Physio|Balance Pilates
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"Creating Intelligent Bodies"
Gwen Miller, C.H.E.K. Practitioner III
One of the first things I do with new clients who have scoliosis is to find an appropriate elongation for them. An elongation is a position that can be held long enough to stretch the torso, while keeping the spine and pelvis in the most optimal neutral alignment possible. An appropriate elongation should provide a sense of relief of weight or pressure, and best of all relief of pain. I like to think about elongation before exercise as providing awareness of a more optimal plumb line for the spine, and providing relief for the muscles on each side of the scoliotic curves, whether they are taut or constricted.

There are a variety of ways to accomplish elongation. Finding an appropriate elongation takes into consideration other factors such as other spinal pathologies and contraindications that the person may have, such as disc derangement (no flexion), high blood pressure, glaucoma (no upside-down positions), shoulder health (the ability to raise arms overhead and bear partial body weight without discomfort), bone density (elongation for a person with bone density loss, which is osteopenia or osteoporosis, must be performed very carefully and in small doses).
An elongation using a pull up bar can be done very easily at home. I prefer using a pull up bar that is installed securely in a doorway, as opposed to the type that hang from the door frame. When using a pull up bar for elongation, your feet stay on the floor. You need to be able to reach your arms overhead and bear partial body weigh comfortably. 

How to do it:
1.Stand under the pull up bar, reach up and hold the bar with arms at shoulder width (or wider if needed for comfort).
2.Adjust shoulder blades down, and draw abdominals in softly – maybe 30-40% effort, not maximum effort.
3.Slowly bend your knees until you feel a comfortable stretch in your ribcage and back. Think about allowing the weight of your pelvis to traction the spine. Keep your feet on the floor and breathe. The first time you try this, stay for just 20-30 seconds, and then slowly take the weight of your body back into your feet and legs and slowly stand up. See how you feel. This is to prevent rebound, which will feel like muscles spasms from overstretching. If you feel good, then go ahead and go back in, and hold for a little longer. If you felt any twinge of rebound, this means that you will need to keep more weight on your feet, which will elicit less stretch, until your muscles become accustomed to the stretch.

Elongation can be done several times a day for pain relief and as part of a scoliosis management exercise program. One needs to be mindful of the load on the shoulders in this particular elongation, so always keep the feet on the floor, and make sure there is no discomfort in the shoulders.

Hypermobility Syndrome and Scoliosis
A few thoughts about hyper mobility:
​The Rocobado Flexibility Test or the Beighton score is basically the sane thing. This test is for hypermobility syndrome /Ehlers-Danlos and is an indicator of hypermobility in the body. Hypermobility can be all over the body or in some locations and not others. 
The test checks the flexibilty at the fingers, elbows, neck, spine, and knees, and screens for movement that is beyond what would normally be found.
A nice example of the flexibility test is in this YouTube video:
https://www.youtube.com/watch?v=yQG7q_cXfB4

Many people with scoliosis that I work with have, or were, hypermobile, and I've often wondered about that connection. Tendons and ligaments connect muscle to bone and bone to bone, and in the hypermobile joints may be made up of a softer kind of collagen, like the kind that makes your skin elastic rather than the tougher less elastic kind that is what makes the tendons and ligaments stronger. This is why people who are hyper mobile, in general terms, need to strengthen the muscles around their joints (including the spine) and stay out of their end range of motion in their joints - so tricky because the information from the mechanoreceptors in the joints to the brain will be based on a greater range of movement than is actually safe or ideal for the long term health of the joints. Using a mirror to check alignment while exercising is helpful, to check for things like hyperextended elbows ( look for an inner elbow "shadow" instead of the inner elbows popped up) knees (to the hypermobile person the knees will feel slightly bent when they are not hyperextended) hips (think Warrior II in yoga, thigh parallel to the mat, rather than hips below the knees). Carefully controlled exercises for the stabilizing muscles, within a smaller range of movement for the joints will help increase stability.
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 ​Using elongation techniques in a scoliosis management exercise program