Bodywork Pain Management Articles
“Scoliosis: A Case Study”
In a three-year research case study of a young girl,
scoliosis responded dramatically to Deep Tissue Therapy and
Chiropractic Treatment.
By Erik Dalton, Ph.D., Certified Advanced Rolfer®
, Rolf Lines,
Fall 2000
Copyright © 2000 Rolf Institute
She was 13 when Amy's mother brought her to me for clinical
treatment in
1993 . Extremely self conscious of her curvature, she would
neither look me in the eye nor disrobe down to her undergarments
to allow her mother and I to examine her scoliotic deformity. I
was pessimistic about how much help I could offer after
observing her gait and other aberrant movement patterns. But the
very first test I performed through her sweatshirt quickly
triggered that Amy could possibly be a good candidate for deep
tissue manual therapy.
|
Typically, the degree of scoliosis demonstrated in Amy's
structure (Figure A) would indicate facet tropism (remodeling
of the bony ribs, vertebrae, intervertebral discs). She
presented as a classic picture of structural scoliosis where
deformity of bones and soft tissues had distorted her
structure to a point that massage manual therapy seemed of little
help. But as I ran her through some typical motion tests, I
found it possible to straighten some of her thoracic curve by
passively side bending her to the right and rotating her left,
both in standing and sitting. This alerted me to the
possibility of, at least, some degree of reversible functional
scoliosis contributing to her pronounced S-curve.
Interestingly, during her interview, her mother confided that
Amy had long ago developed a daily routine of hanging by a bar
with her left arm hoping to straighten her embarrassing curve.
Amazingly, that simple daily ritual may have been the reason
Amy was able to maintain rib and facet joint mobility and
hydration in her discs.
Obviously, Amy had developed some remodeling of the discs
at the thoracolumbar junction--that would prove to be the
challenge. I had a chiropractic buddy x-ray her to confirm
if there were any true leg length discrepancy before beginning
pelvic balancing. As shown in the photograph, she still needs
some work in the lower extremity. |
|
Figure A
shows how "lumbar bowing" is created by hypertonic
erectors, QL and obliques on her left side while the
right psoas, trapezius and posterior deltoid muscles are
forced to hold the dysfunctional pattern. |
|
Figure
B show marked improvement in Amy's scoliosis after
30 months of therapy. |
|
In the beginning, Amy was taken through a modified Rolfing®
"Ten Series" focusing on how changes made to her legs
relieved pressure at her ankylosed T-12/L1 thoracolumbar
junction. Notice how the right knee had to be brought into mild
hyperextension to relieve lumbopelvic strain.
Given Amy's description of the onset of her scoliosis, she
may have suffered a mild polio-type episode rendering her
partially paralyzed on the right side of her body. One year
prior to the first sighting of the scoliotic curve, she had
experienced a severe whole-body infection that left her
partially paralyzed on her right side. Initial palpation
revealed increased neuromuscular facilitation in the deep
muscles on the opposite (concave) side of the curve which seems
to follow Davis's Law.*
Hypertonicity and adhesions were particularly hard to release
in her quadratus, erectors, and obliques on the left.
Although there was apparent tightness in the right psoas,
rhomboids, trapezius, and posterior deltoids, they responded
easily to deep tissue work and assisted stretching techniques.
This suggests that their primary function may have been to hold
the dysfunctional pattern rather than being instrumental in it's
creation ( See Figures 2: B & C below ). The resulting muscle
imbalance patterns that emerged in Amy's body presented an
unusual scoliotic case where a strong functional component was
hidden in her primary structural scoliosis.
 |
Since the sympathetic and para-sympathetic nervous systems
are embedded in the psoas, the psoas is frequently the first
muscle to be affected by bacterial or viral attacks such as
Amy's. As the muscles atrophied and overstretched on the
paralyzed side, reciprocal inhibition shortened the concave
side. Thus the battle begins between the group who will have
dominance in creating her asymmetrical curve. Surprisingly, the
psoas often loses this battle because of its susceptibility to
facet dysfunction at critical "cross-over" junctions,
particularly at T-12/L1.
After the first of almost three years, I brought in a
wonderful 86 year old chiropractic friend and mentor to help
with the chronically locked facet joints in Amy's curve. Doc
Atwater had been an original instructor at the second
Chiropractic college founded in America, here in Oklahoma City.
He saw her about nine times, and we worked as a team in several
instances. Just a-stretchin' and a-poppin'! His primary job was
to open and close dysfunctional joints too adhesive for the
Myoskeletal methods to be effective. High velocity thrusting
procedures were needed to help mobilize those fibrotic and
calcified joint capsules. Manual procedures to release Amy's
abdominal and pelvic diaphrams were beneficial in opening up the
front side of her body.
* Davis's Law states: “If muscle ends are brought closer
together, the pull of tonus is increased, which shortens the
muscle (and may even cause hypertrophy).”
|
