I’ve had a lot of questions on how to tell which part of the scoli curve is concave versus convex. It’s time to have a lesson on deciphering scoli curves.
Every scoliosis curve has a concave and a convex part. They are opposing sides of the curve. Most scoli spines have multiple curves and therefore have multiple concave and convex parts of the spine.
I have a silly way to remember which side is the concave part of the curve by thinking of an actual cave made out of rock. If I’m inside a cave it’s round over my head. If I’m “in” the cave portion of a scoli curve it’s rounded over my head. Therefore, I’m “in” the concave portion of the curve.
If I remember which side is the “cave” (concave) part of a curve, the opposite side of the curve is the convex portion. To give you a visual way to remember the convex part of a curve think of the rounded mirrors used in stores to prevent shoplifting. It’s rounded out, or curved out so the store manager can see lots of people in the store from standing in one spot. The convex part of the scoli curves rounds out.
I’m going to use the picture sent to me by a young woman in Asia I used in the blog post here to describe this further.
The numbers 2 and 3 are the concave portions of the curves and numbers 1 and 4 are the convex portions of the curves. Can you see how 2 and 3 are “inside the cave” of the curve? Can you visualize how 1 and 4 are going out?
Most people’s muscles are beefier and more built up on the convex portions of their curve (1 and 4 in the picture above). While they are the longer muscles, they’re usually the workhorse muscles and have been attempting to hold the back upright for many years. The muscles inside the concave portion are shorter and usually more atrophied, which would be 2 and 3 in the picture above.
Let’s take the norm of muscle development for scoliosis and turn it on its head. I wrote about Usain Bolt here, who happens to be of my favorite people living with scoliosis. For the third Olympics in a row he’s won the 100-meter dash and continues to reign supreme as the fastest man in the world. Yes, he has scoliosis if you didn’t know. And no, he has never worn a brace or had surgery.
His back fascinates me, scoli anatomy nerd extraordinaire that I am, because he has trained the muscles in both of his concave portions to be BIGGER than the convex portions. That’s crazy from an anatomical standpoint!
I don’t want to get any emails from people saying that’s just how he was built. No way. No scoli backs are built like that. I’m sure that’s how his trainers have halted the progression of his curves and helped his back, pelvis, and legs to function at the elite level that they’ve function at over the last 3 Olympics. He has more muscle in the concave portions of his curves because he worked those areas of his back to help stabilize his scoli curves.
There you have a break down of the convex and concave portions of curves, the natural muscle development, and then what the fastest person in the world has done with his scoliosis to throw the normal concave/convex muscle development on its head.
There is one question that remains still: How do I build up the correct muscles in my back to halt to progression of my curve? Ah, yes, the million dollar scoliosis question.
Eight years of researching and toying around with exercises for different scoli bodies led me to write the book Analyzing Scoliosis; The Pilates Instructor’s Guide to Scoliosis. The book, which has over 50 research referencing, gives you the tools you need to figure out which exercises your unique scoliosis body (or that of your client’s) needs to stabilize the curves. It was a labor of love and has helped those with scoliosis all around the world. I can’t encourage you enough to get the book so you can educate yourself.