A recent, widely-reported research article* reports that the act of doing a yoga side plank on one specific side will actively decrease the curves in people with scoliosis. As a certified Pilates instructor with scoliosis and an advocate for movement in treating scoliosis, I was definitely intrigued.

With an estimated five to seven million people in the United States living with scoliosis, a miracle cure (as in, a simple exercise done for one-and-a-half minutes for only five days a week) would of course garner national attention. But after doing extensive research on my own, I’ve discovered a huge problem with this recent research: the plank was done on the wrong side. Despite unknowingly having their participants conduct the plank on the wrong side, the researchers were still able to report that an overwhelming majority of the participants experienced overall decreases in their individual Cobb Angle measurements.

Before I detail my own findings, which directly contradict the aforementioned research, it’s important to note that I’m a huge proponent of studying the effects of exercise on scoliosis. So little research exists, despite being desperately needed so that the medical world at large and the millions of those living with scoliosis discover that exercise is indeed a viable therapy.

I was startled when I first read these findings because it was counterintuitive to everything I had been taught, practiced on myself and taught to my clients. I sent out emails to trusted colleagues around the world, and they too, were just as confused as I was. At the same time, I received numerous emails asking for my opinion on the side plank “cure.”

I studied the research report meticulously and for final reference, I consulted Three-Dimensional Treatment for Scoliosis: A Physiotherapeutic Method for Deformities of the Spine written by Christa Lehnert-Schroth, P.T. where I located the exact side plank exercise referenced in the current study.  There I found that contrary to the recent report, the exercise is supposed to be done with the CONCAVE side of the curvature in the rib cage aiming down towards the floor. The researchers had it opposite, having patients do a plank with the CONVEX side down. Even so, the subjects still reported positive results. How was this possible? I had to dig deeper.

The researchers relate guy wires (muscles) holding up a tower (the spine) to the spinal extensors, or the set of muscles running up and down near the spine. They state that the left extensors are bending the tower to the right because they are shorter. They conclude that the right extensors need to be fired to pull the tower (the spine) back up. There are a lot of issues with this theory.

If you’ve ever looked at someone who has scoliosis with a bare back, the spinal extensors on the convex side are big and beefy looking (despite physically being longer compared to the concave side). The concave spinal extensors (despite being shorter) are usually atrophied to almost nothing. Sometimes they don’t even fire. The researchers refer to the right bulkier muscled side as bring the “weaker side”. While the right side is the longer side of the spinal extensors, it is not necessarily the weaker side.

The main focus should not be to make the long, overworked spinal extensors to work more and become shortened. That’s simply incorrect. Initially, you’ve got to look at another group of muscles to help.

The muscles further away from the spine in the ribcage actually act as more efficient guy wires than the spinal extensors, which are the trapezius and rhomboid muscles. The spine is physically closer to the shoulder blade on the right side in people with scoliosis in the rib cage where the spine bends to the right. What you don’t want to do is make the spine become even closer to the shoulder blade by shortening the muscles that connect them. If your right hand is on the floor for a side plank, you’d fire the right rhomboids and trapezius muscles more, strengthening already too short muscles. It makes no sense. If you focus on the muscles on the right side initially, you’ll end up in muscles spasms.

Muscles don’t push on bones, they pull. If the goal is to pull the spine back to a more neutral position, you’d do a plank with the left hand down. This would fire the left rhomboids and trapezius muscles, which would then pull the spine back towards the left shoulder blade to a more neutral position.

Yet despite my disputing the researchers’ choice of side plank, the research subjects still reported a decrease in Cobb Angle measurements by doing the side plank with the convex side down. This still didn’t make sense, so I had to look further into the flaws of the research sample:

There were 25 people initially in the study, of which only 19 complied. The researchers acknowledged this was a very small sample size.

There were two different types of scoliosis allowed in the study: adolescent idiopathic scoliosis and degenerative scoliosis. This is a giant red flag, as the two types of scoliosis are quite different.

Idiopathic scoliosis usually has at least two curves and the research shows that seven patients had secondary curves. Meaning that seven patients with “S” curves had idiopathic scoliosis and the last 12 compliant patients with a single “C” curve had degenerative scoliosis. Therefore, less than half of the study participants had idiopathic scoliosis. However, most of the news coverage stated that this research was for idiopathic scoliosis, which is incorrect.

Degenerative scoliosis usually shows up after the age of 40 and is oftentimes associated with osteoporosis. There were people in this study as old as 85 and their degrees of curvature were much higher than those with idiopathic scoliosis.

Of the seven people that had idiopathic scoliosis, their curvatures ranged from 6 to 43 degrees in their initial X-ray. Of the 12 people with degenerative scoliosis, their initial curves ranged from 10 to 120 degrees. That’s a huge discrepancy in curvature on the top number.

While comparing the beginning and ending Cobb Angle degrees for 22 patients in the research, (25 were initially in the study, 19 complied…yet 22 patients’ info was given on a particular line graph, indicating that data is missing), everyone who had an initial Cobb Angle ABOVE 40 degrees had a huge decrease in their final Cobb Angle measurement. Only one person with idiopathic scoliosis was above 40 degrees, the other six were below. The numbers are not nearly as impressive for degree changes under 40 degrees, with three of the curves actually increasing. The individual patient who initially started with a 43 degree Cobb Angle had a huge decrease in his or her final X-ray measurement, ending around 12 degrees. As the mean research statistics are combined, that huge decrease figure offset the other six. It turns out the numbers aren’t as impressive as initially suspected.

There were eight patients who had very severe scoliosis, with their initial X-ray indicating their Cobb Angle measurement ranged from above 50 degrees, all the way up to 120 degrees. Since we know the highest measurement for someone with idiopathic scoliosis was 43 degrees, we know that everyone above that number had degenerative scoliosis. They most likely also had osteoporosis and were above the age of 40.

Even though the two different groups of people with scoliosis most likely had a big age discrepancy (“adolescent” would imply 18 years-old and younger) of idiopathic being age six to 18 and degenerative being age 40 to 85, both groups as a whole had their Cobb Angle’s decrease.

Another flaw lies in the timeframe in which the second follow-up X-ray took place, ranging from three to 22 months later. That’s a wide, expansive range of time.

Yet regardless of the lengthy follow-up timeframe, the differences between idiopathic and degenerative scoliosis, the huge discrepancy in age, the expansive range of the initial Cobb Angle, AND doing the side plank on the wrong side, this study showed an overall decrease in scoliosis curves. This still wasn’t making sense. I had to dig even deeper.

So, why did this research show positive results? I think the secret lies in core engagement and correct alignment. The patients were taught to elevate the ribcage towards the concave side (which would be the ceiling in the researchers case) before doing the exercise, which would bring them to better overall alignment. Also, despite there being only 19 compliant patients, a total of seven different modifications of the side plank were given (although none of the publications that reported on this research managed to include this important information).

Many of the variations included some kind of strengthening for the concave side, be that pushing the free hand down on yoga blocks or holding a yoga strap to pull the top leg up. Take away: you must modify each exercise for the individual scoliotic body in front of you.

In summary, the majority of people with scoliosis in this study had degenerative scoliosis, most likely also had osteoporosis, and were probably over the age of 40. We have no idea what their exercise routine and strength level was before this study. I’ll bet there’s a high possibility that just the act of firing all the muscles in the body in an anatomically correct posture was the reason for the profound decrease in their Cobb Angles.

Unfortunately, there isn’t a one exercise magic pill for people living with scoliosis. I mean, come on, with a mere 19 compliant patients SEVEN modifications were given to just ONE exercise. The researchers couldn’t even find one simple exercise for all 19 patients! That’s right: the researchers gave seven different exercises to their 19 compliant patients. Not one, but seven. This proves that you must mold exercises for each and every scoliotic body in front of you…and that’s what these researchers did. That is a big reason for their success.

In conclusion, even with all of the flaws in this study, the researchers still found an overall improvement in Cobb Angle measurements by doing an exercise one-and-a-half minutes a day, five days a week. That’s incredible! This would lead one to believe that exercise, no matter how incorrect it may be, can still have positive results on scoliosis if correct alignment is involved along with the muscles of the core being fired. Now THAT’S something to consider, and certainly something that needs to be studied further.

Can you imagine what research would find if they redid this study doing the correct side plank?

What do you think about all this? I’d love to hear your feedback.

 

*http://online.wsj.com/articles/study-doing-the-side-plank-reduced-spinal-curving-in-scoliosis-patients-1414443022

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1

How can you say the exercises are incorrect if they work. This article is majorly incorrect, side planks do not work the traps and rhomboids, it primarily focuses on obliques and lats. I don't see how the study you presented has flaws. If i were to do a side plank just on my right side, over time i would develop laevoconvex scoliosis. So when you talk about a side plank on the convex side being "incorrect", there is no logic in that. Like you said there is no 'magic pill' so of course every scoliotic patient needs to be catered to differently. That's like saying everyone who is sick could be treated with the same drugs. It's just an obvious no.

2

Hi Toby, in a million years I truly could never have imagined that this simple rebuttal article of mine would cause such waves in the scoliosis world. I've corresponded publicly (on this blog) and privately (via email, on the phone, and physically seeing clients at my studio) with people who are confused on which side to do the plank on, people who think I'm wrong, people who think I'm right, people who's scoli has gotten worse by doing the side plank the way the article says, and people who's practitioner gave them this exact exercise on the side the research suggests. Yes, there is no magic pill.

Now, for the side plank muscles. Yes, obliques and lats are some of the prime movers in a side plank, but they alone are not going to be muscles directly responsible for moving the spine back to center. I'f you just focus on lats and obliques working you'll end up with extreme muscle strength discrepancy in your back. You've got to focus on smaller, spinal muscles that have a direct line of pull on the spine (like traps and rhomboids). I've had many Schroth practitioners who've reached out to me privately agreeing with my stance. The way I suggest is in Schroth's original book.

That being said, we need more research that is pushed out the the public on exercises that help scoli that people can understand because obviously the mass of the scoli world is hungry for it.

Blessings,
Erin

3

Hi. I am also a Schroth P.T. and I have 2 thoughts.

1) I have never thought of the thoracic convex side as beefier. I have thought that the 'apparent' muscle hypertrophy is generally explained by muscle and other soft tissues resting on significantly rotated ribs. If derotation can be achieved with exercise, improved symmetry occurs.

2) Interestingly, I have found that almost everyone with scoliosis has a weak right gluteus medius. For degenerative left lumbar scoliosis - or adolescent onset scoliosis of the Lehnert-Schroth 4C classification - where in either case, there is most often a shift of the hips to the right, strengthening the right glut. medius would assist with the hip shift to the left, create balance, and likely some benefit.

I teach mainly classic Schroth exercises for my clients, but I do teach basic core exercises as needed (I have been a Back Care P.T. for > 30 years). Sometimes I include a modified side plank on the convex thoracic side, not specifically because of what it does for the scapular stabilizers, but for what it does for a weak right glut. medius.

Little story...one of my clients came with a new XRay in which her thoracolumbar curve was dramatically improved. I said, "so, were you shifting your hip in this film?" Quietly, so that her very

relieved mother couldn't hear, she whispered, "Yes, I did". Hip shift is huge for some of our clients.

4

Jennie,
Thank you for you comments. I too have seen glute med weakness, and have it myself. Last week I actually bought a pair of MBT shoes to help my glute med's fire while I'm on my feet teaching throughout the day. I woke up this morning with some tired glute med muscles (specifically right) because I found out how to work them during my every day life. Woo hoo for scoli glute med's getting stronger! Keep loving on the scoli community.
Blessings,
Erin

5

I have 22 or so degree lumber , spine is about an inch off at most severe point , hurts all the time , right leg goes numb sitting in wrong position , had surgery at 18 , they pulled the rod out later , now 57, after 48 years of athletics , weights , football , martial arts , yoga, I am fit and limber , still hips are out of alignment , so read the article from researches and started planking convex down for 4 weeks , then switched to concave side down After reading your article. Back started hurting massively after 2 weeks , switched back to convex down. Hypothesis , building core on concave side began pushing curve further to convex side , side plank convex down seems to push curve toward center by strengthen of core on that side. Best to all

6

If you've had spinal fusion surgery you should NOT be doing a side plank in an attempt to move your spine, it'll send you back into surgery. Years ago, a choice was made that your spine should be fused. From that point on, your goal is to stabilize your spine IN THAT POSITION. Regardless of if you have the hardware in your back still or not, you still must stabilize your spine and not force it to move. Exactly what vertebra are fused in your back? Is your spine fused into your pelvis? Is your lumbar spine fused? I need more info on your first fusion surgery to comment about your pelvis and leg numbness. Blessings, Erin

7

Hi Erin ,

Looks like the apex is t12. really not to sure where it is fused since the surgery was done 39 years ago. Not down to the pelvis I am pretty sure.

To tell you the truth, I am not to worried about hurting my back, I have

engaged in all manner of radical exercise including heavy squats, bent rows

and been kicked and punched all over including ribs ,back , head,

nose , ear , eye , tooth (pretty much everywhere )during a long but not very illustrious martial arts career.

As an aside, for those who care to read my dribble, bent rows are a god-send.

They work by bending over at the waist and pulling a straight bar into your waist.

This exercise serves to build the spinus erectors and with the newly developed

strength reduces pain and adds to back support dramatically. I have been doing this

exercise 38 years.

Here is the thing, I have an x-ray of L5 thru T9 only..

The x-ray shows the quadratus lumborum on the convex side as being almost a vertebrae shorter than its counterpart on the concave side.

This muscle is stretched on the concave side just about at the apex of the curve. So I am assuming that as the curve formed it pulled this longer muscle into its stretched position on the concave side while shortening this muscle on the convex side.

I went to a chiropractor years ago, they tried to move the whole mess to no avail.

Years ago, I began lifting weights with my neck on a neck machine where

one sits and pushes forward, then pushes sideways and then pushes back.

I started with 5 pounds and a few weeks later I was up to 45 pounds (young and strong).

I soon started waking up at night choking. and unable to breath, I almost passed

out several times. My then wife said I was blue.

I went to a sleep doctor who diagnosed the problem as overdeveloped neck

muscles impeding breathing. I stopped the exercise and sleep returned to normal.

My point is that muscles do in fact when developed and enlarged, push against surrounding internal structures. In this case my neck muscles began pushing against and constricting my trachea impeding the air flow.

So, this is where my hypothesis comes from whereby, increasing the size of the quadratus lumborum and other core muscles via side plank on the convex side to match those of the concave side might in my opinion move the spine more toward center. This also may be the secret to the results reported by researchers at Columbia.

If we take a look at the mechanics of the side plank and the muscles affected, we see that

the muscles on the down facing side are the main focus of that exercise . With this in mind,

it appears to follow that the pain I experienced subsequent to performing the exercise concave side down was the result of increased strength of core muscles on the concave side , probably increasing the size of those muscles and as in the previous neck example, moving the curve more off center based on increased girth or, as others have suggested , pulling the spine toward concave side creating more curve.

.

Either way, I needed lots of ibuprophen for a few days after doing side plank concave side down.

Best wishes John

8

Hi John,
Thanks for your long reply. Since you don't know exactly where your fusion goes to, I would not attempt to do exercises to move your spine. It's wonderful (and slightly amazing) that you've been able to do all the physical movements you've done over the past few decades without breaking a rod. I've had many people come to me after they broke their rods doing movements that you've described. I don't want you to be thrown into surgery to fix a broken rod.

OK, let's talk core muscles real quick. The core anatomically doesn't move the spine or any part of the body. The core is the transverses abdominis, lumbar multifidus, pelvic floor muscles, and diaphragm. It stabilizes your lumbar spine and pelvis and does not move you. The QL is not a core muscle. It's a secondary stabilizing muscle (forced to attempt to stabilize the spine when the core doesn't engage) and also a moving muscle. It's the "hip hiker". It's deep into the body as well. X-rays don't show muscle, so whoever looked at your spine must have seen that your ribs on one side are closer to your pelvis and then made the assumption that the QL is therefore shorter on that side. It may be the case, but that doesn't mean that the QL pulled your spine to that position. If you're fused, I'd be VERY CAREFUL about manipulating the QL during exercise to beef it up. If you are in fact fused in the lumbar spine, you don't want to change the length of the QL. A choice was made by your surgeon that the QL will remain that length post-surgery for the rest of your life.

Last thing, don't focus on your QL. That muscle causes much pain in people and my guess is overworked and too short for you (probably on both sides). Focus on your core and on your lumbar erector muscles and deeper stabilizing spinal muscles, making them even strength. If any exercise causes you pain, you need to stop! Remember you can't stretch your back because it's fused. I'm sure you are VERY tight in your torso. Regular massage or myofascial therapy would be very good for your back.

Hope this helps, Erin

9

addendum , so hypothesis would seems to suggest 'pulling' of spine not a factor but instead increase of core on convex side is a push . Also seems that location , severity of curve and god knows what else may be a factor , since I never got my md or my ba I could be wrong , wouldn't be the first time won't be the last . Stay in the fight scoliosis suffers , no matter how much or hurts, how far you fall , no matter how dark it gets you are never out of the fight

10

Muscles pull on bones, they don't push. When focusing on using muscles to help scoliosis, you must figure out what muscles and fascia are too short (tight) that could be pulling bones off of center and release those. You then must figure out what muscles can pull the spine into correct alignment, which depend on your precise scoliosis. There are a myriad of reasons why the spine ended up in the condition it's in, but if you're focusing on exercise as a form of therapy, you must analyze pulling of muscle and fascia. Blessings, Erin

11

Hi I am pretty confused to which side to actually do the plank on as I'm not sure which would help with my scoliosis. Although my left rib cage seems more prominent than my right would that mean my spine is curving to the left? Also is it a side plank or a front plank. And also when will you exercises be out to help with scoliosis at home . Thank you

12

You, along with the rest of the world is confused. Truly, don't waste your time on it unless a practitioner looks at your back and determines a side plank would help you. You can now view some of my exercises I suggest for scoli. On the shop page of SpiralSpine.com you'll see that you can now rent the first installment of Scoliosis Education, which is where I show exercises for scoli. I'm currently working on getting it available in DVD form. Blessings, Erin

13

I have 19 degree scoliosis and I have been reading about the whole side plank to help better your scoliosis not completely fix it. Once I read the study referenced above I was excited to try it out but none of the articles mentioned what side to do the plank on they just wrote side plank helps with your explanation and details on what side to do the plank can't to see if there even a slight imporvent anything would be awesome thanks for you article above helped me tons! Best wishes.

14

Hey Oscar, way to go on being proactive with wanting to help your scoliosis. It's wonderful that your curve is small, being only at 19 degrees. As you've read from this article (and the mounds of comments and other posts I've written on the side plank theory) I'm simply not a big fan of this. I'd rather get with someone who can look at your back while doing it to 1. see if it will help your back and if it will 2. help you determine at that point which side to do it on. There simply isn't a quick answer as to which side for you to do it on. If you don't want to see someone you can feel the muscles in the concave part of your scoli to see if the muscles are firing and test it on both sides of the side plank. Hope this helps. Blessings, Erin

15

Hi, please reconsider your hypothesis here as it would be a travesty to spread misinformation. In your own article, you mention muscles pulling bones, not pushing them. Thus, the concave side must be stronger than the convex as the muscles pull the vertebrae together. To strengthen the other side (which can appear bigger due to rotation and compression causing the muscles to bulge out), it must be pointed towards the floor - similar to how a plank strengthens ones abs and a bridge ones back. It'd be great to update this info so people aren't actually making their backs worse. Cheers.

16

Hi Joe, thanks for the comment. Research shows that idiopathic scoliosis is actually not caused by muscles that are too short (hence the short concave muscles don't cause the scoli). There are other factors. One theory is that the physical spinal chord grows at a slower rate than the bones around it during a growth spurt, therefore the spinal chord is too short for the vertebral chain. The muscles then adapt around that. I worked on two scoliosis clients this morning, both with severe lumbar curves. My hands were all over their lumbar spinal muscles to give feedback for the concave muscles so they could fire. Regardless how much we argue over which hand should go down (or whether we should do side planks at all for scoli!), the concave muscles need length and strength. They need some extra love and attention. Blessings, Erin

17

My 87-year-old mother is looking at surgery for her scoliosis. Since I have the same condition, only not as severe, I am very very interested in long-term exercise therapy to keep me from having to accept the surgical solution. Thank you very much for clarifying the work of these researchers in the study session, and for making it a point to make the exercise solution viable.

18

Hi David,

I first must ask why your 87-year-old mother is looking at having surgery for her scoli? If it's to get her out of pain, I highly doubt that will happen. Surgery doesn't promise to get anyone out of pain. I don't mean to scare you, but I bet there's a high likelihood she won't make it out of surgery. Some teenage girls don't make it out of surgery (you just don't hear about those cases in the news). She could stroke out in the middle of surgery at her age. There's a million things that could happen. Let's find a great movement practitioner she can see instead, to help her live out her years with less pain (and less life-threatening surgeries).

Now, onto you. If you haven't watched the Starting Point Series (an icon at the top of the page) I'd highly recommend you do so. I mention key words to search for when finding a practitioner in your town. Lastly, I'll be starting webinars where I show how I work with my scoli clients in the next month or two. You won't want to miss those. Make sure you're on the newsletter list so you know when those happen and can gain info on a long-term exercise therapy for your scoli.

Great job being proactive with your (and your mom's) scoli.

Blessings,

Erin

19

Hey Erin the left lower back muscles are way stronger than the right.That is the convex side right ? So should i do the side planks on the left or right arm? Thank you in advance

20

If the left low back is stronger, it's the convex side. That side needs to be down, meaning your upper right curve's concave is down. Left hand needs to be down. Make sense?

Erin

21

My curve is on the RIGHT so does that mean my right arm is facing down or do i put my left arm down?? Can i have a simply yes or no because i dont do well with explanations lol

22

Nicky, you're pretty funny. Here's your simple answer. The research says do it with the right hand down for you. I'd say either do it with your left hand down or not at all. Frustrating and confusing, right? I've got some free webinars coming out with exercises for scoli you can do at home. I hope to have them out in a month or two, so hold tight. Make you're on my email list so you know when the free webinar is coming out. Blessings, Erin

23

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24

Hi,

I have scoliosis and I might have misunderstood it but if your right side is the convex side and you do it on your left side facing down(concave facing down) then to keep your body in that position its your left lateral flexors who do the job which to me seems counter intuitive as you are strenghtening your left side which would then pull harder your spine to the left and make the curvature on the right bigger but I'm confused so I'm probably wrong. Could you clear this up for me please?

Thanks

25

We need to define two things: 1. what vertebra are affected by the right scoli curve? and 2. exactly what "lateral flexors" are you referencing to? Let's assume it's an upper right curve where the apex of the curve is about T8. If that's the case, the mid traps are going to have a stronger force acting on on the apex of the curve than the spinal extensors (which I'm assuming that's what you're referencing when you say lateral flexors). The left mid traps will be able to pull the right curve directly to the left and be the target moving muscles to fire. That is why the left hand would go down on the floor. Did I make the gray a bit more black and white for you? Blessings, Erin

26

I have a c-curve and my concave side is on the left. My rib cage naturally shifts to the right unless I adjust it. If I do the plank position with concave (left) side down and raise my right arm up as is generally done in this pose, it exacerbates my curve. If I do it with my top arm extending the flank of my body I can consciously extend the shorter side. With the arm extending up, I find it more effective with my convex side towards the floor. Essentially, I use the lifted arm to pull the protruding ribs into the midline and fill/lengthen the corresponding short side. Do you find the positioning of the arm makes a difference in your work?

27

Hi Stephanie, I don't use the side plank as a corrective exercise in my work for my scoli or my clients'. I would say that the positioning of your top arms could definitely change the pull of the exercise and help you come out of the concave side depending on exactly how your scoli presents itself and where the arm is placed. Keep the awareness up of bringing the ribs to neutral (or even pushing the ribs past neutral - even better) but be careful of doing a side plank only on one side for extended periods of time because muscle tone could very easily become very uneven from right to left side. -Erin Myers

28

thx, Erin. I always do it on both sides in my practice, but I change the position of my top arm accordingly. For me that seems to work quite well (but I also have a comprehensive practice that includes many other things in addition to plank)... we're each so unique :). Thanks for your response!

29

Stephanie, It sounds like you have a good head on your shoulders in regards to the side planks. The more body knowledge you have the better you'll be able to work on your scoli and your clients'. Keep it up!

30

I have the same type of scoliosis as the degenerative patients, though i'm not at the age range they are, in that case which side would you recommend doing the plank on ?

31

I’d be careful doing this exercise, even if you supposedly have the same curve. Age and the root cause of the actual scoli (degenerative is based in osteoporosis where your does not seem to be that way) plays a huge roll in this. I’d be wary. Find a well-trained movement practitioner (like Pilates) in your town who you can book one private with so they can give you exercises for your scoli.
Erin

32

Which is the background of Pilates practitioners? Are them physiatrists as professionals of other scoliosis methods??

33

Pilates instructors are movement practitioners. Look at www.Pilates.com to get more of a background of Pilates. Not only am I a teacher of Pilates but I've also been a teacher trainer of Pilates for almost 10 years with the company Balanced Body, which is the link I typed above.

34

I think it should to be done as the study, says that is over convex side. The way to see if it is useful or not is to see if the curve decrease during that pose. If decrease then is sure because muscles activity, but if it we do it over the other side, we cannot be sure if decrease the curve because muscle activity or because gravity force. As Schroth nook says, sleeping over the concave side decrease the curve.

35

I think it should to be done as the study says, that is over convex side. The way to see if it is useful or not is to see if the curve decrease during that pose. If decrease then is sure because muscles activity, but if it we do it over the other side, we cannot be sure if decrease the curve because muscle activity or because gravity force. As Schroth book says, sleeping over the concave side decrease the curve.

36

So I'd it curved to the left you'd sleep on the right side?

37

I agree, Arturo.

38

Just throwing this out there - the Schroth therapist I see has me sleeping with my concave side down, not my convex side down. As if we all needed another wrench to be thrown into this conversation! There is simply not a magic pill (or one magic exercise) to fit all scoli cases.

39

So you are saying that before after x-rays are wrong?
Yes, your concave side down decrease your curve, you not need any muscular activation, the same I suppose can not be said about the convex side.

40

I'm not saying the X-rays are wrong. Here are my 2 major issues (which I state in my blog post):
1. They did not just tell their patients to do a side plank, which most people reading this blog are attempting to do. They taught them the exercise, made sure they knew how to correctly do it for their scoli, AND followed up with them to AGAIN make sure they were doing correctly. ALSO, there were 7 different modifications to the side plank exercise, all of which will have different muscles firing. So in fact, they are not doing a simple side plank, but 7 different variations of a side plank. How would a normal person know what to do?
2. Two different groups of scoli were lobbed into this very small study; young idiopathic patients and older degenerative scoli patients. The origin of those two groups of scoli are VERY different and those bodies will respond VERY differently to exercise. The study was very flawed by one particularly high curve from the degenerative group (and most people on this post have idio scoli). If you look at the study, many of the idio scoli people didn't get better and one patient actually got worse by doing this.

Those are the main reasons why I think this research should be thrown out. There are too many variables, so I don't trust it. I'd love for the research to be done again with stricter parameters.

41

Is true and very much strange so many degenerative cases something I think too many less often than IS and all of them are the only really big curves. Anyway I see in the study a 43º improving to around 25º, it says explicitly about a 49.2% reduction case.
Dr. Loren Fishman is in Facebook, I have send him PM and he responded me, is true what you said about some difference among different cases, but the exercise was always done with concave side of the main curve down, is what the study says. Certainly to get a reduction need to change the structure, so what is needed is to change the length of the muscles, not just only make them stronger and of course convex side muscles need to be shorter, Schroth also says this and also says that concave side muscles need to be longer. It seems to be a fact that strengthening a muscle makes it shorter, so if it is done over the convex side and THE CURVE HAS A SIGNIFICANT REDUCTION IN THIS POSE (I don't know if this happens) then we may think we are strengthening the convex side and making longer the concave side .

42

You're right. Some people have had a curvature decrease using a form of a side plank pose with the convex side down that the study proved, and some did not, which the study also showed. Actually, some increased in their curvature. I'm not putting my money in any camp with ANY side plank being a magic pill, because if nothing else, this little study shows that NOT ALL curves showed a decrease while doing the side plank with the convex side down.

43

Surely there is none method 100% effective. I cannot imagine a 120º degenerative case, except it would be an extreme osteoporosis case, but then vertebras should to be extremely deformed so only a very much effective method may achieve such reduction. There's a SEAS study only about IS showing good reductions in adults, buy anyway nothing is so impressive like this study. If it's not a fraud (is strange so many and extreme degenerative cases) it must to be understood what exactly is doing this exercise in the body.

44

I would agree with those conclusions. I would also say that there needs to be more clear research, with precise exercises done that can be repeated at home without the supervision of an exercise specialist. The different types of scoli must be broken down in the research and cannot be clumped together. It's too confusing and clear conclusions cannot be reached. I'd also add that if research desires to show that an exercise needs to be done unilaterally (only on one side), that both side must be tested so it's clear as to which side actually produces results. Arturo, I think we can finally agree upon those conclusions. 😉 I hope other parents of kids with scoli around the world see you as an admirable example of how to fight for their child's scoli. Bless you, Arturo, and your daughter. -Erin

45

Thanks Erin, you are a good, passionate and also beautiful woman really.
Unfortunately science is in deapers so we cannot deduce what is possible to do or not. In an adult the cause of the curve, the only actual cause is the tissues deformation, gravity force leads to progression but only because tissues are not normal, so the only one possible solution is to alter those tissues in the right way, but we don't know how much may be altered in a natural way, how much may muscles be shortened, ligaments be strengthened, discs regenerated..

We knew before this study that some significant modifications are possible since people using Spinecor for adults with reduction in brace holds the reduction after removing the brace for a while.. The only way we have to know the true is through these studies.. 'Only one' side plank seems something really logic, I have heard recognized authorities saying that cannot work but they never said why, I realized in all this time that nobdy around the world has enough knowledge about scoliosis to say what may be and what no.

46

Spiral Spine has migrated away from the Disqus platform for discussions. Please go directly to spiralspine.com to comment on blog posts from now on. We are using a new platform for discussions. The direct link for this blog post is http://spiralspine.com/side-plank-theory-scoliosis/ . Thanks Arturo and I look forward to chatting with you on my website. -Erin Myers

47

'There I found that contrary to the recent report, the exercise is supposed to be done with the CONCAVE side of the curvature in the rib cage aiming down towards the floor.'
I have the Schroth book and I don't see where they said this. May you say me where did you see this?

48

page 111, Fig. 270, the picture in the bottom left corner of the page. I quote from the wording, "Scoliosis: The concave side faces the floor." http://www.amazon.com/Three-Dimensional-Treatment-Scoliosis-Physiotherapeutic-Deformities/dp/0914959026/ref=sr_1_1?ie=UTF8&qid=1455575280&sr=8-1&keywords=three-dimensional+treatment+for+scoliosis Three-Dimensional Treatment For Scoliosis by Christa Lehnert-Schroth, PT

49

Are you sure is figure 270? I have the Spanish version so number of pages are different, but of figures should to be the same and I don't see that,

50

Here it is.

51

Thanks, is really strange in the Spanish version there's not nothing like this.

52

If Schroth is doing since around a century the Side Plank over the concave side, it's a proof it doesn't work over this side, otherwise we have thousands of amazing reductions and never was a Schroth study showing it.

53

I don't have enough information to come to that conclusion. The thing is that this is just one tiny exercise in a massive book of exercises specifically for people with scoli. And, the Schroth method HAS HAD thousands of amazing reductions and TONS of research to back it up. Schroth has never claimed that one exercise is a magic pill for scoli. Actually, Schroth strongly states that each different kind of scoli needs DIFFERENT exercises for successful curve reduction. Interestingly, if you see under the heading in the picture I posted above it says, "omit in the case of four-curve scoliosis." I have four-curve scoli. There's a reason my body doesn't like side planks as a rehab exercise. Most degenerative scoli cases are a big "c" curve, or three-curve scoli. That's possibly one reason why older people have had success with this exercises...despite what side it's done on.

54

Hmmm. Yes, very odd. I don't have an answer for that.

55

I will say from experience, that your theory holds true, as I had my "s" curve daughter perform yoga exercises with this in mind and her degree went from 10 to 5 degrees in a few months. It just made more sense to me and we thought the exercises really could only help her strengthen her overall spine anyway. After a few months there was a re-check at her doctor's and it's down to almost a straight spine, despite her going through another 3.5 inches growth spurt in one year, and her pediatrician asked what we were doing. He said he was intrigued and he was very happy with these results, too. She is doing right side planks on her concave side and stretches on her convex side, along with cat stretches, bridges and downward dogs, and it worked so well we were surprised and elated and goes to show you that there is still a LOT of research to be done about this !

56

Hi Corinne,
I have a 12 year old daughter with moderate 'S' curve. We are very much opposed to surgery and are trying alternative treatments. The success of your daughter's correction is heartening. Just to be clear, is she doing side planks on her upper/lower concave side ? Also are you doing anything else as support along with yoga such as nutritional supplements ? Could you please list anything else that she may be doing to reverse the curve. Thanks a bunch.

57

Yes, we concentrated planks on her concave/ 'hollow' side, which in her case was her thoracic /upper spine. ((Her lumbar curve was prettyninsignificant so we focused on her larger curve.) No supplements, as she has an excellent, healthy diiet. I strongly suggest reading as many yoga for scoliosis sites as you can. I am including the link to a video which we founded her exercises on and i found extremely useful and informative. To that, we added bridges, cat stretches, supermen, and her favorite lying stretch, when you lay down flat on yougr back and bring the bent leg on you convex side acrros your body to touch the floor on the concave side, to stretch out the convex side. Since the curve is pretty insignificant now, i had her switch to exercises that focus on both sides instead of targeting one, just to keep everything in line. When we started, she was faithfully doing the exercises 5x per week, as she had no desire to enter middle school with a brace (which i read were a temporary 'band aid' anyway) now we do strsight yoga 2x per week to keep it in check.. i hope this helps! Here is that link https://m.youtube.com/watch?v=9TWtrCmzaOw Good luck to you! You're right in being proactive with this. Educate yourself as much as you can.

58

Thank you very much for your reply, Corinne. We will practice the exercises you mentioned and yes, I will read up some more about Yoga for Scoliosis. Hoping for the best !

59

Corinne, I'm so happy to hear that your daughter was able to decrease her curves to almost nothing with just exercise. Way to go!!!!
Blessings,
Erin

60

also, as per the study:

- strengthening the quadratus lumborum and paraspinal muscles of the convex side works to equalize and balance the muscular tensions that produce and sustain degenerative and adolescent idiopathic scoliosis. A small variation to the Iyengar version of the side-plank,Vasisthasana has proven to be a reliable way to accomplish this in our studies so far

- Some scoliotic curves are a simple “C,” generally in the lumbar or lumbar and thoracic spine. Others are “S” or inverted “S” in their shape, and a few are triple or even quadruple curves. In our first study of 25 patients we concentrated on the lowest curve, only using Vasisthasanaand only with the convex side downward, but found that the upper curves also got smaller, but not as quickly, and not as much. Some researchers believe that the upper curves can be compensatory, which would explain this effect. We are nevertheless working now with other postures and having somewhat better results with the upper curves at this point. The more complex curves require individual analysis.

61

Tedi,
Thanks for your post. Great information. Please keep everyone at Spiral Spine informed of your movement findings as you do more research.
Blessings,
Erin

62

Hi Ted,
I sure will. I'm in the process of revamping the entire site and plan on having a section where all the scoli research I have will be accessible for everyone to read on their own.
Blessings,
Erin

63

the research is about the lumbar curve which is actually the lower curve in S shape scoliosis, therefore the convex side of the lumbar curve is on the same side with the concave side of the thoracic curve. Thus there is no contradiction doing the plank exercise on the convex side of the lumbar curve as the study states.

64

Hello tedi, i am really very surprised that no one has replied to this comment because it truly solves the big controversy here (or lack there of). If you read this Erin please weigh in with your thoughts. Study says lumbar convex down for the plank. Erin says NOooo! Thoracic concave must be down! THEY ARE THE SAME THING IN AN S CURVE! YOUR EXCERCISE IS THE SAME THING. It seems to me what the confusion is that in almost all of Erins posts she will say concave down but does not refer to whether that is lumbar or thoracic. Just my 2 cents. Dave

65

Hi Tedi and Dave,
Sorry for my delay in responding to Tedi's post. His comment slipped through the cracks. By no means did I intentionally not respond. I haven't read the side plank research in some time (because I think it's a joke and have been reading other scoli movement research that's pretty awesome...I'll share it, don't worry). That being said, I'm pretty sure the side plank research was aimed at cuing just the thoracic curve. They're saying that the thoracic convex side should be down (meaning thoracic concave and lumbar convex is up, not the lumbar concave).

Tedi, you're right in saying that the lumbar concave should be up. Yes...meaning that the thoracic concave should be down. Tedi, we are saying the same thing, but I think you've misinterpreted the research about what side is down. You want thoracic concave down and lumbar concave up. The research says the opposite.

The lumbar concave is too short and not strong enough. That side needs to up be. I prefer to do regular Pilates side lying leg work with the lumbar concave up and a rolled up mat under the convex lumbar side on the floor to work this area. It forces the lumbar curve to open up over the rolled up yoga mat. Then, in that long, stretched state, I'll do different side lying leg exercises (up and down, forward and back, circles etc) to get the muscles in the concave area to fire and build up strength and girth. I do this in my workout video Hard Core Scoli.

Hope this helps guys! Nice job working through all this.
Blessings,
Erin

66

Thank you so much for your reply Erin. I wasn't meaning to speak about you without addressing you directly. Lol. I will have to pull up the original study to confirm as this is sort of hearsay that I picked from another site talking about the study. Here is what was said. (Here is a direct quote from the author to further clarify: " The 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.”) So i will try and confirm this.
Don't get me wrong I am not buying this whole study, at all. You will not offend me by proving it is a load of crap. I have been forced to be a skeptic about any suggested treatments for scoliosis because there are so many purveyors of success by pseudo scientific practitioners out there, that if I followed them all I would be broke for sure. There are two things that motivate me. Pain reduction and scientific proof. Are you thinking that not only were the participants doing the exercise incorrectly but that results were fabricated? Because if you are not thinking they were fabricated here is my thoughts. If that study can prove that even ONE single person maintained correction in the 30-40% by doing anything, that is far more than any other treatment method can provide. Evidence for curve reduction is pretty much non existent out there. As far as I am concerned if the outcomes were not fabricated they must be on to something if they are showing reduction in an S curve. C curves to me are far less complicated by things like rotation and there is some existing evidence of ability to reduce these curves by postural improvements, leg lifts etc. So if you think that any treatment modality you are working on, or are even aware of are better at reducing curves, to me, they hold absolutely no value unless backed by radio graphic evidence. Do you have any evidence for them? Testimonials and anecdote on there own can verify alien abductions, proof of bigfoot, evidence for the loch ness monster and so on. Scour the net and you can find a testimonial for just about anything. Please don't get me wrong Erin, I do not mean to personally attack you at all. I am glad someone is out there chasing these answers. We need you! The reason I am quizzing you is not to defend this study, but to disprove it if it is bogus. I just want to establish for certain there is no validity to it. If the results are not fabricated to me there is something to investigate here regardless if anyone thinks the exercise was done incorrectly (which it may be possible that you think they are being done correctly). Anyway lend me your thoughts. Thanks for your response! Dave

Thank you!

67

Hi Dave,

Convex of the lumbar curve down is what I'm saying, so the other site you're looking at is agreeing with what I'm saying, and disagreeing with the study. I do have X-ray proof showing that how I work with clients decreases Cobb Angles in some cases. Actually, I have an email sitting in my inbox right now from a mom showing the X-rays of her daughter from a few months ago. In a 10 month time period of me working with her, the daughter's main Cobb Angle went from 75 to about 60 degrees. And for the record, we never once did a side plank 😉

Enough of that, I've got what you really want...research proof showing that movement helps. You said it wasn't out there, yes it is. This is from the original version of The Beautiful Scoliotic Back. I'm working on putting all this info into a new book called Analyzing Scoli. I hope to have it out in the next year or so, just depends on how much downtime I have with my heavy scoli client load. The info below is a drop in the bucket to the amount of research that's actually out there. I left this information as a comment to a man, many comments ago on this page:

Medical research idiopathic scoliotic findings

• Rotational stiffness is related to the severity of curve in frontal plane 2
• The more rigid the curve, the more likely it is to worsen 4
• Muscles weaker on concave side of thoracic spine 7
• Weaker when rotating towards concavity of spinal curve 5
• Asymmetry between lumbar paraspinals and obliques 5, 6
• Causes postural alterations in orientation of head, shoulders, scapulas, pelvis, and rotation of body segments in horizontal plane 9
• Characterized by decrease in standing stability 9
• Surgery reduces frontal plane curvature and only minimally helps with axial rotation, so rib hump can persist after surgery 2
• Results of exercise to correct muscle asymmetry are equal to or better than bracing 6
• Scientific community gives very little consideration to physical exercise as a form of therapy for scoliosis 10
• Physical exercise important during growth to delay or prevent need for bracing and/or keep scoliosis under 30 degrees 10
• Physical exercise positively influences breathing function, strength, and postural balance 10
• Muscle deficiency can be corrected with specific torso rotation and lumbar extensor strengthening 6
• Frontal plane curvature corrects in response to lateral bending, but axial rotation does not 2
• Ribcage side-shift exercises can stabilize curvature progression in adolescents 4
• Functional scoliosis caused by tension of muscles surrounding the spine 1

Research and References

1. Azegami, H., Murachi, S., Kitoh, J., Ishida, Y., Kawakami, N., Makino, M. (1998). Etiology of idiopathic scoliosis. Clinical Orthopaedics and Related Research. 357:229-236.

2. Beuerlein, M., Raso, V.J., Hill, D.L., Moreau, M.J., Madooh, J.K. (2003). Changes in alignment of the scoliotic spine response to lateral bending (abstract). Spine. 28(7):693-698.

3. www.ESpine.com

4. Hawes, M. (2003). The use of exercises in the treatment of scoliosis: an
evidence-based critical review of the literature. Pediatric Rehabilitation.
6(3-4): 171-182.

5. McIntire, K., Asher, M., Burton, B., Liu, W. (2007). Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study. http://www.scoliosisjournal.co...

6. Mooney, V., Brigham, A. (2003). The role of measured resistance exercises in adolescent scoliosis. Orthopedics. 26(2):167-171.

7. Mooney, V., Gulick, J., Pozos, R. (2000). A preliminary report on the effect of measured strength training in adolescent idiopathic scoliosis (abstract). Journal of Spinal Disorders. 13(2): 102-107.

8. Myers, T. Anatomy Trains. 2nd edn. Edinburgh: Churchill Livingston; 2009.

9. Nault, M., Allard, P., Hinse, S., LeBlanc, R., Caron, O., Sadeghi, H. (2002).
Relations between standing stability and body posture parameters in a
scoliosis. Spine. 27(17): 1911-1917.

10. Negrini, S., Antomini, G., Carabalona, R., Minozzi, S. (2003). Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Pediatric Rehabilitation. 6(3-4): 227-235.

11. Omey, M.L., Micheli, L.J., Gerbino, P.G. (2000). Idiopathic scoliosis and
spondylolysis in the female athlete. Clinical Orthopaedics and Related
Research. 372: 74-84.

12. Pashman, R. (2001). Adolescent Idiopathic Scoliosis. Backtalk 24(1).

13. Taft, E., Francis, R. (2003). Evaluation and Management of Scoliosis. Journal of Pediatric Health Care 17(1): 42-44.

14. Thek Lineback, K. Scolio Pilates. Hauge Printing; 2011.

15. Warren, M., Brooks-Gunn, J., Hamilton, L., Warren, F., Hamilton, W. (1986). Scoliosis and fractures in young ballet dancers. New England Journal of Medicine. 314(21): 1348-1353.

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Hey Erin, I hope you are doing well. I wanted to comment on a few things mentioned on this post. I want you to know that in no way am I lashing out at you. I just want you to take a few things into thought.
With the side plank, the convex side DOES need to be facing the floor. In order to correct or decrease worsening, contrary to what you believe, or have been told, this actually does promote a straighter spine, especially if you exaggerate the pose. If you perform the side plank the wrong way (concave facing the ground), you are promoting and further increasing the concavity, which is completely opposite of the intended effect. The researchers found significant results because they DID the exercises in the correct fashion. These researchers no what they are doing and have an understanding of the kinesiology of the spine.
The researcher are correct when they say that the longer/stretched extensors are the areas that need to be strengthen (hence, convex side facing the ground with a side plank). And yes, the point IS to make the long side stronger which coincides with that muscle shortening. I don't think you understand the purpose of these muscles.
The rhomboids should not even be a concern with this exercise. In the side plank position, the rhomboids shouldn't be of a concern at all because they are not hardly working at all. The point of the side plank is to strengthen the core muscles and spinal lateral flexors, it has nothing to do with the trapezius or the rhomboids.
I don't think you understand why the muscles on the convex side of a curve are beefier. It is is the rib cage causing the beefy appearance. Because of vertebral rotation, overtime, the ribs will create a rib-hump which will give the appearance that the muscles on the convex side are stronger. Here is a picture to help you understand: http://www.waltfritzseminars.com/blog/?p=839. Scroll down to view the superior view of the ribcage.
Erin, I have scoliosis. If I consciously straighten my spine and place my hands behind me on both sides of my vertebral column, I can physically feel where the once-was convex side is working to keep my spine straight. On the once-was concave side, the muscles are not tightened, which means they are not working nearly as hard as the once-was convex side. This, my friend, is why the side plank works when the convex side is placing down. I don't think you quite understand what muscles are involved and how muscles are used during certain movements.

To anyone reading this comment, PLEASE PLEASE PLEASE do not perform the exercise with the concave side down, you will only worsen the concavity. Erin, please do your own research study worthy of publication before telling your information-seeking readers to perform the complete opposite exercise of a study that has shown to have significant findings (proven results).

69

It has very much sense! I believe that only people showing successful reduction cases may say to people suffering something so difficult to fix as scoliosis is, what to do or not to do.

70

You're fired up Patrick and so passionate about movement. I love it! I'm always up for a good conversation about a topic I know a lot about, so let's get at it. This should be good!

As for the "proven results" comment you mentioned at the end, if you go through the actual research, that's not the whole truth. The research is quite flawed, which I went through in my main post. That being said, let's talk kinesiology and muscles.

My major issue with this whole "magic pill" side plank exercise is that no one does this exercise (or any exercise for that matter) correctly at home unless they've been taught it repeatedly with much correction, which yes did happen in this study. I don't want to encourage ANYONE to really do this at home unless they've seen someone who's given or "prescribed" this precise exercise for their precise scoli. I would agree with you that if this exercise was done with the thoracic convex side down for some people in a very exaggerated past midline fashion with correct modifications for their scoli and in great alignment that it could be beneficial for some people. If I did it for my scoli I would end up in psycho muscles spasms and it would make my specific scoli worse. But yes, kinetically and theoretically I would agree with you.

I know very well that there is vertebral rotation that is involved with all idiopathic curves. I battle it with my clients daily. It goes down the spine like a DNA double helix. Yes, in the convex portion of a thoracic curve the ribs protrude posteriorly (I hare the wording "rib hump"). Nice link that you posted in your comment by the way. Totally true and a good post. Anyways, the muscles are also beefier on that side than on the concave portion because they have been the workhorses that have been holding up the spine in that part of the curve for a long time. Yes, those extensor spinal muscles are long and are also overworked and beefy, yet need to be shortened. True. I do understand that the spinal extensors are what they are attempting to shorten by doing the side plank exercise, but in a side plank, the traps and rhomboids HAVE to work because that's what connects the scapula (and hence arm) to the spine and you must stabilize yourself on your arm to do the side plank. In this exercise you cannot have some of those muscles work without the others. It's kinetically impossible.

In most people with a thoracic convex curve to the right you can't shorten the right spinal extensors first because the too short traps and rhomboids take over. It's an evil little cycle. To get out of it, you must let the entire right thoracic convex side chill out (be that time, trigger point work, myofascial work, etc). You must, must, must strengthen the atrophied concave traps and rhomboids and shorten them. I would choose to strengthen them in a different way besides a side plank, but if correctly aligned a side plank will do the job. The atrophied concave spinal extensors also must be worked, but extremely carefully in a long state to help the workhorse convex spinal erectors not have to work so hard. The concave erectors have been locked short for a long time and have to be released and then strengthened in a long state.

As for the core work comment you made, there are many more efficient and effective ways to strengthen someone else core than a side plank, especially for someone with scoli. A side plank is not the only option.

Phew! That was a long reply. I'm very passionate about scoli and correct exercise and stand firm behind my position. Thanks for your comment a putting you passion down in writing.
Blessings,
Erin

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Thank you for the reply, Erin. I went back and read my comment, and good grief! I sounded so angry, I'm sorry for that, it was not reflected of what my tone actually was. Thank you, also, for your passion for the body and wellness.

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I find the article confusing where the author refers to right and left side. Wouldn't it have been better to continue using convex and concave? I felt like the author was thinking about her own spine. In my case, the big beefy muscles (convex side) are on the left, so I had to try a second time to follow this. Then I gave up. It's too difficult, frankly. The writer should revise this article without saying left and right and just stick with convex and concave. I will stop reading and just work with the concave side down (my left, not my right -- I think).

73

Sorry for any confusion I may have caused you. One of the biggest challenges I face is attempting to simplify the extremely complex topic of scoliosis. With every curve there is a concave and a convex portion, yes, you are are correct. Forget left and right. Convex will be the muscularly beefier side, yes, again, you are correct. And, if you have a curve in your ribcage, the convex side will be closer to the shoulder blade.

I remember concave by thinking I'm inside of a cave, where it's rounded over my head. I know it's a weird way to think about it, but that mental picture has stuck through all these years and has been the only way for me to remember how to differentiate between the two. The shoulder blade on the atrophied side, the concave side, is farther away from the spine. Hence, those muscles need to be fire in order to pull the spine towards the shoulder blade.

Do NOT do the plank with the convex, the beefier side, down. That's what the research says - and what I'm arguing NOT to do. It's only making the beefier muscles stronger and pulling the spine farther away from center. You need to work the atrophied muscles to help pull the spine closer to the midline. The concave side needs to be down.
Blessings,
Erin

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Hi Erin, I agree with you, but we also agree with the study. Why I'm saying this is because the study says:

"To understand why this yoga pose may help in sco- liosis, it is important to conceptualize the physics involved in creating scoliotic curves. A simplified analy- sis of how humans stand erect involves the symmetrical downward pull of the dorsal, abdominal, intercostal, and paraspinal muscles. Scoliosis, then, could be explained by asymmetry in the force these muscles exert on the spine. The spine will bend toward the stronger side, and thus, the muscles of the convex side may be weaker than their smaller-appearing counterparts on the concave side (Figure 5). We speculate that the side plank pose is useful for strengthening the convex side’s quadratus lumborum, iliopsoas, transverses abdominus, oblique, intercostal, and paraspinal musculature, which, in turn, might straighten the spine (Figure 5)."

Is clear that the authors made a mistake, calling convex what is concave. Or not?

Here you can find the ORIGINAL AND FULL RESEARCH: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268609/pdf/gahmj.2013.064.pdf

Hoping you'll answer me what about you think, after reading the full research.

Thanks, Kevin.

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Hi Kevin,
I've read the full research MANY times, and I just don't really like anything about it. No, I don't think they have concave and convex mixed up in their theory, but research shows that with idiopathic scoliosis the muscles aren't what initiate the scoliosis - other factors are (like hormonal imbalance, nutritional deficiencies, neurotransmitter imbalances, the dura and spinal chord physically being shorter than the bones of the spine, etc...) are what cause it. Muscles respond to the original cause that bent the spine. The research also doesn't mention the role of the rhomboids and the trapezius muscles, which would act more like the wires on the Eiffel Tower than the Erectors of the spine because of their angle of pull.
-Erin

76

I see this post is now a year old, but stumbled upon it this morning.

I am 20 years old and have S curve idiopathic scoliosis - the left side of my stomach has a straighter edge while my right side is curved inwards. Meaning my lower curve is concave.

I noticed it's significantly more difficult for me to perform the side plank on the side when my lower concave curve is facing the floor, than the other way around. If I do it on that side, is there a chance my higher curve could be negatively affected? This was a great post, thank you!

77

Hi Frances, I just want to make sure I have this correct. It seems as thought you have a backwards "S" curve, with an upper right curve in your thoracic/rib cage area and a lower left curve in your lumbar spine area. Each curve has a concave and a convex portion, so it can be tricky when attempting to describe the curves correctly. If my interpretations of your curves is correct, then what hand is on the floor when the exercise is harder?
Blessings,
Erin

78

Yes! I think I expressed it incorrectly.

It's much harder when my right hand is on the floor, even though I'm right handed. When I'm on that side, my thoracic curve is convex towards the floor

79

Yeah, the hard thing is that there could be so many reasons that it's harder with your right hand down. It's most likely not going to help your upper curve, but obviously it's helping some other under worked area of the body. There are simply too many variables, which is why I'm not a fan of the "magic pill" side plank exercise. Do what you feel is necessary, but be careful. Look at all the other posts about the side plank on SpiralSpine.com that I posted of people's back who got worse doing it. If you continue to do it on that side, you're going to want to measure your back with the scoliometer to make sure it's not getting worse (Scoliometer by Spiral Spine in the iTunes App Store is what I use to track my clients' back with. I have lots of blog posts about that too).

80

I know this discussion is old, but I was doing some reading about this study online and found your site. I have a C shape convex to the right. I don't know the degree or really much about it. I was diagnosed back in elementary school in the 80s then it was not spoken about ever again. I am trying to learn more about it now that I am in my 40s. I do yoga and while I don't focus on only one pose (like plank) I do find yoga to be helpful. I have Ms. Elise Browning's book (I have found it to be a good resource). I am interested in learning more about your take on it and how pilates might help strengthen my muscles and hold my spine in place. I will spend some more time poking around at your site. But if you happen to read this, could you tell me if there a list of practitioners on your site somewhere? I couldn't find one. Thank you so much for writing this (and for the other posts and videos too)!

81

Hi Nancy,
Welcome to the discussion and congrats on wanting to take control of your scoli. As for a list of practitioners, watch my video blog post titled How Do I Make My Scoliosis Better? http://spiralspine.com/make-my-scoliosis-better/. Let me know what town you're in and I'll let you know if I know someone there. I'd encourage you to get Hard Core Scoli http://spiralspine.com/book/, my workout DVD if you want to have an at home Pilates workout for scoli. Also, please watch the Starting Point Series http://spiralspine.com/scoliosis-starting-point-series/ to get a better grasp on your scoliosis and to figure out where to prop yourself when exercising, be that yoga or Pilates.

Blessings,
Erin

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Rameshwar kapoor

Hi All,
I also have a mild scoliosis which is a 'C" shaped in my lower back section. Which makes convex to my left side and concave on other. I recently found out that by performing side plank it may help improve the curvature. I then tried doing side plank keeping convex side downwards and concave facing upside. Though I have done it only once and going to continue with the same. I feel when we lift the hip during performing said exercise with body weight on hand instead of elbow then it makes your muscles to strengthen and push the convex side upwards. I guess that may help but it actually depends upon the final results. Even if we do it on the other side then we can't raise the hip as it will again worsen the curve as that would strengthen the muscles of concave side . I feel one can just get into the side plank position with concave facing the floor but should't raise the hip, that may work as stretching the concave side. That's what I understand and would love to discuss it with all. Thank you

83

I believe I am the same as you Rameshwar. C shape if you look at me from behind. So my personal left hand side of my body is straight & my right hand side is curved inwards. So I call my right hand side my Concave side. I believe that is correct. I think Erin was saying in contrast to the original study, to try the side plank with the concave (curved inside) side facing the ground. Is this correct?

84
Rameshwar kapoor

Exactly, thats why I said that whatever we do and if that benefits any of us then we can share that info with each other to help. I hope so, that you got my email id and we can even communicate there as I don't wish to flood Erin's page with msgs everyday. I hope you understand that. I'm doing certain changes in plank to strengthen lower right side of my back where you and me have got the "C" curve. I did read about schroth method a bit too and from there I was trying to mold the plank according to the need. mail me on rameshwarkapoor24@gmail.com and we'll try to share some more info in detail. hope to hear from you soon.

85

If you do exactly what you've been doing and raise the top leg in your side plank (the right leg) it will help to fire the muscles in your low right back that need strengthening.

86

This is v.helpful. Thank you

87
Rameshwar kapoor

Thank u Erin, that's exactly what I'm gonna do. Actually I'm doing Side plank along with other stretching exercises, like Head to knee, Head to knee side wise and kind of hanging so that I first stretch the concave side and then perform side plank to strengthen the convex side. Do you think this would work out??

88

The concept seems like a good start. Do it all in front of a mirror so you can keep an eye on alignment. Either go to neutral or overcorrect your curves while exercising. If you need help with learning about watching your alignment while exercising you can get Hard Core Scoli.

http://www.amazon.com/gp/product/B00W3XHVEK/ref=as_li_qf_sp_asin_il_tlie=UTF8&camp=1789&creative=9325&creativeASIN=B00W3XHVEK&linkCode=as2&tag=spirspin-20&linkId=ILBF2L26AZYYVPHU

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Rameshwar kapoor

Thanks for the suggestion But do you think that side plank following stretching exercises would work out??

90

Truth be told - there are too many variables for me to promise anything. I don't trust the research mentioned above to say it'll work, but the fact that you had mentally worked through your scoli and described it in an understandable fashion makes me think that you can test to see if your plan will work. This isn't going to be a magic pill, but do it for a bit and see if you have success. You can see in other blog posts that other people didn't have as much success with the side plank though.

Feel free to upload a picture of your back to this post if you want me to look at it. It's hard for me to say anything without seeing it.

91
Rameshwar kapoor

Hi Erin, its been quite long since I posted a comment. I've something to talk about. Need to share a pic with you. How to do that, I've no idea. May be you have my email id, so if you could just drop a mail to me then I can also share the pic through mail (maintaining the privacy). Reply awaited.

Thank you

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Rameshwar kapoor

Hmmm, I could not mark my spine myself, needed someone to mark it for me and take a picture. I'll do it asap and then upload that here. That said, about side plank we can't come to conclusion as we need to 1st continue doing it for quite a sometime and then if there are any changes, be it good or bad, will help us understand the side plank properly. Anyway I got to know about one scoliosis center in London, links is below
http://www.scoliosissos.com/results/patient-results-20-39yrs.shtml
I wanted to check for more info as what all therapies they use, trying to get the info and share with you guys.
Till then go hard on your scoli 😉

93

If you in fact live in London and have access to the Scoliosis SOS clinic in London you hit a gold mine!

94

Scoliosis SOS clinic has helped people

Do a Google search for 'daily mail scoliosis SOS' & you will find many stories of patients it has helped.

However when I looked into it, it required a few months off work (although they can provide a sick note for you) & it was £££ be aware. The consultation is also quite hefty. So you need to be ready to take this step time wise & financially. Of course if it works thats wonderful.

That's why I'm trying to see if I can gain improvement through yoga first/a more time/cost effective way.

Private Skype consultations over the internet Erin?!

95

Where do you live? I can help you find an someone in your town who can help you.

96

Thanks Erin. That's very kind. I live in Richmond, Surrey, U.K. South west London

97

Sophie, I just reached out to a Pilates instructor I trained who now lives in the London area. Her name is Prue Armstrong and she gave me permission to give you her private info. I'll email it to you. Prue is AWESOME and knows how to work with people who have scoli. We shared many clients when she was living in Nashville, Tennessee. If for some reason she's befuddled by your scoli she'll be able to hook you up with someone in your area who is a better fit.

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Erin thank you so much! I'll check her out! Your recommendation is very valuable to me as most people in even the osteopathy, pilates fields don't actually know what to do with us! Thank you

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Rameshwar kapoor

Unfortunately not but if I got no solution for my scoli then would try for that. Till then need to stick to same regime, I'm quite confident of. Wish me luck 🙂

100

To add to my comment below, I have a side C curve in the lower section of my spine. So when you look at me from the back, you see a C, a bend to the left. I will now try doing the side plank with the bend, the concave side facing the floor, right hand on the floor & report back.

101

Sophie, I'm glad you were aware that your scoli was getting worse and stopped the exercise. If you haven't already seen them, check our my two other posts on the side plank theory.

http://spiralspine.com/side-plank-exercise-scoliosis-norway-case-study/

http://spiralspine.com/yoga-side-plank-scoliosis-demonstration/

102

Wow. Thank you so much for writing this. I have side scoliosis & have been doing said exercise on the side that is straight & it has got worse! I will try with the curved, concave side facing towards the floor now. Thank you!!!!

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Rameshwar kapoor

Hi Sophie, did you try the side plank otherwise. Like concave to face the floor?? If so then what results did you get?? Like it worsened further or you could improve a bit?? I'm also performing side plank on convex side since more than couple of weeks and haven't seen much difference but wanted to check as you mentioned in your post that performing plank on your convex side worsened your curve. So if you could share something, would be a great help. will wait for your reply

Thank you

104

Hi Rameshwar,
Well I've been doing the side plank since that post for as long as i can stand it (really only about 40 seconds!) and sadly I can't see it's better but it's also not worse (when doing the other side it was). The original study I think said to start with 30 seconds, then aim for one minute & then for as long as you can do. So it could be I'm not doing it for long enough. Or maybe our type of curve is more complex to solve. I would love this website to post more exercises to help straighten a side curve please!!

105

Sophie, I have helped many of my private clients maintain and even decrease their curvatures through exercise, but giving a miracle pill exercise over the internet that is a one-sized-fits-all is something that doesn't exist. The last thing I want to do is give an exercise that makes some of my followers' scoli get worse. That being said, I get the request for exercises ALL THE TIME. Hold tight, I hear your request for exercises...

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Rameshwar kapoor

Hi Erin,
As you mentioned in the reply to Sophie that you did help some with exercises so could you even suggest something here for the ppl having "c" shape in the lower section. Though I'm trying side plank on concave side now, I would like to know some more options and try and I feel for that there is no one better than you here to advice right. So request you to share something.

107

I need to see a picture of your back, be that an X-ray, a bare back picture where you are wearing a tight top, or dot sticker pictures (see the starting point series). A ""c" shape in the lower section" is not enough information for me to give an exercise. To further that, There's a high likelihood that you and Sophie may have slightly different curves, so Sophie needs to upload a pic of her back too.

108

I will do!

109

Hi Erin! Thank you for your reply! I understand it's hard to give one size fits all as we are all different. My curve is quite straightforward (so to speak!) It's a simple side C curve, so I just meant for more straightforward cases would be amazing or some insight or anything! Thank you for being so engaged! Sophie

110

I know I'm sounding redundant, but if you go through the steps in the Starting Point Series and use that knowledge while working your core in Hard Core Scoli, you should see results in your spine. If you pair that with finding a local practitioner (be that Pilates, Gyrotonic, or a Schroth practitioner) you should see a big change in your body. Use the Scoliometer By Spiral Spine App to track your rotation, write it in My Scoli Journal to see what therapies work (before you blow your savings on a multi-month clinic). If you need stories and suggestions of practitioners check out The Beautiful Scoliotic Back.

111

This is Massively helpful Erin! Not redundant at all as I found this thread through Google & had not yet found the other links on your website of Starting Point, Hard Core Scoli, the amazing app & further resources. Thank you for being so active on this page & committed to helping people. I appreciate it.

112
Rameshwar kapoor

Hi Sophie,
Thank you for your valuable reply. Even I did try planks on convex side and I didn't feel much difference but a bit ( worsned). Then I saw in Erin's one of the blogs that one guy practiced plank on convex side for couple of months and it worsened then I thought to do it on concave side. I'm doing it keeping certain things in mind. There is something called as rotation in your spine causing scoliosis so we need to reverse it. During plank on concave side I feel it does de-rotate the spine. As you do the plank your pelvis should be tilted towards left and torso on right.
Now as you are doing it for 40 secs a day, so I feel that would either take alot of time to show any changes. If you can do it for some more time then it may show the changes little sooner. I'm doing it for 30 secs, 20 repetitions. If calculated then 10 mins everyday for 6 days a week. You try to do it as per your strengths but improve the duration. Keep in mind that you need to even strengthen your shoulder.
Would update back if any changes seen.

113

Hi Rameshwar.
Thats a really good idea. I'll try & do your style of repetitions. I thought it had to be all in one go.
I'm interested in the fact that the scoliosis could be due to rotation in the spine as well.
Can you elaborate on how you do the side plank (on the concave side that goes in) & position the pelvis & torso at the same time?
Thank you!

114
Rameshwar kapoor

Hi Sophie,
Would you be able to share your email id??, so that I could send some attachments carrying some details on side plank and other stuff too, to fix the spine. As you have got very similar curve like I have so why don't we keep sharing the experience and look into that we should achieve what we are looking for. Let's help each other and once we succeed then will share with everyone so that they could help themselves. What say??

115

Yes I'm interested how do we share details?

116
Rameshwar kapoor

I'll give you my email id, thats rameshwarkapoor24@gmail.com. Send me an introduction mail, will carry forward from there.

117

Has anyone tested out whether doing it opposite to what the original study says gives better results?

118

To my knowledge there has not been research done to test the opposite side, if so I'd LOVE to see it. It would benefit the entire scoli world for this research to be done, since so many extremely knowledgeable scoli practitioners around the world have been debating over this. Furthermore, if this test is done they should redo the side plank research I wrote about above to fix the massive issues and to see if it really does work. Or we can all just agree that doing a side plank is not a magic cure for scoliosis and we can all just move on and help those with scoliosis with all of our different methods that do work.

119

Erin, It would be great to test the opposite side, also if the side plank study is redone and an extense follow up. But we must to take decisions with what we have. People affected by scoliosis must to be sure about what really works or may works and what never worked in order to avoid a surgery. It's full of non surgical methods trying to achieve this but we only knew about a study showing one that effectively can do it and it is about braces. But now we also have a study showing that a Yoga exercise may reduce in a very much significative way a curve, also a big curve and also an adult curve! So there is not any doubt we must to prove with that exercise of course!!!

If we think that Global Advance is a serious company, then we think that this study is also serious, at least in the sense that the escence of the abstract is right, so we may think that x-rays before-after values are right and the exercise was done as they said was done, that is, with the convex side of the main curve downward. Then we may be sure that there is evidence that this kind of exercise done in this way may reduce in a very much significant way a curve. We have not evidence about nothing else.. there is not any other study showing it.

120

Believe it or not, there are dozens of studies showing different specific exercises decrease Cobb Angle and rotation...they just weren't published in the last 12 months and therefore didn't make the news this year. This is one of the reasons I created Spiral Spine, to give this information out to the mass public in bite size, digestible pieces that they can immediately implement into their lives.

You seem to desperately want "the truth" and so my suggestion to you would be to get your hands on all these articles and read for yourself. I know someone who is a professor at a university and was able to do searches in all medical journals and find studies for me to read. I gave her a few key words, or names of specific titles I'd found, and she ran with it. I probably have over a hundred scoli studies I got that way. I read all the studies, disected them, and chose which ones I trusted and wanted to try on myself and my clients. I also knew one person who paid $20 to get access to an actual medical library at a large university then did all the searches herself there.

You don't have to be a doctor to get ahold of these studies. I would encourage you to not hang your hat too much on this one study. Open your eyes to the mounds of other studies. Best of luck, Arturo.

121

Erin, I'm seeking since 6 years ago something able to reduce in a significant way a big curve in adulthood, is not something only about this year, I may say I have looked for in tons of posts in the NSF forum, cientists sites, I even talked really a lot with a recognized scoliosis researcher so I may be really sure that never before was a controlled study showing significant reductions in adults.

I have talked with literally thousands of professionals around the world, a lot of them said me that they get good reductions in adults, but when I insisted in seeing the proof, they didn't want to talk with me any more.. just only one exception in all these years.

Nothing may do me more happy than seeing other studies proving great adult reductions too. By now I only may trust in this side plank study, the only proving what I looked for.

If you really know about other studies proving the same, say me please wich are, a reference, the name of the study, the reserchers, doctors.. something let me to find them.

122

I commend you for pursuing "truth" about scoliosis. Putting all this research in one place will take me a long time. I'll put it on my list for future blog posts. Thanks for telling me what you want. Martha C. Hawes PhD wrote a great book called Scoliosis and the Human Spine. It's really heavy, but she writes all about this research. I think I bought it through the national scoliosis website store.

Tell me more about you, or whoever it is who has Scoli. Age, degree, what type of Scoli, current exercise or therapies, what therapies have been tried, where you/they live... While academic findings are great, there oftentimes does get to be a point where you just have to try some different therapies and trust some people to help you. Age is not on your side with Scoli.

123

There's not other serious study in the world proving a significant reduction in an adult with a big curve. Martha Hawes (who was under 'surgical range') never published studies showing that, nobody did it, that's the reason why this side planks provoked so great interest around the world. This kind of discussions were exhausted in the Nsf forum, nobody around the world did a study showing a reduction in a big adult curve. If someone says the contrary, then must to show it.

I'm trying to know all I may know about this side plank before insists to my daughter to do it every day. She is 21 y.o. and has a 55º right thoracolumbar C curve according last x-rays 6 months ago. We live in Argentine, she is doing Gpr since 6 years ago when x-rays showed 57º. She has a really flexible spine, when she is lying down over her left shoulder and hip, I see all her vertebras aligned. She need to strenghten tissues fighting against gravity force. I thought they was mainly ligaments and fascias, but is difficult to believe this with this study. If there is something I don't know about it I need to know what is and I only may trust in evidences.

124

AHHHHHHH! Okay, now I understand why you are so persistent on all this; your 21 year old daughter has a curve over 50 degrees. Thank you for telling me this, now I know how to help you most effectively. You're a dad who is determined to help to his daughter. I see now.

If your daughter is 21 and still has a flexible curve (which is GREAT!!!!) then I would still lump her into the AIS (adolescent idiopathic group), not the degenerative scoliosis group. The huge curve reduction that we've been writing back and forth about was from an elderly person with degenerative scoliosis, most likely caused from osteoporosis. This is not the case for your daughter.

I don't know if you live near Buenos Aires, but I did a quick search online for Pilates and Gyrotonic instructors in the town and there are TONS. Since I couldn't find any Schroth practitioners there, I'd start with finding the most experienced and knowledge Pilates and or Gyrotonic practitioner in your town for your daughter. Start with what you've got locally, and lucky for you there are lots of great options! There are MANY continuing education courses for both of the modalities I mentioned and I bet at least one instructor there has attended one. I bet you'll be surprised what you find.

Lastly, now that I know this is about your daughter and you're looking for practical and evidence based exercises to do for our daughter, I've cut and copied this portion of a handout I put together from a scoliosis training course I taught a few years back.

Medical research idiopathic scoliotic findings

• Rotational stiffness is related to the severity of curve in frontal plane 2
• The more rigid the curve, the more likely it is to worsen 4
• Muscles weaker on concave side of thoracic spine 7
• Weaker when rotating towards concavity of spinal curve 5
• Asymmetry between lumbar paraspinals and obliques 5, 6
• Causes postural alterations in orientation of head, shoulders, scapulas, pelvis, and rotation of body segments in horizontal plane 9
• Characterized by decrease in standing stability 9
• Surgery reduces frontal plane curvature and only minimally helps with axial rotation, so rib hump can persist after surgery 2
• Results of exercise to correct muscle asymmetry are equal to or better than bracing 6
• Scientific community gives very little consideration to physical exercise as a form of therapy for scoliosis 10
• Physical exercise important during growth to delay or prevent need for bracing and/or keep scoliosis under 30 degrees 10
• Physical exercise positively influences breathing function, strength, and postural balance 10
• Muscle deficiency can be corrected with specific torso rotation and lumbar extensor strengthening 6
• Frontal plane curvature corrects in response to lateral bending, but axial rotation does not 2
• Ribcage side-shift exercises can stabilize curvature progression in adolescents 4
• Functional scoliosis caused by tension of muscles surrounding the spine 1

Research and References

1. Azegami, H., Murachi, S., Kitoh, J., Ishida, Y., Kawakami, N., Makino, M. (1998). Etiology of idiopathic scoliosis. Clinical Orthopaedics and Related Research. 357:229-236.

2. Beuerlein, M., Raso, V.J., Hill, D.L., Moreau, M.J., Madooh, J.K. (2003). Changes in alignment of the scoliotic spine response to lateral bending (abstract). Spine. 28(7):693-698.

3. www.ESpine.com

4. Hawes, M. (2003). The use of exercises in the treatment of scoliosis: an
evidence-based critical review of the literature. Pediatric Rehabilitation.
6(3-4): 171-182.

5. McIntire, K., Asher, M., Burton, B., Liu, W. (2007). Trunk rotational strength asymmetry in adolescents with idiopathic scoliosis: an observational study. http://www.scoliosisjournal.com/content/2/1/9

6. Mooney, V., Brigham, A. (2003). The role of measured resistance exercises in adolescent scoliosis. Orthopedics. 26(2):167-171.

7. Mooney, V., Gulick, J., Pozos, R. (2000). A preliminary report on the effect of measured strength training in adolescent idiopathic scoliosis (abstract). Journal of Spinal Disorders. 13(2): 102-107.

8. Myers, T. Anatomy Trains. 2nd edn. Edinburgh: Churchill Livingston; 2009.

9. Nault, M., Allard, P., Hinse, S., LeBlanc, R., Caron, O., Sadeghi, H. (2002).
Relations between standing stability and body posture parameters in a
scoliosis. Spine. 27(17): 1911-1917.

10. Negrini, S., Antomini, G., Carabalona, R., Minozzi, S. (2003). Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Pediatric Rehabilitation. 6(3-4): 227-235.

11. Omey, M.L., Micheli, L.J., Gerbino, P.G. (2000). Idiopathic scoliosis and
spondylolysis in the female athlete. Clinical Orthopaedics and Related
Research. 372: 74-84.

12. Pashman, R. (2001). Adolescent Idiopathic Scoliosis. Backtalk 24(1).

13. Taft, E., Francis, R. (2003). Evaluation and Management of Scoliosis. Journal of Pediatric Health Care 17(1): 42-44.

14. Thek Lineback, K. Scolio Pilates. Hauge Printing; 2011.

15. Warren, M., Brooks-Gunn, J., Hamilton, L., Warren, F., Hamilton, W. (1986). Scoliosis and fractures in young ballet dancers. New England Journal of Medicine. 314(21): 1348-1353.

125

Erin, thamks for let me know all of this. Some of those study I think I have never seen before and are really interesting. Also I'm analyzing what you put in your training course. I feel you are really passional, I don't know have many degrees do you have and how many you would have reduced, but even not being free of interest of course, I think you are really honest and you are sure about what you say. I know also other proffesionals about whom I may say the same.

Schroth is not in my country, I know about Pilates and Gytronic since many years ago as I know about Abr, Fed, Trm, Feldenkrais, Eutonia, Body mind centering, Spinecor, Alexander, EDF, Antigymnastique, Qui Gong, Yoga (of every kind) , Sohier, Chiropractice (eastern, tibetean, Indian..), Osteopaty, Okido.. Dohrn Method, Drop rain.. I may fill a lot of lines really naming all of the hundreds of alternative therapies, some of them really strange, almost unknow that I know. I analyzed all of them, I extracted the principles behind them, good ideas, good concepts, very much reasonable really, but how I may know if they may be enough? I cannot know it, so I only may trust in facts, and now I know a fact. As I said you before, really a lot of professionals, practicioners of those methods and others 'guaranteed me' a good reduction, but never showing me just only one case as I was asking for. I cannot believe a degenerative scoliois may reach 120º and if it can, it could not be very much different to a idhiopatic one so I have now a proof about something that works, how I may decide for other else having not any proof?. It would have not any sense, I cannot be so irresponsible, so I only may decide to consider other method if someone show me a proof, if not is because they cannot and they cannot because what they do don't work, at least not as I need. Anyway of course I'll appreciate very much if you say me who you think is the best practicioner in my city (Buenos Aires) of course, even thinking as I think that is extremely difficult to find someone doing what I need.

126

Arturo, I'm very passionate about all that I do, as you can tell. You can check out my bio at the "About Erin" tab at the top of the site. My husband jokes that I'd have three PhD's by the time I'm 45 if I had no other obligations in life because all I would do is go to school. I love school and I love gaining more knowledge. I have two sons, a husband, loads of clients, organic gardens, along with my own spiral spine to maintain. So, I share all my research and "papers" with the scoli world via Spiral Spine from all my night time reading.

I'm glad you benefited from the research I posted. I hesitated to post it because I've acquired MANY more exercise research papers since I wrote that. I'm a perfectionist, and didn't want to give you something incomplete.

Two quotes of Albert Einstein ring in my ears: "I have no special talent; I am only passionately curious", and "It's not that I'm so smart; it's just that I stay with problems longer." There ya go.

I hear you about all the different modalities. I know, it's overwhelming...for me too. The KEY is finding a very knowledgeable practitioner. That's it. The practitioner can stem from any of the modalities you mentioned. It's ALL about the person who is teaching. Many great instructors are trained in many modalities.

Since it's been years since I've studied Spanish, I'm not going to be much help in going through websites in Buenos Aires reading bios of instructors. Call or email each studio asking for rehab instructors who know how to work with clients that have scoliosis. In a town as large as yours, I KNOW there's an instructor there who can work with your daughter.

127

Thanks Erin, but that is what I did, I talked with tons of practitioners of every kind of specialities you may imagine, but nobody never up to now, gave me what I was asking for. So, is simply the conclusion, they cannot show me a reduction in an adult with a big curve because they cannot achieve this and of course, why should I trust in someone saying what they cannot prove? It would have not any sense of course!

128

In the Beautiful Scoliotic Back I put an excerpt from an interview, that happened years ago, where someone asked me about who would be on my scoliosis practitioner dream team. It was a really hard question to answer because I have so much empathy for people like your daughter, who are all around the world. I dare not puncture their balloon of hope because they don't have a specific type of practitioner at their fingertips. I get emails from people like that every day - people looking for help but can't find practitioners in their town.

It was because of that one little question that spawned me to start making usable products for people with scoliosis who could affordably access them all around the world. Use the Scoliometer By Spiral Spine app and check to see if specific exercises help or hurt your daughters back. That's real data on your daughter's back. Get the Hard Core Scoli video so your daughter can start to strengthen her core and increase the knowledge of her scoli body. If she has a very mobile lumbar scoli curve she is REALLY going to need a strong core to help stabilize it. If you study the Scroth literature, among many other scoli therapy techniques around the world, they all incorporate core work.

Save up your money and make a family journey to a Schroth clinic sometime in the next 10 years. It's never going to be too late for your daughter to see a practitioner. I actually just got an email from a 47 year old lady who JUST saw a Schroth practitioner for the first time. She has a 50 degree curve and is using Hard Core Scoli as a guide when she can't see her practitioner. There ARE active things your daughter can do.

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My daughter is following a tratment with her Physiatrist since 6 years ago and according x-rays her curve didn't progress and fortunately she is free od pain and having a really normal life. I agree musclular strenght is needed, but I'm looking for reducing her curve. Schroth I think is really good although is really very hard for me to understand the book, but is asymetric, sure is good, but they never posted just only one reduction in an adult, so I cannot be sure if they can. Certainly this study don't include Schroth but it's according Sosort's definitions and is very much dissapointing really http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4243472/

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I encourage you to email the head of the head of Schroth in Germany (Dr. Weiss) and also in Boston, Massachusetts in the USA (Dr. Moramarco). Email your daughter's latest X-ray and I'm sure they's be glad to give you their opinion of what's possible with your daughter's back and also to give you proof of what they've done in people with similar curves.

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As I know Dr. Weiss is not any more with Schroth, only with braces.
I wrote to Asklepios Schroth Klinik 6 years ago when I began to read about scoliosis. Also I talked with Dr. Rigo to his Schroth Clinic in Barcelona. You would be really surprised if you'd know with how many people I talked and only once I obtained a reference to a case of an adult obtaining a significant reduction. Almost all never replied when I asked for just only one case.

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flclerici@yahoo.com

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You've been a busy man over the past few year, Arturo. You're more knowledgable on the subject than I first suspected. When I come across more data that would be helpful to you I'll definitely post it to help you on your quest. I know the data is out there.

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In your opinion, having left lumbar C curve scoliosis, I should be doing planks on my right arm - that is, with the concave section (right, non raised portion of my back) closest to the floor. If I'm understanding correctly, this should strengthen the muscle, which naturally starts to pull my spine toward the right. This all seems fine to me - it feels natural and balanced to work on strengthening the weak portion of my back.

Now, according to the study, I should be doing planks on the convex side, making an already muscly side even more so.

I appreciate your analysis. It was the best thing I could find online on a subject I have been wondering and wondering about. Why don't we have better answers now? What is the medical community dragging their feet for when it comes to researching the effect of exercise on scoliosis? Is it because there's no money to be made for the doctors? As in, no brace, no surgery = no industry? I've often believed the reason I was confined to a brace 14 hours a day for 6 years as a kid was because someone wanted to make money. No one ever insisted on stretches or exercises...

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I'm actually going to be doing two follow-up blog posts on this side-plank article because I've received so many emails from people about it from around the world. I specifically talk about a lumbar curve in one of the posts. Stay tuned for the two follow-up posts where I in-depthly talk about thoracic versus lumbar curves in regards to doing side-planks. Hint: I'm not a fan of doing a side-plank for lumbar curves.

I share your frustration with the American medical world when it comes to scoliosis. I'm so sorry to hear no one ever shared movement therapy options with you when you were younger. Unfortunately, I've heard stories like yours many times. It's because of stories like yours that I started Spiral Spine. I pray my megaphone will be loud enough to let those with scoliosis know that there are options.

It might be shocking to hear, but there IS lots of awesome research proving the effects of exercise and other conservative practices regarding scoliosis - it's just outside of the United States that it's being done. I don't know if the reason many doctors in America say there are no other options besides bracing (many of which are prescribed are useless) and surgery is because they are ill informed or they just want to make money. I do know that many people with good research have had a hard time getting their research published. I have also seen in some medical text books used in medical schools where it explicably says that exercise therapy is not a viable form of therapy for scoliosis. Regardless of speculation, I'm grateful your eyes have been opened.

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As I know, there's not any doubt that people in the study having a C right/left curve, did it over the right/left convex side. And there is not around the world other study showing reduction doing it (or other exercise) in other way. Evidence don't need faith, something needed in anything else.

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We did some work with a side plank type exercise about 5-6 years ago, and while it may reduce the cobb angle in some cases, it generally increased the rotation in the thoracic spine over time and may cause curve progression. We discontinued it a while ago.

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Do you think it was what happened with the 120º woman of the study? The reduction was almost 50%. Surely she should have died if rotation would have increased!

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Certainly you must to show now x-rays proving what you are saying! You are discouraging surely a lot of people, not only me saying this! I need to know now if what you are sayimg is true or not!

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Hi Arturo, "Surely she should have died if the rotation would have increased"??? That statement tells me all I need to know about your level of understanding in this conversation, which is clearly a dead end proposition.

Keep working the learning curve process, but I will at least point you in the right direction. Think of AIS as primarily a neuro-hormonal condition and the spinal curve as the primary symptom of the underlying condition. Good luck and be well.

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I think a 120º curve should imply a very much severe rotation, probably leading to death. Do you don't think that? Even if it's thoracic? We are talking about a giant curve, death with so kind of curve would not surprise very much to noone. Why do you believe Harrington invented surgery? Certainly it surprise me very much a Dr. may see it as something absurd!. And if after doing the exercise the rotation increased as you are saying it should have happened, what would be expected? But if it is what you saw, please let me see the proof. People around the world must to know if this exercise is dangerous as you are saying it is. Anyone may say what they want, but few as Dr. Fischer proved it. If you know the key for reduction in adults, shows it in a controlled study as he did.

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Idiopathic scoliosis is not fatal. Even in very severe curves. To imply otherwise is merely lack of education on the condition. You may want to sit this one out and leave it up to the professionals.

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Thoracics over 90º may reduce lung space (it's a mater of geomtry) in a dangerous way, of course reducing life span. What may be said about really giant curves! Is the first time in my life I hear someone doubting about this. May you copy a link to some article supporting what you are saying? I'm really surprised.

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I really don't have the time to do your research for you, but Here is a 50 year follow up study of untreated patients....They didn't die any more or earlier than the general population.

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http://jama.jamanetwork.com/article.aspx?articleid=195893#REF-JOC21444-47

This is only about LIS. ' according to Dickson,24 the presence of a significant thoracic deformity prior to age 5 years indicates a real risk of cardiopulmonary compromise, whereas LIS is most commonly a matter of deformity without any serious organic health problems. For these reasons, inferences about the natural history of LIS from uncontrolled studies of heterogeneous groups are questionable.'
It seems they are sure that people of the study had not a curve before 10 y.o. Anyway:
'In LIS, only patients with thoracic apices and curves of more than 100° are at increased risk of death from cor pulmonale and right ventricular failure'
I have never realized before what the table 2 implies. Thoracolumbar curves may increase over the doble in adulthood. I'm really very much worry, this is the type of curve of my daughter.

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Scoliosis is very much as serious health concern, no doubt, just not a fatal one. Thoraco lumbar curves do have a higher risk of progression then other curve patterns and early stage intervention is critical. Basically you have to get the center masses of the torso and pelvis lined up neurologically or they tend to collapse during periods of rapid growth.

Simple concept, difficult application.

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I'm thimking only in young adults and I only have evidence about Side Plank.. may be a not clear evidence about Spinecor for adults to.. I'm not sure about this.

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Here is another study.....

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here is a review of literature on the topic...

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Forgot to attach the study. Sorry.

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and here is a review of literature on the topic...

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Dr. Stitzel, it's nice to correspond with a professional on all this side-plank craziness. Your findings don't surprise me at all with the increased rotation. Most people have absolutely no core strength, so asking one to do a side-plank for an extended period of time would of course cause compensatory bodily alignments. Thanks for your comments.

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Hi Erin, I think you assessment may be accurate in many cases. It could also have to do with the amount of thoracic rotation in the specific case as well.
Ultimately, treatment needs to focus on more important parameters and cobb angle reductions. Keep up the good work Erin.

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It's really difficult to imagine a big reduction of the curve and an increase of rotation really.. Do you have x-rays showing it?

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Hi Arturo, please don't confuses a reduction in cobb angle (lateral bending) and a reduction in the curvature. One does not equal the other.

We do have x-rays of the rotation increasing when using rehab that produces an effect very similar to side plank exercises.

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Dr. Clayton, of course I perfectly understand what is a three dimensional curve. You have a scoliosis clinic so of course you are not free of interest in debunking this side plank study. Of course people around the world should not to trust in what you are saying without giving the proof, so why you don't post those x-rays? Where I can see them?

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Yes, yes. Well said. Oh, if there was only a magic pill exercise for scoli!

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Erin, you said me that you don't doubt about the before-after x-rays measurements, so I don't understand why you are saying this now. If you think that big curves also in adults were not reduced in the way said in the study, please say me why.

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There was one major curve reduction. One. You seem to want to base all your movement on research, but that seems to be like a case study, not a study. Aldo, we have no idea what exercise was actually done because so many modifications were given. There simply isn't enough information in this study.

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The abstract was enough clear. It was done with convex side of the main curve downward. If you don't doubt about seriousness of this abstract I don't understand why you say we cannot trust in what it clearly says.

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It's evidence. Evidence is what I need to know what decision is reasonable or not. Is the only one evidence we may see in a study showing an immportant reduction in an adult. If someone may also do it, why they are not proving it in the same way as Dr. Fischer did? The answer is not difficult to imagine: they cannot.

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Actually, funny you bring that up. We are working on some ground breaking research on neurotransmitters and Serotonin may actually be as close to a magic pill as we'll ever get.

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It would be great to see it some day working, specially if also works in adults, but up to now we only knows that the side plank works, since is what it says a controlled study, the only one around the world proving that something so 'magic' is possible.

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I read the published research on the scoliosis neurotransmitter work a few months ago and was intrigued. It makes sense. Please keep me updated on your research.

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Hi Erin, Will do. Dr. Mark Morningstar did a very detailed lecture on the topic about a year ago. Here is the link.

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Dr. Clayton, of course I perfectly understand what is a three dimensional curve. You have a scoliosis clinic so of course you are not free of interest in debunking this side plank study. Of course people around the world should not to trust in what you are saying without giving the proof, so why you don't post those x-rays? Where I can see them?

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Hello Erin, my daughter has a 70 dégrée scoliosis , she's 13 years old , can the side plank help ? She has a thoratic scoliosis with a right convex . Thank you for a reply.

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Yes, I bet your daughter could benefit from doing side planks BUT you have to remember that this in not a magic pill. With a 70 degree curve going to the right, her upper left posterior ribcage is very compressed. It needs to be lengthened and strengthened. Since your daughter is so young, and has such a high degree of curvature, I bet your daughter would benefit greatly by going to a Schroth intensive so she (and you) can learn all the best movements to stop the curve from progressing. I'd also immediately find a manual therapist and Pilates and or Gyrotonic instructor in your town to work with her weekly. One exercise done for a few minutes a day, which this research article is saying, will very doubtfully stop or reduce your daughters curve because she's so young and her curve is so high. You need to get some outside help if you want to stop the progression of her scoli.

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Thank you

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I wasted my time trying since some years ago to know which are the muscles allowing to bear a great burden on the shoulders, because they stretch the spine making us taller .. I conclude that Science is in diaspers, so nobody may saying it. Obviously those are the muscles that should to be strengthened in order to reduce the curve, supposing muscles can do it. Some people says that fascias are the tissues not allowing gravity force to compress the spine increasing the curve.. others says this about ligaments.. This 'experiment' seems to prove that are muscles.. which ones? Who knows..

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Hi Arturo, idiopathic scoliosis is primarily a neuro-hormonal condition the creates a spinal curve (via the muscles) as the primary symptom. The muscles are just the vehicle of delivery.