but I’m glad to say that I’m probably the most comfortable I’ve ever been, and a big part of that has to do with the fact I’ve been working on and listening to my body’s needs for close to 7 years.

I have some recent photos of my scoliosis progress. These photos (below) were taken (from left to right) before, after, and a few hours after again, my regular Egoscue Skype session with my therapist (the wonderful Theresa Mathes at Egoscue Austin).

I was pretty messed up when I started the session. A combination of not doing my Egoscue exercises regularly, coupled with bad sleep and a lot of stress meant that my ribcage was twisted and sticking me in the lungs (“Full breaths? Not for you!”), my hips were terribly uneven, my head was really far forward of my body (which was killing my shoulders and neck), and my femurs were rotated due to my hips being so misaligned, which caused knee pain and an uneven gait when I walked.

The exercises Theresa gave me helped a lot, and as you can see in the middle photo, my body had adjusted, but it was resisting the changes I was asking it to keep, so within 3-4 hours, the twisting and misalignments started creeping back in, causing pain and shortness of breath.

“To heck with it,” I thought. “I’m a PAS now, and I can feel what my body needs. I’ll come up with my own exercise menu!” (See what a benefit it is to be certified in your chosen postural alignment modality?)

So I hit back—hard. And here were the results. Keep in mind,  my session with Theresa happened in the morning, and I came up with my own menu by late that same afternoon, which means these changes happened within HOURS of each other*. My body is now used to responding to the changes I ask it to make (well, except those days when it’s being particularly ornery), so this is the benefit of doing my Egoscue exercises regularly:

Three photos showing the before, immediately after, and "after" after results of doing my Egoscue exercises for my scoliosis, all within one day.

Before my therapy session, right after, and several hours later, after adding in my own Egoscue exercises.

I overlaid some lines to make the changes more clear, but I do apologize for the poor resolution on the first two photos—Theresa took those with her computer’s camera, and the last one I took with my phone.

Maybe I’m biased, but I’d say that’s a great improvement in less than 12 hours!

This is what I still love about Egoscue, even after several years: It grows and changes with my needs, and it’s something I can work on and experience changes with every day.

While I’m now exploring incorporating more modalities to complement and hopefully improve my healing even more—Nutritious Movement‘s methods for little postural corrections throughout my day, the Yoga Trapeze because I’ve heard great things about inversion therapy for back issues, and MovNat or Patch Fitness for natural movement exercises—the Egoscue Method continues to impress me with how adaptable it is to my ever-changing needs.

However…

Did you know there are more postural alignment therapies out there? You’ve maybe heard of the Schroth Method, but what about the Feldenkrais Method? The Alexander Technique? Yoga for Scoliosis? The Gokhale Method?

There are more, but I’m taking this month to highlight three of these postural alignment modalities on my blog.

Each week, I’ll share a post written by a practitioner in one of these alternative fields, to help you better understand these methods, and open an opportunity for you to explore them more!**

I love the Egoscue Method, but thousands of people, including scoliotics, have been helped by these other methods, too, and it’s terrible that not enough people know about these options, to make better-informed decisions about their own health.

Part of this blog’s mission is to highlight these other methods so you can decide for yourself if you’re interested to research them further, so I’m really excited to host this series on Young, Wild and Pain-Free!

Next week: We’ll kick things off with Lori Robbins, a certified Yoga for Scoliosis teacher and certified Restorative Exercise Specialist through Katy Bowman’s Nutritious Movement Center. Lori will discuss her backstory, and why she believes yoga and “nutritious movements” can be beneficial to scoliotics.

Don’t miss it! See you next week!

 

*Results not typical. It’s taken me YEARS of working with my body to get it respond this quickly, but when I first started, I would feel relief after doing my Egoscue exercises, but it would take weeks to get it to respond this rapidly after only a few hours.

**Disclaimer: These posts will be meant for inspiration, not instruction, only. Consult your medical professional before attempting any of the methods, techniques or exercises discussed in this or any past or future blog posts.