Soft Tissue Stiffness in Scoliosis
Having scoliosis may feel like your back is permanently welded in the wrong position but fortunately, the crook in a spine with scoliosis is not cast in bronze. It can be reshaped and improve with proper help. It can also worsen over time, if left untreated. Active Release Technique for scoliosis can help.
Because scoliosis causes certain postural muscles on one side of the body to shorten and weaken, a logical choice for alternative scoliosis treatment is soft tissue therapy (ie: massage, myofascial release, etc.). Yet, not all soft tissue treatments are the same; some are far more effective than others at helping correct a crooked spine. One of the most effective for scoliosis treatment is called Active Release Technique for scoliosis, a highly specialized form of myofascial release therapy.
You may have heard of A.R.T. in relation to sports injuries. Many consider it is the Gold Standard for soft tissue treatment in the athletic world. Most professional sports teams have an ART provider available to treat their athletes because of they are aware of the quick and effective results it achieves.
ART was developed by Michael Leahy, D.C., he himself is a triathlete. His prior background and an engineer gave him a unique and detailed insight into how the structure of the human body works. With this, Dr. Leahy was reportedly able to consistently resolve over 90% of his patients’ problems with his specialized techniques. He has taught and certified a growing number of health care providers all over the world to use ART.
Active Release Technique for Scoliosis
While most A.R.T. providers continue to focus their treatment on athletes, a handful of them have utilized their unique insights into the human body and manual skills toward the treatment of scoliosis. The specialization of our practice is the non-surgical treatment of scoliosis and as a Certified A.R.T. Provider I have developed highly effective specific applications of Active Release Techniques for scoliosis.
To understand the basis for the work it is best to first examine how the body changes and mal-adapts in scoliosis to better understand how such specialized treatment works to stop the progression of the curves and even help correct some curves.
“Movement becomes habit which becomes posture which becomes structure.”
– Thomas Myers, Author of Anatomy Trains
Studies done at the Schroth Institute for Scoliosis in Germany have shown that scoliosis patients all have abnormal movement patterns that are one of the scoliosis causes. If these aberrant movement pattern stay in place long enough they begin to adversely affect the person’s posture. Postural changes that stay uncorrected will eventually cause structural changes in the body. This is the downward spiral that is commonly found in scoliosis that must be corrected to avoid a future of pain and disability.
In order to reverse this process and make postural corrections and finally rebalancing the muscular components involved in scoliosis it is important that you first make changes in the structural components of the body that have been adversely affected by scoliosis.
This process of restoring proper function to the body is one called “retracing” and it involves taking the body back through the same pathway it took to get where it is today, in the reverse. Starting at the end (i.e.: a progressive scoliosis curve) and working backwards toward a more balances spinal structure is a process called Structural Rebalancing.
Rotation Dysfunction of Scoliosis
To understand how Structural Rebalancing works let’s first examine the components of the body that are frequently found to be out of balance in scoliosis. Most often, the structures involved in respiration including the diaphragm, muscles of the rib cage, deep postural muscles of the spine and muscles involved in rotation of the body overall will be adversely affected in scoliosis. The imbalances of these muscles and the associated muscle groups cause an “unseen” unilateral rotation dysfunction of the spine.
The muscles surrounding the spine greatly affect its shape and movement. In the book Anatomy Trains – Myofascial Meridians for Manual and Movement Therapist the author Thomas Myers discusses interconnected lines of functional muscle chains that he calls “Anatomy Trains”. The colored lines (also known as kinestic chains) on the cover of his book show the direction of the different muscle chains.
Scoliosis Fascia Adhesion
The groups of muscles are interconnected via fascia (a web like substance found between the muscles, bones and nerves) and shared bony attachments and they help perform specific movement patterns in the body. In his book he furthers a concept called “tensegrity” and applies it to the chains of muscles in the body that must maintain an overall tension along the line to keep the body balanced. (1) If any lack or over abundance of tension in one part of the line occurs then muscles in the other parts of those chains or ones in an antagonist group must take up the slack or release it.
Kinetic Chains in Scoliosis
In the case of scoliosis the primary kinesthetic chains involved in the rotation dysfunction are the Spiral Lines in the body. The dysfunction occurs when one of these lines becomes overly shortened and taut while the other becomes overly stretched and painful.
The Spiral Lines are mirrored pairs of lines that wrap around the body in a helix and serve to maintain balance across the body and aid in rotation movements of the body. The larger muscles of this group run from the base of the skull to the top two vertebra in the spine, to the muscle sin the neck, across to the muscles beneath the opposite shoulder blade, to the core abdominal muscles on the side of the back that wrap around and attach to the others on the opposite side of the abdomin and attach to the front of the hip on the other side. Although this same line continues on into the lower extremity in same fashion, I will end the discussion here for the scope of this article being limited to the spine.
When one of these lines becomes taut and shortened it creates an imbalance that maintains a rotational torque in the body along the axis of the spine. The eventual torsion buckling of this crooked spine causes the lateral shift which serves to further enhance a scoliosis pattern in the spine. (See Illustration – (2))
Soft tissue work, therapeutic movements or ones sided activities that lead to a further spiraling causes the kinesthetic chains to mal-adapt further worsening the rotation dysfunction and adds to worsening of the curvatures.
In compensation, the muscles in the opposite spiral line become stretched and due to the prolonged tension on the proprioceptive fibers and they become overly strained and often eventually painful while trying to contain the curvature. This cause’s extreme torsion and strain to the body that has an impact on the muscles that surround the spine and cause a corkscrew scoliosis curve.
Active Release Technique for Scoliosis
Myofascial Therapies such as Active Release Techniques are used to loosen shortened surrounding structures to help de-rotate the spine. The way it works is that a contact is applied to the shortened tissue and tissue slack is taken up, then the tissue is actively lengthened or made to slide in relation to the contact and the adjacent tissues. These techniques are designed to alter the connective tissues which had become fibrotic when a muscle is in a shortened state for a prolonged period of time, thereby freeing up the muscle or other tissue that was lengthened.
Although A.R.T. is certainly not the only muscle technique that can be applied in this work, because of it’s specificity for each of the involved tissues (there are over 500 specific ART moves involving the structures of the body) we find that it produces the best results.
To apply the correct treatment to correct rotational dysfunction both locally and globally through out the body you must first understand the basic premise behind the work.
Unilateral Rotation Dysfunction in Scoliosis
In scoliosis muscles and other tissues in the shortened Spiral Line that have caused the rotation dysfunction have changed in some important ways. They are shortened (blue), less elastic and less freely movable compared to the other side, which are lengthened (red). These changes in tensegrity of the muscle chains has also resulted in plastic remodeling and deformation of the surrounding connective tissues that further bind up the affected tissues causing localized hypoxia of the structures. Since the tissues are not getting enough oxygen theses structures eventually adapt producing tough, dense scar tissue in the affected area.
As this scar tissue builds up it ties down the structures keeping them from moving freely, muscles become even shorter, tension on tendons and bones causes deformation of the skeleton causing nerves to become trapped and eventually causing pain.
This is particularly true for the muscles involved in respiration such as the diaphragm and intercostal muscles on the concave side of the thoracic curve.
It becomes crucial to break this abnormal neuromuscular pattern by releasing the fascial adhesions surrounding these muscles on the shortened side and to re-establish normal movement patterns of the muscles on the other side.
This achieved by shortening the affected tissue then applying tension with your manual contact in the direction that lengthen the tissue or releases it allowing it to restore its normal slide relative to the adjacent tissue. The provider must possess superior palpation skills that can evaluate the tightness and movement of muscles, fascia, ligaments, tendons and nerves involved and a solid practical understanding of the functional anatomy of involved structures is key to both the assessment and treatment. The affected tissues in the abnormally shortened Spiral Line are treated with Active Release Technique for scoliosis by combining accurately directed manual tension while the patient is directed to move the muscle through its full range of motion.
ART is quite effective restoring proper biomechanical function in chronic musculoskeletal conditions, like scoliosis. It does this by releasing the related tissue adhesions between the muscles, fascia and nerves of the body caused by prolonged abnormal postural dysfunctions. The power of Active Release Technique for scoliosis lies in its ability to effectively resolve chronic tissue adhesions that have not responded to other forms of therapy.
Over the course of treatment this allows for restoration of the normal muscle function by allowing for loosening up of the fascia so the muscles can now begin to set new postural patterns that become habit and positively impact the overall movement patterns of the body and stopping the progression of the curves due to the abnormal movement patterns that had contributed to the scoliosis in the first place.
For more information or to find out if you may benefit from Active Release Technique for scoliosis call (800) 943-1254 for a Free Phone Consultation.Dr. Brett Diaz, D.C. ScoliosisTreatmentAlternatives.com Dr. Brett Diaz, D.C. is the Director of Clinical Services for Scoliosis Treatment Alternative at O.C. Back & Body Doctor’s in Irvine California, a Regional Center for Scoliosis Systems. We offer a multidisciplinary approach that specializes in the non-surgical treatment of scoliosis. We offer specific treatment for scoliosis that include the SpineCor soft scoliosis brace, Schroth Method scoliosis exercises, Active Release Techniques for scoliosis, de-rotation traction therapy for scoliosis, Egoscue based rotational scoliosis exercise rehabilitation, physical therapy for scoliosis, specific chiropractic adjustments for scoliosis. Our highly specialized services are provided a unique healing environment at a 5000 square foot state-of-the-art facility.
He has over 24 years experience in integrating chiropractic with other alternative health fields to deliver the highest quality care through fully integrated and customized programs for his patients that emphasize restoring proper nerve function and biomechanical integrity to improve health overall. He has developed a Spinal Corrective Care Program that promotes postural restoration and the reduction of subluxations caused by scoliosis. Through a protocol of gentle adjustments and specific manual therapies (ART) they are able to correct soft tissue dysfunctions that are inherent in scoliosis to help promote better outcomes with dynamic bracing and scoliosis specific exercises. In addition, the protocol includes flexion distraction and specific neuromuscular re-education programs for reduction of the rotation of the spine helps prepare the scoliotic spine for further corrective care with the SpineCor scoliosis brace and the Schroth Method scoliosis exercises.
Dr. Diaz holds Certifications in Active Release Technique (ART), the gold standard for care of soft tissue adhesions, such as those found in scoliosis. ART is a Myofascial release treatment that is quite effective restoring proper nerve function in chronic musculoskeletal conditions, like scoliosis, due to related to adhesion’s between the muscles, fascia and nerves of the body caused by prolonged abnormal postural dysfunctions. The power of Active Release Techniques lies in its ability to effectively resolve chronic tissue adhesions that have not responded to other forms of therapy and he has developed an ART Scoliosis Treatment Programs specifically targeted to treat the unique uni-directional problems in scoliosis.
He obtained his Doctor of Chiropractic degree from the Los Angeles College of Chiropractic in 1987 and is also a Certified Exercise Rehabilitation Specialist through the American College of Integrative Medicine Program.
His long standing passion for helping his clients reach their peak health potential has lead him to attend seminars far and wide including one on Strength Conditioning and Training at the Soviet National Athletic Training Center in Moscow in 1986 where he was first introduced to the concepts of balancing the body’s kinestic chains.
His extensive background has allowed him to become a highly effective at delivering interesting and compelling talks on such topics as Scoliosis Causes, Body Awareness for Better Health and Injury Prevention, Health Enhancement, Stress Reduction, Proper Ergonomics and Non-Surgical Scoliosis Treatment. Doctor Diaz is the editor and a contributing author to Scoliosis Treatment Alternatives, Chiropractic Wellness Magazine and other health and wellness related publications.
(1) Anatomy Trains – Myofascial Meridians for Manual and Movement Therapist, Thomas Myers p. 41-49
(2) Illustration from Health in Your Hands – Your Plan for Natural Scoliosis Prevention and Treatment, Kevin Lau, D.C.