Encouraging news for those with scoliosis, and valuable information for yoga and Pilates instructors who have clients with scoliosis: Regularly performing a yoga side-plank pose on the convex side of the primary curve can significantly reduce the curve’s angle in people with scoliosis, according to research published in Global Advances in Health and Medicine (2014; 3 , 16–21; doi: 10.7453/gahmj.2013.064).
Lead study author Loren Fishman, MD, medical director of Manhattan Physical Medicine and Rehabilitation and teacher at Columbia Medical School in New York, told IDEA Fitness Journal, “Since scoliosis is an asymmetrical condition, I . . . treated it asymmetrically, asking patients to do the pose on the weaker side only. That strengthens the specific spinal muscles on the convex side that are needed to help with curve reduction. While the National Scoliosis Foundation recommends 25 yoga poses, it does not cite clinical results and does not suggest that the poses be done asymmetrically.”
Fishman’s findings were based on a study of 25 adolescent and adult patients with idiopathic or degenerative scoliosis. Each participant agreed to perform one yoga pose at least once daily. Investigators took scoliosis radiographs before treatment and at the conclusion of the intervention for each participant, which ranged from 3 to 22 months later.
“The time difference among participants in getting a second X-ray was due to the fact that some participants lived far away, were children and/or had intercurrent illnesses,” Fishman said. “The X-rays were all done by independent radiologists who knew nothing of the study. Our instructions were to have a repeat • X-ray in 3 months.” Nineteen patients successfully completed the trial and practiced the pose more than three times a week for an average of 7 months. In this group, adolescents improved 49.6% and adults improved 38.4%.
Conventional treatment recommendations for scoliosis include bracing for patients with curves in the 25- to 45-degree range, and surgery for patients with curves greater than 45 degrees. For those wearing a brace, participation in 2-hour exercise sessions three times per week for 3–4 months is required, after which patients are urged to continue exercising for 30 minutes per day for the rest of their lives.
“Since many scoliosis patients are adolescent girls,” said Fishman, “the unwieldy bracing and lengthy exercising are socially awkward, emotionally painful and physically difficult. And yet untreated scoliosis can progress at 7% per year and result in disability and life-threatening health risks.”
Fishman recommends that instructors who are approached for training by a person with scoliosis should make an effort to speak to the client’s doctor and make some teaching modifications.
When speaking with a client’s physician, says Fishman, there should be three objectives:
- to learn of other conditions that may affect the client’s safe participation in yoga
- to understand the patient’s curves: where they are and their measurements in degrees
- to recommend to the physician that a follow-up X-ray be done in 3 months
Fishman advises instructors to modify exercises for clients with scoliosis as follows:
- Limit side plans to the weaker side. The whole point is to do the exercise only on the convex side of the lower curve (of the S shape). The back must be asymmetrically strengthened. If someone with scoliosis is in a class where participants do the side plank on both sides, then the person should do it again on the same side when the class is doing it on the other side. General core work—such as planks and bridging—can be done together with other students.
- Encourage people with scoliosis to raise the upper-side (concave-side) ribs toward the ceiling, and to hold the pose for as long as they can to maximize the strengthening effect. During the pose, the quadratus lumborum muscle should be tight and hard on the convex side, but softer and more pliant on the concave side. The study’s limitations included
Its lack of a control group, the small number of participants, and reliance on self-reporting by subjects regarding adherence. More research is needed.