Scoliosis for massage therapists

Scoliosis

Definitions: lateral curvature of the spine
A curve is identified by the side of the convexity (the side it sticks out to) and the area that it affects (cervical, thoracic, lumbar)
Types:

congenital scoliosis

idiopathic (unknown cause) infantile (birth-3 years), juvenile(3-9years old), adolescent (10-19 years old) scoliosis. Most common is adolescent girls. A young girl that has not reached menarche is at much higher risk for scoliosis progression than a girl 2 years after onset of menses (skeletally mature).

neuromuscular conditions such as poliomyelitis, cerebral palsy , muscular dystrophy ,amyotonia congenita , Friedreich's ataxia, spina bifida

mesenchymal disorders : Marfan's syndrome ,Morquio's syndrome ,rheumatoid arthritis

postural (functional) scoliosis - postural misalignment due to habitual patterns of use

Hysterical scoliosis- a non-structural deformity of the spine that develops as a manifestation of a psychological disorder.

Classification of severity of curvature:

Mild - curves of less than 20 degrees. Normal is often considered to be curves of 10 degrees or less

Moderate -20 - 50 degrees with early structural changes in the vertebrae and rib cage

Severe- 40 -50 degrees or more with significant rotational deformity of the vertebrae and rib cage, pain and degenerative joint disease are often present. Curves of more than 60-70 degrees are associated with cardiopulmonary changes.

Causes: Idiopathic scoliosis means that there is no known cause. Some possible causes are scar tissue, spasm or proprioception problem, sensory-motor amnesia, abnormal postural control because of vestibular system dysfunction, imbalanced posture due to trauma, food allergies, side dominance
Signs/Symptoms:

rotation and lateral flexion of the spine often with fixed rotation of the vertebrae

uneven leg length

uneven muscle development in legs and back

muscle pain from spasm, atrophy and overuse

arthritis

stenosis of the spinal column

nerve compression

Scoliosis may be related to or cause the following: TMJ, thoracic outlet syndrome, carpal tunnel syndrome, quadratus lumborum dysfunction, shoulder/forearm tendinitis, plantar fascitis, achilles tendinitis, sacro-iliac strain or dysfunction, headaches, digestive problems, dizziness

Measurements:

asymmetric shoulder level

prominence of the scapula on the side of the convexity

protrusion of the hip to one side

asymmetrical ASIS

increased lumbar lordosis

leg turn out (laterally rotated leg)

foot problems such a flat feet on one foot more than the other.

Treatments: structural integration,
lengthen structures on the concave side, lengthen hip flexors and erector spinae: strengthen the muscles on the chronically weakened side, decompress joints
Other helpful therapies include acupuncture, physical therapy, pilates, movement therapies, eliminate food allergens

Resources:
Eric Dalton - Scoliosis: A Case Study of Deep Tissue Clinical Massage
Scoliosis - From Back.com
Getting it Straight Scoliosis and Structural Integration By Lana Lensman : Massage and Bodywork Magazine

Straight Talk Symptomatic Scoliosis By Erik Dalton : Massage and Bodywork Magazine

The treatment of scoliosis with massage - Douglas Graham Pubmed Dec 1887 (yes that date is right)

CASE REPORT (pdf Massage therapy foundation.)Impact of massage therapy in the treatment of linked pathologies: Scoliosis, costovertebral dysfunction, and thoracic outlet syndrome Michael Hamm, LMP

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