Scoliosis in simple is the abnormal curvature of vertebral column. A much better definition for scoliosis is a lateral deviation of the spinal column from the median, usually accompanied by rotation of vertebrae .

Parameters used in determining scoliosis

• Direction- scoliosis may take 2 possible shapes, C shaped which is characterized by a curvature of spinal column to one side and S shaped with at least 2 curves with deviations from both sides of the median line of the spinal column.

• Location- The boundaries of scoliosis are determined by the vertebrae that deviate laterally from the median. Precise delineation regarding boundaries is possible only by means of X-ray.

• Angle- The larger the scoliosis angle the more severe the disorder is.

• Rotation in the spinal vertebrae- usually rotation occurs in the thoracic vertebrae and is denoted by a protuberance of the ribs on one side of the upper back when bending forward.

• Structural Imbalance- for example differences in length of the lower limbs may create an imbalance in pelvic position which will later appear as a disorder in the alignment of the spinal column caused by an out of balance base. Here in this case the problem cannot be solved by therapeutic exercise alone.

• Functional imbalance in the musculoskeletal system- characterized by obvious functional differences on either side of the body.

• Secondary Visual indications

The diagnosis of scoliosis cannot be based solely on external indications. The final diagnosis always entails X-rays as well.

• Functional motor difficulties- In certain cases, unlike normal development , the characteristic imbalance of scoliosis may impair normal motor functioning in areas like coordination, Balance and vertical organisation of body.

Though scoliosis can develop in a variety of forms, most types can be classified under Functional (Flexible) scoliosis and Structural (Rigid) Scoliosis. Flexible scoliosis is mostly caused due to Incorrect movement patterns,that entail asymmetric use of body in daily activities, Imbalance in antagonistic muscle group strength on either side of the spinal column, and differences in the length of lower limbs caused by pathological factors like accidents, fractures etc.

Structural scoliosis refers to a disorder involving physical changes in the structure of the spinal vertebrae.

THERAPEUTIC EXERCISES FOR SCOLIOSIS

Remedial exercise is a controversial issue. Many studies of the effect of therapeutic exercise on scoliosis have found that the disorder continues to progress despite exercise. In 1941 , the American Orthopedic Association came to the conclusion that the use of exercises should be avoided in treating scoliosis.It was based on a study of 435 patients of whom 60% manifested a worsening of the angle of scoliosis and the remaining 40% found no change. However closer examination of these studies reveals certain flaws and certain changes were made in this study by Solberg. And as a result Therapeutic exercise may actually produce improvement in the scoliosis and engender significant changes both in body posture and general functioning of Spinal column.

Types Of Exercise For Scoliosis

1. Symmetrical exercises aimed to strengthen back and abdominal muscles and for functional improvement in ranges of joint motion.

2. Breathing exercises to increase lung volume and thorax mobility and flexibility.

3. Asymmetrical exercises for lengthening muscles on the concave side, and for contracting muscles on the convex side. It also encourages specific movement of spinal column vertebrae in desired directions.

4. Static exercises which also make use of body weight for releasing tension along the spine.

All movement treatment of scoliosis should be conducted only by trained,qualified individuals and under the supervision of an orthopedist.

This article has been written by Dr Arya Krishna BAMS, Fellowship in orthopedic Rehabilitation