Late-Onset Scoliosis is Common in Older Adults

by Nina

Reclining Nude, back by Henri Matisse

A recent New Times article Scoliosis Can Hit Well Past Adolescence by Jane Brody confirmed something I have been observing in the yoga community: late-onset scoliosis is quite common in older people. I developed the problem myself in my fifties, so I’m quite aware of the condition, and I’ve noticed a large number of other older yoga practitioners with the same problem. Here’s what Jane Brody said about this:

"Although scoliosis is generally thought of as a problem of adolescents, who often require bracing or surgery to correct the curvature, the condition is actually far more prevalent in older adults. In a study by orthopedists at Maimonides Medical Center in Brooklyn of 75 healthy volunteers older than age 60, fully 68 percent had spinal deformities that met the definition of scoliosis: a curvature deviating from the vertical by more than 10 degrees."

Even a mild version of scoliosis can result in chronic pain of different types. While your pain could be in your back, it might also be in your hip (because scoliosis can make your hips uneven) or even your leg and/or knee (because scoliosis can make one leg “virtually” shorter than the because that hip is higher).

Baxter, who teachers Yoga for Back Care, has already written about scoliosis (see Friday Q&A: Scoliosis). But I decided to write about it today because I think it’s important for us all—students and teachers alike—to realize what a common problem this is. And if you (or a student of yours) are having mysterious back pain, hip pain, or leg pain, it’s worth being checked out to see if this is causing the problem. Some people just don’t think of it! I personally know of two cases of women with pain who didn’t realize they had scoliosis. In one case, the yoga student’s teacher casually mentioned, well, of course, you have scoliosis, because it was visible to his sharp eyes. She had no idea! And in another case, it was I myself who noticed it while I was assisting a fellow student doing a backbend. I just asked her, “Do you have scoliosis?” She was surprised I had asked, but we when talked afterward, it turned out she was having quite a lot of pain, including in her hip. So I encouraged her to get checked out by a health professional, and sure enough, she did have scoliosis.

Getting checked out is not necessarily a big deal. A health professional can do a visual test that is quite simple (he or she will watch your spine as you come bend into a forward bend), although in same cases, if your scoliosis is very mild, you may need an X-ray to detect it. But it is worth knowing the source of your physical problems because, yes, yoga can help. Even Jane Brody had a yoga pose recommended to help her:

Determined to minimize further shrinkage and to avoid pain and nerve damage, I consulted a physiatrist who, after reviewing X-rays of my misshapen spine, said the muscles on my right side, where the spinal protrusion is, were overdeveloped relative to the left. He prescribed a yoga exercise — a side plank — to strengthen the muscles on the left and exert enough of a tug on my spine to keep it from protruding farther to the right. He suggested that the exercise might even straighten the curve somewhat.

That pose sounds like Vasisthasana (aka Side Plank pose) to me! And there are whole lot of other yoga poses you can do to strengthen your back and balance your curve. So if you’ve been diagnosed with this condition, seek out a yoga for back care teacher who understands scoliosis, take a Yoga for Scoliosis workshop, or check out Elise Browning Miller’s web site (she’s a long-time yoga teacher who uses yoga to manage her own scoliosis) for info on her books and DVD and other resources.

Friday Q&A: Hip Pain

Q: I was hoping someone could give me some advice for poses that can help reduce the pain of minor hip dysplasia. My left hip regularly becomes inflamed and sore, and I would like to know what stretches can provide pain relief and also strengthening poses to develop the muscles in a way that will cushion my joint.

A: Dysplasia is an inherited condition. You are born with it. It is due to a shallow acetabulum and how then the hip sits inside the pelvis. It might be helpful for you to learn how much internal rotation and external rotation you have in that hip compared to your other, non-symptomatic hip. Once you know your available range of motion, you need to respect this and not try to put your hip into positions that it can't anatomically go into due to structural assymmetries. That said, you then need to look at how you position that hip in standing poses. If you tend to turn the front leg out too much or too little this will affect how the pelvis rolls over the hip. It would be helpful if you ask a teacher to help you analyze how you hold your legs and to try to get that hip into a more mid-range position. Once that hip is in neutral, you can strengthen the muscles around the hip by  holding your poses for up to 90 seconds. Building strength with isometric muscle contractions through the joint will nourish the joint and help keep it healthy.

The down side of this is that in standing poses you are typically in weight bearing positions, which may tend to aggravate the joint too much. If this is the case, you may want to try to recreate the neutral hip position in symmetrical seated positions such as Dandasana or Upavista Konasana. The same principle would apply to stretching muscles that cross both your knee and hip joints. Keep your hip/knee in neutral to avoid aggravating the joint. —Shari

A: In addition to the sound information Shari has shared with you, know that in adults with hip dyplasia, arthritis developing in the hips can also add to the unusual structure of the hip with dysplasia. So if you have not had a recent check up to assess your joint via xrays or MRI, it might be good to consider doing so, so you know the present condition of the joint.  And certainly, respecting the safe range of motion of that hip joint will give you a sense of how you may need to modify your poses, especially weight bearing ones. Another advantage to working one on one with a good teacher is  that you can also learn some poses that will be helpful when your hip is painful, which likely implies some underlying inflammation in the joint. Standing poses would not be a good idea at that time.

I like to teach students to re-create many of the standing poses while lying supine, or on your back, with the soles of your feet pressed against a baseboard, as if it was the floor.  In addition, doing some supported inversions with your legs in the air, such as Vipariti Karani or Chair Shoulderstand, will take most of the weight off your hip joints and potentially allow the inflamed area some rest.  A final suggestion is for the standing version of Mountain Pose. Imagine your pelvis bones lifting off your leg or femur bones as you root down with your leg bones towards your feet.  My students with hip arthritis often report back that this instruction feels very good in the hips.  —Baxter