Yoga for Teens with Scoliosis
By Elise B. Miller

Scoliosis is a lateral curvature of the spine that affects two to four percent of the population. The word scoliosis is derived from the ancient Greek word, Skoliosis, meaning a curve. Scoliosis is either structural or nonstructural. A structural scoliosis has a rotational component whereas a non-structural or functional scoliosis has no rotation and is created by an imbalance of muscles. A nonstructural scoliosis will usually straighten when the trunk is flexed in a forward bend. With a structural scoliosis, the rotation of the spine and ribs becomes more visible. Adolescent idiopathic scoliosis, which appears in teenagers, is the most common form of scoliosis; its cause is unknown. Scoliosis tends to run in families and affects more girls than boys as they go through their adolescent growth spurt. Lateral curves are often first noticed by parents. Many times parents observe postural imbalances when their children are wearing bathing suits or when hemming the child's pants or skirt. A comment often heard is, "I noticed a problem because I always have to alter her clothes so they will hang evenly." lateral curves can be detected by pediatricians during routine physical exams but the majority of lateral curves are detected in school screening programs. These programs are conducted on students aged 10 - 16 years (grades 5 - 9), the age group of highest risk for adolescent idiopathic scoliosis. For many, the curvature is minor, doesn't get worse, and causes no problem. These young adults lead a normal life with no treatment. It is difficult, however, for a physician to determine whether scoliosis discovered early is going to be minor or severe. This is why it's important to keep measuring the curve over time. If a minor curve is detected and the adolescent is still growing, then bracing is often recommended. If the curve becomes worse, reaching 50 degrees or more, then surgery is often recommended; the spine is fused to prevent further curvature.

Whether scoliosis is first detected in school screening programs or by a Yoga teacher who observes a teenage student bending over forward, one should be very careful in labeling a mild, non-progressive curve as scoliosis. The implications for the teenager's future can be profound. Self-image as well as health and life insurance issues should be considered.

Scoliosis can be categorized into several major patterns. Ninety percent of teenagers who have a scoliosis in the thoracic or mid-back bend to the right. This condition is called right thoracic scoliosis. If the major curve is in the lumbar or lower back; seventy percent curve to the left, this is called a left lumbar curve. A thoraco-lumbar curve occurs lower in the thoracic and continues down in the lumbar like a large C curve. Eighty percent of these curves go to the right. These three curves usually have compensating minor curves going in the opposite direction and are smaller with lesser degrees of vertebral rotation. There is also an S curve or equal curve in the mid-back and lower back. The most common is a right thoracic, left lumbar curve as it occurs to the right in the thoracic and left in the lumbar. With the patterns in the mid-back, a shoulder blade will protrude on the side of the curve. Often the shoulder is higher with the back rounded on the side of the curve due

to the rotation of the spine. Also the head can be tilted to one side due to scoliosis. Curves in the lower thoracic and lumbar affect the hips where one hip is higher or the pelvis is rotated, which can cause sacro-iliac problems.
Whether a teenager has been diagnosed with a minor or major curve, Yoga can be a useful alternative or supplement to treatment. Practice of asana will improve posture, bring more alignment to the body, increase flexibility and strength, and address the rotational component of scoliosis. In addition Yoga will bring teenagers grace and a positive body image, vital during the formative years. When parents approach a teacher to bring Yoga to their teenage daughter or son, find out if the teenager is truly interested or if the parents are insistent. Attitude and commitment are very important. If the teenager shows resistance after a few sessions, reconsider whether it is worth your time and effort. More often than not, the teen will come around if your approach is realistic. Encourage teens to practice on their own but don't lead them to self defeat by overwhelming them. In the beginning give a basic practice of no more than 20 minutes. When teaching Yoga to teenagers, first bring focus to their posture. By becoming more aware of imbalances throughout the body, these young adults can then learn to feel what is aligned and what is not. Often the imbalances are unconscious and need to be awakened. Because of the importance of a positive body image, this awakening needs to be done with sensitivity and even humor. Also, moving young adolescents into poses quickly and freely is often a good idea before having them quietly stand in Tadasana, when you can observe their alignment.

Alternate between movement and stillness. Generally, make the Yoga fun yet challenging. At this age, the muscles that support the spine must be both lengthened and strengthened. Many postures simultaneously lengthen the spine and strengthen the para-spinal muscles (longitudinal muscles down the spine) and other supporting muscles of the back. These actions are very important to help offset further lateral curvature and rotation. Adho Mukha Svanasana and Urdhva Mukha Svanasana are good examples. Standing poses strengthen the legs, creating a solid foundation from which the spine can stretch and become freer. Chair Bharadvajasana (Chair Twist) is a good choice to address the rotational component of scoliosis. This pose allows the spine to twist yet encourages the pelvis and legs to remain stable. Because of the simplicity of the pose, teenagers can better concentrate on de-rotating their curve. Once they have this understanding, it can be applied to other twists. Always end with Savasana even though the students may resist. Teenagers are under a great deal of stress and the imbalances caused by scoliosis can add to the imbalance of the nervous system. Observe any imbalances and adjust each individual to bring more alignment to the shoulders and hips. You may place an eye wrap or hand towel under the concave or compressed side of the back so the student lie evenly on the floor. Instruct the student to breathe evenly into both sides of the ribs and lungs. Then encourage them to relax the brain and all parts of the body. You will be surprised how open teens are to relaxing deeply.

For more information, go to Elise's website (www.ebmYoga.com) for articles she has written for Yoga Journal and the National Scoliosis Foundation. Also on her website, you can order a booklet of poses Yoga for Scoliosis as well as her upcoming video Yoga for Scoliosis. On this video, Elise leads a teenager and other students through poses geared for those with scoliosis. This will be available after November 15th.