Sunday, January 29, 2012

Kyphosis, Lordosis and Scoliosis... English please?

These are all terms to explain extreme curvature of the spine. Your body naturally has a small curve in the upper part of your back called the thoracic, as well as a small curve going the other way in your lower back, called the lumbar.  Notice this picture.  The upper back curves forwards slightly and the lower back curves backwards slightly. This is normal as in the picture below.


These pictures represent the extreme curvatures of the spine.  Kyphosis, Lordosis and Scoliosis.

Scoliosis: Very hard to represent since it is a medical issue and very hard to fix.  A curvature in which the spine doesn't just go down your back straight, but curves as it goes down to the side.

Kyphosis:  Larger curvature of the thoracic spine or upper back
Lordosis: Larger curvature of the lumbar spine, or lower back.
There are Pilates exercises that can actually help you fix your these imbalances.


Help to Fix Kyphosis:
Kyphosis:  Larger curvature of the thoracic spine or upper back
The idea is to do exercises that promote chest expansion, thoracic extension (extension through your mid and upper back) and scapular stability (stabilizing the collar region).  Bridging is a great example of scapular stability.  It promotes the idea of a tripod of balance; both shoulders pressing into the mat as your stability points and the third point being the back of the head pressing heavy.  Make sure your head is flat on the mat and not elevated by a prop or pillow.  Performing a proper Bridge:
  1. Make sure your head is flat on the mat, knees are up.  Feet and knees are close together and pulled in towards your bum.  
  2. Your shoulders and head are your tripod of balance.  To be sure your shoulders are in the proper position to stabilize, practice this prep. Shrug your shoulders towards your ears.  Then reach your fingers towards your heels releasing the shoulders down your back into the proper location. Do this a couple of times ending with your fingers reaching towards your heels.  This will ensure your shoulders are starting in proper form. 
  3. Lift your hips up by articulating through each vertebra in your back.  Start by tucking your tail, lifting the lower back, middle back and finally lifting the upper back off the mat.  Keep reaching your knees long throughout the exercise to lengthen your torso. Be careful not to go too high.  You want to keep your back ribs heavy and in line.  Your body should look like a ramp from your knees to the upper part of your ribs.
Reference the picture on the right.  See how my body looks like a ramp.  My ribs are closed and my knees are reaching long.  The picture on my shows my ribs protruding from my shirt.  You can see the tension on my shoulders and neck.  The goal is to promote stability in proper alignment.





For an added challenge try lifting your legs one at a time.  Be sure to keep your knees together and your hips stable.  Try squeezing your butt cheek on the same side of the leg that is in the air to help to stabilize your hips.

To help improve Scoliosis:
Scoliosis:  A lateral curvature of the spine


Obviously fixing a lateral curvature of the spine is not something that is going to happen overnight.  You  have to be very patient and sometimes the help of doctors and chiropractors might be necessary here.  

Scoliosis is a lateral curvature of the spine.  Sometimes you can have one curve, a C curve scoliosis.  Sometimes there are two curves, an S curve scoliosis.  Let's first look at the C curve.  Think of the C as the actual curvature of the spine.  The area the to right of the C, the most concave part of the curve, is usually the most flexible will need to be strengthened.  The area to the left of the C, the convex part of the curve, is usually tighter and will need to be stretched out and strengthened.  

The S curve basically puts two C curves together.  For example; the upper back may be tighter on the left side, but the left side of the lower back might be stretched out or weaker.  The reverse would be true for the right side (upper back more stretched out and lower back is tighter). This is the most challenging type of scoliosis to rectify.  

When having scoliosis, always be careful to keep symmetry through your body, especially in unilateral work (one sided) .  If your range of motion on one side is much greater than on the other, do your best to modify your range of motion (ROM) evenly.  It's okay to restrict one side's ROM so that you can work within the opposite's side actual ROM.  Be patient in your movements and try not to force anything.  You will know when your body is ready.  Try starting on your weaker or less flexible side so you know your body's limitations.

Seated Twist is a great exercise to promote stretching and strengthening to challenge lateral rotation.
  1. Start in a mermaid type position.  Your knees are bent and to the side.  Your top foot is slightly in front of the bottom foot.  Although your arm is extended and giving you balance, there is no weight on the arm itself.  Your other arm is extended.
  2. Sit up perfectly tall, in great posture.  Your abs are engaged, your ribs are drawn in and your collar bone is wide.  Although your arm is extended, your shoulder is still down.  Feel like you are in between two panes of glass.
  3. Keeping that connection, pull your abs away from your arm as you reach your extended arm through the hole created between your body and the stabilizing arm.  Be sure to continue to keep your weight off the stabilizing hand and just use it for balance.
  4. Extend the arm up on an inhale.  Exhale to reach again.  Think of the reaching similar to spine stretch forward.  Make sure to watch the hand as it reaches under.  For an added challenge, try lifting the hip as you reach.  You will be putting more weight onto the stabilizing hand, but still try to keep the shoulder away from your ears and the majority of the work will stay in your abdominal region.




This exercise works for people with scoliosis because while it helps to promote core strength and back strength, it also gives you a great stretch through your entire back.


Working With Lordosis:  
Lordosis: Larger curvature of the lumbar spine, or lower back.
Lordosis is a greater curvature of the lumbar spine.  In other words, think of a swayed back, a larger curve in the lower back above the bum.  If you have trouble keeping your lower back on the mat, this may be you.  


Notice how my lower back is arching off the mat.  This is forced.  For people with lordosis, this is how the back naturally curves.  It is very hard to put the lower back on the mat.

Lordosis is very common in women, especially during pregnancy.  Almost all pregnant women become lordotic during the second or third trimester.  Lordosis is usually caused by weak lower abdominals and hamstrings.  It's also characterized by tight hip-flexors and back extensors.  

There are a number of ways to help rectify lordosis.  The first and easiest version is with toe taps.  When your knees come into table top it is easier to keep the back flat on the mat.  The mat will also support your lower back.  The exercise will give you the awareness necessary to maintain this neutral.

  1. Start with knees in Table Top.  Inner thighs are engaged at the top to make it easier for you to connect your pelvic floor.
  2. Without anything else moving, keep the same 90 degree angle with your knees as you let one leg hinge towards the mat.  Alternate legs as you go.  Only lower the leg as low as you can keep your back flat.  Notice in the second picture to the right my back has lifted off the mat.  This is because I went too low with my leg.  Be careful to only work within your range of motion.
  3. As you let one leg lower, try to keep the other knee stable.  If you notice the knees pulling further into the chest as you lower, try starting with both legs closer into the chest.  This may be a more neutral table top for your body.  
  4. If you notice your shoulders hunching up towards your ears, try turning your palms up.  This is the correct anatomical position and will help you maintain width across the collar.
This exercise is great for every type of back issue since it promotes scapular stability while challenging the abs, lumbar pelvic stability (challenging the hips to maintain neutrality) and lower abdominal strength.  Why I've decided to highlight this for the first exercise of fixing lordosis is that it gives the lower back support.  The lower back is flat on the mat and supported by the mat.

A more advanced exercise to help rectify lordosis:

Thigh Stretch:

Only do this if you can keep a neutral pelvis.  If your lumbar is still too unstable to create a vertical pelvis, this exercise is not for you.  You will know if this is you very quickly.  If your hinge looks like the picture furthest to the right, as opposed to the picture in the middle, don't do this exercise without an instructor present.  Because the lower back is not supported, you will need to use the strength in your lower abdominals to support it.  You will only be able to do this exercise successfully with a sufficient amount of lower abdominal strength.  
  1. Start kneeling with your knees hip width apart.  You can also place a block in between your legs.  This will help you to engage through the pelvic floor and use your lower abdominals.  
  2. Notice picture A.  My head is not centered since I'm smiling at the camera.  You want to have your head straight.  There should be a straight line from your knees to the top of your head.
  3. Look at your back.  If there is a sway, you should definitely tuck your tail slightly to fix this.  Think about pulling up from your inner thighs, then your lowest abdominals and getting even taller from the crown of the head.  You want to keep your ribs closed.
  4. As you start to hinge, think about keeping the straight line from your knees to the crown of your head as in the center picture.  If you feel your ribs start to open, you are most likely arching and could be causing pressure to the lower back.


This exercise is great for lordosis once you are ready to challenge yourself further.  It forces you to keep your back in a straight neutral while challenging that neutral with a hinge.

Good luck!  
As you know there are tons more, but hopefully these are a few to help get you started.  
Enjoy!











3 comments:

  1. i have scoliosis and i cant afford pilates or yoga class.. i will try this exercise, thank you! <3

    ReplyDelete
  2. You're sexy as hell

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