E12: Yoga for Scoliosis

Dr. Andrew Strauss is our co-host for episode 12 of Life Beyond the Curve, Yoga for Scoliosis. As a life-long practitioner of yoga and a CLEAR-certified chiropractor, Dr. Andrew is the perfect co-host for this topic. 


Throughout episode 12, Dr. Andrew and Ashley Brewer, the Executive Director of CLEAR Scoliosis Institute, discuss:

  • The Importance of knowing your scoliosis pattern
  • Why you should work with a professional when practicing yoga for scoliosis
  • How self-awareness is one of the keys to success when it comes to practicing yoga for scoliosis
  • The do's and don'ts of yoga when you have scoliosis

If you love yoga and you have scoliosis, this is the episode for you. If you're looking for methods of pain relief and curve management, consider tuning in. Enjoy the show!

Additional Resources

Blog Articles by Dr. Andrew Strauss

Hudson Valley Scoliosis Correction Center

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Episode 12 Transcript

Ashley B (00:00):

Hello, listeners, Ashley Brewer here, Executive Director of CLEAR Scoliosis Institute. When I recorded episode 12, I had the privilege of meeting with Dr. Andrew Strauss, who is the Vice Chairman of the Board of Directors for CLEAR Scoliosis Institute. Now, he's also the director of Hudson Valley Scoliosis Correction Center in New York, and has been actively engaged in scoliosis treatment for the past 37 years. Now, in fact, Dr. Strauss has even authored two books on the subject of scoliosis and they are "Your Child has Scoliosis", and "The Truth About Adult Scoliosis". During this recording, I got to talk to him about a topic of which I have absolutely no familiarity, and that is yoga for scoliosis. Now, I hope you enjoy this episode as much as I do, and I am looking forward to learning more from Dr. Andrew in the future about yoga and scoliosis. Episode 12, here we go.

Intro (01:13):

You're listening to Life Beyond the Curve, a podcast brought to you by CLEAR Scoliosis Institute. Each week, we interview experts in the industry, answer your pressing questions, and empower you to take control of your scoliosis diagnosis and live life to its fullest. Enjoy the show.

Ashley B (01:44):

Dr. Andrew, thank you so much for joining me today on Life Beyond the Curve.

Dr. Strauss (01:49):

Yeah, I'm very happy to be here, Ashley. It's a topic that I really enjoy speaking about.

Ashley B (01:54):

Yeah, I'm really excited, too, but you're gonna kind of have to bear with me because today we are talking about yoga for scoliosis, and if I am 100% honest with you, I have never done yoga before. So I'm a complete rookie at this topic, and I might ask you some dumb questions. So I apologize in advance, but I know that as a doctor who provides non-invasive scoliosis treatment, and you've mentioned to me, you do yoga every day for an hour, that you are often asked about using yoga as a treatment for scoliosis. I'm sure you hear things like, does it work? Is it helpful? Can it actually treat scoliosis? Let's talk about this for just a little bit.

Dr. Strauss (02:37):

So, yes, a lot of people do ask me about it. The patients know that I do yoga probably because they see it on the website. But yoga for scoliosis is something that's been around for a very long time. And what's interesting is that a lot of the modern techniques are using aspects of yoga for scoliosis. Now, obviously yoga has been around a lot longer than these modern exercise-based programs for scoliosis, and they use those things. For example, body awareness. The one of the underlying principles of SEAS (Scientific Exercise Applied to Scoliosis) is to create body awareness, to be able to train a person so that they can consciously de-rotate their curve and lengthen their spine. Well, this is really what yoga for scoliosis is all about. So when a person is learning a technique, a exercise-based program for scoliosis, it's often really simplified.

Dr. Strauss (03:32):

And the reason for that is we don't want to make it too difficult for the person to do. If a person is motivated and they want to do yoga for scoliosis, well, this takes them into a whole nother level. Here. They can really work with their body. They're going to create a lot of body awareness and they're going to be using skills that can really help them to de-rotate, lengthen, and stabilize their spine. Is it a complete treatment for scoliosis? Well, unfortunately, I gotta say absolutely not. It is not a complete program, but it has a lot of positive things to offer. So when it's used in conjunction with the other aspects of a specific scoliosis exercise-based program, it's a powerful, powerful tool. Not for everybody, a lot of people, they don't want to get into the complexity of it, but there's other people who crave it and for them, it's amazing.

Ashley B (04:22):

So let's talk about what you just hinted at for a second there, using yoga for scoliosis as a method to slow a curve's progression. You just got at it's not a complete treatment. What needs to happen for that to actually be possible, for it to be effective?

Dr. Strauss (04:39):

One of the main things is that we need to stabilize the core. We need to strengthen the muscles. We need to teach the person posture re-education. We need to stretch and lengthen the tissues, not only the spine, but the actual spinal cord itself in many cases. So yoga can assist with all of those processes, but it's not the total package.

Ashley B (05:00):

Abraham Maslow from Maslow's hierarchy of needs once said, "what is necessary to change a person is to change his awareness of himself." And I think this is especially true for anything in our lives, but it definitely applies to our topic for today, yoga for scoliosis, because, and again, I'm a rookie, but from everything I've looked at online and researched, and the understanding that I have gained, an important part of practicing yoga for scoliosis is a patient or an individual being aware of his or her own scoliosis pattern. So what are the common scoliosis patterns that you see and how, like if I had scoliosis, how would I know that information?

Dr. Strauss (05:47):

Okay. So first of all, I really agree with you that body awareness is key to successful yoga for scoliosis. And in order to have body awareness, the person really needs to know exactly what they're working on. Obviously, if you have an x-ray, if you have somebody who can explain that to you, somebody who can touch your back and say, this is here and that is there, and this is what's going on with your back, that would be the number one way for you to achieve that body awareness. And this is what I do in the office is we'll print out an x-ray of the patient, we'll print out a copy of their posture. We'll show them the connection about what's going on with their back and this instructs them on how to do the yoga properly. So what are the common curve patterns? We know that almost 95% of curves in the upper back are going to go to the right.

Dr. Strauss (06:40):

And the theory is that it's trying to, the body is trying to protect itself. The body has an innate intelligence that wants to avoid putting any compression onto the heart. If we see the curve going to the left and the upper back, that's a red flag, we got to look deeper to see, is there something else going on there? And the lower back, the opposite, the large majority of curves are going to go to the left. This is in children. In adults, interestingly, if the curve starts later in life, if this is a degenerative curve that starts maybe in the fifties or sixties, all bets are off with these lower back curves. We have half going to the right half going to the left. If we have an adult who has the remnant of their childhood curve still with them, in other words, they had adolescent scoliosis, for example, well, it doesn't just go away. So as they become older, now they're an adult. Would that curve and the same patterns that we see in children, we're all going to be present in those adults.

Ashley B (07:37):

That makes sense. So let's talk about the basics of yoga for scoliosis. I assume like with any other condition, you have things that you should be really, really careful about, but then there are things that you should do, your do's and your don'ts. So you recently wrote an article for CLEAR about yoga for scoliosis in adults, and you referenced seven poses or best practices for yoga, for scoliosis. I'd like to know what those are. And since this is audio only, if you can do your best to describe them and kind of paint a word picture for me and our listeners, that would be awesome.

Dr. Strauss (08:17):

Okay. So I'm going to use the English, not the, not the Sanskrit names. I'm not going to call it Vierra Bhadrasana.

Ashley B (08:28):

I appreciate that. Reading some of your articles. I was like, Whoa, I'm have no idea what he's talking about. It sounds cool, but I don't know what this means.

Dr. Strauss (08:36):

Right. So they're, they're common names for all of these postures, but the essential idea here is that number one, we want the person to be very conscious of their breathing. This is kind of a basic underlying principle as we're going through yoga is that the person has to be very aware of their breathing and even directing their breathing to expand the contracted parts of their rib cage. Number two, we want to lengthen the spine. This is a powerful, uh, effective yoga done properly. And almost all people with scoliosis are gonna feel compression. You know, gravity is pushing down on our heads all the time. And if you have a straight spine, you deal with it. We were, we were built to ha--to deal with that. But if you have a scoliosis, that pressure of gravity on your spine all day becomes compressive and doing yoga is a tremendous relief because it can effectively lengthen the spine.

Dr. Strauss (09:34):

And here we're going to be using, uh, postures like, um, Trikonasana. We're going to be using forward bending postures, like, uh, like, um, a head to knee. Trikonasana, by the way, sorry, is triangle pose back into the Sanskrit name there for a second. Um, the next thing that we want to really focus on is core strengthening. All of the research is telling us that it is very important for a person to have core strength. And the interesting thing is what's the best exercise for the person to do? Well, the one that they really will do, the one that they enjoy doing. So there really aren't too many rules about do's and don'ts with regard to the exercises. Okay, you don't want to do a lot of twisting. You don't want to do like long distance running. You could do swimming. You could even do one sided sports, for example, like tennis. It's still gonna really help with the core strengthening aspect because the body will not allow the dominant side to be more than about 10% stronger than the dom--the not the non-dominant side. Like if we see somebody like Serena, we don't see her with a huge built-up right side and a small withered up left side. She looks proportional because she knows if she wants to strengthen her right side, she has to strengthen her left side to allow the right side to get stronger.

Ashley B (10:50):

I know that's a common theme with scoliosis is just making sure that you're not doing something on one side of your body, more than the other. And you're again aware of that, going back to the awareness factor.

Dr. Strauss (11:00):

Yeah. Yeah. And so, so again, if what the person enjoys doing is yoga, well, that's fantastic. It's not the only way to exercise for scoliosis, but it's an effective way to strengthen the core. And here we're going to be using things like plank pose. These, these will will cause great strengthening of the abdominals and all the back muscles. So then there's a few that I think that are, that are good. What you asked me about what things people should be aware of.

Ashley B (11:30):

Yes. So, uh, painting a word picture of the things, the best practices for scoliosis. So you've gone through breathwork, lengthening the spine, core strengthening exercises. Um, you referenced some specific poses. Let's talk about these. So you talked about the warrior pose. So I, I do know that one. I think I know that one, but if you could describe that for somebody who's listening, that'd be awesome.

Dr. Strauss (11:55):

Okay. So that's also the, the Sanskrit name for that is Virabhadrasana. And here, the person is standing with their feet about four feet apart. Their one foot is pointing directly in front of them and the other foot is pointing to the side. Now they're going to extend down into that foot, into that foot that's bent out to the side, so that their knee is directly over the ankle, keeping their up their upper body upright. And they they're going to stretch out their arms to lengthen their body. And this is the, this is essentially the pose.

Ashley B (12:30):

And that makes sense, considering the lengthening of the spine you talked about. So in your article, you referenced warrior poses, core strengthening poses, which we talked about, a hamstring and calf stretching poses. Does that tie into the lengthening of the spine? Or where does that come in?

Dr. Strauss (12:45):

Okay. So due to the, the abnormal posture, many people with a scoliosis are going to have issues with their lower back, pain in the lower back, pain in the pelvic joints, the sacroiliac joints. And what happens is the hamstrings and the calves really shorten to try to stabilize those areas and to protect them. But it also makes them very fragile. It makes them very weak because any kind of strains that they do, because they don't have any length in their hamstrings, they're very prone to injuring their lower backs. So by lengthening the hamstrings, they're giving themselves room to move, they're preventing injury, they're helping relieve lower back pain and pain associated with the sacroiliac joints.

Ashley B (13:29):

It's interesting that you say that because I, I, I'm a smaller human just by build and I've never had like a very strong core until recently, but I've also have horrible flexibility in my hamstrings and my calves. And I injured myself while I was working out. I got a herniated disc in my low back. And now that you're saying this, it all makes sense. And it all ties together. So maybe I do need to practice yoga.

Dr. Strauss (13:58):

Yeah. It's a, it's a great tool. It's, uh, it's something to look at. It's definitely something to look into and see, it's not for everybody, but for me, I love it. I find that I do a lots of different types of exercises, but I always come back to my yoga. For some reason, it just really agrees with me. And I love it.

Ashley B (14:16):

Now, you also talked in one of your articles about some things you need to just practice with caution or pay extra attention to when you're practicing yoga, you brought up one of these things, torsion or twisting of your spine. The other was loss of normal spinal curves, degeneration, and sacroiliac instability. Can we talk about why someone who has scoliosis may need to focus on those things or be extra careful when it comes to those things?

Dr. Strauss (14:45):

Right. So this is all part of the body awareness that we want to, we want to bring out in a person who's doing yoga for scoliosis. We want them to be able to maintain the normal curves. Now scoliosis is an abnormal curve, but we also have normal curves in our spine. We have a normal forward curve in the neck and lower back and a normal backward curve in the upper back. And those curves are protective. Many people with scoliosis lose those curves. It's--I would say almost all, really. When we see a kid with a significant curve in their middle back, for example, their back is going to be very, very flattened, unstable, and weak.

Ashley B (15:22):

Is that just the normal compensation that happens in the body?

Dr. Strauss (15:26):

Exactly right. We call it a flat back and it's really very, very common. And then they also are going to lose the curve in their neck. Lower back? Some of them are going to have excessive curve in the lower back. Adults are going to have a flattening even of that curve in the lower back. So we want them to be aware of that and maintain that and not do postures that are going to aggravate or make that, make that even flatter than it is already. Um, like I was just saying sacroliac instability, especially in adults, very, very common. That's, that's probably the number one lower back pain symptom that adults with scoliosis will come in with. So we want to stabilize that. We want to be careful when we do the postures, not to put too much strain on the SI joints so that they can, uh, not, not aggravate them and strengthen them. We'll often even have the person wear a sacroiliac belt, while they're doing the yoga to stabilize them.

Ashley B (16:22):

That's interesting. Now let's talk about torsion or twisting in the discs. Why would somebody need to be cognizant of that?

Dr. Strauss (16:31):

Research tells us that if the torsion or the twisting of the spine exceeds around 20 degrees, which is really not that much, we start to get weakness in the discs. We start to get disc bulging and herniations this again, a very, very common symptom that adults with scoliosis will present with. So we have to be really careful with the twisting postures because that if we want it, we want to protect them. If we increase that twisting, we're going to possibly cause problems for them. So it's very important that the person know how their spine is twisted and only do the twist to untwist the spine, not to increase the twisting.

Ashley B (17:10):

Now let's talk a little bit to the last one was degeneration. And I think this kind of, and correct me if I'm wrong, but ties into pain. I know adults frequently have pain when they have scoliosis where that's maybe not the case with adolescents. Let's talk a little bit about that. Cause I would assume that many adults practice yoga for scoliosis, not only to help stabilize the curve, but also to reduce some of the pain that may be associated with it.

Dr. Strauss (17:37):

Okay. So ironically, there is often not pain associated with this kind of degeneration. Interesting is that we will often find patients that have spurring and degenerative changes in their spine and really not giving them any problem. I'll say to them, Do you have any issues in that area? No, my problem is over here. I don't really have any problems in that area. Well, that's where they have their degenerative changes. Now, okay, once the degeneration becomes more significant, once you start to get what's called stenosis where the bony degenerative changes will start to encroach on the whole, through which the nerves emit or through which the spinal cord emits, then they start to become symptomatic. But interestingly, many people with early degenerative changes are not even aware of it. They have no symptoms other than maybe some mild stiffness, restricted motion, that kind of thing.

Ashley B (18:27):

That's very interesting. And especially when it comes to scoliosis, because I look at a lot of scoliosis x-rays working for CLEAR. And when you look at them, you would think that an individual would absolutely always know that they have scoliosis, just because looking at a scoliosis x-ray versus a normal x-ray and that's, that's not always the case is what I've learned. So, very interesting. So one of my favorite parts of this show, Dr. Andrew, is getting to hear stories about patients, uh, success stories about patients who've worked with CLEAR-certified doctors and gotten great results. I would love to hear about a patient that you've worked with, who has also practiced yoga for scoliosis. Do you have someone in mind that you could share about?

Dr. Strauss (19:14):

Yep, I do. Because I have patients that come to me and they were already been very, very active in doing yoga for their whole life. And that's perhaps one of the reasons that they come to me is because they know that I am aware of yoga and I'm aware of yoga for scoliosis. So what I do is I work with them and I give them advice about curve shape. I be-I let them become more aware of their curve pattern. I tell them basically the things that we've been talking about today, but in a lot more detail, so they know this, I should do, I should turn to the right in this particular pose, but not to the left. I should do this stretching, but not that stretching. And this is the core strengthening I should focus on. And this is the body awareness that I need to be very aware of. So it's, it's really like gently encouraging the person. In those situations, it's not like starting from scratch. Okay, with somebody like you, who's never done yoga, we would have to start from the very beginning. Oftentimes these people come to me, they've already been doing yoga for years. They just want to know how do I do it right? How do I do it in such a way that I'm not going to aggravate my curve?

Ashley B (20:17):

You see differences in their spine at all, just as a result from practicing yoga? Just,

Dr. Strauss (20:22):

Yeah, it's very interesting. When you see somebody who's been actively doing yoga, they have already built up a lot of core strength and I believe they have some kind of like body intelligence. So you see that the curves can be more stable. The curves can be smaller. The curves can be, for example, instead of just one curve or two curves, you see three or four curves some of them, sometimes in these people, as if the body is trying to compensate inside itself to deal the scoliosis. So yes, definitely it creates a lot of body awareness and it was very helpful for the person with scoliosis.

Ashley B (20:54):

And in having that body awareness, I know that part of the CLEAR approach is a custom-prescribed home exercise program. Do you find that your patients who have practiced yoga have an easier time with that exercise program just because of their body awareness already coming into it?

Dr. Strauss (21:13):

Exactly. You know, there's something called a kinesthetic intelligence, which is essentially like a, like a gymnast or an acrobat, somebody who just has tremendous body awareness and intelligence about how their body moves. So people that have been doing yoga for a while have really developed that kind of awareness. So when they, when they're taught the exercises, it's very straightforward and very easy for them.

Ashley B (21:34):

So we only have so much time on one episode and I want to pick your brain about this more in a future episode, maybe get into some more of the do's and don'ts and specific poses, but for all intents and purposes, if you had just one piece of advice for someone who's considering yoga for scoliosis, what advice would you give that individual?

Dr. Strauss (22:00):

Well, I would say you gotta find somebody, somebody to help you. You got to find somebody in the beginning, at least who is aware of how scoliosis works and aware of how yoga works and then can put those two pieces of the puzzle together for you. Once somebody's instructed you, and once somebody's discussed it with you and some, once somebody has told you the do's and don'ts for your particular situation, I think you're fine to be on your own. You don't need to be going back to them all the time. And our whole approach is to empower the patient, to be able to self treat. We want the patient to be doing 99% of the treatment themselves at their home. Not having to run back to me or any other doctor or any other yoga therapist. They want, I want them to be independent. And so the beginning, you need the, you need the instruction, but after that, you should be fine on your own.

Ashley B (22:49):

Yeah. And I think that's one of the biggest benefits for patients who seek out a CLEAR-certified doctor is just being able to take some of that care and go and do it on their own time, at their own home, in their own space of comfort. So, uh, well, thank you so much for providing this high level overview for us today of yoga for scoliosis. Is there anything else you wanted to add on our overview before we wrap up and jump into it again in a couple of weeks?

Dr. Strauss (23:19):

Well, there's a lot of things I want to talk about, but I like your idea. Let's do this again. I really had fun with this. Um, there's a lot of things to say, and I don't think I could kind of, you know, give it over in one sentence or two. I'd like to really have the time like this, to explore these ideas with you. So thanks so much for the opportunity. I enjoyed it. And I'm looking forward to the next one.

Ashley B (23:38):

Thank you, me, too. Have a great day. If you are listening and would like more information on non-invasive scoliosis care, please visit clear-institute.org, or you can email us at [email protected] There is more to come next week.

 

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