Corrective gymnastics and exercises for scoliosis are fundamental to reduce scoliotic spinal curvature, maintain correction and avoid deterioration.
The exercises are performed in different positions: in a quadruped position, lying down, sitting or standing.
There are methods that only provide exercises in the quadruped position, but this is not enough.
It is also necessary to work standing and sitting so that the posture of the child/adolescent is corrected even in normal everyday situations.
The muscles on the concave side are shortened and maintain the obliquity of the vertebrae on the side of the scoliosis curve; therefore, it is necessary to perform exercises and adopt postural positions that lengthen the muscles.
It is important to let the muscles that have been overstretched by the curve convexity work in a shortened position and, conversely, to stretch the muscles located in the concave part of the curve.
Among the various exercises and postural positions, active elongation plays an important role, i.e. moving the head and sacrum in opposite directions.
Weights can be lifted over the child’s/adolescent’s head or the spine can be stretched and straightened under instruction.
This also gradually improves the sitting position during everyday activities.
The exercises can be divided into two large groups:
- The symmetrical exercises are performed on both sides of the back and neck;
- The asymmetrical exercises are performed with only one shoulder or hip, so that mainly the muscles are stressed by only one side of the trunk. Especially the more serious cases have to perform mainly asymmetric exercises, while the patients with a less pronounced curvature of the spine practically only perform symmetrical exercises.
Contents
How is corrective gymnastics performed and what are the treatment goals?
The scoliosis patient must first become aware of the curvature of his spine so that he can correct it and eliminate the back pain.
For this purpose, aids are used, such as the orthopedic mirror, photos and the wall.
The patient must regularly perform a program of corrective gymnastic exercises.
It is important to correct the daily attitude; for this purpose, scoliosis-reducing positions are preferably taken and worsening positions are avoided.
Exercises to improve balance stimulate the sense of balance and make the child or adolescent perceive the position of the individual parts of the body and adopt a correct posture.
An important area of corrective gymnastics is the strengthening of the muscles, especially the back, lumbar and abdominal muscles, because they form a tonic muscular corset that supports the spine and slows down the progression of scoliosis.
The anterior trunk muscles (abdominal muscles, intercostal muscles, hip flexors) originate from the vertebrae and ribs, so one must not concentrate exclusively on the posterior back muscle strip, because this would lead to a muscular imbalance and strength deficit in certain movements.
Within the framework of corrective gymnastics, various methods can be followed: Klapp, Niederhoffer, Iop, etc., because none of these systems is completely perfect; each method has its advantages and disadvantages, but they complement each other.
Which exercises are finally performed depends on the type of scoliosis and must be adapted over time to the developments of the scoliosis curve.
In severe cases, the orthopedist will recommend surgical intervention or the use of a corset or orthosis, which is intended to stop the progression of curves and straighten the spine as much as possible.
What is the exercise program like before using the corset?
The corrective activity consists mainly of asymmetric and isometric exercises, traction and stretching of the spine, movements on all spatial planes (stretching, bending, sideways inclination, turning, etc.), strengthening of the abdominal muscles.
Not to mention the preparatory exercises for rehabilitation of the respiratory system.
What is the exercise program with corset?
Vertebral manipulation of the spine is not recommended, even if a corset is worn, because it would be like “shaking the leaning tower of Pisa”; if the balance is unstable, the situation can worsen.
That is why isometric contractions of the lumbar, back, chest and abdominal muscles are performed, which consolidate the treatment results obtained through the corset; in this way, the spine is prevented from curving again when the corset is removed.
In order to increase the stability of the patient, some mobilization and muscle building exercises for shoulder and hip are integrated into the program.
The child/adolescent must learn to perceive the new curvature of the spine and develop better coordination with the help of targeted measures.
Also, breathing must be corrected, the patient must breathe into the free part of the corset, that is, into the concave side of the body.
How is scoliosis correction carried out according to the folding method?
The folding method is based on the observation of animals that spend their lives on all fours (dogs, cats, lions, etc.): they do not suffer from scoliosis; that’s why he lets his patients take the quadruped stand.
This position has the following advantages:
- abolition of the effect of gravity;
- Back and trunk muscles are relaxed because they do not have to carry the weight or maintain balance;
- the spine is more mobile.
The tilt of the upper body forward converts the lordosis of the lumbar spine into kyphosis and blocks lateral movements; so you can concentrate on the movements of the upper back.
How is scoliosis correction carried out according to the Niederhoffer method?
The method according to Niederhoffer is based on the principle that the one-sided execution of elongation exercises of the spine and muscles are not sufficient.
There are two muscle groups in the back that act differently and complementarily to each other:
- muscles originating from the upper ribs and vertebrae, attaching to the lower ribs and vertebrae or pelvis, and running vertically;
- muscles that originate from the vertebrae and attach to the shoulder blade or limbs; they have a horizontal course.
In a spine with left curvature, the horizontal muscles of the left side are contracted and stretched to counteract gravity, while the muscles on the right side break down (hypotrophy) because they are used less.
How is scoliosis correction carried out according to the IOP method?
The IOP method is a further development of Klapp’s concept and is based on the principle that the position on all fours does not guarantee good execution of the exercises if only one hand and one knee are supported.
The child/adolescent must be able to sit both hands and both knees; if the leg is stretched, the foot must remain on the ground and not stand in the air.
The arms can be raised when they find support on the wall bars.
Bending the hip or just a lower limb allows the correction to be shifted from the upper back to the lower lumbar region.
Lifting one shoulder or hip in relation to the other cancels out the vertebral rotation caused by scoliosis.
What sport can a scoliosis patient practice?
In any case, competitive sports are not recommended, because the scoliose curvature can develop even further. If the competitive component is eliminated, the sport can help to avoid feeling limited by the deformity by interacting with other children.
Suitable sports are basketball, where a body extension takes place upwards, karate, because here a straight posture must be taken and golf, because it takes place in the fresh air and requires asymmetrical movements.
Swimming does not hurt. In the 80s and 90s, doctors recommended swimming because it was thought it would straighten the spine.
In recent years, it has turned out that swimming cannot actually correct the spine because the movement is very symmetrical, and the natural life situation of the child is not modeled and thus cannot help to correct the posture.
