Side Planking for Scoliosis

Side Planking for Scoliosis

by Dylan Bartley, MSPT, CMP

Researchers at Columbia College of Physicians and Surgeons in New York produced some promising results in the treatment of scoliosis with just one simple exercise: a side plank. This common yoga pose was performed on the convex side of the curve. So if your scoliosis bows out to the right, you should put your right arm down and lift your right hip up off the floor. They offered variations to accommodate varying levels of fitness and different types of curves. The poses were held for as long as possible, once a day, starting at 10-20 seconds.

To measure the success of their intervention, they took x-rays before and afterwards and measured the degree of curvature in their subjects. After 6 months, they found a significant improvement of an average of 41%. They tried to see if there was a difference between younger subjects and older subjects with more degenerative changes and both groups responded well with no significant difference between the two groups.

Scoliosis is a problem of imbalance and asymmetry that tends to progress as we age and can lead to debilitating arthritis and muscle spasm if it goes unchecked. Over the years doctors have tried to stabilize it with complicated surgeries involving rods or uncomfortable braces. Physical therapists have tried to correct it with stretches and strengthening the core and spinal muscles. It would make sense that to treat this problem of asymmetry one would need to attack it with a set of asymmetrical exercises. Unfortunately, there has been little research to back up these hunches until now.

If you are interested in getting an assessment of your spine to see if you have scoliosis or if you’re ready to treat a scoliosis you’ve always known you’ve had, physical therapy is a great place to start. We can set up a custom protocol that would match your current level of fitness and show you how to progress things as you get stronger. Furthermore, structural factors such as a leg length discrepancy or pelvic/sacroiliac dysfunction can be the driving force behind your scoliosis and may be treatable with physical therapy.

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A Modern Take on Rotator Cuff Injuries

A Modern Take on Rotator Cuff Injuries

by Cindy Dehan, MS PT 

The shoulder is considered to be one of the most intricate joint systems in the entire human body, with interactions between the upper arm (the humerus), the scapula, and the thoracic spine, in addition to the complex neurovascular system. The rotator cuff plays a vital role in proper shoulder function. Specifically, the rotation cuff system consists of the interaction of four major muscles: the supraspinatus, the subscapularis, the teres minor and the infraspinatus. The primary roll of the rotator cuff is to center the shoulder joint and allow for proper joint motion.

Identifying the reasons for shoulder pain can be just as complex as the shoulder system itself. Similar to the spine, it is difficult to determine a true pathoanatomical “culprit” for shoulder pain, and it may be more beneficial to conceptualize issues found in the shoulder with regards to functional limitations. The American Physical Therapy Association recently published a clinical guideline article regarding the shoulder and outlined three separate types of classifications that shoulder issues may fall into. Shoulder pain and mobility deficits/adhesive capsulitis (frozen shoulder), shoulder stability and movement coordination impairments/dislocation of the shoulder joint, and shoulder pain and muscle power deficits/rotator cuff syndrome. Any of these conditions can impact the rotator cuff, but for the purposes of this article, we will focus on the muscle power deficits/rotator cuff syndrome (RCS) classification.

Traditionally, pathology of the rotator cuff was thought to be almost always be related to issues with impingement, where compression and high levels of friction were associated with the pain and dysfunction often reported by patients. More recent evidence suggests that mechanical loading of the tissue may cause changes to the tendon quality and contribute to the sensitivity of the tissue. Overhead movements such as throwing, can increase tensile load. Reaching overhead can increase the compressive forces in part of the shoulder complex. It is not uncommon to find pain while catching at midrange when lifting the arm. In fact, pain and weakness are common when performing movements that place any stress onto the rotatory cuff system.

Very few things in life have a specific protocol that you can follow from start to finish without having to adjust a little. Managing rotator cuff issues is no different. Given the fact that underlying cause of shoulder pain and dysfunction can be multifactorial the interventions should be selected to treat the impairments, not necessarily the diagnosis. Specific exercises which address the scapula and rotator cuff, in conjunction with manual therapy, has been shown to be beneficial for patients with RCS. It is also of benefit to look at the mechanics and relationship of the thoracic spine to the shoulder, as treatment to the thoracic spine may improve certain shoulder impairments. Core/midline stabilization can also contribute to issues seen in the shoulder based upon the specific activities someone participates in.

In an ideal world, we could develop a series of movements, exercises or hands on treatment that could fix everyone just the same. But the challenge is that we all are very unique and while we might share a common complaint of shoulder pain, the underlying cause is very different from person to person. That is why it is important to have a thorough, comprehensive exam so that the individual characteristics associated with your shoulder can be addressed and a detailed, personalized approach can be implemented.