The Benefit of Pilates for Scoliosis

Jessica Surya

January 2018

BASI PILATES INDONESIA

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Abstract

Scoliosis defined as an abnormal lateral curvature of the spine. While most mild cases of

scoliosis do not affect the quality of life of the persons in a significant way, scoliosis curve

and the symptoms associated with it tend to get worse with age if left untreated. This paper

consists the understanding of scoliosis, the anatomy of scoliosis, and how Pilates especially

with the BASI Block System can help with this issue. In this paper, I use myself as a case

study subject. After using BASI Block System Conditioning Program, my migraine

frequency has been greatly reduced, my neck and shoulders tension released, my core is

stronger, and my posture is getting better. I have become more aware of my body and have

better understanding of the safety in practicing Pilates both for myself and my clients.

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Table of Contents

Cover Page…………………………………………………………………………….….1

Abstract…………………………………………………………………………………...2

Table of Content……………………………………………………………………….…3

Scoliosis Defined/Anatomical Description……………………………………………....4

Case Study……………………………………………………………………………..…6

Conditioning Program Utilizing BASI Block System……………………………….…..8

Desired Results of Conditioning Program…………………………………………...…14

Conclusions………………………………………………………………………....…..15

Works Cited…………………………………………………………………………….16

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Scoliosis Defined/Anatomical Description

Mayo Clinic defined scoliosis as, “a sideways curvature of the spine that occurs most often

during the growth spurt just before puberty.” There are four types of scoliosis according to

Spine-Health.com. The first and most common type of scoliosis is idiopathic scoliosis in

which the cause of scoliosis is unknown. The second type of scoliosis is congenital scoliosis

where scoliosis is already present at birth. It occurs when the baby’s ribs or spine bones do

not form properly. The third type of scoliosis is neuromuscular scoliosis. Neuromuscular

scoliosis is caused by the muscle problems that affected by problems in the nervous system

such as cerebral palsy, muscular dystrophy, spina bifida, and polio. The fourth type of

scoliosis is degenerative scoliosis where as the body ages, the spine and joints degenerates

and create a new scoliosis or worsen existing ones.

With scoliosis, alterations in normal anatomy occur. The shoulders may be uneven

(asymmetric) with one shoulder being higher than the other. The pelvis may also be uneven,

resulting in skin creases on one flank and unevenness in the hem-line or belt line. With

rotation, one rib protrudes further from the body than the other. Curvature of the spine may

develop as a single curve to a side (shaped like the letter C) or as two curves, side to side,

(shaped like the letter S).

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According to MedilinePlus, how well a person with scoliosis does depends on the type,

cause, and severity of the curve. The more severe the curving, the more likely it will get

worse after the person stops growing. People with mild scoliosis do well with braces. They

usually do not have long-term problems. Back pain may be more likely when the person gets

older. Outlook for those with neuromuscular or congenital scoliosis varies. They may have

another serious disorder, such as cerebral palsy or muscular dystrophy. Complications of

scoliosis can include: breathing problems (in severe scoliosis), low back pain, lower self-

esteem, persistent pain if there is wear and tear of the spine bones, spinal infection after

surgery, and spine or nerve damage from an uncorrected curve or spinal surgery.

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Case Study

I never once in my life dream that one day I will be a Pilates instructor. I was first diagnosed

with a condition called scoliosis when I was 11 years old. Unlike normal spine, mine has an

s-curve. I practiced ballet during my childhood, and I never noticed that I have a scoliosis,

until one day my friend’s mother told me that my spine is not normal, and she ask me to

check with a doctor.

I often had headaches, body aches, breathing difficulty and tensions around my neck

and shoulders. I used to consume painkiller pills to ease the pain. Even worse, as a girl I

suffered a body image problem that greatly affect my self- confidence and self-worth.

To make matter worse, my doctor said that on average scoliosis curve will get worse about 1

degree a year and surgery was eventually inevitable.

In 2012, I read about Pilates and how it can help with scoliosis. So, I started going as

a private client. Just after the first session, I felt better straight away. My breathing was

lighter my tensions eased, after few sessions I noticed that I haven’t consumed any pain killer

pills in quite a while, my headache and body aches was greatly reduced. I’ve become a

believer in Pilates.

So, after feeling the benefit of Pilates for some time, I think it is time for me to give

back. I want to help other people like me, so I decided to take a Pilates teacher training to

share the benefit of Pilates to as many people as possible. At first, I took a teacher training in

Jakarta in 2016. However, I soon realize that that training will not be enough if I truly want to

help other people and be the best that I can be. So, I did some research and found what I think

is the best Pilates teacher Training with BASI Pilates. And thanks to the BASI Block System

I now can feel better about myself and hopefully help others to do the same.

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Picture 1. Taken August 2017 Picture 2. Taken February 2018

My scoliosis is severe S-Curve scoliosis with 60 degrees’ curvature on thoracic curve and 20

degrees’ curvature at lumbar. It is a double major curve on the right thoracic and left lumbar

curve. As a result, convexity to the right at the thoracic and forward rotation on the left.

Convex side of the thoracic curve in the coronal plane. The Shortened Muscle on the left side

and the Lengthen Muscle on the right side. Visually my head not centered over my body, one

shoulder is higher, prominence of the rib, one shoulder blade higher, spine obviously curved

in abnormal spine position, uneven waistline, unequal gaps between arms and the trunk, and

one hip more prominent.

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Conditioning Program Utilizing BASI Block System

The following conditioning routine include a full body workout following the BASI block

system. I will start with a roll down, as a roll down needs me to feel my spine articulated.

The roll down is a great tool to assess imbalances in the body and warming up the body.

The rest of the exercise will follow the BASI block system to ensure that all muscles are

targeted during the session.

Since I have an S-Curve scoliosis, with severe 50 degrees’ curvature on thoracic curve

and 20 degrees’ curvature at lumbar. I have 2 curves to deal with and therefore need to more

specific in my exercises and positioning. I need to know what is the short side and what is the

long side. For my upper curve (Thoracic curve), I need to work on chest expansion

strengthening core and back muscles and aligning my body and, I need an elongation for the

short side.

For the thoracic curve, left side is shortened and tight, and the right side is long and

weak. As these movement always coupled with a rotation, it involves a right rotation. This

right rotation creates a right rib hump.

For the lumbar curve, my lateral side on the right-side is shortened and tight and the

left side is long and weak, therefore this is coupled with rotation. This creates the right hip

being forward in normal stance, and the left hip is shifted.

Since I have been practicing Pilates for one a half years, I have become aware of my

body alignment. The following is an example of conditioning program. The following session

was developed around the needs and limitations for someone with scoliosis. As It is designed

for a client who is on an intermediate level.

Roll Down

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Warm up (Mat)

• Pelvic Curl

• Spine Twist Supine

• Single Leg Stretch

• Double Leg Stretch

The intermediate warm up can be performed for someone with scoliosis. I use a towel or

small pad under the side of the back that is not in contact with the mat for the feedback of my

body. You can apply this padding method for those clients with the severe curve. This will

help your client have something tangible to roll down onto while they are on their backs. It

will help your client with their alignment if they can feel a surface under both sides of their

back.

Foot Work (on Reformer)

• Parallel Heels

• Parallel Toes

• V Position Toes

• Wide Heels

• Wide Toes

• Calf Raises

• Prances

• Single Leg Heel

• Single Leg Toes

For myself, I like to do my foot work on the reformer because it’s easier for me to keep my

pelvic and spine in a neutral spine position when laying supine on the reformer.

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Abdominal Work (on Reformer)

• 100 Prep

• 100

• Coordination

I choose this exercise for my abdominal work because on the reformer I somehow felt that I

can be more focus to keep my pelvic in neutral, and the strap on my hands when I lift my

arms, head and chest It helps me to get more flexion on my chest lift rather than I did it on the

mat or other’s equipment. I can feel that my sternum works. And also these exercises helps

me strengthening my abdominal, and my shoulder extensor control.

Hip Work (On Cadillac)

• Single leg supine series

• Frog

• Down circles

• Up circles

• Hip extension

• Bicycle

This specific leg series is important for me or clients with major muscular or skeletal

imbalances. One can focus on each side of the body individually. It’s important for someone

with scoliosis because their hips and back can be misaligned from the curve. One of the

reason I choose the Cadillac for the hip work is because most scoliosis patients are having

different leg length. since in the Cadillac or tower the straps are separated so it helps in

balancing because we want to make sure that we are building muscles evenly on both sides of

the body. Working the legs individually allows us to work each side and really focus on

building muscle evenly.

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Spinal Articulation (on Reformer)

• Bottom Lift

• Bottom Lift with Extension

• Semi-circle

The spinal articulation concept of scoliosis clients will feel very different the normal clients.

To control the spine up and down one by one vertebra, when the spine is not centered down

the middle of the back is both a challenge and something that is really crucial.

Stretches (on Reformer)

• Standing Lunges

Scoliosis can occur from bony abnormalities of the spine at birth, growth abnormalities

especially with adolescence, degenerative spinal changes in adulthood or abnormal twisting

of the vertebra because of muscle spasm after an injury. The normal curve of the spine allows

the head to be balanced directly over the pelvis. If one or more of these curves is either too

great or too small, the head may not be properly balanced over the pelvis. This can lead to

back pain, stiffness and an altered gait or walking pattern. I chose this exercise because this

exercise works my hip=flexors, hamstrings and gluteal.

Full Body Integration 1 (on Reformer)

• Knee Stretch Series

• Upstretch Series

• Stomach Massage Round Back

• Stomach Massage Flat Back

• Stomach Massage Reaching

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Round back, and flat back are great exercises for scoliosis because it helps us to connect our

back extensor to our abdominals. And Because of spinal and muscular imbalances,

connecting the back extensors and the core at the same time can be challenging and hard.

These exercises needed the trunk stabilization and avoiding the flare rib cage.

Arm Work (on Reformer)

• Arm Seating Series (Chest Expansion, Biceps, Rhomboids, Hug-A-Tree, Salute)

Leg Work (on Wunda Chair)

• Leg press standing

Leg press standing is a great leg work exercise for scoliosis because it really allows us to

work on our balance and to keep the posture aligned and not leaning forward. It’s also good

to elevate the body parts, as we need to initiate the movement from the hamstrings. For

scoliosis balance is always be a challenge. This movement also keeps the body tall and long

from the crown of our head which is the lengthening sensation.

Lateral Flexion/Rotation (on Reformer)

• Mermaid

Mermaid is a wonderful lateral flexion and rotation exercise for the upper body part. and the

twisting or the rotation helps to stretch out the tightness throughout the back and the rib

cages. Because of the uneven spine position, it will be much easier to perform on one side

than it will be on the other. It’s important to stretch intensely on the tight or the short side.

Back Extension (on Wunda Chair)

• Back Extension Single Arm

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Back extension is really important for scoliosis, the muscles and the back are often very tight

And weak. And some of the back extension exercises are really dangerous if the clients are

not aware of their body alignment and awareness. Most clients get a lower back pain after

practicing the back-extension exercise, and this is happened because of they are working on

their back and not their back extensor.

Roll Down

I like to conclude the session with a few very slow Roll Downs to cool myself down

and to allow me to feel the alignment and the sensations inside my body and also to compare

it with before the session.

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Desired Results of Conditioning Program

Practicing the BASI Conditioning Program desired the clients to have a good body awareness

and alignment, focuses on all those small postural muscles to get a better posture, to get

flexibility of the spine. As our spine has many nerves, muscles, and ligaments that serve as

connection to areas throughout the body, keeping our back in top condition is one of the best

things we can do for both our backs and general health. Not only that, practicing BASI

Conditioning program also strengthens muscles, reduces back pain, and any discomfort.

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Conclusion

I have an S-Curve scoliosis and I often suffered from neck and shoulders tensions, chronic

migraine, and lower back pain. After practicing Pilates for one a half years and especially

after following the BASI Block System in my practice, my body awareness, alignment and

posture have been improved. My core and muscles have become strengthened. And

personally, for me the most important of all, my pains, migraine and tensions have been

greatly reduced, and I feel stronger, healthier, and happier more than ever. All this progress I

owe to the BASI Block System that allows every muscle, every part of my body targeted

during the exercise program. My goal is now to use this knowledge and experience to help

improve the quality of life of others with scoliosis like me with BASI Block System.

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Works Cited

Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, 2013

“Scoliosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Dec.

2017, www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716.

“Scoliosis.” MedlinePlus Medical Encyclopedia, medlineplus.gov/ency/article/001241.htm.

https://www.spine-health.com/conditions/scoliosis/types-scoliosis Baaj, MD Ali. “Types of Scoliosis.” Spine-Health, www.spine-health.com/ conditions/

scoliosis/types-scoliosis.