Wednesday, June 3, 2009

Dancing with Scoliosis? Fear Not!

Medical findings rate dancers among the most prolific sub-series of athletes who have scoliosis. (Gymnasts and swimmers also rank near the top.) But do not fear! Dancing does not cause scoliosis! This statistical data, most likely came from medical records of adolescents who noticed the spinal curvature and sought a professional opinions (Non-athletes perhaps do not use or look at their bodies enough to even recognize the presence of scoliosis until they experience back pain later in life.) Being active, constantly scrutinizing ones physique in a mirror and aiming to move in symmetrical patterns is possibly why postural variations are most often noticed in dancers in the first place. And a teacher’s good eye can also detect muscle or bone imbalance.

The main concern for early detection of scoliosis is to help reduce the possiblity of complications with aging. Progression of scoliosis can lead to back pain or arthritis in the spine, negative body image, and in severe cases, increased pressure on the lungs and heart.

The lateral curve of the spinal column in scoliosis can appear as and “S” shape, or a “C” shape when viewing the spine from the backside. It is sometimes accompanied by a twist in which one side of the ribs rotates forward and the other back, or by one side of the pelvis sitting higher than the other.

Unless screening is done, this imbalance can go undetected for many teenagers. My own mother has scoliosis and did not know it until age 46 when she accompanied me on an office visit to an orthopedic spine specialist. I was 16 then and in ballet class had noticed a small hump on one side of my back when looking sideways in the mirror. Medical specialists know little about the causes of scoliosis, but have some proof that heredity may play a role, so my doctor decided to look at my mom too.

Options for treatment at that time were: 1. Surgery to install an immoveable titanium rod into the spinal column, thus limiting much of the mobility of the spine, 2. Wear a cumbersome brace for 23 hours a day for five years, 3. Do nothing and see what happens. The severity of a curve is measured in degrees called Cobb angle, formed by drawing intersecting lines through the vertebrae as pictured on an x-ray image. The higher the Cobb angle number, the more sever the curve, with 40 degrees being a case in which bracing of surgical action is considered. For me, at just shy of 40 degrees, my doctor advised no intervention as long as I kept on dancing. So I did.

Even now, there are few new options in this country for treating scoliosis. The Schroth method of physical therapy, first developed in the 1960s in Germany, has made an appearance in the US recently, but is still not accepted as a valid medical treatment by western medicine practice, so remains relatively obscure. (The method is a series of breathing, strengthening and stretching activities based on the individual case. The series is taught and must be repeated daily for the remained of the individuals life in order to be effective.)

As symmetrical as we appear on the outside, internally we are very much the opposite—one stomach, one liver, one heart—our torso balances the protection of these organs in the best way that it can, sometimes causing compromises in the alignment of the extremely flexible and resilient spine. We are also in general either right or left-handed which causes upper back muscles to develop unevenly. It is my guess that most people have at least a mild form of scoliosis.

Those of us who have this imbalance in a more noticeable way can consider strength and flexibility as aids toward relief. There’s no way to stop the changes in bones as we age, but supporting muscles can be kept strong and pliable. And scoliosis should not keep you from dancing. Many dancers find the effects of scoliosis to be minimal on their ability to dance, but they also may encounter problems when they stop dancing.

In her book “Getting Started in Ballet” Anna Paskevska states the following: “The very nature of ballet training—working both sides of the body equally and in harmony—helps to correct the misalignment that scoliosis creates.” Some may argue that scoliosis cannot be “corrected” but it is true that ballet training provides the opportunity, through working symmetrically, to strengthen weaker muscles and release the tense ones. And where there is mobility, there can be change.

Dance on!

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