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Yoga > Yoga Therapy

Yoga for Scoliosis: New Research Supports the Benets of


Side Plank
BY Kathryn Ashworth

ON November 26, 2014

Scoliosis a ects 6 million Americans. Chances are you or someone you know
has it. Either way, its likely youve heard of it. And if youre an asana teacher,
youve probably encountered this condition in at least one of your students.
In fact, you may have spent countless hours trying to understand scoliosis in
order to help empower your students to alleviate their symptoms. But if
youre not familiar with it, light online research will provide a wealth of
information. )e Mayo Clinic's website states that Scoliosis is a sideways
curvature of the spine that occurs most often during the growth spurt just
before puberty. While scoliosis can be caused by conditions such as cerebral
palsy and muscular dystrophy, the cause of most scoliosis is unknown.

Scoliosis a ects 6 million Americans.


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According to )e National Scoliosis Foundation, scoliosis a ects both


genders, and its onset typically occurs between the ages of 10 and 15.
Treatment includes bracing, and in more advanced cases, surgery. )ough
mild scoliosis often presents few symptoms, severe forms may limit lung
capacity, place pressure on the heart, and reduce overall range and quality of
physical movement.
When I was asked to write an article about a recent scoliosis study for Yoga
International (more on that later), I immediately thought of my friend
Amanda. Amanda was diagnosed with a 45-degree S-shaped curve when she
was 14. Her doctors concluded that much of her growth was nished, and
that bracing was not an option. As she puts it, My movement would be
severely compromised from the base of my neck all the way down. )e
conclusion she and her family drew was to hold o on surgery for the time
being. We decided to wait," she says, "but there's a lingering fear that my ribs
could eventually collapse into my lungs."
Amanda has since developed a regular asana practice. And when I asked her
for her personal reections on what it's like to live with scoliosis and how
yoga aids her symptoms, this is what she had to say:
Everything is crooked when the spine is crooked. And it requires
mindfulness to pull it together. I nd that asana alleviates pain in nooks that
would otherwise hold it. And when I'm not practicing, I feel the pain return
to certain parts of my back that feel pressure (the uneven jutting of my spine
into muscle, and that muscle pain not being alleviated). Eventually I become
used to the pain, and it becomes less noticeable over time. But in many ways
thats worse, as it gradually builds and stores itself within my body."

Everything is crooked when the spine is crooked. And it


requires mindfulness to pull it together. I nd that
asana alleviates pain in nooks that would otherwise
hold it."
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Many of us can relate to Amandas story in our own way. We too came to
asana and wanted to alleviate a little pain, whether emotional or physical,
and we stick around because it works. Yet, while yoga has been a valuable
therapeutic resource for thousands of years, its only within the past several
decades that scientic studies have been conducted to measure its e=cacy.
And the more I read the ndings of these reports, the more I see that our
intuitive inclination to the mat is spot-on.

Side Plank for Scoliosis


In one of the most recent studies, published in Global Advances in Health
and Medicine, (http://www.gahmj.com/doi/abs/10.7453
/gahmj.2013.064?journalCode=gahmj&) a team of researchers set out to
study the side e ects of side plank on reducing spinal curvature in scoliosis
patients. )e study, conducted by Dr. Loren Fishman and the Columbia
College of Physicians and Surgeons in NYC, included 25 participants, each
diagnosed with idiopathic scoliosis. "Idiopathic" refers to the fact that the
causes of the scoliosis are unknownwhich is often (85% of the time) the
case.
)e study was conducted to demonstrate the e ects of asymmetrical
strengthening, and appears to focus primarily on C-curve scoliosis (a C curve
refers to a single curve, as opposed to an S shape where there is an upper
curve and a lower curve facing in opposite directions). Each participant was
instructed to hold the posture on the convex side of their spinethe side
that's rounded outwarddaily, and for as long as possible. According to the
study, this averaged about 1.5 minutes a day for 6.1 days a week.
)e results of their practice were
measured in three ways: individual
reports, radiographic assessment
(taken before and after), and Cobb
measurements (Cobb Angle
(http://radiopaedia.org/articles

For 19 of the 25
participants, the
reduction of curvature
averaged 40.9%.

/cobb-angle) is a standard
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measurement used to gauge the development of scoliosis). Over a 6.8-month


period, pre- and post-Cobb measurements indicated an overall signicant
reduction within primary scoliotic curves. Furthermore, for 19 of the 25
participants, the reduction of curvature averaged 40.9%.
Initial write-ups on the reports have circulated across social media and the
yoga biosphere, with glowing reviews from the yoga community. For the
most part, many are simply glad that a study was conducted at all.
For Roger Cole, a Stanford-educated scientist and certied Iyengar yoga
teacher, the research is validating. )is is exciting work because it provides
the best scientic evidence I know of to date that a simple yoga technique
may provide a powerful means to help correct scoliosis. Up until now, we
have had to rely on anecdotal success stories." He adds that, While the study
does not denitively prove that yoga is an e ective treatment for scoliosis, it
looks promising and should certainly grab the attention of the medical
community. It justies larger clinical trials that could one day put yoga
treatment of scoliosis squarely in the mainstream of modern, evidence-based
medicine.
Its true. Studies such as this prove
that we no longer have to rely on our
hunches, though thats not to say
that a lack of scientic research
would have deterred most of us from
our practices. Perhaps the most
powerful draw to yoga is the feeling

What about S-curve


scoliosis? And why are
we focusing on
asymmetrical
strengthening alone?

of the practice. We just know it


works. Again, we feel it. Yet evidence such as this provides direction for
practitionersin this case, a specic pose. But there are a few lingering
questions which arise after reading the study: What about S-curve scoliosis?
And why are we focusing on asymmetrical strengthening alone?
Yoga teacher Ellen Saltonstall, who has collaborated with Dr. Fishman on two
books (Yoga for Arthritis and Yoga for Osteoporosis), puts the intricate
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nature of scoliosis into context: "I have been using this technique in my
scoliosis protocol and I nd it to be very helpful. Educating the student or
patient is crucial, since each person's scoliosis is very specic and often
confusing to them. It is important to know whether the curve is a C curve or
an S curve, which was not addressed in this study. Students need to identify
(either on their own or with professional eyes) exactly where their curvature
is convex (rounded outward) and where it is concave (hollowed inward), and
whether they have multiple curves, which is common. Once they know that,
they can do the appropriate actions on the appropriate side in this pose."
And as for asymmetrical strengthening, Cole brings up another valid point:
"An important question left unanswered is whether people should also
practice the pose on the other side. Yoga technique generally seeks symmetry,
and it is possible that working one side to the complete exclusion of the
other over the long term could lead to new imbalances (at the very least, an
imbalance in shoulder strength, but perhaps also other complex imbalances
between spinal muscles). On the other hand," he adds, "practicing the pose on
the second side could theoretically slow or even negate therapeutic benets
on the rst side. Only further study can resolve the issue."
I contacted Dr. Fishman for his expertise about these quandaries, but also, I
couldnt help but wonder: Out of over 8,000 yoga postures known to asana,
why did he choose side plank as the point of focus?

He also conrmed that practicing asymmetrically could


pose a few risks, but that practicing side plank on both
sides would negate its therapeutic e ects.
In regard to Coles statement, Fishman agreed that further study was needed,
and expressed sincere interest in conducting further research. He also
conrmed that practicing asymmetrically could pose a few risks, but that
practicing side plank on both sides would negate its therapeutic
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e ects. Reversing this asymmetrical condition requires an asymmetrical


means. Muscle strength seems to be the key. It is true that doing the side
plank on one side only could cause new or other asymmetrical problems to
develop in the wrist and the shoulder or rarely in the sacroiliac joint. But
doing the pose on both sides would utterly nullify the process of
asymmetrical strengthening thatvasisthasana (side plank) initiates. )e side
plank should be done daily on one side, only with the convex side of the
lumbar curve downward, for as long as possible each time.
As for specic practices for S-curve scoliosis, Fishman had this to say:
)at depends on the individual. Sometimes the upper curve is
compensatory, and by straightening the lower part of the spine, the upper
part straightens itself. Ive seen that happen. Sometimes the upper curve may
be independent or may even have come rst. With the help of other yoga
experts Ive gured out a number of other e ective asanas for reducing and
correcting the upper curve, including, but not limited to, ardha

chandrasana (half moon pose).


So why did Dr. Fishman choose side plank after all? He expressed that in
many ways, the pose chose himthat it was through trial and error, and
noticing how e ective the pose was within his own practice. But for those
who want to try these methods for themselves, Fishman cautions that certain
measures are necessary for safety. I believe the people practicing this
method must be monitored every month or so because the process is so
strong that if unmonitored and done too long, it may actually reverse the
process and produce a curve on the other side. When the curve gets down
near zero or is negligible, then the pose should be done on both sides to keep
the spine straight.
Fishman concluded our interview stating that he truly believes this
treatment could help patients forego braces (which are sometimes worn for as
much as 23 hours a day) and better yet, surgery, which is often extremely
painful and debilitating.
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How do you feel about the study?


Many have thought scoliosis to be
incurable. However, research such as
this certainly leaves one wondering.
Based on the results of Dr. Fishmans

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Would you try side


plank as a treatment for
your scoliosis?

research, would you try side plank as a treatment for your scoliosis, or
suggest it to your friends? Please leave your comments below.

ABOUT Kathryn Ashworth (https://yogainternational.com/profile/37207)


Kathryn Ashworth has a BA in Anthropology and is an assistant producer at
Yoga International. She is currently receiving her 200-hour yoga teacher
training through the Himalayan Institute tradition.
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